WorldWideScience

Sample records for random load dispensing

  1. Evaluating dispensers loaded with codlemone and pear ester for disruption of codling moth (Lepidoptera: Tortricidae)

    Science.gov (United States)

    Polyvinyl chloride polymer (pvc) dispensers loaded with ethyl (E,Z)-2,4-decadienoate (pear ester) plus the sex pheromone, (E,E)-8,10-dodecadien-1-ol (codlemone) of codling moth, Cydia pomonella (L.), were compared with similar dispensers and a commercial dispenser (Isomate®-C Plus) loaded with codle...

  2. Efficiency in the loading of a sodium magneto-optical trap from alkali metal dispensers

    Science.gov (United States)

    Muhammad, R.; Ramirez-Serrano, J.; Magalhães, K. M. F.; Paiva, R.; Shiozaki, R.; Weiner, J.; Bagnato, V. S.

    2008-10-01

    We study the loading of sodium atoms into a magneto-optical trap from current-controlled sodium metal dispensers. Contrary to what was previously reported [V. Wippel, C. Binder, W. Huber, L. Windholz, M. Allegrini, F. Fuso, E. Arimondo, Eur. Phys. J. D 17 (2001) 285] we demonstrate a significantly higher number of trapped atoms that make Na dispensers a feasible source of atoms for cold-atom studies. The inherent rise in pressure that naturally arises from metal dispensers as they are heated to release atoms is partially controlled by placing the metal dispensers near the pumping port where an ion pump is connected. We also study the effects of placing the sodium dispensers at different distances from the main vacuum chamber where the atoms are trapped and the effectiveness of using a Zeeman slower to cool the atoms as they emerge from the dispensers. We observe trapping of up to 1.9 × 10 8 atoms, which is significantly higher by almost three orders of magnitude than previously reported experiments.

  3. Cluster randomized trial of text message reminders to retail staff in tanzanian drug shops dispensing artemether-lumefantrine: effect on dispenser knowledge and patient adherence.

    Science.gov (United States)

    Bruxvoort, Katia; Festo, Charles; Kalolella, Admirabilis; Cairns, Matthew; Lyaruu, Peter; Kenani, Mitya; Kachur, S Patrick; Goodman, Catherine; Schellenberg, David

    2014-10-01

    Artemisinin combination therapies are available in private outlets, but patient adherence might be compromised by poor advice from dispensers. In this cluster randomized trial in drug shops in Tanzania, 42 of 82 selected shops were randomized to receive text message reminders about what advice to provide when dispensing artemether-lumefantrine (AL). Eligible patients purchasing AL at shops in both arms were followed up at home and questioned about each dose taken. Dispensers were interviewed regarding knowledge of AL dispensing practices and receipt of the malaria-related text messages. We interviewed 904 patients and 110 dispensers from 77 shops. Although there was some improvement in dispenser knowledge, there was no difference between arms in adherence measured as completion of all doses (intervention 68.3%, control 69.8%, p [adjusted] = 0.6), or as completion of each dose at the correct time (intervention 33.1%, control 32.6%, p [adjusted] = 0.9). Further studies on the potential of text messages to improve adherence are needed. © The American Society of Tropical Medicine and Hygiene.

  4. Fatigue Reliability under Random Loads

    DEFF Research Database (Denmark)

    Talreja, R.

    1979-01-01

    We consider the problem of estimating the probability of survival (non-failure) and the probability of safe operation (strength greater than a limiting value) of structures subjected to random loads. These probabilities are formulated in terms of the probability distributions of the loads and the...... propagation stage. The consequences of this behaviour on the fatigue reliability are discussed....

  5. Fatigue durability under random cyclic loading

    Science.gov (United States)

    Volkov, S. S.; Struzhanov, V. V.

    2017-12-01

    Methods for predicting the durability of metals have been developed while taking into account the effect of random loads acting during the service life of structures. Methods of the theory of functions of random variables are applied. Normal distribution and the Rayleigh distribution are used to estimate the random loads from the experimental histogram. A numerical example illustrates the influence of the statistical parameters of the load distribution on the predicted number of cycles before failure.

  6. Treatment efficiency of patients with shin fracture after intraosseous blocked osteosynthesis by using the load dispenser

    Directory of Open Access Journals (Sweden)

    Yu. V. Sukhin

    2017-08-01

    Full Text Available The purpose of research: еvaluation of the effectiveness of the device for determining the value of the load on the lower extremity while walking in real time with controlling and signalization of excessive and insufficient load. Materials and methods. Еlaborated and applied device, that allows to determine the load magnitude on the lower extremity in real time, and also to signal about excessive or weak load. The sensory block with the insole and the sensor is located in shoes, under patient's heel, and the main block is fixed on the shin with the help of the strap. Current value of the load on the leg is registered in real time. Received data is recorded in non-volatile memory. The system provides an opportunity to notify patient or doctor by email about the presence of a strong or weak load on the lower extremity, and also about the absence of load for a long period. Results. We used the loading batcher in 38 patients with the shin bones fractures, who were on inpatient treatment at the traumatology and orthopedics center in Odessa in the period from 1.5 to 12 months. The main group included patients, who used the load batcher on the lower extremity in rehabilitation period (transversal fracture of the shin bones diaphysis – 9 patients, oblique fracture – 11 patients. The control group consisted of patients, who didn't use the load batcher (10 patients with oblique fracture of the shin bones in the middle third, 8 patients with transversal fracture of both shin bones in the middle third. As a result of applying the device we succeeded to reduce the fracture fusion period for two weeks and avoid such complications as contracture of joint and fracture non-union. Conclusions. The device allows patients with traumatic consequences reaching the optimal load in rehabilitation period, avoiding excessive load on the lower extremity. The elaboration provides an opportunity to determine the statistics of the load and its transfer to the server

  7. Randomized Controlled Trial of Home-Based Hormonal Contraceptive Dispensing for Women At Risk of Unintended Pregnancy.

    Science.gov (United States)

    Melnick, Alan L; Rdesinski, Rebecca E; Marino, Miguel; Jacob-Files, Elizabeth; Gipson, Teresa; Kuyl, Marni; Dexter, Eve; Olds, David

    2016-06-01

    Women frequently experience barriers to obtaining effective contraceptives from clinic-based providers. Allowing nurses to dispense hormonal methods during home visits may be a way to reduce barriers and improve -effective contraceptive use. Between 2009 and 2013, a sample of 337 low-income, pregnant clients of a nurse home-visit program in Washington State were randomly selected to receive either usual care or enhanced care in which nurses were permitted to provide hormonal contraceptives postpartum. Participants were surveyed at baseline and every three months postpartum for up to two years. Longitudinal Poisson mixed-effects regression analysis was used to examine group differences in gaps in effective contraceptive use, and survival analysis was used to examine time until a subsequent pregnancy. Compared with usual care participants, enhanced care participants had an average of 9.6 fewer days not covered by effective contraceptive use during the 90 days following a first birth (52.6 vs. 62.2). By six months postpartum, 50% of usual care participants and 39% of enhanced care participants were using a long-acting reversible contraceptive (LARC). In analyses excluding LARC use, enhanced care participants had an average of 14.2 fewer days not covered by effective contraceptive use 0-3 months postpartum (65.0 vs. 79.2) and 15.7 fewer uncovered days 4-6 months postpartum (39.2 vs. 54.9). Home dispensing of hormonal contraceptives may improve women's postpartum contraceptive use and should be explored as an intervention in communities where contraceptives are not easily accessible. Copyright © 2016 by the Guttmacher Institute.

  8. Effectiveness of a multi-component intervention on dispensing practices at private pharmacies in Vietnam and Thailand--a randomized controlled trial.

    Science.gov (United States)

    Chalker, J; Ratanawijitrasin, S; Chuc, N T K; Petzold, M; Tomson, G

    2005-01-01

    Private pharmacies are the first line of health care in many communities, commonly selling antibiotics in small doses and prescription-only drugs such as steroids without medical supervision. The aim was to study the effectiveness of a multi-faceted intervention on the dispensing practices of drug sellers in Hanoi and Bangkok. The study was a randomized, controlled trial with 68 Hanoi and 78 Bangkok pharmacies, randomly selected and assigned for intervention and control. Behaviour was assessed by five simulated client visits per pharmacy per dispensing practice, at baseline and a month or more after each intervention. Three three-month interventions were implemented sequentially with four months in between: enforcement of regulations with local inspectors visiting to emphasize the importance of prescription-only medicine legislation; education, performed face-to-face in Hanoi and by a large group in Bangkok; and peer review, voluntary in Bangkok and compulsory in Hanoi. The intervention resulted in significant improvements in Hanoi, reducing the dispensing of illegal steroids (29% vs. 62%) and low dose antibiotics (69% vs. 90%), sustained by means of the peer review (17% vs. 57% steroids and 71% vs. 95% antibiotics), and in fewer dispensers asking no questions and giving no advice (11% vs. 30% steroids and 51% vs. 81% antibiotics). The only significant improvement in Bangkok was the reduction in illegally dispensing steroids (25% vs. 44%) after the regulatory intervention. In Bangkok, fewer of those in the group who volunteered for the peer review asked no questions and gave no advice for low-dose antibiotics requests after the peer review (58% vs. 81%). A multi-component intervention can have a profound effect in changing dispensers' behaviour, but the effect is dependant on the context and the method of implementation. Possible reasons for differences are discussed.

  9. Fatigue in Steel Structures under Random Loading

    DEFF Research Database (Denmark)

    Agerskov, Henning

    1999-01-01

    Fatigue damage accumulation in steel structures under random loading is studied. The fatigue life of welded joints has been determined both experimentally and from a fracture mechanics analysis. In the experimental part of the investigation, fatigue test series have been carried through on various...... types of welded plate test specimens and full-scale offshore tubular joints. The materials that have been used are either conventional structural steel with a yield stress of ~ 360-410 MPa or high-strength steel with a yield stress of ~ 810-1010 MPa. The fatigue tests and the fracture mechanics analyses...... test results. Both the fracture mechanics analysis and the fatigue test results indicate that Miner's rule, which is normally used in the design against fatigue in steel structures, may give results, which are unconservative, and that the validity of the results obtained from Miner's rule will depend...

  10. Foam Dispenser

    Science.gov (United States)

    1985-01-01

    William G. Simpson, a NASA/Marshall employee, invented and patented a foam mixing dispensing device. He is supplying his Simpson mixer to a number of foam applications where it is used to apply foam for insulation purposes.

  11. Dispenser Concept for Unmanned Aerial Vehicles (UAV, Drone, UAS)

    OpenAIRE

    Suri, Manan

    2017-01-01

    System, design and methodology to load and dispense different articles from an autonomous aircraft are disclosed. In one embodiment, the design of a unique detachable dispenser for delivery of articles is described along with an intelligent methodology of loading and delivering the articles to and from the dispenser. Design of the dispenser, interaction of the dispenser with the flight control unit and ground control or base-station, and interaction of the base station with the sender or reci...

  12. On Fatigue Life Under Stationary Gaussian Random Loads (A)

    DEFF Research Database (Denmark)

    Talreja, R.

    1973-01-01

    Power spectra are taken to represent stationary Gaussian random loads. Location, scale, and shape parameters are defined for power spectra and proposed as a convenient set of load parameters for random loads. The center frequency of a power spectrum, defined as its weighted average frequency, is ...... introduced by Weibull for probability distributions, is employed to correlate fatigue lives under different power spectral shapes. Good correlations in the test results are obtained....

  13. The effectiveness and cost-effectiveness of 3- vs. 6-monthly dispensing of antiretroviral treatment (ART) for stable HIV patients in community ART-refill groups in Zimbabwe: study protocol for a pragmatic, cluster-randomized trial.

    Science.gov (United States)

    Fatti, Geoffrey; Ngorima-Mabhena, Nicoletta; Chirowa, Frank; Chirwa, Benson; Takarinda, Kudakwashe; Tafuma, Taurayi A; Mahachi, Nyikadzino; Chikodzore, Rudo; Nyadundu, Simon; Ajayi, Charles A; Mutasa-Apollo, Tsitsi; Mugurungi, Owen; Mothibi, Eula; Hoffman, Risa M; Grimwood, Ashraf

    2018-01-29

    Sub-Saharan Africa is the world region with the greatest number of people eligible to receive antiretroviral treatment (ART). Less frequent dispensing of ART and community-based ART-delivery models are potential strategies to reduce the load on overburdened healthcare facilities and reduce the barriers for patients to access treatment. However, no large-scale trials have been conducted investigating patient outcomes or evaluating the cost-effectiveness of extended ART-dispensing intervals within community ART-delivery models. This trial will assess the clinical effectiveness, cost-effectiveness and acceptability of providing ART refills on a 3 vs. a 6-monthly basis within community ART-refill groups (CARGs) for stable patients in Zimbabwe. In this pragmatic, three-arm, parallel, unblinded, cluster-randomized non-inferiority trial, 30 clusters (healthcare facilities and associated CARGs) are allocated using stratified randomization in a 1:1:1 ratio to either (1) ART refills supplied 3-monthly from the health facility (control arm), (2) ART refills supplied 3-monthly within CARGs, or (3) ART refills supplied 6-monthly within CARGs. A CARG consists of 6-12 stable patients who meet in the community to receive ART refills and who provide support to one another. Stable adult ART patients with a baseline viral load alive and retained in care 12 months after enrollment. Secondary outcomes (measured at 12 and 24 months) are the proportions achieving virological suppression, average provider cost per participant, provider cost per participant retained, cost per participant retained with virological suppression, and average patient-level costs to access treatment. Qualitative research will assess the acceptability of extended ART-dispensing intervals within CARGs to both providers and patients, and indicators of potential facility-level decongestion due to the interventions will be assessed. Cost-effective health system models that sustain high levels of patient retention

  14. The Damage Effects in Steel Bridges under Highway Random Loading

    DEFF Research Database (Denmark)

    Agerskov, Henning; Nielsen, Jette Andkjær

    1996-01-01

    In the present investigation, fatigue damage accumulation in steel bridges under highway random loading is studied. In the experimental part of the investigation, fatigue test series on welded plate test specimens have been carried through. The fatigue tests have been carried out using load...

  15. Probability of stress-corrosion fracture under random loading

    Science.gov (United States)

    Yang, J. N.

    1974-01-01

    Mathematical formulation is based on cumulative-damage hypothesis and experimentally-determined stress-corrosion characteristics. Under both stationary random loadings, mean value and variance of cumulative damage are obtained. Probability of stress-corrosion fracture is then evaluated, using principle of maximum entropy.

  16. Fatigue in Aluminum Highway Bridges under Random Loading

    DEFF Research Database (Denmark)

    Rom, Søren; Agerskov, Henning

    2014-01-01

    Fatigue damage accumulation in aluminum highway bridges under random loading is studied. The fatigue life of welded joints has been determined both experimentally and from a fracture mechanics analysis. In the experimental part of the investigation, fatigue test series on welded plate test...

  17. Advanced Medication Dispenser

    Directory of Open Access Journals (Sweden)

    A.I. Alexan

    2013-12-01

    Full Text Available Medication dispensing is an important activity that can have major implications if done improperly. Dispensing must be done in the correct time interval, at the correct user, with the correct drug and dose. We propose a smart medication dispenser that can satisfy these needs and provide a mechanism for supervision. In order to ensure that the dispensing process is error free, the concept of a new smart medication container is used. A smart medication container is “smart” as it holds the medication dispensing parameters for the drugs it contains: dispensing time and date and name. Based on this information, the actual dispensing is done.

  18. Implementation of patient education at first and second dispensing of statins in Dutch community pharmacies: the sequel of a cluster randomized trial

    Directory of Open Access Journals (Sweden)

    Van de Steeg-van Gompel Caroline HPA

    2011-11-01

    Full Text Available Abstract Background As a result of the previous part of this trial, many patients with cardiovascular disease were expected to receive a statin for the first time. In order to provide these patients with comprehensive information on statins, as recommended by professional guidance, education at first and second dispensing of statins had to be implemented. This study was designed to assess the effectiveness of an intensive implementation program targeted at pharmacy project assistants on the frequency of providing education at first dispensing (EAFD and education at second dispensing (EASD of statins in community pharmacies. Methods The participating community pharmacies were clustered on the basis of local collaboration, were numbered by a research assistant and subsequently an independent statistician performed a block randomization, in which the cluster size (number of pharmacies in each cluster was balanced. The pharmacies in the control group received a written manual on the implementation of EAFD and EASD; the pharmacies in the intervention group received intensive support for the implementation. The impact of the intensive implementation program on the implementation process and on the primary outcomes was examined in a random coefficient logistic regression model, which took into account that patients were grouped within pharmacy clusters. Results Of the 37 pharmacies in the intervention group, 17 pharmacies (50% provided EAFD and 12 pharmacies (35.3% provided EASD compared to 14 pharmacies (45.2%, P = 0.715 and 12 pharmacies (38.7%, P = 0.899, respectively, of the 34 pharmacies in the control group. In the intervention group a total of 72 of 469 new statin users (15.4% received education and 49 of 393 patients with a second statin prescription (12.5% compared to 78 of 402 new users (19.4%, P = 0.944 and 35 of 342 patients with a second prescription (10.2%, P = 0.579 in the control group. Conclusion The intensive implementation program

  19. Fatigue in Steel Highway Bridges under Random Loading

    DEFF Research Database (Denmark)

    Agerskov, Henning; Nielsen, Jette Andkjær

    1999-01-01

    Fatigue damage accumulation in steel highway bridges under random loading is studied. The fatigue life of welded joints has been determined both experimentally and from a fracture mechanics analysis. In the experimental part of the investigation, fatigue test series on welded plate test specimens...... have been carried through. The materials that have been used are either conventional structural steel with a yield stress of f(y) similar to 400-410 MPa or high-strength steel with a yield stress of f(y) similar to 810-840 MPa. The fatigue tests have been carried out using load histories, which...

  20. Fatigue in Steel Highway Bridges under Random Loading

    DEFF Research Database (Denmark)

    Agerskov, Henning; Nielsen, J.A.; Vejrum, Tina

    1997-01-01

    In the present investigation, fatigue damage accumulation in steel highway bridges under random loading is studied. The fatigue life of welded joints has been determined both experimentally and from a fracture mechanics analysis.In the experimental part of the investigation, fatigue test series...... on welded plate test specimens have been carried through. The materials that have been used are either conventional structural steel with a yield stress of ~ 400-410 MPa or high-strength steel with a yield stress of ~ 810-840 MPa.The fatigue tests have been carried out using load histories, which correspond...

  1. Dissolvable microneedle fabrication using piezoelectric dispensing technology.

    Science.gov (United States)

    Allen, Evin A; O'Mahony, Conor; Cronin, Michael; O'Mahony, Thomas; Moore, Anne C; Crean, Abina M

    2016-03-16

    Dissolvable microneedle (DMN) patches are novel dosage forms for the percutaneous delivery of vaccines. DMN are routinely fabricated by dispensing liquid formulations into microneedle-shaped moulds. The liquid formulation within the mould is then dried to create dissolvable vaccine-loaded microneedles. The precision of the dispensing process is critical to the control of formulation volume loaded into each dissolvable microneedle structure. The dispensing process employed must maintain vaccine integrity. Wetting of mould surfaces by the dispensed formulation is also an important consideration for the fabrication of sharp-tipped DMN. Sharp-tipped DMN are essential for ease of percutaneous administration. In this paper, we demonstrate the ability of a piezoelectric dispensing system to dispense picolitre formulation volumes into PDMS moulds enabling the fabrication of bilayer DMN. The influence of formulation components (trehalose and polyvinyl alcohol (PVA) content) and piezoelectric actuation parameters (voltage, frequency and back pressure) on drop formation is described. The biological integrity of a seasonal influenza vaccine following dispensing was investigated and maintained voltage settings of 30 V but undermined at higher settings, 50 and 80 V. The results demonstrate the capability of piezoelectric dispensing technology to precisely fabricate bilayer DMN. They also highlight the importance of identifying formulation and actuation parameters to ensure controlled droplet formulation and vaccine stabilisation. Copyright © 2015 Elsevier B.V. All rights reserved.

  2. A randomized-controlled trial with a Canadian electronic pill dispenser used to measure and improve medication adherence in patients with schizophrenia

    Directory of Open Access Journals (Sweden)

    Emmanuel eStip

    2013-08-01

    Full Text Available Objective: Medication adherence is extremely important in preventing relapse and lowering symptoms in schizophrenic patients. However, estimates show that nearly half of these patients have poor adherence. The Brief Adherence Rating Scale (BARS seems to be the most reliable tool assessing adherence in schizophrenia and shows that the antipsychotic adherence ratio (AAR is about 49.5 % in schizophrenia. The aim of the study was to test if an electronic pill dispenser named DoPill® improved AAR of schizophrenic patients. Furthermore, we compared AAR obtained by the DoPill® and the BARS, in order to verify whether the DoPill® provides reliable assessment of medication adherence. Methods: The DoPill® is a smart pill dispenser that beeps and flashes at the appropriate time of the day. Each of its 28 compartments is covered by a plastic lamina that, when taken off, sends a signal to the pharmacist. Patients were randomized to the DoPill® or Treatment As Usual group (TAU for six weeks. The BARS was used as a reference measure. Results: Forty-six percent of patients were deemed to be non-adherent with antipsychotic medication. The mean AAR was 67 % after six weeks. DoPill® recorded better AAR than some of those found in the literature and were lower than the BARS estimate we found. Conclusion: These results suggest that DoPill® is a valid tool that provides more reliable and objective data for the clinician about their patient’s adherence, than existing assessment tools like the BARS. Furthermore, the device may help patients successfully manage their medication regimen.

  3. A randomized controlled trial with a Canadian electronic pill dispenser used to measure and improve medication adherence in patients with schizophrenia.

    Science.gov (United States)

    Stip, Emmanuel; Vincent, Philippe D; Sablier, Juliette; Guevremont, Catherine; Zhornitsky, Simon; Tranulis, Constantin

    2013-01-01

    Medication adherence is extremely important in preventing relapse and lowering symptoms in schizophrenic patients. However, estimates show that nearly half of these patients have poor adherence. The Brief Adherence Rating Scale (BARS) seems to be the most reliable tool assessing adherence in schizophrenia and shows that the antipsychotic adherence ratio (AAR) is about 49.5% in schizophrenia. The aim of the study was to test if an electronic pill dispenser named DoPill(®) improved AAR of schizophrenic patients. Furthermore, we compared AAR obtained by the DoPill(®) and the BARS, in order to verify whether the DoPill(®) provides reliable assessment of medication adherence. The DoPill(®) is a smart pill dispenser that beeps and flashes at the appropriate time of the day. Each of its 28 compartments is covered by a plastic lamina that, when taken off, sends a signal to the pharmacist. Patients were randomized to the DoPill(®) or treatment as usual groups for 6 weeks. The BARS was used as a reference measure. Forty-six percent of patients were deemed to be non-adherent with antipsychotic medication. The mean AAR was 67% after 6 weeks. DoPill(®) recorded better AAR than some of those found in the literature and were lower than the BARS estimate we found. These results suggest that DoPill(®) is a valid tool that provides more reliable and objective data for the clinician about their patient's adherence, than existing assessment tools like the BARS. Furthermore, the device may help patients successfully manage their medication regimen.

  4. Adherence with ethinylestradiol 20 μg/drospirenone 3 mg in a flexible extended regimen supported by the use of a digital tablet dispenser with or without acoustic alarm: an open-label, randomized, multicenter study.

    Science.gov (United States)

    Wiegratz, Inka; Elliesen, Jörg; Paoletti, Anna Maria; Walzer, Anja; Kirsch, Bodo

    2015-01-01

    To evaluate the effect of a digital dispenser's acoustic alarm function on adherence to ethinylestradiol (EE) 20 μg/drospirenone 3 mg in a flexible extended regimen (EE/drospirenoneFlex) among women in five European countries (France, Germany, Italy, Spain, UK) seeking oral contraception. Randomized, parallel-group open-label study. Women aged 18-35 years received EE/drospirenoneFlex administered in a regimen with cycle lengths of their choice with the aid of a digital pill dispenser over 1 year. In group A (N=250), the dispenser's acoustic alarm was activated (ie, acoustic alarm + visual reminder). In group B (N=249), the acoustic alarm was deactivated (ie, visual reminder only). In addition, the women recorded pill intake daily in diary cards. The primary efficacy variable was the mean delay of daily pill release after the dispenser reminded the woman to take a pill (reference time). Secondary efficacy variables included number of missed pills, contraceptive efficacy, bleeding pattern, tolerability, and user satisfaction. Dispenser data showed a mean (standard deviation [SD]) daily delay in pill release of 88 (126) minutes in group A vs 178 (140) minutes in group B (Pdispenser's activated acoustic alarm improved adherence with daily tablet intake of EE/drospirenoneFlex, reducing missed pills. EE/drospirenoneFlex provided effective contraception and a good tolerability profile.

  5. Advanced Medication Dispenser

    OpenAIRE

    Alexan, Alexandru I.; Oşan, Anca Roxana; Oniga, István László

    2013-01-01

    Medication dispensing is an important activity that can have major implications if done improperly. Dispensing must be done in the correct time interval, at the correct user, with the correct drug and dose. We propose a smart medication dispenser that can satisfy these needs and provide a mechanism for supervision. In order to ensure that the dispensing process is error free, the concept of a new smart medication container is used. A smart medication container is “smart” ...

  6. Automatic fluid dispenser

    Science.gov (United States)

    Sakellaris, P. C. (Inventor)

    1977-01-01

    Fluid automatically flows to individual dispensing units at predetermined times from a fluid supply and is available only for a predetermined interval of time after which an automatic control causes the fluid to drain from the individual dispensing units. Fluid deprivation continues until the beginning of a new cycle when the fluid is once again automatically made available at the individual dispensing units.

  7. Potable water dispenser

    Science.gov (United States)

    Cunningham, H. R. (Inventor)

    1973-01-01

    A dispenser particularly suited for use in dispensing potable water into food and beverage reconstitution bags is described. The dispenser is characterized by an expansible chamber, selectively adjustable stop means for varying the maximum dimensions, a rotary valve, and a linear valve coupled in a cooperating relation for delivering potable water to and from the chamber.

  8. Randomized crossover study evaluating the effect of a hand sanitizer dispenser on the frequency of hand hygiene among anesthesiology staff in the operating room.

    Science.gov (United States)

    Munoz-Price, L Silvia; Patel, Zalak; Banks, Shawn; Arheart, Kristopher; Eber, Scott; Lubarsky, David A; Birnbach, David J

    2014-06-01

    Forty anesthesia providers were evaluated with and without hand sanitizer dispensers present on the anesthesia machine. Having a dispenser increased the frequency of hand hygiene only from 0.5 to 0.8 events per hour (P = .01). Other concomitant interventions are needed to further increase hand hygiene frequency among anesthesia providers.

  9. The Fatigue Behavior of Steel Structures under Random Loading

    DEFF Research Database (Denmark)

    Agerskov, Henning

    2008-01-01

    Fatigue damage accumulation in steel structures under random loading has been studied in a number of investigations at the Technical University of Denmark. The fatigue life of welded joints has been determined both experimentally and from a fracture mechanics analysis. In the experimental part...... of the investigation, fatigue test series with a total of 540 fatigue tests have been carried through on various types of welded plate test specimens and full-scale offshore tubular joints. The materials that have been used are either conventional structural steel or high-strength steel. The fatigue tests...... and the fracture mechanics analyses have been carried out using load histories, which are realistic in relation to the types of structures studied, i.e. primarily bridges, offshore structures and chimneys. In general, the test series carried through show a significant difference between constant amplitude...

  10. Immediate implants with immediate loading vs. conventional loading: 1-year randomized clinical trial.

    Science.gov (United States)

    Shibly, Othman; Kutkut, Ahmad; Patel, Nishith; Albandar, Jasim M

    2012-10-01

    This 1-year randomized clinical trial compared the bone regeneration and success rates between immediate and conventional loading of dental implants placed immediately after extraction in patients with a past history of periodontal disease. Sixty patients who chose an immediate implant treatment option to replace a hopeless tooth were included in this study. Patients were randomly assigned to receive immediate implants with either immediate loading (group A) or conventional loading after 3 months (group B). At baseline, both groups received a mucoperiosteal flap, extraction, implant placement, allograft bone, and a membrane. Group A received a provisional crown. In group B, a cover screw was placed and primary closure was achieved. The patients were evaluated at 3, 6, and 12 months postoperatively. The 1-year implant survival rate was 95% for the whole study group: 96.6% for group A, and 93.3% for group B. The bone level increased significantly in both groups (group A: 0.99 ± 0.22 mm; group B: 0.75 ± 0.17 mm), and the difference was not statistically significant (p > 0.5). At the 1-year postoperative visit, the mucogingival junction (MGJ) was found to be displaced coronally in 65% of implant sites in group B compared with 15% sites in group A. Both the immediate and delayed loading of immediately placed implants showed similar outcome with regards to treatment success rates and stability of radiographic bone level. Submerging an immediately placed implant and primary soft tissue closure did not show significant outcome advantages over the transmucosal approach. © 2010 Wiley Periodicals, Inc.

  11. Topical Metered-dosing Dispenser Performance Evaluation.

    Science.gov (United States)

    Liu, Qiang; Kupiec, Thomas C; Vu, Nicole T

    2016-01-01

    Topical metered-dosing dispensers are designed for dosing accuracy and ease-of-use by the patients while protecting the packaged products from environmental exposure and contamination. The objective of this study was to evaluate the accuracy, precision, and residual of available topical metered-dosing dispensers with different types of topical cream for practical application. Triplicate samples of five different dispensers were tested. This test was completed using three types of commercial topical cream-bases of dissimilar Total Active Pharmaceutical Ingredient Load Percentages, Transdermal Penetration Percentages, and Specific Gravities. The dispensers were evaluated according to specified dose-uniformity criteria for a total dispensing capacity of 30 mL at 0.5 mL per dose for 60 doses. The study shows Topi-CLICK performed with the best precision and accuracy of dosing in comparison to the airless-pump type dispensers. While the dispensing was highly variable with airless pumps and may require calibration for each packaged product, remarkably the performance of Topi-CLICK was not affected by different types of cream-bases and does not require additional metering calibration. Copyright© by International Journal of Pharmaceutical Compounding, Inc.

  12. The Fatigue Behavior of Steel Structures under Random Loading

    DEFF Research Database (Denmark)

    Agerskov, Henning

    2009-01-01

    Fatigue damage accumulation in steel structures under random loading has been studied in a number of investigations at the Technical University of Denmark. The fatigue life of welded joints has been determined both experimentally and from a fracture mechanics analysis. In the experimental part...... of the investigation, fatigue test series with a total of 540 fatigue tests have been carried through on various types of welded plate test specimens and full-scale offshore tubular joints. The materials that have been used are either conventional structural steel or high-strength steel. The fatigue tests...... and variable amplitude fatigue test results. Both the fracture mechanics analysis and the fatigue test results indicate that Miner’s rule, which is normally used in the design against fatigue in steel structures, may give results, which are unconservative, and that the validity of the results obtained from...

  13. Frequency domain analysis of the random loading of cracked panels

    Science.gov (United States)

    Doyle, James F.

    1994-01-01

    The primary effort concerned the development of analytical methods for the accurate prediction of the effect of random loading on a panel with a crack. Of particular concern was the influence of frequency on the stress intensity factor behavior. Many modern structures, such as those found in advanced aircraft, are lightweight and susceptible to critical vibrations, and consequently dynamic response plays a very important role in their analysis. The presence of flaws and cracks can have catastrophic consequences. The stress intensity factor, K, emerges as a very significant parameter that characterizes the crack behavior. In analyzing the dynamic response of panels that contain cracks, the finite element method is used, but because this type of problem is inherently computationally intensive, a number of ways of calculating K more efficiently are explored.

  14. Adherence with ethinylestradiol 20 µg/drospirenone 3 mg in a flexible extended regimen supported by the use of a digital tablet dispenser with or without acoustic alarm: an open-label, randomized, multicenter study

    Directory of Open Access Journals (Sweden)

    Wiegratz I

    2015-01-01

    Full Text Available Inka Wiegratz,1,2 Jörg Elliesen,3 Anna Maria Paoletti,4 Anja Walzer,3 Bodo Kirsch3 1Kinderwunschpraxis am Goetheplatz, Frankfurt, Germany; 2MVZ Kinderwunschzentrum Wiesbaden GmbH, Wiesbaden, Germany; 3Bayer HealthCare Pharmaceuticals, Berlin, Germany; 4Clinica Ostetrica e Ginecologica, University of Cagliari, Cagliari, ItalyObjective: To evaluate the effect of a digital dispenser's acoustic alarm function on adherence to ethinylestradiol (EE 20 µg/drospirenone 3 mg in a flexible extended regimen (EE/drospirenoneFlex among women in five European countries (France, Germany, Italy, Spain, UK seeking oral contraception.Study design: Randomized, parallel-group open-label study.Methods: Women aged 18–35 years received EE/drospirenoneFlex administered in a regimen with cycle lengths of their choice with the aid of a digital pill dispenser over 1 year. In group A (N=250, the dispenser's acoustic alarm was activated (ie, acoustic alarm + visual reminder. In group B (N=249, the acoustic alarm was deactivated (ie, visual reminder only. In addition, the women recorded pill intake daily in diary cards. The primary efficacy variable was the mean delay of daily pill release after the dispenser reminded the woman to take a pill (reference time. Secondary efficacy variables included number of missed pills, contraceptive efficacy, bleeding pattern, tolerability, and user satisfaction.Results: Dispenser data showed a mean (standard deviation [SD] daily delay in pill release of 88 (126 minutes in group A vs 178 (140 minutes in group B (P<0.0001. Median (lower quartile, Q1; upper quartile, Q3 number of missed pills was 0 (0; 1 in group A vs 4 (1; 9 in group B (P<0.0001. Diary card results revealed similar trends; however, underreporting of missed pills was evident in both groups. No pregnancies were reported during 424 women-years of exposure. Across the two groups, the mean (SD EE/drospirenoneFlex cycle length was 51.0 (31.8 days with strong regional

  15. Resin-Powder Dispenser

    Science.gov (United States)

    Standfield, Clarence E.

    1994-01-01

    Resin-powder dispenser used at NASA's Langley Research Center for processing of composite-material prepregs. Dispenser evenly distributes powder (resin polymer and other matrix materials in powder form) onto wet uncured prepregs. Provides versatility in distribution of solid resin in prepreg operation. Used wherever there is requirement for even, continuous distribution of small amount of powder.

  16. Implantable Drug Dispenser

    Science.gov (United States)

    Collins, E. R. J.

    1983-01-01

    Drugs such as insulin are injected as needed directly into bloodstream by compact implantable dispensing unit. Two vapor cavities produce opposing forces on drug-chamber diaphragm. Heaters in cavities allow control of direction and rate of motion of bellows. Dispensing capsule fitted with coil so batteries can be recharged by induction.

  17. Small-Portion Water Dispenser

    Science.gov (United States)

    Joerns, J. C.

    1986-01-01

    Pressure regulated and flow timed to control amount dispensed. Dispenser provides measured amount of water for reconstituting dehydrated foods and beverages. Dispenser holds food or beverage package while being filled with either cold or room-temperature water. Other uses might include dispensing of fluids or medicine. Pressure regulator in dispenser reduces varying pressure of water supply to constant pressure. Electronic timer stops flow after predetermined length of time. Timed flow at regulated pressure ensures controlled volume of water dispensed.

  18. Perceptions of Dispensers Regarding Dispensing Practices in ...

    African Journals Online (AJOL)

    Erah

    1School of Pharmaceutical Sciences, University Sains Malaysia, 11800 Penang, Malaysia, 2Department of Social and. Administrative Pharmacy, College of ... among drug sellers and consumers regarding quality of medicines. It highlighted lack ... practices and the salient issues and factors affecting dispensing practices in ...

  19. Perceptions of Dispensers Regarding Dispensing Practices in ...

    African Journals Online (AJOL)

    The interviews which focused on three major components, namely dispensing practices, regulation and influencing factors, and suggestions for improvements were audio-taped, transcribed verbatim and analyzed. Results: Thematic content analysis of the interview components yielded further seven major themes which ...

  20. Micromachined chemical jet dispenser

    Science.gov (United States)

    Swierkowski, S.P.

    1999-03-02

    A dispenser is disclosed for chemical fluid samples that need to be precisely ejected in size, location, and time. The dispenser is a micro-electro-mechanical systems (MEMS) device fabricated in a bonded silicon wafer and a substrate, such as glass or silicon, using integrated circuit-like fabrication technology which is amenable to mass production. The dispensing is actuated by ultrasonic transducers that efficiently produce a pressure wave in capillaries that contain the chemicals. The 10-200 {micro}m diameter capillaries can be arranged to focus in one spot or may be arranged in a larger dense linear array (ca. 200 capillaries). The dispenser is analogous to some ink jet print heads for computer printers but the fluid is not heated, thus not damaging certain samples. Major applications are in biological sample handling and in analytical chemical procedures such as environmental sample analysis, medical lab analysis, or molecular biology chemistry experiments. 4 figs.

  1. Pressure multiplying dispenser

    Science.gov (United States)

    DeFord, Henry S.; Moss, Owen R.

    1986-01-01

    A pressure multiplying dispenser for delivering fluid, preferably as a spray to the atmosphere, from a source of fluid, preferably a spray bottle, is described. The dispenser includes in combination a hollow cylindrical member, a nozzle delivery tube within the cylindrical member and a hollow actuator piston slideable within the cylindrical member which acts to multiply the pressure of a squeeze applied to the spray bottle.

  2. Clinical and radiographic outcome following immediate loading and delayed loading of single-tooth implants: Randomized clinical trial.

    Science.gov (United States)

    Gjelvold, Björn; Kisch, Jenö; Chrcanovic, Bruno Ramos; Albrektsson, Tomas; Wennerberg, Ann

    2017-06-01

    Immediate loading of single implants is generally considered a reliable procedure. The objective of the present prospective randomized clinical study was to compare the overall treatment outcome following immediate loading (IL) and delayed loading (DL) of single implants after 1 year of follow-up. Patients with a missing maxillary tooth (15-25) were randomly assigned to IL or DL. The protocol included implant installation in healed sites, immediate loading, delayed loading, temporary screw-retained restoration, and replacement with a permanent single implant crown. Outcome measures were implant survival, marginal bone level, soft tissue changes, papillae index, pink, and white esthetic score (PES and WES), patient judged aesthetics, and oral health impact profile (OHiP-14). Implant survival rate was 100% and 96% for IL and DL, respectively. Implant success rate was 96% and 88% for IL and DL, respectively. Statistically significant lower papilla index scores were found in the IL group at temporary crown and definitive crown placement. An overall statistically significant improvement after 12 months for PES, WES and OHIP-14 was found. This prospective randomized study showed that single implants in the maxilla can present satisfactory results with respect to either immediate loading or delayed loading after 12 months. © 2017 Wiley Periodicals, Inc.

  3. Immediate loading of mandibular dental implants in partially edentulous patients: a prospective randomized comparative study.

    Science.gov (United States)

    Margossian, Patrice; Mariani, Paul; Stephan, Grégory; Margerit, Jacques; Jorgensen, Christian

    2012-04-01

    While immediate loading in the edentulous mandible is a well-documented procedure, there are limited scientific data on immediate loading in the partially edentulous mandible. Two-year success rates of immediate loading and conventional delayed loading of dental implants in partially dentate mandibles were compared. Patients were randomized into three groups: group A (n = 40), immediate provisionalization with nonocclusal loading; group B (n = 40), immediate provisionalization with occlusal loading; and group C (n = 37), delayed loading with single-stage surgery. Baseline and 2-year measurements included implant stability quotient, insertion torque, and peri-implant bone crest radiography. Two hundred nine implants were immediately loaded in 80 patients. The 2-year success rates were 93.3% for group B and 100% for groups A and C. Immediate provisionalization provided success rates similar to those for delayed loading only when not loaded in occlusion.

  4. A randomized-controlled trial with a Canadian electronic pill dispenser used to measure and improve medication adherence in patients with schizophrenia

    OpenAIRE

    Emmanuel eStip; Emmanuel eStip; Emmanuel eStip; Philippe D. Vincent; Philippe D. Vincent; Philippe D. Vincent; Catherine eGuevremont; Simon eZhornitsky; Constantin eTranulis; Constantin eTranulis; Constantin eTranulis; Juliette eSablier; Juliette eSablier

    2013-01-01

    Objective: Medication adherence is extremely important in preventing relapse and lowering symptoms in schizophrenic patients. However, estimates show that nearly half of these patients have poor adherence. The Brief Adherence Rating Scale (BARS) seems to be the most reliable tool assessing adherence in schizophrenia and shows that the antipsychotic adherence ratio (AAR) is about 49.5 % in schizophrenia. The aim of the study was to test if an electronic pill dispenser named DoPill® improv...

  5. A randomized controlled trial with a Canadian electronic pill dispenser used to measure and improve medication adherence in patients with schizophrenia

    OpenAIRE

    Stip, Emmanuel; Vincent, Philippe D.; Sablier, Juliette; Guevremont, Catherine; Zhornitsky, Simon; Tranulis, Constantin

    2013-01-01

    Objective: Medication adherence is extremely important in preventing relapse and lowering symptoms in schizophrenic patients. However, estimates show that nearly half of these patients have poor adherence. The Brief Adherence Rating Scale (BARS) seems to be the most reliable tool assessing adherence in schizophrenia and shows that the antipsychotic adherence ratio (AAR) is about 49.5% in schizophrenia. The aim of the study was to test if an electronic pill dispenser named DoPill® improved AAR...

  6. Response of stiff piles to random two-way lateral loading

    DEFF Research Database (Denmark)

    Bakmar, Christian LeBlanc; Byrne, B.W.; Houlsby, G. T.

    2010-01-01

    A model for predicting the accumulated rotation of stiff piles under random two-way loading is presented. The model is based on a strain superposition rule similar to Miner's rule and uses rainflow-counting to decompose a random time-series of varying loads into a set of simple load reversals....... The method is consistent with the work of LeBlanc et al. (2010) and is supported by 1g laboratory tests. An example is given for an offshore wind turbine indicating that accumulated pile rotation during the life of the turbine is dominated by the worst expected load....

  7. DYNAMIC STRAIN MAPPING AND REAL-TIME DAMAGE STATE ESTIMATION UNDER BIAXIAL RANDOM FATIGUE LOADING

    Data.gov (United States)

    National Aeronautics and Space Administration — DYNAMIC STRAIN MAPPING AND REAL-TIME DAMAGE STATE ESTIMATION UNDER BIAXIAL RANDOM FATIGUE LOADING SUBHASISH MOHANTY*, ADITI CHATTOPADHYAY, JOHN N. RAJADAS, AND CLYDE...

  8. Comprehensive analysis of MHC class II genes in teleost fish genomes reveals dispensability of the peptide-loading DM system in a large part of vertebrates.

    Science.gov (United States)

    Dijkstra, Johannes M; Grimholt, Unni; Leong, Jong; Koop, Ben F; Hashimoto, Keiichiro

    2013-11-26

    Classical major histocompatibility complex (MHC) class II molecules play an essential role in presenting peptide antigens to CD4+ T lymphocytes in the acquired immune system. The non-classical class II DM molecule, HLA-DM in the case of humans, possesses critical function in assisting the classical MHC class II molecules for proper peptide loading and is highly conserved in tetrapod species. Although the absence of DM-like genes in teleost fish has been speculated based on the results of homology searches, it has not been definitively clear whether the DM system is truly specific for tetrapods or not. To obtain a clear answer, we comprehensively searched class II genes in representative teleost fish genomes and analyzed those genes regarding the critical functional features required for the DM system. We discovered a novel ancient class II group (DE) in teleost fish and classified teleost fish class II genes into three major groups (DA, DB and DE). Based on several criteria, we investigated the classical/non-classical nature of various class II genes and showed that only one of three groups (DA) exhibits classical-type characteristics. Analyses of predicted class II molecules revealed that the critical tryptophan residue required for a classical class II molecule in the DM system could be found only in some non-classical but not in classical-type class II molecules of teleost fish. Teleost fish, a major group of vertebrates, do not possess the DM system for the classical class II peptide-loading and this sophisticated system has specially evolved in the tetrapod lineage.

  9. Study on optimized dispensing of F-18 FDG auto dispenser

    Energy Technology Data Exchange (ETDEWEB)

    Ji, Bong Geun; Lee, Sang Hun; Kim, Jong Eon; Kim, Won Tae; Kim, Tae Jeong [Dept. of Radiological Science, Kaya University, Kimhae (Korea, Republic of)

    2016-09-15

    This is a study on the optimized dispensing of the auto dispenser used for the purpose of reducing the exposure dose and accurate radiation dose of radioisotope with regard to the PET/CT practitioners. The research method was to find the optimized dispensing method through evaluating the results according to the syringe type, dispensing rate, and vial pressure and through the application of corrected values. As a result of this study, 9.38 mCi has been dispensed on average in the case of 5 ml syringe, and the reproducibility close to 10 mCi was shown at the dispense of 9.55 mCi in the case of 3 ml syringe. In the evaluation according to the dispensing rate, the quantity of radioisotope close to 10 mCi was dispensed at the rate of 5 mm/min when the measurement was carried out by increasing the rate by 5 mm/min units in the order of 5, 10, 15 and 20 mm/min . In the evaluation result according to the vial pressure before/after the use of Needle filter, it was measured to be 9.53 mCi before use and 9.84 mCi after use confirming that the dispensing after using Needle filter showed the optimal value. In addition, in the evaluation of radioactivity before/after the application of corrected values according to the increase in dispense frequency, it was measured 9.53 mCi before correction and 10.07 mCi after correction confirming that the value with correction applied was closer to the quantitative value. Thus, a good optimized method was confirmed to use a 3 ml syringe with dispensing rate of 5 mm/min, to use a Needle filter at dispensing, and to set the corrected value of [y = 0.097 × χ] according to the dispensing frequency of equipment.

  10. Lyophilized spore dispenser

    Science.gov (United States)

    Jessup, A. D. (Inventor)

    1973-01-01

    A lyophilized spore dispenser is provided which produces a finely divided, monoparticulate cloud of bacterial spores. The spores are contained within a tightly sealed chamber, and a turbulator orifice connected to an air supply source provides a jet of air which stirs up the spores and causes the spores to be suspended in eddy currents within the chamber. This air jet also produces a positive pressure within the chamber which forces the spores out of an injection orifice.

  11. Random spectrum loading of dental implants: An alternative approach to functional performance assessment.

    Science.gov (United States)

    Shemtov-Yona, K; Rittel, D

    2016-09-01

    The fatigue performance of dental implants is usually assessed on the basis of cyclic S/N curves. This neither provides information on the anticipated service performance of the implant, nor does it allow for detailed comparisons between implants unless a thorough statistical analysis is performed, of the kind not currently required by certification standards. The notion of endurance limit is deemed to be of limited applicability, given unavoidable stress concentrations and random load excursions, that all characterize dental implants and their service conditions. We propose a completely different approach, based on random spectrum loading, as long used in aeronautical design. The implant is randomly loaded by a sequence of loads encompassing all load levels it would endure during its service life. This approach provides a quantitative and comparable estimate of its performance in terms of lifetime, based on the very fact that the implant will fracture sooner or later, instead of defining a fatigue endurance limit of limited practical application. Five commercial monolithic Ti-6Al-4V implants were tested under cyclic, and another 5 under spectrum loading conditions, at room temperature and dry air. The failure modes and fracture planes were identical for all implants. The approach is discussed, including its potential applications, for systematic, straightforward and reliable comparisons of various implant designs and environments, without the need for cumbersome statistical analyses. It is believed that spectrum loading can be considered for the generation of new standardization procedures and design applications. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. Study on Stationarity of Random Load Spectrum Based on the Special Road

    Science.gov (United States)

    Yan, Huawen; Zhang, Weigong; Wang, Dong

    2017-09-01

    In the special road quality assessment method, there is a method using a wheel force sensor, the essence of this method is collecting the load spectrum of the car to reflect the quality of road. According to the definition of stochastic process, it is easy to find that the load spectrum is a stochastic process. However, the analysis method and application range of different random processes are very different, especially in engineering practice, which will directly affect the design and development of the experiment. Therefore, determining the type of a random process has important practical significance. Based on the analysis of the digital characteristics of road load spectrum, this paper determines that the road load spectrum in this experiment belongs to a stationary stochastic process, paving the way for the follow-up modeling and feature extraction of the special road.

  13. Fatigue Damage Accumulation Under Quasi-Random Loading of Composite Airframe Elements

    Science.gov (United States)

    Strizhius, V.

    2016-09-01

    To perform engineering estimations of the fatigue life of quasi-randomly loaded layered composites, with geometric concentrators, representing the longitudinal elements of composite wing of a transport airplane, a special rule of fatigue damage accumulation is suggested. The main propositions of the method for calculating the fatigue life of these elements by using this rule are formulated. The examples of estimations presented show a good agreement between analytical results and experimental data. A number of important conclusions about the effect of different levels of cyclic loading and "GAG" cycles of different flight types of the quasi-random "TWIST" program on the total fatigue life are made.

  14. Immediate Occlusal versus Non-Occlusal Loading of Implants: A Randomized Clinical Pilot Study.

    Science.gov (United States)

    Vogl, Susanne; Stopper, Marlene; Hof, Markus; Wegscheider, Walther A; Lorenzoni, Martin

    2015-06-01

    Immediate occlusal and non-occlusal loading protocols have been discussed and, despite varying success rates, are considered viable in selected cases. Preoperative implant planning and intraoperative transfer are essential to the success of implant-supported reconstructions in partially or completely edentulous jaws. This study was performed to compare clinical outcomes of immediate occlusal versus non-occlusal loading of posterior implants. Of 19 patients with 52 screw-type implants replacing mandibular molars or premolars, nine patients with 21 implants were randomized to a study group that received immediate restorations with occlusal loading, whereas 10 patients with 31 implants were randomized to a control group that received provisional restorations without occlusal loading. Occlusal loading was defined as full loading in maximum intercuspidation. Single-tooth or splinted multiunit restorations were incorporated by screw retention or cementation. Marginal bone defects (MBD), implant survival, and implant success were evaluated 12 months after insertion. Both groups revealed similar MBD levels consistent with previous reports. No implants were lost (overall survival: 100%) or found to fail (overall success: 100%). No significant intergroup differences were noted for any of the evaluated parameters. Immediate restorations in partially edentulous mandibles demonstrated successful clinical and radiographic 12-month results. Larger long-term prospective studies are needed to confirm the final evidence and predictability of immediate functional loading as a standard treatment concept for partially edentulous jaws. © 2013 Wiley Periodicals, Inc.

  15. E85 Dispenser Study

    Energy Technology Data Exchange (ETDEWEB)

    Moriarty, K.; Johnson, C.; Sears, T.; Bergeron, P.

    2009-12-01

    This study reviews E85 dispensing infrastructure advances and issues and evaluates the geographic concentration of flexible fuel vehicles (FFVs), E85 stations, ethanol production facilities, and E85 suppliers. Costs, space, financial incentives, and barriers to adding E85 fueling equipment at existing stations are also assessed. This study found that E85 is increasingly available in the U.S. in half of the states; however, the other half have minimal or no E85 fueling options. Despite these gains, E85 is only available at 1% of U.S. gasoline stations. Ethanol production reached 9.5 billion gallons in 2008, but less than 1% is consumed as E85. FFVs have not reached a significant concentration in any county, metropolitan area, or state.

  16. Benzodiazepine loading versus symptom-triggered treatment of alcohol withdrawal: a prospective, randomized clinical trial.

    Science.gov (United States)

    Maldonado, José R; Nguyen, Long H; Schader, E Merritt; Brooks, John O

    2012-01-01

    The objectives were to compare the efficacy of a benzodiazepine loading versus a symptom-triggered protocol in the management of alcohol withdrawal. We conducted a prospective, randomized, controlled trial including 47 consecutive patients admitted to one of two tertiary care medical centers who developed alcohol withdrawal syndrome. Patients were randomly assigned to either a benzodiazepine loading protocol or a symptom-triggered treatment protocol. The Clinical Institute Withdrawal Assessment for Alcohol-Revised scale (CIWA-Ar) was recorded throughout the length of stay, along with measures of autonomic system functioning. The average rate of change of CIWA-Ar scores was -1.5 ± 1.3 for the symptom-triggered group and -2.3 ± 2.5 for the loading group. Average rate of change for systolic blood pressure was -2.7 ± 5.3 for the symptom-triggered group and -2.3 ± 6.4 for the loading group. There was no significant difference between the rates of change for either group on either measure. Similarly, there was no significant difference in total benzodiazepine use between groups. Within 72 h of treatment, 69.6% of patients in the loading group were free of withdrawal symptoms versus 41.7% in the symptom-triggered group, a difference not reaching statistical significance. This study did not reveal clear evidence of a clinical advantage for choosing either treatment method. Copyright © 2012 Elsevier Inc. All rights reserved.

  17. Improved Neural Networks with Random Weights for Short-Term Load Forecasting

    Science.gov (United States)

    Lang, Kun; Zhang, Mingyuan; Yuan, Yongbo

    2015-01-01

    An effective forecasting model for short-term load plays a significant role in promoting the management efficiency of an electric power system. This paper proposes a new forecasting model based on the improved neural networks with random weights (INNRW). The key is to introduce a weighting technique to the inputs of the model and use a novel neural network to forecast the daily maximum load. Eight factors are selected as the inputs. A mutual information weighting algorithm is then used to allocate different weights to the inputs. The neural networks with random weights and kernels (KNNRW) is applied to approximate the nonlinear function between the selected inputs and the daily maximum load due to the fast learning speed and good generalization performance. In the application of the daily load in Dalian, the result of the proposed INNRW is compared with several previously developed forecasting models. The simulation experiment shows that the proposed model performs the best overall in short-term load forecasting. PMID:26629825

  18. Impact of educational intervention on knowledge of dispensers working at community pharmacies in Pakistan

    OpenAIRE

    Hussain A; Ibrahim MI; Malik M

    2013-01-01

    Objective To evaluate the impact of training of dispensers on knowledge of dispensers working at community pharmacies in context to storage temperature, prescription terminologies and status of medicines in Islamabad, Pakistan. Methods A randomized, controlled, blinded intervention study was designed and implemented. Before the implementation of intervention, a baseline study was performed to assess the knowledge of dispensers working at community pharmacies. The study population included all...

  19. On the Response of a Nonlinear Structure to High Kurtosis Non-Gaussian Random Loadings

    Science.gov (United States)

    Rizzi, Stephen A.; Przekop, Adam; Turner, Travis L.

    2011-01-01

    This paper is a follow-on to recent work by the authors in which the response and high-cycle fatigue of a nonlinear structure subject to non-Gaussian loadings was found to vary markedly depending on the nature of the loading. There it was found that a non-Gaussian loading having a steady rate of short-duration, high-excursion peaks produced essentially the same response as would have been incurred by a Gaussian loading. In contrast, a non-Gaussian loading having the same kurtosis, but with bursts of high-excursion peaks was found to elicit a much greater response. This work is meant to answer the question of when consideration of a loading probability distribution other than Gaussian is important. The approach entailed nonlinear numerical simulation of a beam structure under Gaussian and non-Gaussian random excitations. Whether the structure responded in a Gaussian or non-Gaussian manner was determined by adherence to, or violations of, the Central Limit Theorem. Over a practical range of damping, it was found that the linear response to a non-Gaussian loading was Gaussian when the period of the system impulse response is much greater than the rate of peaks in the loading. Lower damping reduced the kurtosis, but only when the linear response was non-Gaussian. In the nonlinear regime, the response was found to be non-Gaussian for all loadings. The effect of a spring-hardening type of nonlinearity was found to limit extreme values and thereby lower the kurtosis relative to the linear response regime. In this case, lower damping gave rise to greater nonlinearity, resulting in lower kurtosis than a higher level of damping.

  20. Influence of container structures and content solutions on dispensing time of ophthalmic solutions.

    Science.gov (United States)

    Yoshikawa, Keiji; Yamada, Hiroshi

    2010-05-25

    To investigate the influence of container structures and content solutions on the time of dispensing from eye dropper bottles. Eye dropper bottle models, solution models (filtrate water/surfactant solution) and a dispensing time measuring apparatus were prepared to measure the dispensing time. With filtrate water and pressure thrust load of 0.3 MPa, the dispensing time significantly increased from 1.1 +/- 0.5 seconds to 4.6 +/- 1.1 seconds depending on the decrease of inner aperture diameters from 0.4 mm to 0.2 mm (P bottle models with inner aperture diameters of 0.4 mm or larger, the dispensing time became constant. The dispensing time using surfactant solution showed the same tendency as above. When pressure thrust load was large (0.07 MPa), the solution flew out continuously with inner aperture diameters of 0.4 mm or larger and the dispensing time could not be measured. The inner aperture diameter most strongly explained the variation of the dispensing time in both the content solutions in the multiple linear regression analysis (filtrate water: 46%, R(2) = 0.462, surfactant solution: 56%, R(2) = 0.563). Among content solutions and container structures, the dispensing time was mostly influenced by the diameter of the inner aperture of bottles.

  1. A Statistical Model Updating Method of Beam Structures with Random Parameters under Static Load

    Directory of Open Access Journals (Sweden)

    Zhifeng Wu

    2017-06-01

    Full Text Available This paper presents a new statistical model updating method of beam structures with random parameters under static load. The new updating method considers structural parameters and measurement errors to be random. To reduce the unmeasured degrees of freedom in the finite element model, a static condensation technique is used in this method. A statistical model updating equation with respect to element updated factors is established afterwards. The element updated factors are expanded as random multivariate power series. Using a high-order perturbation technique, the statistical model updating equation can be solved to obtain the coefficients of the power series expansions of the element updated factors. The results of two numerical examples show that for the solution of the statistical model updating equation, the accuracy of the proposed method agrees with that of the Monte Carlo simulation method very well. The static responses obtained by the updated finite element model coincide with the measured results very well. Finally, a series of static load tests of the concrete beam are conducted to testify the effectiveness of the proposed method.

  2. Utilization of random process spectral properties for the calculation of fatigue life under combined loading

    Directory of Open Access Journals (Sweden)

    Svoboda J.

    2009-12-01

    Full Text Available The contribution includes the results of experimental works aiming to find a new methodology for the calculation of fatigue life of structures subjected to operational loading from a combination of forces and moments of random character. Considering the fracture mechanics theory, then the damaging of material is both in the micro- and macro-plastic area connected with the rise of plastic deformation and hence with the plastic transformation rate which depends on the amount of supplied energy. The power spectral density (PSD indicating the power at individual frequencies in the monitored frequency band yields information about the supplied amount of energy. Therefore, it can be assumed that there is a dependence between the PSD shape and the size of damage and that the supplied power which is proportional to the value of dispersion s^2 under the PSD curve could be a new criterion for the calculation of fatigue life under combined loading. The searching for links between the spectral properties of the loading process and the fatigue life of structure under load is dealt with by new Grant GA No. 101/09/0904 of the Czech Technical University in Prague and the Institute of Thermomechanics of the Academy of Sciences of the Czech Republic, v.v.i.

  3. Medication dispenser for narcotic rehabilitation patients.

    Science.gov (United States)

    Ho, Vien Q; Gale, Timothy J; Stack, Clive R

    2009-01-01

    This paper describes the design of a medication dispenser developed for narcotic rehabilitation programs. The dispenser holds up to four doses of medication and operates under remote supervision. A direct-into-mouth dispensing mechanism is a feature of the device. The mechanical dispenser mechanism includes a rotating barrel, medication tubes and dispensing slider unit. The electronic design involves a microprocessor PIC18F4550, stepper-motors, sensing devices a LabVIEW-based computer interface for remote supervisory control and monitoring. The dispenser stores medication and successfully delivers it directly into the mouth under remote supervision.

  4. Immediate loading versus immediate provisionalization of maxillary single-tooth replacements: a prospective randomized study with BioComp implants

    NARCIS (Netherlands)

    Lindeboom, Jerome A.; Frenken, Joost W.; Dubois, Leander; Frank, Michael; Abbink, Ingmar; Kroon, Frans H.

    2006-01-01

    PURPOSE: The aim of this prospective randomized study was to evaluate the clinical outcome of immediately loaded solid plasma sprayed (TPS) BioComp (BioComp Industries BV, Vught, The Netherlands) implants versus immediate provisionalized but non-loaded BioComp implants in the anterior and premolar

  5. Task Analysis in Optical & Contact Lens Dispensing. Dispensing Opticians.

    Science.gov (United States)

    Hrushowy, Eugene; Stanley, Dale

    A task force of opticians and educators in British Columbia was assembled to determine the knowledge and skills required of dispensing opticians and contact lens specialists. The ideas generated by the task force were analyzed and distilled into the standardized tasks listed in this document, using Krathwohl's taxonomy. The document contains 36…

  6. Bacterial load in relation to vacuum-assisted closure wound therapy: a prospective randomized trial.

    Science.gov (United States)

    Mouës, Chantal M; Vos, Margreet C; van den Bemd, Gert-Jan C M; Stijnen, Theo; Hovius, Steven E R

    2004-01-01

    Vacuum-assisted closure has become a new technique in the challenging management of contaminated, acute, and chronic wounds. Although promising clinical results have been described, scientific proof to substantiate the mechanism of action of this therapy is scarce. In the present study, we examined whether the positive effect on wound healing found in vacuum-assisted closure-treated wounds could be explained by an effect on the bacterial load. Fifty-four patients who needed open wound management before surgical closure were included in this study. Wounds were randomized to either vacuum-assisted closure therapy (n= 29) or treatment by conventional moist gauze therapy (n= 25). Healing was characterized by development of a clean granulating wound bed ("ready for surgical therapy") and reduction of wound surface area. To quantify bacterial load, biopsies were collected. No significant difference was found in time needed to reach "ready for surgical therapy" comparing both therapies. Wound surface area reduction was significantly larger in vacuum-assisted closure-treated wounds: 3.8 +/- 0.5 percent/day (mean +/- SEM) compared to conventional-treated wounds (1.7 +/- 0.6 percent/day; p vacuum-assisted closure-treated wounds (p vacuum-assisted closure-treated wounds (p vacuum-assisted closure therapy on wound healing, expressed as a significant reduction of wound surface area. However, this could not be explained by a significant quantitative reduction of the bacterial load.

  7. Early loading of plalatal implants (ortho-type II a prospective multicenter randomized controlled clinical trial

    Directory of Open Access Journals (Sweden)

    Gedrange Tomasz

    2007-09-01

    Full Text Available Abstract Background In orthodontic treatment, anchorage control is a fundamental aspect. Usually conventional mechanism for orthodontic anchorage control can be either extraoral or intraoral that is headgear or intermaxillary elastics. Their use are combined with various side effects such as tipping of occlusal plane or undesirable movements of teeth. Especially in cases, where key-teeth are missing, conventional anchorage defined as tooth-borne anchorage will meet limitations. Therefore, the use of endosseous implants for anchorage purposes are increasingly used to achieve positional stability and maximum anchorage. Methods/Design The intended study is designed as a prospective, multicenter randomized controlled trial (RCT, comparing and contrasting the effect of early loading of palatal implant therapy versus implant loading after 12 weeks post implantation using the new ortho-implant type II anchor system device (Orthosystem Straumann, Basel, Switzerland. 124 participants, mainly adult males or females, whose diagnoses require temporary stationary implant-based anchorage treatment will be randomized 1:1 to one of two treatment groups: group 1 will receive a loading of implant standard therapy after a healing period of 12 week (gold standard, whereas group 2 will receive an early loading of orthodontic implants within 1 week after implant insertion. Participants will be at least followed for 12 months after implant placement. The primary endpoint is to investigate the behavior of early loaded palatal implants in order to find out if shorter healing periods might be justified to accelerate active orthodontic treatment. Secondary outcomes will focus e.g. on achievement of orthodontic treatment goals and quantity of direct implant-bone interface of removed bone specimens. As tertiary objective, a histologic and microtomography evaluation of all retrieved implants will be performed to obtain data on the performance of the SLA surface in human bone

  8. Influence of container structures and content solutions on dispensing time of ophthalmic solutions

    Directory of Open Access Journals (Sweden)

    Keiji Yoshikawa

    2010-05-01

    Full Text Available Keiji Yoshikawa1, Hiroshi Yamada21Yoshikawa Eye Clinic, Tokyo, Japan; 2Santen Pharmaceutical Co., Ltd., Osaka, JapanPurpose: To investigate the influence of container structures and content solutions on the time of dispensing from eye dropper bottles.Methods: Eye dropper bottle models, solution models (filtrate water/surfactant solution and a dispensing time measuring apparatus were prepared to measure the dispensing time.Results: With filtrate water and pressure thrust load of 0.3 MPa, the dispensing time significantly increased from 1.1 ± 0.5 seconds to 4.6 ± 1.1 seconds depending on the decrease of inner aperture diameters from 0.4 mm to 0.2 mm (P < 0.0001. When using the bottle models with inner aperture diameters of 0.4 mm or larger, the dispensing time became constant. The dispensing time using surfactant solution showed the same tendency as above. When pressure thrust load was large (0.07 MPa, the solution flew out continuously with inner aperture diameters of 0.4 mm or larger and the dispensing time could not be measured. The inner aperture diameter most strongly explained the variation of the dispensing time in both the content solutions in the multiple linear regression analysis (filtrate water: 46%, R2 = 0.462, surfactant solution: 56%, R2 = 0.563.Conclusions: Among content solutions and container structures, the dispensing time was mostly influenced by the diameter of the inner aperture of bottles.Keywords: dispensing time, model eye dropper bottle, model ophthalmic solution, nozzle internal space volume, nozzle inner aperture diameter

  9. 21 CFR 888.4200 - Cement dispenser.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cement dispenser. 888.4200 Section 888.4200 Food... DEVICES ORTHOPEDIC DEVICES Surgical Devices § 888.4200 Cement dispenser. (a) Identification. A cement dispenser is a nonpowered syringe-like device intended for use in placing bone cement (§ 888.3027) into...

  10. Stochastic rocket dynamics under random nozzle side loads: Ornstein-Uhlenbeck boundary layer separation and its coarse grained connection to side loading and rocket response

    Energy Technology Data Exchange (ETDEWEB)

    Keanini, R.G.; Srivastava, N.; Tkacik, P.T. [Department of Mechanical Engineering, University of North Carolina at Charlotte, 9201 University City Blvd., Charlotte, NC 28078 (United States); Weggel, D.C. [Department of Civil and Environmental Engineering, University of North Carolina at Charlotte, 9201 University City Blvd., Charlotte, NC 28078 (United States); Knight, P.D. [Mitchell Aerospace and Engineering, Statesville, North Carolina 28677 (United States)

    2011-06-15

    A long-standing, though ill-understood problem in rocket dynamics, rocket response to random, altitude-dependent nozzle side-loads, is investigated. Side loads arise during low altitude flight due to random, asymmetric, shock-induced separation of in-nozzle boundary layers. In this paper, stochastic evolution of the in-nozzle boundary layer separation line, an essential feature underlying side load generation, is connected to random, altitude-dependent rotational and translational rocket response via a set of simple analytical models. Separation line motion, extant on a fast boundary layer time scale, is modeled as an Ornstein-Uhlenbeck process. Pitch and yaw responses, taking place on a long, rocket dynamics time scale, are shown to likewise evolve as OU processes. Stochastic, altitude-dependent rocket translational motion follows from linear, asymptotic versions of the full nonlinear equations of motion; the model is valid in the practical limit where random pitch, yaw, and roll rates all remain small. Computed altitude-dependent rotational and translational velocity and displacement statistics are compared against those obtained using recently reported high fidelity simulations [Srivastava, Tkacik, and Keanini, J. Appl. Phys. 108, 044911 (2010)]; in every case, reasonable agreement is observed. As an important prelude, evidence indicating the physical consistency of the model introduced in the above article is first presented: it is shown that the study's separation line model allows direct derivation of experimentally observed side load amplitude and direction densities. Finally, it is found that the analytical models proposed in this paper allow straightforward identification of practical approaches for: (i) reducing pitch/yaw response to side loads, and (ii) enhancing pitch/yaw damping once side loads cease. (Copyright copyright 2011 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim)

  11. Fatigue Damage of V-Lock Chain Ring Under Random Load

    Directory of Open Access Journals (Sweden)

    Zhang Qiang

    2016-10-01

    Full Text Available To study the influence of the random load on the V-lock chain ring for mining, the numerical simulation technology is used. The dynamic tension is obtained by using the dynamic model of the plough. The life and damage nephograms are obtained by using ANSYS Workbench. The analysis results show that the short fatigue life region of the V-lock chain ring for mining is mainly concentrated on the transition region between the medial straight edge and arc, and the fatigue damage of the link chain on the side of the motion direction of the plow head is larger than that on the other side. This link chain has strong anti-fatigue performance.

  12. Stochastic rocket dynamics under random nozzle side loads: Ornstein-Uhlenbeck boundary layer separation and its coarse grained connection to side loading and rocket response

    CERN Document Server

    Keanini, R G; Tkacik, Peter T; Weggel, David C; Knight, P Douglas

    2011-01-01

    A long-standing, though ill-understood problem in rocket dynamics, rocket response to random, altitude-dependent nozzle side-loads, is investigated. Side loads arise during low altitude flight due to random, asymmetric, shock-induced separation of in-nozzle boundary layers. In this paper, stochastic evolution of the in-nozzle boundary layer separation line, an essential feature underlying side load generation, is connected to random, altitude-dependent rotational and translational rocket response via a set of simple analytical models. Separation line motion, extant on a fast boundary layer time scale, is modeled as an Ornstein-Uhlenbeck process. Pitch and yaw responses, taking place on a long, rocket dynamics time scale, are shown to likewise evolve as OU processes. Stochastic, altitude-dependent rocket translational motion follows from linear, asymptotic versions of the full nonlinear equations of motion; the model is valid in the practical limit where random pitch, yaw, and roll rates all remain small. Comp...

  13. High-Voltage Droplet Dispenser

    Science.gov (United States)

    Eichenberg, Dennis J.

    2003-01-01

    An apparatus that is extremely effective in dispensing a wide range of droplets has been developed. This droplet dispenser is unique in that it utilizes a droplet bias voltage, as well as an ionization pulse, to release a droplet. Apparatuses that deploy individual droplets have been used in many applications, including, notably, study of combustion of liquid fuels. Experiments on isolated droplets are useful in that they enable the study of droplet phenomena under well-controlled and simplified conditions. In this apparatus, a syringe dispenses a known value of liquid, which emerges from, and hangs onto, the outer end of a flat-tipped, stainless steel needle. Somewhat below the needle tip and droplet is a ring electrode. A bias high voltage, followed by a high-voltage pulse, is applied so as to attract the droplet sufficiently to pull it off the needle. The voltages are such that the droplet and needle are negatively charged and the ring electrode is positively charged.

  14. Dynamic Reliability Analysis of Gear Transmission System of Wind Turbine in Consideration of Randomness of Loadings and Parameters

    Directory of Open Access Journals (Sweden)

    Lei Wang

    2014-01-01

    Full Text Available A dynamic model of gear transmission system of wind turbine is built with consideration of randomness of loads and parameters. The dynamic response of the system is obtained using the theory of random sampling and the Runge-Kutta method. According to rain flow counting principle, the dynamic meshing forces are converted into a series of luffing fatigue load spectra. The amplitude and frequency of the equivalent stress are obtained using equivalent method of Geber quadratic curve. Moreover, the dynamic reliability model of components and system is built according to the theory of probability of cumulative fatigue damage. The system reliability with the random variation of parameters is calculated and the influence of random parameters on dynamic reliability of components is analyzed. In the end, the results of the proposed method are compared with that of Monte Carlo method. This paper can be instrumental in the design of wind turbine gear transmission system with more advantageous dynamic reliability.

  15. Impact of educational intervention on knowledge of dispensers working at community pharmacies in Pakistan

    Directory of Open Access Journals (Sweden)

    Hussain A

    2013-09-01

    Full Text Available Objective: To evaluate the impact of training of dispensers on knowledge of dispensers working at community pharmacies in context to storage temperature, prescription terminologies and status of medicines in Islamabad, Pakistan.Method: A randomized, controlled, blinded intervention study was designed and implemented. Before the implementation of intervention, a baseline study was performed to assess the knowledge of dispensers working at community pharmacies. The study population included all community pharmacy outlets in Islamabad. Pharmacies of Islamabad which were visited in pre intervention phase (n=118 were divided into two geographical regions: A (intervention and B (control. Thirty pharmacies were randomly selected from each region. Keeping in view the results of the baseline study an educational intervention was designed to improve the knowledge of dispensers working at community pharmacies in Pakistan.Results: A significant difference in the overall knowledge of dispensers was observed between the pre-post intervention groups. Knowledge of dispensers regarding storage of drugs, prescription terminologies and status of drugs was improved after the training. On the other hand no significant difference was observed between the pre-post control groups.Conclusion: The study has highlighted that improvements in knowledge of dispensers working at community pharmacies are possible through suitable interventions. But, results of interventions can only be sustainable through continuous monitoring and reinforcement of the training.

  16. Impact of educational intervention on knowledge of dispensers working at community pharmacies in Pakistan.

    Science.gov (United States)

    Hussain, Azhar; Ibrahim, Mohamed Izham; Malik, Madeeha

    2013-07-01

    To evaluate the impact of training of dispensers on knowledge of dispensers working at community pharmacies in context to storage temperature, prescription terminologies and status of medicines in Islamabad, Pakistan. A randomized, controlled, blinded intervention study was designed and implemented. Before the implementation of intervention, a baseline study was performed to assess the knowledge of dispensers working at community pharmacies. The study population included all community pharmacy outlets in Islamabad. Pharmacies of Islamabad which were visited in pre intervention phase (n=118) were divided into two geographical regions: A (intervention) and B (control). Thirty pharmacies were randomly selected from each region. Keeping in view the results of the baseline study an educational intervention was designed to improve the knowledge of dispensers working at community pharmacies in Pakistan. A significant difference in the overall knowledge of dispensers was observed between the pre-post intervention groups. Knowledge of dispensers regarding storage of drugs, prescription terminologies and status of drugs was improved after the training. On the other hand no significant difference was observed between the pre-post control groups. The study has highlighted that improvements in knowledge of dispensers working at community pharmacies are possible through suitable interventions. But, results of interventions can only be sustainable through continuous monitoring and reinforcement of the training.

  17. Fatigue of bridges with a horizontal rotation axle under random wind load

    NARCIS (Netherlands)

    Maljaars, J.; Steenbergen, R.D.J.M.

    2012-01-01

    The operating mechanisms of movable bridges are subjected to various types of fluctuating loads which may induce fatigue damage. Wind load acting on the bridge deck - when the bridge is open - is one of the important load types. A wind load model is proposed that can be used in the fatigue design

  18. Immediate non-occlusal loading of single implants in the aesthetic zone : A randomized clinical trial

    NARCIS (Netherlands)

    den Hartog, Laurens; Raghoebar, Gerry M.; Stellingsma, Kees; Vissink, Arjan; Meijer, Henny J. A.

    P>Aim This study compared the outcome of immediate non-occlusal loading with conventional loading for single implants in the maxillary aesthetic zone. It was hypothesized that immediate non-occlusal loading is not inferior to conventional loading. Materials and Methods Sixty-two patients with a

  19. Qualification, knowledge and experience of dispensers working at community pharmacies in Pakistan

    OpenAIRE

    Hussain A; Ibrahim MIM

    2011-01-01

    Pharmacies are managed by a variety of dispensers in terms of qualification, knowledge and experience in Pakistan. Objective The study aimed to document the state of knowledge, experience and qualification of dispensers working at community pharmacies in Pakistan. Methods A comparative cross sectional study was conducted at a randomly selected sample of 371 pharmacies in the three cities of Pakistan. A structured questionnaire for data collection was developed and finalized by focused group d...

  20. Prescription habits of dispensing and non-dispensing doctors in Zimbabwe

    DEFF Research Database (Denmark)

    Trap, Birna; Hansen, Ebba Holme; Hogerzeil, Hans V

    2002-01-01

    The number of dispensing doctors has increased in the last decade, but the implication of this trend on the quality of health care and drug use is unknown. We present a comparative drug utilization study of 29 dispensing doctors and 28 non-dispensing doctors in Zimbabwe based on standard indicato...

  1. Are US jurisdictions prepared to dispense medical countermeasures through open points of dispensing? Findings from a national study.

    Science.gov (United States)

    Rebmann, Terri; Loux, Travis M; Swick, Zachary; Dolgin, Harlan; Reddick, David; Wakefield, Mary

    2015-01-01

    Communities will rely on open points of dispensing (PODs) for mass dispensing of medical countermeasures following a bioterrorism attack or a pandemic. US Cities Readiness Initiative (CRI) open POD preparedness is assessed using the Technical Assistance Review (TAR) but focuses on oral prophylaxis dispensing; mass vaccination readiness is not well measured. Non-CRI preparedness had not been studied. In 2013 an online questionnaire was sent to all 456 CRIs and a random sample of 500 non-CRIs to measure open POD preparedness and exercise participation. Hierarchical linear regression was used to describe factors associated with higher POD preparedness and exercise participation scores. In total, 257 subjects participated, for a 41% response rate. Almost all open PODs have existing written plans and/or a layout for each site (93.4%, n=240, and 87.0%, n=220). Only half (46.7%, n=120) have an alternative dispensing modality in place, and even fewer (42.6%, n=104) report having adequate staffing. Determinants of open POD preparedness were perceived preparedness, participation in more POD exercises, and more closed POD coverage. Most jurisdictions conducted a full-scale exercise and a staff notification drill (83.7%, n=215 for both). Fewer than half (40.5%, n=104) have conducted a vaccination clinic exercise. Determinants of increased POD exercises were perceived preparedness, years of work experience, community type (nontribal), and larger population. Because successful open POD deployment is critical, jurisdictions need to plan for mass vaccination, use of alternative dispensing modalities, and recruitment strategies to increase POD staffing.

  2. Effects of Low-Load Motor Control Exercises and a High-Load Lifting Exercise on Lumbar Multifidus Thickness: A Randomized Controlled Trial.

    Science.gov (United States)

    Berglund, Lars; Aasa, Björn; Michaelson, Peter; Aasa, Ulrika

    2017-08-01

    Randomized controlled trial. The aim of this study was to compare the effects of low-load motor control (LMC) exercises and a high-load lifting (HLL) exercise, on lumbar multifidus (LM) thickness on either side of the spine and whether the effects were affected by pain intensity or change in pain intensity. There is evidence that patients with low back pain (LBP) may have a decreased size of the LM muscles with an asymmetry between sides in the lower back. It has also been shown that LMC training can affect this asymmetry. It is, however, not known whether a high-load exercise has the same effect. Sixty-five participants diagnosed with nociceptive mechanical LBP were included and randomized into LMC exercises or a HLL exercise, the deadlift. The LM thickness was measured using rehabilitative ultrasound imaging (RUSI), at baseline and after a 2-month training period. There were no differences between interventions regarding effect on LM muscle thickness. However, the analysis showed a significant effect for asymmetry. The thickness of the LM muscle on the small side increased significantly compared with the large side in both intervention groups, without influence of pain at baseline, or change in pain intensity. At baseline, there was a difference in thickness of the LM muscles between sides. It seems that exercises focusing on spinal alignment may increase the thickness of the LM muscles on the small side, irrespective of exercise load. The increase in LM thickness does not appear to be mediated by either current pain intensity or the magnitude of change in pain intensity. 2.

  3. Effectiveness of loaded sit-to-stand resistance exercise for children with mild spastic diplegia: a randomized clinical trial.

    Science.gov (United States)

    Liao, Hua-Fang; Liu, Ying-Chi; Liu, Wen-Yu; Lin, Yuh-Ting

    2007-01-01

    To investigate effectiveness of a functional strengthening program, the loaded sit-to-stand (STS) resistance exercise, for children with cerebral palsy (CP). A single-blind, randomized block design. STS exercises were carried out at the children's homes. Twenty children (12 boys, 8 girls; age range, 5-12y) with spastic diplegia CP and classified by the Gross Motor Function Classification System as level I or II were stratified by their severity and age and randomly allocated into either the experimental or control group. Both groups received their regular physical therapy. The experimental group underwent loaded STS exercise 3 times a week for 6 weeks. Goal dimension scores of the Gross Motor Function Measure (GMFM), gait speed, 1 repetition maximum (1-RM) of the loaded STS, isometric strength of knee extensor, and Physiological Cost Index (PCI). The outcome measures were conducted at the beginning and end of the 6-week study. After loaded STS exercise, the experimental group showed statistically significant differences in GMFM goal dimension scores, 1-RM STS, and PCI from the control group. The changes in gait speed and isometric strength of the knee extensor did not differ significantly between the 2 groups. After the loaded STS exercise, children with mild spastic diplegia improved their basic motor abilities, functional muscle strength, and walking efficiency.

  4. Antimalarial Drugs for Pediatrics - Prescribing and Dispensing ...

    African Journals Online (AJOL)

    Purpose: To assess dispensing and prescribing practices with regard to antimalarial drugs for pediatrics in private pharmacies and public hospitals in Dar es Salaam, Tanzania. Methods: This was a cross-sectional, descriptive study that assessed the knowledge and practice of 200 drug dispensers in the private community ...

  5. Hand-Controlled Brazing-Paste Dispenser

    Science.gov (United States)

    Gilbert, Jeffrey L.

    1994-01-01

    Hand control proven superior to foot control. Hand-operated switch added to hand-held brazing-alloy-paste dispenser yields improved, more consistent brazing-alloy beads. Dispenser used to apply paste between adjacent tubes in heat exchanger. Switch reliable and safe, and removed and reattached easily.

  6. Comparison between colloid preload and crystalloid co-load in cesarean section under spinal anesthesia: a randomized controlled trial.

    Science.gov (United States)

    Tawfik, M M; Hayes, S M; Jacoub, F Y; Badran, B A; Gohar, F M; Shabana, A M; Abdelkhalek, M; Emara, M M

    2014-11-01

    Hypotension is a common problem during spinal anesthesia for cesarean delivery. Intravenous fluid loading is used to correct preoperative dehydration and reduce the incidence and severity of hypotension. Different fluid regimens have been studied but colloid preload and crystalloid co-load have not been compared. In this randomized double-blind study, 210 patients scheduled for elective cesarean section under spinal anesthesia were randomly allocated to receive either 6% hydroxyethyl starch 130/0.4 500 mL before spinal anesthesia (colloid preload) or Ringer's acetate solution 1000 mL administered rapidly starting with intrathecal injection (crystalloid co-load). Maternal hypotension (systolic blood pressure colloid preload group and 102 in the crystalloid co-load group. There were no significant differences in the incidence of hypotension (52.4% vs. 42.2%; P=0.18) or severe hypotension (15.5% vs. 9.8%; P=0.31) between colloid preload and crystalloid co-load groups, respectively. The median [range] ephedrine dose was 5 [0-45]mg in the colloid preload group and 0 [0-35]mg in the crystalloid co-load group (P=0.065). There were no significant differences in maternal nausea or vomiting or neonatal outcomes between groups. The use of 1000 mL crystalloid co-load has similar effect to 500 mL colloid preload in reducing the incidence of hypotension after spinal anesthesia for elective cesarean delivery. Neither technique can totally prevent hypotension and should be combined with vasopressor use. Copyright © 2014 Elsevier Ltd. All rights reserved.

  7. Survival and success rates of immediately and early loaded implants: 12-month results from a multicentric randomized clinical study.

    Science.gov (United States)

    Grandi, Tommaso; Garuti, Giovanna; Guazzi, Paolo; Tarabini, Luciano; Forabosco, Andrea

    2012-06-01

    Our objective was to compare survival and peri-implant bone levels of immediately nonocclusally vs early loaded implants in partially edentulous patients up to 12 months after implant placement. Eighty patients (inclusion criteria: general good health, good oral hygiene, 30-65 years old; exclusion criteria: head and neck irradiation/cancer, pregnancy, uncontrolled diabetes, substance abuse, bruxism, lack of opposing occluding dentition, smokers >10 cigarettes/day, need for bone augmentation procedures) were selected in 5 Italian study centers and randomized into 2 groups: 40 patients in the immediately loaded group (minimal insertion torque 30 Ncm) and 40 patients in the early loaded group. Immediately loaded implants were provided with nonoccluding temporary restorations. Final restorations were provided 2 months later. Early loaded implants were provided with a definitive restoration after 2 months. Peri-implant bone resorption was evaluated radiographically with software (ImageJ 1.42). No dropout occurred. Both groups gradually lost peri-implant bone. After 12 months, patients of both groups lost an average of 0.4 mm of peri-implant bone. There were no statistically significant differences (evaluated with t test) between the 2 loading strategies for peri-implant bone level changes at 2 (P = .6730), 6 (P = .6613) and 12 (P = .5957) months or for survival rates (100% in both groups). If adequate primary stability is achieved, immediate loading of dental implants can provide similar success rates, survival rates, and peri-implant bone resorption as compared with early loading, as evaluated in the present study.

  8. Time-Variant Reliability Analysis for Rubber O-Ring Seal Considering Both Material Degradation and Random Load

    OpenAIRE

    Baopeng Liao; Bo Sun; Meichen Yan; Yi Ren; Weifang Zhang; Kun Zhou

    2017-01-01

    Due to the increase in working hours, the reliability of rubber O-ring seals used in hydraulic systems of transfer machines will change. While traditional methods can only analyze one of the material properties or seal properties, the failure of the O-ring is caused by these two factors together. In this paper, two factors are mainly analyzed: the degradation of material properties and load randomization by processing technology. Firstly, the two factors are defined in terms of material failu...

  9. The random field model of the spatial distribution of heavy vehicle loads on long-span bridges

    Science.gov (United States)

    Chen, Zhicheng; Bao, Yuequan; Li, Hui

    2016-04-01

    A stochastic model based on Markov random field is proposed to model the spatial distribution of vehicle loads on longspan bridges. The bridge deck is divided into a finite set of discrete grid cells, each cell has two states according to whether the cell is occupied by the heavy vehicle load or not, then a four-neighbor lattice-structured undirected graphical model with each node corresponding to a cell state variable is proposed to model the location distribution of heavy vehicle loads on the bridge deck. The node potential is defined to quantitatively describe the randomness of node state, and the edge potential is defined to quantitatively describe the correlation of the connected node pair. The junction tree algorithm is employed to obtain the systematic solutions of inference problems of the graphical model. A marked random variable is assigned to each node to represent the amplitude of the total weight of vehicle applied on the corresponding cell of the bridge deck. The rationality of the model is validated by a Monte Carlo simulation of a learned model based on monitored data of a cable-stayed bridge.

  10. Clinical and Radiographic Evaluation of Immediate Loaded Dental Implants With Local Application of Melatonin: A Preliminary Randomized Controlled Clinical Trial.

    Science.gov (United States)

    El-Gammal, Mona Y; Salem, Ahmed S; Anees, Mohamed M; Tawfik, Mohamed A

    2016-04-01

    Immediate loading of dental implants in situations where low bone density exist, such as the posterior maxillary region, became possible recently after the introduction of biomimetic agents. This 1-year preliminary clinical trial was carried out to clinically and radiographically evaluate immediate-loaded 1-piece implants with local application of melatonin in the osteotomy site as a biomimetic material. 14 patients with missing maxillary premolars were randomized to receive 14 implants of 1-piece type that were subjected to immediate loading after 2 weeks of initial placement. Group I included 7 implants with acid-etched surface while group II included 7 implants with acid-etched surface combined with local application of melatonin gel at the osteotomy site. Patients were recalled for follow up at 1, 3, 6, and 12 months after loading. All implants were considered successful after 12 months of follow-up. Significant difference (P implant loading when considering the implant stability. At 1 and 3 months there were significant differences in the marginal bone level between the 2 groups. These results suggest that the local application of melatonin at the osteotomy site is associated with good stability and minimal bone resorption. However, more studies for longer follow-up periods are required to confirm the effect of melatonin hormone on osseointegration of dental implants.

  11. Immediate and early loading of chemically modified implants in posterior jaws: 3-year results from a prospective randomized multicenter study.

    Science.gov (United States)

    Nicolau, Pedro; Korostoff, Jonathan; Ganeles, Jeffrey; Jackowski, Jochen; Krafft, Tim; Neves, Manuel; Divi, Jose; Rasse, Michael; Guerra, Fernando; Fischer, Kerstin

    2013-08-01

    There is a lack of well-designed prospective, randomized clinical trials evaluating the efficacy of immediate and early loading of implants placed in the partially edentulous posterior maxilla or mandible. The aim of this study was to evaluate crestal bone level changes over 3 years following immediate or early loading of Straumann implants with a chemically modified surface (SLActive®, Institut Straumann AG, Basel, Switzerland) placed in the posterior maxilla and mandible. Subjects received temporary restorations immediately or 28 to 34 days after surgery, with permanent restorations placed at 20 to 23 weeks. Bone level changes were measured by comparison of standardized radiographs taken on the day of implant placement and 5, 12, 24, and 36 months thereafter. Two hundred thirty-nine of two hundred sixty-six patients (89.9%) completed the trial. Implant survival rates were 97.4% and 96.7% in the immediate and early loading groups, respectively (p = not significant). Over 36 months, the mean bone level change for immediately loaded implants was 0.88 ± 0.81 mm versus 0.57 ± 0.83 mm for the early-loaded group (p loading had no significant influence on bone level change. Changes in crestal bone level occurred mostly during the first 5 months postloading. After this bone remodeling period, crestal bone level was stable up to 36 months. Implants with a chemically modified surface are safe and predictable for immediate and early loading in the posterior maxilla and mandible. © 2011 Wiley Periodicals, Inc.

  12. Evaluation and visualization of multiaxial fatigue behavior under random non-proportional loading condition

    Directory of Open Access Journals (Sweden)

    Takahiro Morishita

    2017-07-01

    Full Text Available In cyclic multiaxial stress/strain condition under nonproportional loading in which principal direction of stress/strain are changed in a cycle, it becomes difficult to analyze stress/strain ranges because of complexity of multiaxial stress/strain states depending on time in cycles. In order to evaluate stress/strain simply and suitably under non-proportional loading, Itoh and Sakane have proposed a method called as IS-method and a strain parameter for life evaluation under non-proportional loading NP. In the method, 6-components of stress/strain are converted to an equivalent stress/strain indicating the amplitude and the direction of principal stress/strain as a function of time as well as an intensity of loading nonproportionality fNP. Based on IS-method, the authors also have developed a tool which enables to analyze multiaxial stress/strain condition with the nonproportionality of loading history and evaluate failure life under nonproportional multiaxial loading. The tool indicates the analyzed results on monitor and users can understand visually not only variation of the stress/strain conditions but also non-proportionality during the cycle, which helps the design of material strength.

  13. FAS: dispensers and complete autogas filling stations; FAS: distributeurs et stations de GPLC

    Energy Technology Data Exchange (ETDEWEB)

    Anon.

    2004-10-15

    Since 1975 the company FAS Flussiggas-Anlagen GmbH, Salzgitter - Germany, is one of the leading manufacturers of LPG equipment and components according to PED and ATEX with CE-marking for mobile and stationary bulk plants in Europe. The main products are dispensers, Autogas filling stations, vaporizers, loading arms, electronic cylinder filling scales, flanged valves and safety equipment. (authors)

  14. Monitoring codling moth (Lepidoptera: Tortricidae) in orchards treated with pear ester and sex pheromone combo dispensers

    Science.gov (United States)

    Lures for monitoring codling moth, Cydia pomonella (L.), were tested in apple and walnut blocks treated with Cidetrak CM-DA Combo dispensers loaded with pear ester, ethyl (E, Z)-2,4-decadienoate (PE), and sex pheromone (E,E)-8,10-dodecadien-1-ol (codlemone). Total and female moth catches with combin...

  15. The Quality of Pharmacy Practice Among Dispensers in Private ...

    African Journals Online (AJOL)

    The quality of pharmacy practice provided by dispensers in private pharmacies was studied. Parameters used include levels of education of the dispensers, access to health information, knowledge and practice regarding dispensing of drugs to patients, and disposal of expired drugs. A total of 150 dispensers selected from ...

  16. Evaluation of medicines dispensing pattern of private pharmacies in Rajshahi, Bangladesh.

    Science.gov (United States)

    Saha, Shuvashis; Hossain, Md Tawhid

    2017-02-13

    In developing country like BANGLADESH, people depend more on pharmacies due to expediency, shorter waiting time, cost reduction, availability of credit and flexible opening hours. The aim of this study was to investigate medicines dispensing patterns of the pharmacies in RAJSHAHI, BANGLADESH and to identify and analyze contribution of drugsellers and quacks in irrational drug use. This cross-sectional study was conducted during January 2016 - April, 2016 in 75 randomly selected private pharmacies including both licensed and unlicensed pharmacies of covering LAKSHMIPUR area. During the whole study process, total 7944 clients visited the pharmacies under observation and 24,717 medicines were dispensed. 22.70% of all these drugs were sold without a prescription. Out of the 5610 items dispensed without prescription, 66.2% were dispensed on the request of clients themselves and 33.8% on the recommendation of a drug seller. Number of medicine in a prescription was highly variable ranging from 2 to 5 medicines per prescriptions (mean = 3.03). The average number of medicines dispensed from each of the pharmacies during the observation period was 392, varied pharmacy to pharmacy - ranging from 194 to 588. Lowest selling medicines were sedative and hypnotics and highest selling medicines were antimicrobials. The recommendation rate for antibiotics was highest for the quacks (26.48%) though the major amount of the antimicrobials (n = 3039, 65.83%) were dispensed on prescription. Macrolides, quinolones, metronidazoles and cephalosporins are most favourite drug of quacks, clients and pharmacists. Majority of medicines were dispensed irrationally without any prescription and over the counter dispensing of many low safety profile drugs was common. The results and discussion presented in this paper will be helpful to provide a baseline to redirect further studies in this area.

  17. Bone regeneration around implants in periodontally compromised patients: a randomized clinical trial of the effect of immediate implant with immediate loading.

    Science.gov (United States)

    Shibly, Othman; Patel, Nishith; Albandar, Jasim M; Kutkut, Ahmad

    2010-12-01

    This 2-year randomized clinical trial compared bone regeneration and esthetic outcome between immediate and conventional loading of dental implants placed immediately after extraction in patients with a history of periodontal disease. Patients were randomly assigned to receive immediate implants with either immediate loading or conventional loading after 3 months. Both groups received a periodontal flap, tooth extraction, implant placement, allograft bone, and membrane placement. The immediate loading group received a temporary crown. In the conventional loading group primary closure was achieved. All patients were followed up at 3, 6, 12, and 24 months. Evaluation included radiographic bone changes, papillary esthetic outcome, and implant survival rate. Seventy-two patients were recruited into the study. However, 60 patients received immediate implant placement after extraction: 30 with conventional loading and 30 with immediate loading. In the immediate loading group the implant survival rate at 2 years was 96.7%, and the mean bone gain was 1.19 mm. The corresponding figures in the conventional loading group were 93.3% and 1 mm. The gain in bone level occurred mainly from baseline to 1 year postoperatively in both groups (P Immediate loading of a single implant placed in a fresh extraction site in periodontally compromised patients resulted in similar bone gain and soft tissue esthetic outcomes compared to delayed loading. Primary closure and delayed loading to ensure bone regeneration around implants were not critical in this study.

  18. Utilization of random process spectral properties for the calculation of fatigue life under combined loading

    National Research Council Canada - National Science Library

    Svoboda J; Balda M; Fröhlich V

    2009-01-01

    ... of forces and moments of random character. Considering the fracture mechanics theory, then the damaging of material is both in the micro- and macro-plastic area connected with the rise of plastic deformation and hence with the plastic...

  19. Can dressings soaked with polyhexanide reduce bacterial loads in full-thickness skin grafting? A randomized controlled trial.

    Science.gov (United States)

    Saleh, Karim; Sonesson, Andreas; Persson, Kerstin; Riesbeck, Kristian; Schmidtchen, Artur

    2016-12-01

    Polyhexamethylene biguanide (PHMB)-based antiseptic solutions can reduce bacterial loads in different clinical settings and are believed to lower risk of infections. We sought to assess the efficacy of a PHMB-based solution in lowering bacterial loads of full-thickness skin grafting wounds and the risk of surgical site infections (SSIs). In this double-blinded clinical trial, 40 patients planned for facial full-thickness skin grafting were randomized 1:1 to receive tie-over dressings soaked with either PHMB-based solution or sterile water. Quantitative and qualitative bacterial analysis was performed on all wounds before surgery, at the end of surgery, and 7 days postoperatively. In addition, all patients were screened for nasal colonization of Staphylococcus aureus. Analysis of wounds showed no statistically significant difference in bacterial reductions between the groups. The SSI rates were significantly higher in the intervention group (8/20) than in the control group (2/20) (P = .028). Higher postoperative bacterial loads were a common finding in SSIs (P = .011). This was more frequent when S aureus was present postoperatively (P = .034), intraoperatively (P = .03), and in patients with intranasal S aureus colonization (P = .007). Assessment of SSIs is largely subjective. In addition, this was a single-center study and the total number of participants was 40. Soaking tie-over dressings with PHMB solution in full-thickness skin grafting had no effect on postoperative bacterial loads and increased the risk of SSI development. The presence of S aureus intranasally and in wounds preoperatively and postoperatively increased postoperative bacterial loads, which in turn resulted in significantly more SSIs. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  20. Hydrogen fuel dispensing station for transportation vehicles

    Energy Technology Data Exchange (ETDEWEB)

    Singh, S.P.N.; Richmond, A.A. [Oak Ridge National Lab., TN (United States). Chemical Technology Div.

    1995-07-01

    A technical and economic assessment is being conducted of a hydrogen fuel dispensing station to develop an understanding of the infrastructure requirements for supplying hydrogen fuel for mobile applications. The study includes a process design of a conceptual small-scale, stand-alone, grassroots fuel dispensing facility (similar to the present-day gasoline stations) producing hydrogen by steam reforming of natural gas. Other hydrogen production processes (such as partial oxidation of hydrocarbons and water electrolysis) were reviewed to determine their suitability for manufacturing the hydrogen. The study includes an assessment of the environmental and other regulatory permitting requirements likely to be imposed on a hydrogen fuel dispensing station for transportation vehicles. The assessment concludes that a dispensing station designed to produce 0.75 million standard cubic feet of fuel grade (99.99%+ purity) hydrogen will meet the fuel needs of 300 light-duty vehicles per day. Preliminary economics place the total capital investment (in 1994 US dollars) for the dispensing station at $4.5 million and the annual operating costs at around $1 million. A discounted cash-flow analysis indicates that the fuel hydrogen product price (excluding taxes) to range between $1.37 to $2.31 per pound of hydrogen, depending upon the natural gas price, the plant financing scenario, and the rate of return on equity capital. A report on the assessment is due in June 1995. This paper presents a summary of the current status of the assessment.

  1. Survival and Complications of Single Dental Implants in the Edentulous Mandible Following Immediate or Delayed Loading: A Randomized Controlled Clinical Trial.

    Science.gov (United States)

    Kern, M; Att, W; Fritzer, E; Kappel, S; Luthardt, R G; Mundt, T; Reissmann, D R; Rädel, M; Stiesch, M; Wolfart, S; Passia, N

    2018-02-01

    It was the aim of this 24-mo randomized controlled clinical trial to investigate whether the survival of a single median implant placed in the edentulous mandible to retain a complete denture is not compromised by immediate loading. Secondary outcomes were differences in prosthetic complications between the loading principles. Each of the 158 patients who received an implant was randomly assigned to the immediate loading group ( n = 81) or the delayed loading group ( n = 77). Recall visits were performed 1 mo after implant placement (for only the delayed loading group) and 1, 4, 12, and 24 mo after implant loading. Nine implants failed in the immediate loading group, all within the first 3 mo of implant loading, and 1 implant failed in the delayed loading group prior to loading. Noninferiority of implant survival of the immediate loading group, as compared with the delayed loading group, could not be shown ( P = 0.81). Consistent with this result, a secondary analysis with Fisher exact test revealed that the observed difference in implant survival between the treatment groups was indeed statistically significant ( P = 0.019). The most frequent prosthetic complications and maintenance interventions in the mandible were retention adjustments, denture fractures, pressure sores, and matrix exchanges. There was only 1 statistically significant difference between the groups regarding the parameter "fracture of the denture base in the ball attachment area" ( P = 0.007). The results indicate that immediate loading of a single implant in the edentulous mandible reveals inferior survival than that of delayed loading and therefore should be considered only in exceptional cases (German Clinical Trials Register: DRKS00003730).

  2. A randomized controlled clinical trial of edentulous patients treated with immediately loaded implant-supported mandibular fixed prostheses.

    Science.gov (United States)

    Alfadda, Sara Abdulaziz

    2014-12-01

    A 1-year blinded two-arm parallel randomized controlled clinical trial was conducted to test the null hypothesis that immediate loading of four dental implants between the mental foramina with a fixed prosthesis has no benefits compared with the conventional loading technique in terms of implant success and clinical function. Forty-five patients, completely edentulous in the mandibles seeking implant-supported prostheses at the Faculty of Dentistry, University of Toronto, were recruited. Four TiUnite dental implants (NobelBiocare®, Göteborg, Sweden) were placed following the one-stage surgical protocol. Immediately after surgery, the patients were randomly assigned to either study arms by a third independent party. In the experimental arm (EA), existing mandibular denture was converted into an interim implant-supported fixed bridge (ISFB) on the same day of surgery. In the control arm (CA), the mandibular denture was hollowed out and relined with a soft tissue reline. The implants were loaded with the permanent ISFB at least 3 months postsurgery. Patients were assessed by a calibrated independent investigator at 2, 6, and 12 months following completion of treatment. A total of one hundred sixty implants were placed. Due to anatomical limitations, one patient was excluded from the study. Four patients in the EA did not receive intervention as allocated and were transferred to the CA. Implant success rate was comparable between the two arms and exceeded 96%. Marginal bone loss was statistically significantly more in the immediate loading arm, -0.296 mm versus -0.037 mm (intention to treat: p = .002; per protocol: p = .021). The relatively early intervention and insertion of the final prosthesis in the immediate arm, when bone healing and remodeling process had not yet been completed, might explain the difference in the amount of bone loss. Immediate loading of four dental implants with a fixed prosthesis in the edentulous mandible is a feasible treatment option

  3. Dynamically programmable electronic pill dispenser system.

    Science.gov (United States)

    Boquete, Luciano; Rodriguez-Ascariz, Jose Manuel; Artacho, Irene; Cantos-Frontela, Joaquin; Peixoto, Nathalia

    2010-06-01

    Compliance in medicine dispensation has proven critical for dosage control, diagnosis, and treatment. We have designed, manufactured, and characterized a novel dynamically programmable e-pill dispensing system. Our system is initially programmed remotely through a cell phone. After programming, the system may be reconfigured in order to adapt pill dispensation to new conditions. In this paper we describe the mechanics, electronics, control, and communication protocols implemented. Our dyn-e-pill devices can be actuated for over 350 h with two pill retrievals per hour. We challenged the charging circuit and demonstrated that the system has a lifetime longer than 6 h with a 30 min charging cycle, while it lasts for 14 h of uninterrupted use with a full charge.

  4. Automated drug dispensing system reduces medication errors in an intensive care setting.

    Science.gov (United States)

    Chapuis, Claire; Roustit, Matthieu; Bal, Gaëlle; Schwebel, Carole; Pansu, Pascal; David-Tchouda, Sandra; Foroni, Luc; Calop, Jean; Timsit, Jean-François; Allenet, Benoît; Bosson, Jean-Luc; Bedouch, Pierrick

    2010-12-01

    We aimed to assess the impact of an automated dispensing system on the incidence of medication errors related to picking, preparation, and administration of drugs in a medical intensive care unit. We also evaluated the clinical significance of such errors and user satisfaction. Preintervention and postintervention study involving a control and an intervention medical intensive care unit. Two medical intensive care units in the same department of a 2,000-bed university hospital. Adult medical intensive care patients. After a 2-month observation period, we implemented an automated dispensing system in one of the units (study unit) chosen randomly, with the other unit being the control. The overall error rate was expressed as a percentage of total opportunities for error. The severity of errors was classified according to National Coordinating Council for Medication Error Reporting and Prevention categories by an expert committee. User satisfaction was assessed through self-administered questionnaires completed by nurses. A total of 1,476 medications for 115 patients were observed. After automated dispensing system implementation, we observed a reduced percentage of total opportunities for error in the study compared to the control unit (13.5% and 18.6%, respectively; perror (20.4% and 13.5%; perror showed a significant impact of the automated dispensing system in reducing preparation errors (perrors caused no harm (National Coordinating Council for Medication Error Reporting and Prevention category C). The automated dispensing system did not reduce errors causing harm. Finally, the mean for working conditions improved from 1.0±0.8 to 2.5±0.8 on the four-point Likert scale. The implementation of an automated dispensing system reduced overall medication errors related to picking, preparation, and administration of drugs in the intensive care unit. Furthermore, most nurses favored the new drug dispensation organization.

  5. Development of a new dispenser for microbiological control agents and evaluation of dissemination by bumblebees in greenhouse strawberries.

    Science.gov (United States)

    Mommaerts, Veerle; Put, Kurt; Vandeven, Jessica; Jans, Kris; Sterk, Guido; Hoffmann, Lucien; Smagghe, Guy

    2010-11-01

    To date, in modern agriculture, biological control strategies are increasingly becoming the preferred pest management approach. However, the success of microbiological control agents (MCAs) largely depends on efficient dissemination into the crop. The pollinator-and-vector technology employs pollinating insects like bees for a better dissemination. In this study, a new dispenser for bumblebee workers of Bombus terrestris L. was developed. Binab-T-vector and Prestop-Mix were used as two typical MCA products for dissemination. In a first series of experiments in the laboratory for optimisation, the newly developed dispenser was a two-way type dispenser, 20 cm long, with two rectangular compartments and different entrance and exit holes. In addition, the amounts of MCA loaded on the workers were 10 times higher with the new dispenser as compared with the side-by-side passageway (SSP) dispenser. Typically, the highest amounts were recovered from the thorax and legs of the workers. In a second series of experiments under greenhouse conditions with the use of queen-right B. terrestris hives, successful dissemination in strawberry flowers was obtained at different distances from the hive (0-8 m, 8-18 m and 18-21 m), and the workers inoculated the first, second and third flowers that were consecutively visited. In addition, the new dispenser caused no adverse effects on worker foraging intensity, whereas a dramatic reduction was scored with an SSP dispenser. Finally, the data suggested that it is necessary to refill the newly developed dispenser at 3 day intervals. The results demonstrated that, with the use of the newly developed dispenser, bumblebee workers carried high amounts of MCA, and this resulted in a successful dissemination of MCA into strawberry flowers. Copyright © 2010 Society of Chemical Industry.

  6. State legal innovations to encourage naloxone dispensing.

    Science.gov (United States)

    Davis, Corey; Carr, Derek

    The opioid overdose epidemic continues to claim the lives of tens of thousands of Americans every year. Increased access to the opioid antagonist naloxone can reduce opioid-related morbidity and mortality. In this commentary, we describe several recent legal innovations designed to encourage pharmacists to ensure that naloxone is available when and where it is needed, and dispel some common misconceptions regarding potential legal risks associated with pharmacy naloxone dispensing. Data are drawn from state laws and regulations, as catalogued by the Westlaw database. States have rapidly modified law and policy to increase layperson access to naloxone. As of August 2016, 44 states permit naloxone to be prescribed for administration to a person with whom the prescriber does not have a prescriber-patient relationship. Forty-two states permit naloxone to be dispensed via a non-patient-specific mechanism such as a standing or protocol order, and 5 states permit some pharmacists to prescribe naloxone on their own authority. The liability risk associated with naloxone dispensing is no higher than any other medication, and may be lower than some. However, to encourage the prescription and dispensing of naloxone, 36 states provide additional protection from civil liability for pharmacy naloxone dispensing, and 32 states provide protection from potential criminal action. Naloxone access laws in 31 states explicitly provide that dispensing naloxone as permitted by law cannot be grounds for disciplinary action by the state board of pharmacy or similar entity. Pharmacists are key members of the health care team and are uniquely situated to reduce potential opioid overdose risk. Pharmacists should be aware of and utilize innovative state laws designed to increase access to naloxone. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

  7. A randomized controlled clinical trial of two types of tapered implants on immediate loading in the posterior maxilla and mandible.

    Science.gov (United States)

    Kim, Young-Kyun; Lee, Jong-Ho; Lee, Ji-Young; Yi, Yang-Jin

    2013-01-01

    The aim of this study was to compare clinical outcomes and stability following immediate loading of two types of tapered implants in the partially edentulous posterior maxilla and mandible. A randomized controlled trial with 1 year of follow-up was performed on participants missing two consecutive teeth in a posterior quadrant with tapered implants with a hybrid textured surface. Group 1 received Osstem TSIII HA implants, and group 2 received Zimmer TSV implants. Group 1 implants were 4.5 or 5.0 mm in diameter, and group 2 implants were 4.7 mm in diameter; all implants were 10 mm long. Subjects received provisional restorations within 48 hours. Definitive restorations were provided 3 months (mandible) or 6 months (maxilla) later. Outcome measures were survival and success rates, marginal bone level change, implant stability quotient, and peri-implant soft tissue indices. Fifty participants completed the trial (group 1: 52 implants in 26 patients; group 2: 48 implants in 24 patients). The success rates were similar--98.1% in group 1 and 97.9% in group 2--at 12 months after immediate loading, but marginal bone loss was significantly different according to the implant design. Implant stability increased significantly in both arches. There were no significant differences in soft tissue indices between implant systems. If high primary stability is acquired, tapered implants with hybrid textured surfaces are predictable for immediate loading in the posterior maxilla and mandible. In spite of the influence of implant design on marginal bone loss, all tapered implants showed successful clinical outcomes and stability in immediate loading.

  8. An alternative direct compound dispensing method using the HP D300 digital dispenser.

    Science.gov (United States)

    Jones, Raisa E; Zheng, Wei; McKew, John C; Chen, Catherine Z

    2013-10-01

    Evaluation of compound activity in vitro is crucial to drug discovery efforts and require that the compounds be accurately and reliably titrated and dispensed to the assay wells. The HP D300 dispenser uses inkjet technology to achieve small-volume dispensing that allows concentration-response testing using the direct dilution paradigm. Although inkjet technology has been long in existence, it is new to the field of screening and drug development. We have evaluated the D300 dispenser in a biochemical assay, a cell-based reporter gene assay, and a cytotoxicity assay. The software for this instrument is user friendly, and the compound-dispensing process is streamlined. However, a limitation is that this dispenser is currently applicable to only 96-well and 384-well plate formats and not to 1536-well high-density plates. Our results indicate that the D300 generates clean and reproducible results that correlate with those produced with more commonly used instruments such as the pin tool. We found that the instrument is useful and can improve the throughput of compound dispensing in 96-well and 384-well plates.

  9. Qualification of a precision pattern dispenser.

    Science.gov (United States)

    Van Ammel, Raf; Sobiech-Matura, Katarzyna; Wätjen, Uwe; Vercammen, Tom; Castelein, Pieter; Wuyts, Roel; Paul, Johan

    2017-06-16

    In order to automate sample preparation processes, a precision pattern dispenser was designed to reproducibly dispense radioactive solutions at pre-defined positions. It is composed of an automatic liquid sample handling unit coupled to an XYZ table. Qualification tests were conducted to evaluate the performance of the instrument and to assess the compliance with the requirements, in particular trueness (< 2%) and repeatability (< 1%). The instrument allows preparing sources in different source holders and on air filters, in a fast and accurate way. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  10. Process For Patterning Dispenser-Cathode Surfaces

    Science.gov (United States)

    Garner, Charles E.; Deininger, William D.

    1989-01-01

    Several microfabrication techniques combined into process cutting slots 100 micrometer long and 1 to 5 micrometer wide into tungsten dispenser cathodes for traveling-wave tubes. Patterned photoresist serves as mask for etching underlying aluminum. Chemically-assisted ion-beam etching with chlorine removes exposed parts of aluminum layer. Etching with fluorine or chlorine trifluoride removes tungsten not masked by aluminum layer. Slots enable more-uniform low-work function coating dispensed to electron-emitting surface. Emission of electrons therefore becomes more uniform over cathode surface.

  11. Effects of a low-glycemic load vs low-fat diet in obese young adults: a randomized trial.

    Science.gov (United States)

    Ebbeling, Cara B; Leidig, Michael M; Feldman, Henry A; Lovesky, Margaret M; Ludwig, David S

    2007-05-16

    The results of clinical trials involving diet in the treatment of obesity have been inconsistent, possibly due to inherent physiological differences among study participants. To determine whether insulin secretion affects weight loss with 2 popular diets. Randomized trial of obese young adults (aged 18-35 years; n = 73) conducted from September 2004 to December 2006 in Boston, Mass, and consisting of a 6-month intensive intervention period and a 12-month follow-up period. Serum insulin concentration at 30 minutes after a 75-g dose of oral glucose was determined at baseline as a measure of insulin secretion. Outcomes were assessed at 6, 12, and 18 months. Missing data were imputed conservatively. A low-glycemic load (40% carbohydrate and 35% fat) vs low-fat (55% carbohydrate and 20% fat) diet. Body weight, body fat percentage determined by dual-energy x-ray absorptiometry, and cardiovascular disease risk factors. Change in body weight and body fat percentage did not differ between the diet groups overall. However, insulin concentration at 30 minutes after a dose of oral glucose was an effect modifier (group x time x insulin concentration at 30 minutes: P = .02 for body weight and P = .01 for body fat percentage). For those with insulin concentration at 30 minutes above the median (57.5 microIU/mL; n = 28), the low-glycemic load diet produced a greater decrease in weight (-5.8 vs -1.2 kg; P = .004) and body fat percentage (-2.6% vs -0.9%; P = .03) than the low-fat diet at 18 months. There were no significant differences in these end points between diet groups for those with insulin concentration at 30 minutes below the median level (n = 28). Insulin concentration at 30 minutes after a dose of oral glucose was not a significant effect modifier for cardiovascular disease risk factors. In the full cohort, plasma high-density lipoprotein cholesterol and triglyceride concentrations improved more on the low-glycemic load diet, whereas low-density lipoprotein cholesterol

  12. Immediate vs. early loading of SLA implants in the posterior mandible: 5-year results of randomized controlled clinical trial.

    Science.gov (United States)

    Kokovic, Vladimir; Jung, Ronald; Feloutzis, Andreas; Todorovic, Vladimir S; Jurisic, Milan; Hämmerle, Christoph H F

    2014-02-01

    The aim of this study was to compare clinical results of immediate and early loading (EL) self-tapping implants placed in posterior mandibles. Twelve patients with bilateral edentulous posterior mandibular were randomly assigned to treatment either with immediate (test) or early loaded implants (control). Seventy-two self-tapping implants with SLA surface (Ø 4, 1/4, 8 mm; length 8 and 10 mm) were analyzed in this study. Test implants (36) were loaded on the day of surgery and control implants 6 weeks later. The measuring of implant stability quotient (ISQ) was performed on 0, 6th, 12th, and 52nd week after implant insertion. The bone resorption, modified plaque, and bleeding index were notified at 1 and 5 years later. After 5 years, survival in the both groups was 100%. The mean value of primary implant stability was 76.92 ± 0.79 ISQ. In the first 6 weeks, ISQ values significantly increased in the test group (77.92 ± 1.16 vs. 79.61 ± 0.90) as well as in the control group (7.92 ± 1.05 vs. 77.55 ± 0.99). A significant longitudinal increase in ISQ value was recorded in test and control group. The differences between immediate and early loaded implants were statistically insignificant (P > 0.05). At the 5 years, no statistically significant differences were found between immediate and early loaded implants with respect to mean crestal bone loss measurements (0.4 ± 0.24 vs. 0.8 ± 0.15 mm), mean bleeding index (0.22 ± 0.11 vs. 0.25 ± 0.11), and mean plaque index (0.17 ± 0.15 vs. 0.19 ± 0.20). Based on these results, the self-tapping implants inserted in posterior mandible can provide adequate primary stability value as the main factor for immediate and EL protocol. © 2013 John Wiley & Sons A/S. Published by Blackwell Publishing Ltd.

  13. Emergency Contraceptive Pill Knowledge, Attitudes and Dispensing ...

    African Journals Online (AJOL)

    ... metropolis completed a questionnaire that assessed knowledge about ECP, attitude towards this contraceptive and actual dispensing practices. The results showed that the mean age of the respondents was 38.8 (10.9) years. There were more male (57.3%) than female respondents (42.7%). The overall mean knowledge ...

  14. Household Storage of Pharmaceuticals, Sources and Dispensing ...

    African Journals Online (AJOL)

    A cross sectional study was conducted in rural areas of Kibaha district within the Coastal region of Tanzania to assess knowledge on dosage, storage, expiry and ... The majority of drug store (53 %) and ordinary retail shop (75 %) sellers did not dispense correct doses of antimalarials due to low literacy and lack of dosage ...

  15. Alcohol Dispenser Training in Amherst Massachusetts

    Science.gov (United States)

    Riccelli, Carlene

    1986-01-01

    Reviews efforts of the Alcohol Dispenser Training program in Amherst, Massachusetts over a five-year period. Evaluations indicate that participants agree that training is worthwhile, that they are more aware of the effects of alcohol on their patrons, and that they have better knowledge of appropriate strategies for preventing intoxication of…

  16. Dispensing and quality of Amoxycillin preparations in retail ...

    African Journals Online (AJOL)

    A study on dispensing practice and quality of amoxycillin capsules and syrups was conducted in retail pharmacies in 5 regions of Tanzania. Data on dispensing practice was collected by interviewing 75 dispensers through structured questionnaires. Quality of amoxycillin capsule formulations and dry powder for suspension ...

  17. A cost-effective and versatile xenon gas dispenser.

    Science.gov (United States)

    Hung, Joseph C; Lenz, Warren N; Reed, Terry L; McGough, Christopher G

    2005-04-01

    To modify a commercial xenon gas dispenser so that two xenon unit-dose vials could be combined with a modified dispenser to deliver a recommended dose. To maintain the same operating mechanism, changes were made only to the vial shield and the needle port of the original gas dispenser. The modified gas dispenser consisted of two puncture needles and two vial holders shielded with the same thickness of lead as the commercial dispenser. Our evaluation showed that the modified gas dispenser operated the same way as the commercial unit, and the average 133Xe residual activity in either one or two xenon unit-dose vials of the modified gas dispenser was not significantly different from that in one vial of the commercial xenon gas dispenser. The modified xenon gas dispenser allows the stock of xenon gas vials to be managed cost-effectively. The modified unit can be used to dispense two low-activity xenon gas vials to deliver a standard dose to a patient. Also, the modified gas dispenser can be used to combine different amounts of xenon activity in two unit-dose vials in order to customize the dose delivered to patients with special needs (e.g., obese patients). Our modified device can also function as a single-dose dispenser by placing an empty vial alongside the unit-dose vial of radioactive xenon gas.

  18. 21 CFR 200.50 - Ophthalmic preparations and dispensers.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Ophthalmic preparations and dispensers. 200.50... preparations and dispensers. (a)(1) Informed medical opinion is in agreement that all preparations offered or... of injury resulting from contamination during use. (c) Eye cups, eye droppers, and other dispensers...

  19. 21 CFR 872.3080 - Mercury and alloy dispenser.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Mercury and alloy dispenser. 872.3080 Section 872...) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3080 Mercury and alloy dispenser. (a) Identification. A mercury and alloy dispenser is a device with a spring-activated valve intended to measure and...

  20. 21 CFR 880.6430 - Liquid medication dispenser.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Liquid medication dispenser. 880.6430 Section 880.6430 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... Devices § 880.6430 Liquid medication dispenser. (a) Identification. A Liquid medication dispenser is a...

  1. A Permutation Importance-Based Feature Selection Method for Short-Term Electricity Load Forecasting Using Random Forest

    Directory of Open Access Journals (Sweden)

    Nantian Huang

    2016-09-01

    Full Text Available The prediction accuracy of short-term load forecast (STLF depends on prediction model choice and feature selection result. In this paper, a novel random forest (RF-based feature selection method for STLF is proposed. First, 243 related features were extracted from historical load data and the time information of prediction points to form the original feature set. Subsequently, the original feature set was used to train an RF as the original model. After the training process, the prediction error of the original model on the test set was recorded and the permutation importance (PI value of each feature was obtained. Then, an improved sequential backward search method was used to select the optimal forecasting feature subset based on the PI value of each feature. Finally, the optimal forecasting feature subset was used to train a new RF model as the final prediction model. Experiments showed that the prediction accuracy of RF trained by the optimal forecasting feature subset was higher than that of the original model and comparative models based on support vector regression and artificial neural network.

  2. Time-Variant Reliability Analysis for Rubber O-Ring Seal Considering Both Material Degradation and Random Load

    Science.gov (United States)

    Liao, Baopeng; Yan, Meichen; Zhang, Weifang; Zhou, Kun

    2017-01-01

    Due to the increase in working hours, the reliability of rubber O-ring seals used in hydraulic systems of transfer machines will change. While traditional methods can only analyze one of the material properties or seal properties, the failure of the O-ring is caused by these two factors together. In this paper, two factors are mainly analyzed: the degradation of material properties and load randomization by processing technology. Firstly, the two factors are defined in terms of material failure and seal failure, before the experimental methods of rubber materials are studied. Following this, the time-variant material properties through experiments and load distribution by monitoring the processing can be obtained. Thirdly, compressive stress and contact stress have been calculated, which was combined with the reliability model to acquire the time-variant reliability for the O-ring. Finally, the life prediction and effect of oil pressure were discussed, then compared with the actual situation. The results show a lifetime of 12 months for the O-ring calculated in this paper, and compared with the replacement records from the maintenance workshop, the result is credible. PMID:29053597

  3. Time-Variant Reliability Analysis for Rubber O-Ring Seal Considering Both Material Degradation and Random Load.

    Science.gov (United States)

    Liao, Baopeng; Sun, Bo; Yan, Meichen; Ren, Yi; Zhang, Weifang; Zhou, Kun

    2017-10-20

    Due to the increase in working hours, the reliability of rubber O-ring seals used in hydraulic systems of transfer machines will change. While traditional methods can only analyze one of the material properties or seal properties, the failure of the O-ring is caused by these two factors together. In this paper, two factors are mainly analyzed: the degradation of material properties and load randomization by processing technology. Firstly, the two factors are defined in terms of material failure and seal failure, before the experimental methods of rubber materials are studied. Following this, the time-variant material properties through experiments and load distribution by monitoring the processing can be obtained. Thirdly, compressive stress and contact stress have been calculated, which was combined with the reliability model to acquire the time-variant reliability for the O-ring. Finally, the life prediction and effect of oil pressure were discussed, then compared with the actual situation. The results show a lifetime of 12 months for the O-ring calculated in this paper, and compared with the replacement records from the maintenance workshop, the result is credible.

  4. Time-Variant Reliability Analysis for Rubber O-Ring Seal Considering Both Material Degradation and Random Load

    Directory of Open Access Journals (Sweden)

    Baopeng Liao

    2017-10-01

    Full Text Available Due to the increase in working hours, the reliability of rubber O-ring seals used in hydraulic systems of transfer machines will change. While traditional methods can only analyze one of the material properties or seal properties, the failure of the O-ring is caused by these two factors together. In this paper, two factors are mainly analyzed: the degradation of material properties and load randomization by processing technology. Firstly, the two factors are defined in terms of material failure and seal failure, before the experimental methods of rubber materials are studied. Following this, the time-variant material properties through experiments and load distribution by monitoring the processing can be obtained. Thirdly, compressive stress and contact stress have been calculated, which was combined with the reliability model to acquire the time-variant reliability for the O-ring. Finally, the life prediction and effect of oil pressure were discussed, then compared with the actual situation. The results show a lifetime of 12 months for the O-ring calculated in this paper, and compared with the replacement records from the maintenance workshop, the result is credible.

  5. Lactobacillus fermentum CECT 5716 Reduces Staphylococcus Load in the Breastmilk of Lactating Mothers Suffering Breast Pain: A Randomized Controlled Trial.

    Science.gov (United States)

    Maldonado-Lobón, Jose A; Díaz-López, Miguel A; Carputo, Raffaele; Duarte, Pilar; Díaz-Ropero, Maria Paz; Valero, Antonio D; Sañudo, Ana; Sempere, Lluis; Ruiz-López, María Dolores; Bañuelos, Óscar; Fonollá, Juristo; Olivares Martín, Mónica

    2015-11-01

    Recent results indicate that human mastitis and painful breastfeeding may be characterized by a mammary bacterial dysbiosis, a process in which the population of potential pathogens increases at the expense of the normal mammary microbiota. The objective of the present study is the evaluation of three different doses of Lactobacillus fermentum CECT5716 to reduce the load of Staphylococcus in the breastmilk of women suffering from painful breastfeeding. A randomized double-blinded controlled study with four study groups was performed. Three groups received the probiotic strain for 3 weeks at doses of 3×10(9) colony-forming units (CFU)/day, 6×10(9) CFU/day, or 9×10(9) CFU/day. The fourth group received a placebo of maltodextrin. The main outcome of the study was Staphylococcus counts in breastmilk. The secondary outcomes were Streptococcus, Lactobacillus, and total bacteria counts in breastmilk, immunoglobulin A and interleukin 8 concentrations in breastmilk, and breast pain scores. At the end of the study, a significant decrease in the Staphylococcus load was observed in the probiotic groups compared with the baseline loads (p=0.045), whereas the control group maintained similar levels over time. A significant difference in the pain score was observed among the groups receiving the three probiotic doses compared with the control group (p=0.035, p=0.000, and p=0.028, respectively). A dose-response effect could not be observed because the three doses tested induced similar effects, and no significant differences were detected. We conclude that L. fermentum CECT5716 is an efficient treatment for breast pain during lactation associated with a high level of Staphylococcus in breastmilk.

  6. Immediate versus early non-occlusal loading of dental implants placed flapless in partially edentulous patients: a 3-year randomized clinical trial.

    Science.gov (United States)

    Merli, Mauro; Moscatelli, Marco; Mariotti, Giorgia; Piemontese, Matteo; Nieri, Michele

    2012-02-01

    To compare immediate versus early non-occlusal loading of dental implants placed flapless in a 3-year, parallel group, randomized clinical trial. The study was conducted in a private dental clinic between July 2005 and July 2010. Patients 18 years or older were randomized to receive implants for fixed partial dentures in cases of partial edentulism. The test group was represented by immediate non-occlusal implant loading, whereas the control group was represented by early non-occlusal implant loading. The outcome variables were implant failure, complications and radiographic bone level at implant sites 3 years after loading, measured from the implant-abutment junction to the most coronal point of bone-to-implant contact. Randomization was computer-generated with allocation concealment by opaque sequentially numbered sealed envelopes, and the measurer was blinded to group assignment. Sixty patients were randomized: 30 to the immediately loaded group and 30 to the early loaded group. Four patients dropped out; however, the data of all patients were included in the analysis. No implant failure occurred. Two complications occurred in the control group and one in the test group. The mean bone level at 3 years was 1.91 mm for test group and 1.59 mm for control group. The adjusted difference in bone level was 0.26 mm (CI 95% -0.08 to 0.59, p = 0.1232). The null hypothesis of no difference in failure rates, complications and bone level between implants that were loaded immediately or early at 3 years cannot be rejected in this randomized clinical trial. © 2011 John Wiley & Sons A/S.

  7. The effect of antioxidant supplementation on hepatitis C viral load, transaminases and oxidative status: a randomized trial among chronic hepatitis C virus-infected patients

    DEFF Research Database (Denmark)

    Groenbaek, K.; Friis, H.; Hansen, Max

    2006-01-01

    Objective To assess the effect of antioxidant supplementation on hepatitis C viral load, transaminases and oxidative status. Methods We performed a randomized, placebo-controlled, double-blind trial to assess the effect of antioxidant supplementation on serum alanine aminotransferase, plasma hepa...... and catalase) or plasma levels of oxidative markers (malondialdehyde and 2-amino-adipic semialdehyde) were found. Conclusion Supplementation with vitamin C, E and selenium increased the antioxidant status, but had no effects on alanine aminotransferase, viral load or oxidative markers....

  8. The effect of implementing cognitive load theory-based design principles in virtual reality simulation training of surgical skills: a randomized controlled trial

    DEFF Research Database (Denmark)

    Andersen, Steven Arild Wuyts; Mikkelsen, Peter Trier; Konge, Lars

    2016-01-01

    . Increased cognitive load when part tasks needed to be integrated in the post-training procedures could be a possible explanation for this. Other instructional designs and methods are needed to lower the cognitive load and improve the performance in virtual reality surgical simulation training of novices.......Background Cognitive overload can inhibit learning, and cognitive load theory-based instructional design principles can be used to optimize learning situations. This study aims to investigate the effect of implementing cognitive load theory-based design principles in virtual reality simulation...... training of mastoidectomy. Methods Eighteen novice medical students received 1 h of self-directed virtual reality simulation training of the mastoidectomy procedure randomized for standard instructions (control) or cognitive load theory-based instructions with a worked example followed by a problem...

  9. EVALUASI DAMPAK PENERAPAN AUTOMATED DISPENSING MACHINE TERHADAP DISPENSING ERROR DI FARMASI RAWAT JALAN INSTALASI FARMASI RUMAH SAKIT BETHESDA YOGYKARTA

    Directory of Open Access Journals (Sweden)

    Purwoadi Sujatno

    2016-06-01

    Full Text Available Dispensing error is not uncommon in the medication proccess. Otomatisation of outpatient pharmacy services decrease the incidence of dispensing error, as well as improving the efficiency of picking, packing and labeling process. Since August 2014 an automated dispensing machine was installed in outpatient pharmascy Bethesda Hospital Yogyakarta, integrated with electronic prescribing and hospital information system. The objective of the study was to evaluate the impact of automated dispensing machine on the dispensing error at outpatient pharmacy Services using before and after study method. The procentage of drugs deliver by automated dispensing machine at the third and sixth month of implementation was 46% and 59%. Failure mode and effeect analysis of dispensing process done before the implementation, and the integration with electronic prescription and hospital information system, as well as the development of smart pack is the key of successed. The average of medications picked after the implementation of automated dispensing machine was (37,915.33 ± 3,160.12, higher than before implementation (36,812.67 ± 2,890.81, but not significant. The average of dispensing error after implementation (15,67 ± 6,28 was reduced significantly (p<0,05 than before (50.33 ± 34.47. The most frequent type of dispensing error were wrong quantity dispensed, wrong drug dispensed and wrong strength dispensed. The implementation of automated dispensing machine significantly reduce the incidence of dispensing error. Further investigaation needed to know the incidence of dispesning error cause by the machine and manual and factors that influenced.

  10. Immediate Loading of Anterior Single Tooth Implants Placed in Healed Sites : Five-Year Results of a Randomized Clinical Trial

    NARCIS (Netherlands)

    den Hartog, Laurens; Raghoebar, Gerry M.; Stellingsma, Kees; Vissink, Arjan; Meijer, Henny J. A.

    2016-01-01

    Purpose: The aim of this study was to compare the 5-year outcome of immediate loading with that of conventional loading for anterior single-tooth implants placed in healed sites. It was hypothesized that immediate loading is not inferior to conventional loading. Materials and Methods: A total of 62

  11. The role of pharmacists and emergency contraception: Are pharmacists' perceptions of emergency contraception predictive of their dispensing practices?

    Science.gov (United States)

    Richman, Alice R; Daley, Ellen M; Baldwin, Julie; Kromrey, Jeff; O'Rourke, Kathleen; Perrin, Kay

    2012-10-01

    Pharmacists can play a critical role in the access to emergency contraception (EC). We assessed if knowledge and attitudes were predictive of EC dispensing among a statewide sample of Florida pharmacists, who have legal authority to refuse to dispense medications. In 2008, surveys were mailed to a random sample of 1264 pharmacists registered with the Florida Board of Pharmacy. Data from 272 pharmacists (22% response rate) were analyzed using bivariate and multivariate logistic regression. Fifty-six percent of respondents incorrectly answered that EC causes birth defects, and 46% replied that it causes abortion. Only 22% said that EC can be purchased in advance of need. Many felt uncomfortable dispensing to adolescents (61%) and men (58%). Knowledge about EC was the most important predictor of dispensing [odds ratio (OR)=1.57, 95% confidence interval (CI) 1.22-2.03]. In particular, pharmacists who reported that EC does not act as an abortifacient were more likely to dispense it (OR=4.64, 95% CI 2.15-10.00). Correct information about EC was the most important predictor of pharmacists' dispensing EC. To expand availability of EC, pharmacists will have to become better informed. Copyright © 2012 Elsevier Inc. All rights reserved.

  12. Antidepressant medication dispensing among montelukast initiators.

    Science.gov (United States)

    Zhou, Esther H; Kaplan, Sigal; Mosholder, Andrew; Moeny, David; Ding, Yulan; Wu, Yute; Iyasu, Solomon; Hammad, Tarek A

    2013-11-01

    This study investigates the potential association between montelukast use and psychiatric adverse events by monitoring changes in antidepressant medication dispensing rates before and after initiating montelukast. The primary study group of montelukast initiators was identified using the Wolters Kluwer's SOURCE Lx® pharmacy claims database (WK). This group included 232,159 patients ≤45 years old who had at least two montelukast prescriptions from 2003 to 2007. Comparison groups comprised of 264,704 fluticasone initiators and 89,635 long-acting β-agonist corticosteroid (LABA/ICS) initiators were also identified. Antidepressant medication dispensing rates in these three groups were determined using WK, and changes in rates before and after the first asthma controller medication prescription date were evaluated using interrupted time-series analysis (ITS). ITS was performed separately for four age categories, with a focus on youth (12-17 years) and young adult (18-24 years). For patients 18-24 years old, antidepressant medication dispensing rates increased significantly after initiating montelukast [1.93% (1.55-2.32%, p montelukast. However, similar increases were observed in the fluticasone and LABA/ICS comparison groups. The results of this study cannot support a specific association between initiation of montelukast treatment and an increase in psychiatric adverse effects.

  13. Manual vs. integrated automatic load-distributing band CPR with equal survival after out of hospital cardiac arrest. The randomized CIRC trial

    NARCIS (Netherlands)

    Wik, L.; Olsen, J.A.; Persse, D.; Sterz, F.; Lozano Jr, M.; Brouwer, M.A.; Westfall, M.; Souders, C.M.; Malzer, R.; Grunsven, P.M. van; Travis, D.T.; Whitehead, A.; Herken, U.R.; Lerner, E.B.

    2014-01-01

    OBJECTIVE: To compare integrated automated load distributing band CPR (iA-CPR) with high-quality manual CPR (M-CPR) to determine equivalence, superiority, or inferiority in survival to hospital discharge. METHODS: Between March 5, 2009 and January 11, 2011 a randomized, unblinded, controlled group

  14. Improving outpatient primary medication adherence with physician guided, automated dispensing

    Directory of Open Access Journals (Sweden)

    Moroshek JG

    2017-01-01

    Full Text Available Jacob G Moroshek1,2 1Bioinformatics and Computational Biology, 2Carlson School of Management, University of Minnesota, Minneapolis, MN, USA Background: Physician dispensing, different from pharmacist dispensing, is a way for practitioners to supply their patients with medications, at the point of care. The InstyMeds dispenser and logistics system can automate much of the dispensing, insurance adjudication, inventory management, and regulatory reporting that is required of physician dispensing. Objective: To understand the percentage of patients that exhibit primary adherence to medication in the outpatient setting when choosing InstyMeds. Method: The InstyMeds dispensing database was de-identified and analyzed for primary adherence. This is the ratio of patients who dispensed their medication to those who received an eligible prescription. Results: The average InstyMeds emergency department installation has a primary adherence rate of 91.7%. The maximum rate for an installed device was 98.5%. Conclusion: Although national rates of primary adherence have been found to be in the range of 70%, automated physician dispensing vastly improves the rate of adherence. Improved adherence should lead to better patient outcomes, fewer return visits, and lower healthcare costs. Keywords: automated dispensing, adherence, compliance, medication, physician dispensing, InstyMeds

  15. Compensatory load redistribution in Labrador retrievers when carrying different weights--a non-randomized prospective trial.

    Science.gov (United States)

    Bockstahler, Barbara; Tichy, Alexander; Aigner, Patricia

    2016-06-07

    Retrievers are dogs particularly bred to retrieve birds or other small game, for the retrieval, the dogs are typically sent to the place where the shot game has fallen or to search the field for the wounded but still live game in order to return them to the hunter as quickly as possible. Examples of game animals are pheasants, mallard ducks and rabbits. For training, dummies with a variety of weights are used to simulate the retrieval of various types of game. The aim of this non-randomized prospective study was to investigate if peak vertical force, vertical impulse and paw pressure contact area are increased in the forelimbs when carrying different weights, and if the symmetrical weight distribution between contralateral limb pairs is disturbed. Ten actively working Labrador retrievers were walked over a pressure plate with or without carrying 0.5, 2.0 and 4.0 kg dummies. The aim of this study was to determine if vertical ground reaction forces and paw pressure contact area are increased in the forelimbs when carrying different weights, and if symmetrical weight distribution is disturbed between contralateral limb pairs. Peak vertical force and vertical impulse were significantly increased in the forelimbs and decreased in the hindlimbs in all weight carrying conditions. These results demonstrate the significant effects of carrying weight in the mouth on the ground reaction forces, which likely produce additional stress on the forelimb joints. Carry of game or a dummy is likely to alter the forelimb load distribution.

  16. The effect of cognitive load and patient race on physicians' decisions to prescribe opioids for chronic low back pain: a randomized trial.

    Science.gov (United States)

    Burgess, Diana J; Phelan, Sean; Workman, Michael; Hagel, Emily; Nelson, David B; Fu, Steven S; Widome, Rachel; van Ryn, Michelle

    2014-06-01

    To test the hypothesis that racial biases in opioid prescribing would be more likely under high levels of cognitive load, defined as the amount of mental activity imposed on working memory, which may come from environmental factors such as stressful conditions, chaotic workplace, staffing insufficiency, and competing demands, one's own psychological or physiological state, as well as from demands inherent in the task at hand. Two (patient race: White vs Black) by two (cognitive load: low vs high) between-subjects factorial design. Ninety-eight primary care physicians from the Veterans Affairs Healthcare System. Web-based experimental study. Physicians were randomly assigned to read vignettes about either a Black or White patient, under low vs high cognitive load, and to indicate their likelihood of prescribing opioids. High cognitive load was induced by having physicians perform a concurrent task under time pressure. There was a three-way interaction between patient race, cognitive load, and physician gender on prescribing decisions (P = 0.034). Hypotheses were partially confirmed. Male physicians were less likely to prescribe opioids for Black than White patients under high cognitive load (12.5% vs 30.0%) and were more likely to prescribe opioids for Black than White patients under low cognitive load (30.8% vs 10.5%). By contrast, female physicians were more likely to prescribe opioids for Black than White patients in both conditions, with greater racial differences under high (39.1% vs 15.8%) vs low cognitive load (28.6% vs 21.7%). Physician gender affected the way in which patient race and cognitive load influenced decisions to prescribe opioids for chronic pain. Future research is needed to further explore the potential effects of physician gender on racial biases in pain treatment, and the effects of physician cognitive load on pain treatment. Published 2014. This article is a U.S. Government work and is in the public domain in the USA.

  17. Evaluation of medicines dispensing pattern of private pharmacies in Rajshahi, Bangladesh

    OpenAIRE

    Saha, Shuvashis; Hossain, Md. Tawhid

    2017-01-01

    Background In developing country like BANGLADESH, people depend more on pharmacies due to expediency, shorter waiting time, cost reduction, availability of credit and flexible opening hours. The aim of this study was to investigate medicines dispensing patterns of the pharmacies in RAJSHAHI, BANGLADESH and to identify and analyze contribution of drugsellers and quacks in irrational drug use. Methods This cross-sectional study was conducted during January 2016 - April, 2016 in 75 randomly sele...

  18. The effect of implementing cognitive load theory-based design principles in virtual reality simulation training of surgical skills: a randomized controlled trial.

    Science.gov (United States)

    Andersen, Steven Arild Wuyts; Mikkelsen, Peter Trier; Konge, Lars; Cayé-Thomasen, Per; Sørensen, Mads Sølvsten

    2016-01-01

    Cognitive overload can inhibit learning, and cognitive load theory-based instructional design principles can be used to optimize learning situations. This study aims to investigate the effect of implementing cognitive load theory-based design principles in virtual reality simulation training of mastoidectomy. Eighteen novice medical students received 1 h of self-directed virtual reality simulation training of the mastoidectomy procedure randomized for standard instructions (control) or cognitive load theory-based instructions with a worked example followed by a problem completion exercise (intervention). Participants then completed two post-training virtual procedures for assessment and comparison. Cognitive load during the post-training procedures was estimated by reaction time testing on an integrated secondary task. Final-product analysis by two blinded expert raters was used to assess the virtual mastoidectomy performances. Participants in the intervention group had a significantly increased cognitive load during the post-training procedures compared with the control group (52 vs. 41 %, p  = 0.02). This was also reflected in the final-product performance: the intervention group had a significantly lower final-product score than the control group (13.0 vs. 15.4, p  Increased cognitive load when part tasks needed to be integrated in the post-training procedures could be a possible explanation for this. Other instructional designs and methods are needed to lower the cognitive load and improve the performance in virtual reality surgical simulation training of novices.

  19. Isolation of Raoultella planticola from refillable antimicrobial liquid soap dispensers in a dental setting.

    Science.gov (United States)

    Momeni, Stephanie S; Tomlin, Nancy; Ruby, John D

    2015-04-01

    Liquid antimicrobial soaps are commonly used in the dental health care setting for hand washing to minimize the potential spread of infectious agents to health care workers and patients. The purpose of the current study was to evaluate possible bacterial contamination of antimicrobial liquid soap dispensers located in 2 institutional comprehensive dental care clinics. Fourteen soap dispensers and 16 original stock containers were sampled. A 1-milliliter aliquot was diluted in 10 mL of phosphate buffer (Tween-80; Acros). Serial dilutions were plated in duplicate on neutralizing agar and incubated for 7 days. Molecular identification was performed using 500 base pair comparisons of 16S ribosomal ribonucleic acid sequencing. Taq polymerase chain reaction was performed with sequence-specific primers for Raoultella species. Bacterial growth was observed at 18 hours for 57% (8 of 14) of soap dispenser samples. Bacterial densities ranged from 4 × 10(2) to 6 × 10(9) colony-forming units per milliliter. Original commercial containers exhibited no growth. Isolates were identified as Raoultella (Klebsiella) planticola. This is the first study to the authors' knowledge indicating recovery of R. planticola from antimicrobial liquid soap dispensers. R. planticola is a recognized environmental opportunistic pathogen that potentially poses a health concern. These findings indicate compliance problems with infection prevention recommendations and support the US Centers for Disease Control and Prevention's recommendation that dispensers should not be topped off. High bacterial loads of R. planticola are inconsistent with infection control practices and are a concern because transmission and possible infection to the health care worker or the patient may occur. Copyright © 2015 American Dental Association. Published by Elsevier Inc. All rights reserved.

  20. A Simulated Learning Environment for Teaching Medicine Dispensing Skills.

    Science.gov (United States)

    McDowell, Jenny; Styles, Kim; Sewell, Keith; Trinder, Peta; Marriott, Jennifer; Maher, Sheryl; Naidu, Som

    2016-02-25

    To develop an authentic simulation of the professional practice dispensary context for students to develop their dispensing skills in a risk-free environment. A development team used an Agile software development method to create MyDispense, a web-based simulation. Modeled on virtual learning environments elements, the software employed widely available standards-based technologies to create a virtual community pharmacy environment. Assessment. First-year pharmacy students who used the software in their tutorials, were, at the end of the second semester, surveyed on their prior dispensing experience and their perceptions of MyDispense as a tool to learn dispensing skills. The dispensary simulation is an effective tool for helping students develop dispensing competency and knowledge in a safe environment.

  1. Disease Propagation Analysis and Mitigation Strategies for Effective Mass Dispensing*

    OpenAIRE

    Lee, Eva K; Chen, Chien H; Pietz, Ferninand; Benecke, Bernard

    2010-01-01

    Mass dispensing of medical countermeasures has been proven to be an effective and crucial means to contain the outbreak of highly infectious disease. The large influx of individuals to the point-of dispensing (POD) centers to receive vaccinations or prophylactic treatment, however, raises the potential risk of serious intra-facility cross-infections. To mitigate the effect, a thorough understanding of how disease propagates during the dispensing under different transmission parameters versus ...

  2. Dispensation fra CFC-reglerne for selskaber

    DEFF Research Database (Denmark)

    Schmidt, Peter Koerver

    2011-01-01

    Artiklen, der er fagfællebedømt, omhandler dispensationsbestemmelsen i SEL § 32, stk. 2, 2-4 pkt, hvorefter Skatterådet kan tillade, at indkomsten i et datterselskab med koncession til at udøve forskellig økonomisk virksomhed ikke skal være omfattet af reglerne om CFC-beskatning. I den forbindels...... analyseres de betingelser, som skal opfyldes for at opnå dispensation på baggrund af nyere administrativ praksis. Der ses på de danske CFC-reglers anvendelsesområde i den henseende....

  3. Dispenser printed electroluminescent lamps on textiles for smart fabric applications

    Science.gov (United States)

    de Vos, Marc; Torah, Russel; Tudor, John

    2016-04-01

    Flexible electroluminescent (EL) lamps are fabricated onto woven textiles using a novel dispenser printing process. Dispenser printing utilizes pressurized air to deposit ink onto a substrate through a syringe and nozzle. This work demonstrates the first use of this technology to fabricate EL lamps. The luminance of the dispenser printed EL lamps is compared to screen-printed EL lamps, both printed on textile, and also commercial EL lamps on polyurethane film. The dispenser printed lamps are shown to have a 1.5 times higher luminance than the best performing commercially available lamp, and have a comparable performance to the screen-printed lamps.

  4. Glycemic index, glycemic load, and blood pressure: a systematic review and meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Evans, Charlotte El; Greenwood, Darren C; Threapleton, Diane E; Gale, Chris P; Cleghorn, Christine L; Burley, Victoria J

    2017-05-01

    Background: High blood pressure is a strong risk factor for cardiovascular disease.Objective: The aim of this study was to determine the associations of dietary glycemic index (GI) and glycemic load (GL) with systolic blood pressure (SBP) and diastolic blood pressure (DBP) in healthy individuals.Design: A systematic review and meta-analysis of randomized controlled trials (RCTs) was carried out. Databases were searched for eligible RCTs in 2 phases. MEDLINE, Embase, CAB Abstracts, BIOSIS, ISI Web of Science, and the Cochrane Library were searched from January 1990 to December 2009. An updated search was undertaken with the use of MEDLINE and Embase from January 2010 to September 2016. Trials were included if they reported author-defined high- and low-GI or -GL diets and blood pressure, were of ≥6 wk duration, and comprised healthy participants without chronic conditions. Data were extracted and analyzed with the use of Stata statistical software. Pooled estimates and 95% CIs were calculated with the use of weighted mean differences and random-effects models.Results: Data were extracted from 14 trials comprising 1097 participants. Thirteen trials provided information on differences in GI between control and intervention arms. A median reduction in GI of 10 units reduced the overall pooled estimates for SBP and DBP by 1.1 mm Hg (95% CI: -0.3, 2.5 mm Hg; P = 0.11) and 1.3 mm Hg (95% CI: 0.2 mm Hg, 2.3; P = 0.02), respectively. Nine trials reported information on differences in GL between arms. A median reduction in GL of 28 units reduced the overall pooled estimates for SBP and DBP by 2.0 mm Hg (95% CI: 0.2, 3.8 mm Hg; P = 0.03) and 1.4 mm Hg (95% CI: 0.1, 2.6 mm Hg; P = 0.03), respectively.Conclusions: This review of healthy individuals indicated that a lower glycemic diet may lead to important reductions in blood pressure. However, many of the trials included in the analysis reported important sources of bias. This trial was registered at PROSPERO as CRD

  5. Randomized Clinical Trial To Compare The Effects Of Preoperative Oral Carbohydrate Loading Versus Placebo On Insulin Resistance And Cortisol Level After Laparoscopic Cholecystectomy.

    Science.gov (United States)

    Pędziwiatr, Michał; Pisarska, Magdalena; Matłok, Maciej; Major, Piotr; Kisielewski, Michał; Wierdak, Mateusz; Natkaniec, Michał; Budzyński, Piotr; Rubinkiewicz, Mateusz; Budzyński, Rzej

    2015-08-01

    Postoperative insulin resistance, used as a marker of stress response, is clearly an adverse event. It may induce postoperative hyperglycemia, which according to some authors can increase the risk of postoperative complications. One of the elements of modern perioperative care is preoperative administration of oral carbohydrate loading (CHO-loading), which shortens preoperative fasting and reduces insulin resistance. The aim of the study is to establish the influence of CHO-loading on the level of insulin resistance and cortisol in patients undergoing elective laparoscopic cholecystectomy. Patients were randomly allocated to one of 2 groups. The intervention group included 20 patients who received CHO-loading (400 ml Nutricia pre-op®) 2 hours prior surgery. The control group received a placebo (clear water). In every patient blood samples were taken 2 hours prior to surgery, immediately after surgery, and on the 1st postoperative day. Levels and changes in glucose, cortisol and insulin resistance were analyzed in both groups. Although there were differences in the levels of cortisol, insulin, and insulin resistance, no statistically significant differences were observed between groups in every measurement. The length of stay and postoperative complications were comparable in both groups. We believe that CHO-loading is not clinically justified in case of laparoscopic cholecystectomy. No effect on the levels of glucose, insulin resistance and cortisol was observed. Even though such procedure is safe, in our opinion there is no clinical benefit from CHO-loading prior to laparoscopic cholecystectomy.

  6. Immediate Loading of Anterior Single-Tooth Implants Placed in Healed Sites: Five-Year Results of a Randomized Clinical Trial.

    Science.gov (United States)

    den Hartog, Laurens; Raghoebar, Gerry M; Stellingsma, Kees; Vissink, Arjan; Meijer, Henny Ja

    The aim of this study was to compare the 5-year outcome of immediate loading with that of conventional loading for anterior single-tooth implants placed in healed sites. It was hypothesized that immediate loading is not inferior to conventional loading. A total of 62 patients with a missing maxillary anterior tooth were included. At random, patients were treated with an implant that was restored either with a nonoccluding temporary crown within 24 hours after implant placement (immediate group) or according to a two-stage procedure after 3 months (conventional group). All implants were placed in healed sites. Follow-up visits were performed after definitive crown delivery and 1 and 5 years thereafter. Outcome measures were radiographic marginal bone level changes, implant survival, complications, soft tissue aspects (probing depth, plaque, bleeding, soft tissue level changes), esthetic outcome, and patient satisfaction. Three patients in each study group were lost to follow-up. No significant differences were found in terms of marginal bone loss (1.16 ± 0.93 mm in the immediate group and 1.20 ± 1.10 mm in the conventional group), survival (one implant lost in the immediate group), complications, soft tissue aspects, esthetic outcome, and patient satisfaction. For anterior single-tooth implants placed in healed sites, the outcome of immediate loading is not inferior to conventional loading.

  7. Medicine dispensing service in primary health care of SUS.

    Science.gov (United States)

    Leite, Silvana Nair; Bernardo, Noemia Liege Maria da Cunha; Álvares, Juliana; Guerra, Augusto Afonso; Costa, Ediná Alves; Acurcio, Francisco de Assis; Guibu, Ione Aquemi; Costa, Karen Sarmento; Karnikowski, Margô Gomes de Oliveira; Soeiro, Orlando Mario; Soares, Luciano

    2017-11-13

    To characterize the medicine dispensing services in the primary health care network in Brazil and in its different regions, aiming to promote the access and rational use of medicines. This is a cross-sectional, quantitative study with data obtained from the Pesquisa Nacional sobre Acesso, Utilização e Uso Racional de Medicamentos (PNAUM - National Survey on Access, Use and Promotion of Rational Use of Medicines), 2015. Observation visits were carried out in 1,175 dispensing units, and interviews were held with 1,139 professionals responsible for the dispensation of medicines in the dispensing units and 495 municipal coordinators of pharmaceutical services. More than half (53%) of the units presented a space smaller than 10 m2 for dispensing of medicines; 23.8% had bars or barriers between users and dispenser; 41.7% had computerized system; and 23.7% had counters for individual care. Among those responsible for dispensation, 87.4% said they always or repeatedly inform users how to use the medicines, and 18.1% reported developing some type of clinical activity. Isolated pharmacies presented a more developed physical and personal structure than those belonging to health units, but we found no significant differences regarding the information provided and the development of clinical activities. There are major differences in the organization models of dispensation between cities, with regional differences regarding the physical structure and professionals involved. The centralization of medicine dispensing in pharmacies separated from the health services is associated with better structural and professional conditions, as in the dispensing units of the South, Southeast, and Midwest regions. However, the development of dispensation as health service does not prevail in any pharmacy or region of the Country yet.

  8. Medicine dispensing service in primary health care of SUS

    Directory of Open Access Journals (Sweden)

    Silvana Nair Leite

    2017-11-01

    Full Text Available ABSTRACT OBJECTIVE To characterize the medicine dispensing services in the primary health care network in Brazil and in its different regions, aiming to promote the access and rational use of medicines. METHODS This is a cross-sectional, quantitative study with data obtained from the Pesquisa Nacional sobre Acesso, Utilização e Uso Racional de Medicamentos (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines, 2015. Observation visits were carried out in 1,175 dispensing units, and interviews were held with 1,139 professionals responsible for the dispensation of medicines in the dispensing units and 495 municipal coordinators of pharmaceutical services. RESULTS More than half (53% of the units presented a space smaller than 10 m2 for dispensing of medicines; 23.8% had bars or barriers between users and dispenser; 41.7% had computerized system; and 23.7% had counters for individual care. Among those responsible for dispensation, 87.4% said they always or repeatedly inform users how to use the medicines, and 18.1% reported developing some type of clinical activity. Isolated pharmacies presented a more developed physical and personal structure than those belonging to health units, but we found no significant differences regarding the information provided and the development of clinical activities. CONCLUSIONS There are major differences in the organization models of dispensation between cities, with regional differences regarding the physical structure and professionals involved. The centralization of medicine dispensing in pharmacies separated from the health services is associated with better structural and professional conditions, as in the dispensing units of the South, Southeast, and Midwest regions. However, the development of dispensation as health service does not prevail in any pharmacy or region of the Country yet.

  9. Immediate functional loading of implants placed with flapless surgery versus conventional implants in partially edentulous patients: a 3-year randomized controlled clinical trial.

    Science.gov (United States)

    Cannizzaro, Gioacchino; Leone, Michele; Consolo, Ugo; Ferri, Vittorio; Esposito, Marco

    2008-01-01

    To compare the efficacy of immediate functionally loaded implants placed with a flapless procedure (test group) versus implants placed after flap elevation and conventional load-free healing (control group) in partially edentulous patients. Forty patients were randomized: 20 to the flapless immediately loaded group and 20 to the conventional group. To be immediately loaded, implants had to be inserted with a minimum torque > 45 Ncm. Implants in the immediately loaded group were provided with full acrylic resin temporary restorations the same day. Implants in the conventional group were submerged (anterior region) or left unsubmerged (posterior region) and were left load-free for 3 months (mandibles) or 4 months (maxillae). Provisional restorations were replaced with definitive single metal-ceramic crowns 1 month postloading. Outcome measures were prosthesis and implant failures, biological and prosthetic complications, postoperative edema, pain, and use of analgesics. Independent sample chi2 tests, Mann-Whitney tests, t tests, and paired t tests were used with a significance level of .05. Fifty-two implants were placed in the flapless group and 56 in the conventionally loaded group. In the flapless group, 1 flap had to be raised to control the direction of the bur and 1 implant did not reach the planned primary stability and was treated as belonging to the conventional group. After 3 years no dropouts or failures occurred. There was no statistically significant difference for complications; however, patients in the conventional group had significantly more postoperative edema and pain and consumed more analgesics than those in the flapless group. Osstell values were significantly higher at baseline in the flapless group (P = .033). When comparing baseline data with years 1, 2, and 3 within each group, mean Osstell values of the flapless group did not increase, whereas there were statistically significant increases in the Periotest values. Implants can be

  10. Influence of second-order random wave kinematics on the design loads of offshore wind turbine support structures

    DEFF Research Database (Denmark)

    Natarajan, Anand

    2014-01-01

    The impact of wave model nonlinearities on the design loads of wind turbine monopile foundations is delineated based on a second-order nonlinear randomwave model that satisfies the boundary conditions at the free surface and by including the effects of convective acceleration in the inertial load...

  11. Impact of Robotic Dispensing Machines in German Pharmacies on ...

    African Journals Online (AJOL)

    To assess the impact of robotic dispensing machines in community pharmacies on staff efficiency and sales of over-the-counter drugs. Setting: The study was done on 253 community pharmacies in Germany that use a robotic dispensing machine manufactured by ROWA during 2008. Method: Data concerning the financial ...

  12. Evaluation and remediation of bulk soap dispensers for biofilm.

    Science.gov (United States)

    Lorenz, Lindsey A; Ramsay, Bradley D; Goeres, Darla M; Fields, Matthew W; Zapka, Carrie A; Macinga, David R

    2012-01-01

    Recent studies evaluating bulk soap in public restroom soap dispensers have demonstrated up to 25% of open refillable bulk-soap dispensers were contaminated with ~ 6 log(10)(CFU ml(-1)) heterotrophic bacteria. In this study, plastic counter-mounted, plastic wall-mounted and stainless steel wall-mounted dispensers were analyzed for suspended and biofilm bacteria using total cell and viable plate counts. Independent of dispenser type or construction material, the bulk soap was contaminated with 4-7 log(10)(CFU ml(-1)) bacteria, while 4-6 log(10)(CFU cm(-2)) biofilm bacteria were isolated from the inside surfaces of the dispensers (n = 6). Dispenser remediation studies, including a 10 min soak with 5000 mg l(-1) sodium hypochlorite, were then conducted to determine the efficacy of cleaning and disinfectant procedures against established biofilms. The testing showed that contamination of the bulk soap returned to pre-test levels within 7-14 days. These results demonstrate biofilm is present in contaminated bulk-soap dispensers and remediation studies to clean and sanitize the dispensers are temporary.

  13. Dispensing patterns of prescription-only antiobesity preparations in ...

    African Journals Online (AJOL)

    Ilse Truter

    Phentermine was the most commonly dispensed active ingredient, followed by orlistat. Further studies on patient outcomes and the cost-effectiveness of these products should be conducted. Keywords: antiobesity medicine, dispensing patterns, drug utilisation review, DUR, pharmacy. Introduction. Obesity is a major global ...

  14. Methods used to assess drug prescribing and dispensing ...

    African Journals Online (AJOL)

    ... of drugs, observations to assess drug sellers/dispensers roles and consumers behaviour, interviews with the drug sellers and nonprofessional providers themselves, use of simulated client approach and use of the patients care indicators such as generic prescribing/dispensing, number of drugs selected from the essential ...

  15. Prevalence of opioid dispensings and concurrent gastrointestinal medications in Quebec.

    Science.gov (United States)

    Williams, R E; Bosnic, N; Sweeney, C T; Duncan, A W; Levine, K B; Brogan, M; Cook, S F

    2008-01-01

    Opioids are frequently prescribed for moderate to severe pain. A side effect of opioid usage is the inhibition of gastrointestinal (GI) motility, known as opioid-induced bowel dysfunction (OBD). OBD is typically treated prophylactically with laxatives and/or acid suppressants. The present study describes the prevalence of outpatient opioid dispensing, opioid patient demographics, and concomitant dispensing of opioids and GI medications in the Quebec Public Prescription Drug Insurance Plan in 2005. Using a retrospective cohort design, opioid dispensings were identified using claims and reimbursement data. Laxative and acid suppressant dispensings were also identified. Concurrent use was defined as having at least one 'GI medication-exposed day' overlapping an 'opioid-exposed day'. More than 11% of the drug plan population was dispensed an opioid in 2005, and dispensings increased with age. Approximately two-thirds of patients who received an opioid were given codeine. Approximately one-third of opioid patients were concomitantly dispensed a GI medication, yet only 2% were dispensed a laxative. Although the GI side effects of opioids are well known, these side effects appear to increase with age and duration of opioid use. Opioid-related side effects, particularly OBD, should be effectively managed so as not to lead to the cessation of opioid therapy.

  16. A chip-to-chip nanoliter microfluidic dispenser.

    Science.gov (United States)

    Wang, Jianbin; Zhou, Ying; Qiu, Haiwei; Huang, Huang; Sun, Changhong; Xi, Jianzhong; Huang, Yanyi

    2009-07-07

    A high-throughput microfluidic device is developed to handle liquid dispensation in nanoliter range. The dispenser system shows no cross-contamination between the microwells, indicating its great potential in large-scale screening experiments. An array of 115 nl PCR reactions, as well as the single channel addressable chip demonstrate the high flexibility and wide applications of this novel system.

  17. Anthelmintic drug dispensing in South Africa: An analysis of ...

    African Journals Online (AJOL)

    More than two billion people worldwide are infected with helminths. The primary aim of the study was to evaluate the dispensing patterns of anthelmintic products using dispensing data of South African community pharmacies. A retrospective, cross-sectional drug utilisation study was conducted on a 2013 community ...

  18. Ocular Hazards in Ophthalmic Dispensing Industry in South East ...

    African Journals Online (AJOL)

    The prevalence of ocular hazards in ophthalmic dispensing industry in south east Nigeria was carried out using 70 subjects drawn from different towns in the region. Tables were used to analyze the data obtained from his study. Results showed that ocular hazards are involved in ophthalmic dispensing depending on the ...

  19. Dispensing patterns of prescription-only antiobesity preparations in ...

    African Journals Online (AJOL)

    Objectives: The aim of the study was to investigate the dispensing patterns of prescription-only antiobesity preparations in South Africa (classified as Anatomical Therapeutic Chemical (ATC) group A08). Design: Retrospective, cross-sectional drug utilisation study using electronic dispensing records. Setting: Private sector ...

  20. 30 CFR 75.1905 - Dispensing of diesel fuel.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Dispensing of diesel fuel. 75.1905 Section 75... HEALTH MANDATORY SAFETY STANDARDS-UNDERGROUND COAL MINES Diesel-Powered Equipment § 75.1905 Dispensing of diesel fuel. (a) Diesel-powered equipment in underground coal mines may be refueled only from safety cans...

  1. Dispensing patterns of prescription-only antiobesity preparations in ...

    African Journals Online (AJOL)

    Ilse Truter

    dispensing database of approximately 54 million records dispensed by 327 community pharmacies in South Africa in 2013. A community pharmacy refers to pharmacies from which some, or all, of the services as prescribed in terms of regulation 18 of the. Regulations Relating to the Practice of Pharmacy in the Pharmacy.

  2. Identification of risks associated with the prescribing and dispensing of oral anticancer medicines in Ireland.

    LENUS (Irish Health Repository)

    Hammond, Lisa

    2012-09-09

    Background Oral anticancer medicines (OAM) facilitate transfer of cancer care into the community, where safeguards developed in hospitals that control their prescribing, dispensing and administration may not exist. Objective To determine if the systems of prescribing and dispensing OAM in Ireland facilitate clinical verification of the prescription, thereby ensuring treatment is tailored and appropriate for the patient. Setting Randomly selected community pharmacies in Ireland and all Irish hospitals with cancer services. Method A questionnaire was sent to a random selection of Irish community pharmacists. A different questionnaire was sent to all Irish hospitals treating cancer patients. One hundred OAM prescriptions were retrospectively reviewed, to assess the information presented and the potential barriers to a community pharmacist performing a clinical verification of the prescription. Main outcome measure Community pharmacist survey: problems experienced when dispensing OAM and risk factors identified with the current system. Hospital pharmacist survey: proportion of hospitals that clinically verify prescriptions for parenteral versus oral anticancer medicines and associated policies. OAM prescription review: proportion of OAM prescriptions that contained sufficient information for a community pharmacist to clinically verify the prescription and safely dispense the medication. Results Sixty-four percent of community pharmacist respondents felt they did not have enough information available to them to safely dispense these prescriptions, and 74 % felt that patients are at risk with the current Irish system of prescribing and dispensing OAM. Irish hospitals do not have systems to ensure that all OAM prescriptions are clinically verified by a pharmacist. Seventeen different agents were prescribed on the prescriptions reviewed. The information provided to the community pharmacist would have allowed them to clinically verify 7 % of the OAM prescriptions

  3. Immediate Versus Delayed Loading of Implant for Replacement of Missing Mandibular First Molar: A Randomized Prospective Six Years Clinical Study

    Science.gov (United States)

    Gande, Vijaya Chandra; Yadlapalli, Sravanthi; Venkata, Ramani Yarlagadda; Kondaka, Sudheer; Chedalawada, Sravya

    2017-01-01

    Introduction Emergence of dental implants made the replacement of missing tooth easy. During the early days of introduction, implants were loaded three to six months after implant insertion, but understanding of healing cascade and improved production technology has changed the phase of restoration from delayed to immediate loading. Aim To evaluate and compare the clinical outcome of immediate and delayed loaded implant supported prosthesis for missing mandibular first molar. The objectives were bleeding on probing, probing depth, implant mobility, marginal bone level and peri-implant radiolucency were evaluated during follow up period. Materials and Methods Twenty patients were included in this study who were in the need of fixed implant supported prosthesis for missing mandibular first molar. Single tooth implant with immediate loading done within two days of implant insertion in one group and another group were loaded after three months of implant insertion. These groups were evaluated clinically and radiographically over a period of 72 months after loading using Wilcoxon matched pairs test and Mann-Whitney U test. Results The study consists of 14 male and six female patients with the age range of 19 to 31 years. There was no bleeding on probing and probing depth remained well within the normal range even after 72 months of loading among both the groups. Minimal marginal bone loss observed with no mobility and peri-implant radiolucency. Conclusion Implant supported prosthesis for missing mandibular first molar with immediate loading can be used as a successful treatment modality. It reduces treatment time, provides early function and prevents undue migration of adjacent tooth. Immediate loading showed similar clinical and radiographic results as that of delayed loading, indicating it as an equally efficient technique for implant supported prosthesis. PMID:28571258

  4. Medicinal clays improve the endurance of loaded inspiratory muscles in COPD: a randomized clinical trial of nonpharmacological treatment

    Directory of Open Access Journals (Sweden)

    Baldi S

    2015-10-01

    Full Text Available Simonetta Baldi,1 Gian Domenico Pinna,2 Claudio Bruschi,1 Fabrizio Caldara,3 Roberto Maestri,2 Elena Dacosto,1 Antonella Rezzani,1 Ermanno Popovich,1 Ezio Bellinzona,1 Paola Crotti,1 Silvia Montemartini,1 Claudio Fracchia1 1Department of Pneumology, 2Department of Biomedical Engineering, Scientific Institute of Montescano, Salvatore Maugeri Foundation, Istituto Di Ricovero e Cura a Carattere Scientifico, Montescano (Pavia, 3Center of Thermal Studies Pietro d’Abano, AbanoTerme, Padua, Italy Background: Inspiratory resistive breathing (IRB challenges affect respiratory muscle endurance in healthy individuals, which is considered to be an interleukin 6 (IL-6–dependent mechanism. Whether nonpharmacological thermal therapies promote the endurance of loaded inspiratory muscles in chronic obstructive pulmonary disease (COPD is unclear. The objectives of this study were to compare the effects of two thermal interventions on endurance time (ET and plasma IL-6 concentration following an IRB challenge.Methods: This study was a randomized, parallel-group, unblinded clinical trial in a single-center setting. Forty-two patients (aged 42–76 years suffering from mild to severe COPD participated in this study. Both groups completed 12 sessions of the mud bath therapy (MBT (n=22 or leisure thermal activity (LTA (n=19 in a thermal spa center in Italy. Pre- and postintervention spirometry, maximum inspiratory pressure, and plasma mediators were obtained and ET and endurance oxygen expenditure (VO2Endur were measured following IRB challenge at 40% of maximum inspiratory pressure.Results: There was no difference in ΔIL-6 between the intervention groups. But, IRB challenge increased cytokine IL-6 plasma levels systematically. The effect size was small. A statistically significant treatment by IRB challenge effect existed in ET, which significantly increased in the MBT group (P=0.003. In analysis of covariance treatment by IRB challenge analysis with LnVO2

  5. Disease propagation analysis and mitigation strategies for effective mass dispensing.

    Science.gov (United States)

    Lee, Eva K; Chen, Chien H; Pietz, Ferninand; Benecke, Bernard

    2010-11-13

    Mass dispensing of medical countermeasures has been proven to be an effective and crucial means to contain the outbreak of highly infectious disease. The large influx of individuals to the point-of dispensing (POD) centers to receive vaccinations or prophylactic treatment, however, raises the potential risk of serious intra-facility cross-infections. To mitigate the effect, a thorough understanding of how disease propagates during the dispensing under different transmission parameters versus POD design and operational factors is necessary. In this study, we employ a large-scale simulation/optimization decision support system, RealOpt, to analyze the propagation of highly infectious disease within dispensing sites. The simulation results are validated and benchmarked by a mathematical model based on ordinary differential equations. Pros and cons of using analytical versus simulation tools are discussed. We further perform sensitivity analysis on the dynamics of intra-POD disease propagation, and explore feasible mitigation strategies for effective mass dispensing.

  6. Enhancing the approach to selecting eyewear (EASE): a multi-centre, practice-based study into the effect of applying contact lenses prior to spectacle dispensing.

    Science.gov (United States)

    Atkins, Nick P; Morgan, Sarah L; Morgan, Philip B

    2009-06-01

    To examine the impact of contact lens application in non-contact lens wearers prior to spectacle dispensing. Ninety-one eligible subjects with no previous contact lens experience were randomly assigned into either a test group (52 subjects) or control group (39 subjects). The former group was offered contact lenses before spectacle dispensing. The latter group proceeded to spectacle dispensing in the normal way without being offered contact lenses. The response to the offer of contact lenses, fit success, the impact on the spectacle dispensing process and the longer term purchase of contact lenses were measured and compared for the test and control groups. Of the test group, 46 (88%) agreed to try contact lenses. All subjects were suitable for contact lenses after a slit lamp examination and lenses were successfully fitted to 45 of the 46 subjects (98%). The test group reported a superior subjective spectacle dispensing experience and spent 267+/-143 pounds (mean+/-standard deviation) on their spectacle frames and lenses, 32% more than the control group (202+/-128 pounds). At 3 months post dispensing, 17 test patients (33% of original cohort) had purchased contact lenses compared with five control subjects (13%) (p=0.001). The opportunity to try contact lenses prior to spectacle dispensing was well received by subjects who generally reported a very positive experience. In particular, contact lenses assisted in seeing frame detail and suitability for wear. One third of subjects proceeded to purchase contact lenses. We recommend that practitioners consider offering contact lenses to all suitable patients who are proceeding to spectacle dispensing to optimise the dispensing process and to provide an opportunity to try contact lenses.

  7. An automatic molecular dispenser of chloride.

    Science.gov (United States)

    Alibrandi, Giuseppe; Amendola, Valeria; Bergamaschi, Greta; Dollenz, Riccardo; Fabbrizzi, Luigi; Licchelli, Maurizio; Lo Vecchio, Carmelo

    2013-03-11

    The combined activity of the 1.1.1-cryptand and of a dicopper(II) bistren cryptate complex including chloride makes the Cl(-) ion be continuously and slowly delivered to the solution, without any external intervention. The 1.1.1-cryptand slowly releases OH(-) ions, according to a defined kinetics, and each OH(-) ion displaces a Cl(-) ion from the cryptate. Chloride displacement induces a sharp colour change from bright yellow to aquamarine and can be conveniently monitored spectrophotometrically, even in diluted solutions. The 1.1.1-cryptand is the motor of a molecular dispenser (the dicopper(II) cryptate) delivering chloride ion automatically, from the inside of the solution. Copyright © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  8. Immediate loading of four interforaminal implants supporting a locator-retained mandibular overdenture in the elderly. Results of a 3-year randomized, controlled, prospective clinical study.

    Science.gov (United States)

    Acham, Stephan; Rugani, Petra; Truschnegg, Astrid; Wildburger, Angelika; Wegscheider, Walther A; Jakse, Norbert

    2017-10-01

    Implant-retained overdentures have become a standard option for the prosthetic treatment of the edentulous mandible in the elderly. This prospective study aimed to compare immediate and conventional loading of four interforaminal implants supporting a Locator-retained mandibular overdenture in elderly patients regarding implant survival, implant stability, and implant-related complications. The study population comprised 20 completely edentulous patients (11 males) aged 60 years and older with severe mandible resorption. Each patient received four interforaminal implants (Neoss Ltd., Harrogate, UK). Following randomization, implants were loaded either immediately after dental implant surgery or 3 months after implant placement with the Locator-abutment system. At follow-up visits 3, 6 12, 24, and 36 months after loading, implant stability was evaluated with Periotest and Ostell. Twenty patients received 80 implants. In eight patients, 32 implants were loaded immediately. Two patients had to be switched from the immediate to the conventional loading group due to insufficient primary stability (≤30 Ncm). Implant survival was similar in both groups after 36 months. No implant was lost. Decreasing Periotest, and accordingly, increasing Ostell measurements indicated adequate osseointegration in both groups. The course of treatment was not significantly different in the two groups. There were comparable incidences of postoperative complaints like swelling, hematoma, or wound dehiscence, as well as need for prosthetic treatment due to abutment loosening or occlusal discrepancies. Incidence of pressure marks and number of patient visits were significantly higher in the conventional loading group. With sufficient primary stability, immediate loading of four interforaminal implants in the edentulous mandible might be the preferential choice in the elderly, reducing total treatment time, and number of patient visits. © 2017 Wiley Periodicals, Inc.

  9. Plug-in nanoliter pneumatic liquid dispenser with nozzle design flexibility.

    Science.gov (United States)

    Choi, In Ho; Kim, Hojin; Lee, Sanghyun; Baek, Seungbum; Kim, Joonwon

    2015-11-01

    This paper presents a novel plug-in nanoliter liquid dispensing system with a plug-and-play interface for simple and reversible, yet robust integration of the dispenser. A plug-in type dispenser was developed to facilitate assembly and disassembly with an actuating part through efficient modularization. The entire process for assembly and operation of the plug-in dispenser is performed via the plug-and-play interface in less than a minute without loss of dispensing quality. The minimum volume of droplets pneumatically dispensed using the plug-in dispenser was 124 nl with a coefficient of variation of 1.6%. The dispensed volume increased linearly with the nozzle size. Utilizing this linear relationship, two types of multinozzle dispensers consisting of six parallel channels (emerging from an inlet) and six nozzles were developed to demonstrate a novel strategy for volume gradient dispensing at a single operating condition. The droplet volume dispensed from each nozzle also increased linearly with nozzle size, demonstrating that nozzle size is a dominant factor on dispensed volume, even for multinozzle dispensing. Therefore, the proposed plug-in dispenser enables flexible design of nozzles and reversible integration to dispense droplets with different volumes, depending on the application. Furthermore, to demonstrate the practicality of the proposed dispensing system, we developed a pencil-type dispensing system as an alternative to a conventional pipette for rapid and reliable dispensing of minute volume droplets.

  10. The effect of instruction in analgesic use compared with neuromuscular exercise on knee-joint load in patients with knee osteoarthritis: a randomized, single-blind, controlled trial.

    Science.gov (United States)

    Holsgaard-Larsen, A; Clausen, B; Søndergaard, J; Christensen, R; Andriacchi, T P; Roos, E M

    2017-04-01

    To investigate the effect of a neuro-muscular exercise (NEMEX) therapy program compared with instructions in optimized analgesics and anti-inflammatory drug use (PHARMA), on measures of knee-joint load in people with mild to moderate knee osteoarthritis (OA). We hypothesized that knee joint loading during walking would be reduced by NEMEX and potentially increased by PHARMA. Single-blind, randomized controlled trial (RCT) comparing NEMEX therapy twice a week with PHARMA. Participants with mild-to-moderate medial tibiofemoral knee OA were randomly allocated (1:1) to one of two 8-week treatments. Primary outcome was change in knee load during walking (Knee Index, a composite score from all three planes based on 3D movement analysis) after 8 weeks of intervention. Secondary outcomes were frontal plane peak knee adduction moment (KAM), Knee Injury and Osteoarthritis Outcome Scores (KOOS) and functional performance tests. Ninety three participants (57% women, 58 ± 8 years with a body mass index [BMI] of 27 ± 4 kg/m2 (mean ± standard deviation [SD])) were randomized to NEMEX group (n = 47) or PHARMA (n = 46); data from 44 (94%) and 41 (89%) participants respectively, were available at follow-up. 49% of the participants in NEMEX and only 7% in PHARMA demonstrated good compliance. We found no difference in the primary outcome as evaluated by the Knee Index -0.07 [-0.17; 0.04] Nm/%BW HT. Secondary outcomes largely supported this finding. We found no difference in the primary outcome; knee joint load change during walking from a NEMEX program vs information on the recommended use of analgesics and anti-inflammatory drugs. ClinicalTrials.gov Identifier: NCT01638962 (July 3, 2012). Ethical Committee: S-20110153. Copyright © 2016 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  11. The evaluation of off-loading using a new removable oRTHOsis in DIABetic foot (ORTHODIAB) randomized controlled trial: study design and rational.

    Science.gov (United States)

    Mohammedi, Kamel; Potier, Louis; François, Maud; Dardari, Dured; Feron, Marilyne; Nobecourt-Dupuy, Estelle; Dolz, Manuel; Ducloux, Roxane; Chibani, Abdelkader; Eveno, Dominique-François; Crea Avila, Teresa; Sultan, Ariane; Baillet-Blanco, Laurence; Rigalleau, Vincent; Velho, Gilberto; Tubach, Florence; Roussel, Ronan; Dupré, Jean-Claude; Malgrange, Dominique; Marre, Michel

    2016-01-01

    Off-loading is essential for diabetic foot management, but remains understudied. The evaluation of Off-loading using a new removable oRTHOsis in DIABetic foot (ORTHODIAB) trial aims to evaluate the efficacy of a new removable device "Orthèse Diabète" in the healing of diabetic foot. ORTHODIAB is a French multi-centre randomized, open label trial, with a blinded end points evaluation by an adjudication committee according to the Prospective Randomized Open Blinded End-point. Main endpoints are adjudicated based on the analysis of diabetic foot photographs. Orthèse Diabète is a new removable off-loading orthosis (PROTEOR, France) allowing innovative functions including real-time evaluation of off-loading and estimation of patients' adherence. Diabetic patients with neuropathic plantar ulcer or amputation wounds (toes or transmetatarsal) are assigned to one of 2 parallel-groups: Orthèse Diabète or control group (any removable device) according to a central computer-based randomization. Study visits are scheduled for 6 months (days D7 and D14, and months M1, M2, M3, and M6). The primary endpoint is the proportion of patients whose principal ulcer is healed at M3. Secondary endpoints are: the proportion of patients whose principal ulcer is healed at M1, M2 and M6; the proportion of patients whose initial ulcers are all healed at M1, M2, M3, and M6; principal ulcer area reduction; time-related ulcer-free survival; development of new ulcers; new lower-extremity amputation; infectious complications; off-loading adherence; and patient satisfaction. The study protocol was approved by the French National Agency for Medicines and Health Products Safety, and by the ethics committee of Saint-Louis Hospital (Paris). Comprehensive study information including a Patient Information Sheet has been provided to each patient who must give written informed consent before enrolment. Monitoring, data management, and statistical analyses are providing by UMANIS Life Science (Paris

  12. Application of basic pharmacology and dispensing practice of antibiotics in accredited drug-dispensing outlets in Tanzania

    Directory of Open Access Journals (Sweden)

    Minzi OM

    2013-01-01

    Full Text Available OM Minzi,1 VS Manyilizu21Unit of Pharmacology and Therapeutics, School of Pharmacy, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, 2Logistics System Strengthening Unit, John Snow Inc, Dar es Salaam, TanzaniaBackground: Provision of pharmaceutical services in accredited drug-dispensing outlets (ADDOs in Tanzania has not been reported. This study compared the antibiotics dispensing practice between ADDOs and part II shops, or duka la dawa baridi (DLDBs, in Tanzania.Methodology: This was a cross-sectional study that was conducted in ADDOs and DLDBs. A simulated client method for data collection was used, and a total of 85 ADDOs, located in Mvomero, Kilombero, and Morogoro rural districts, were compared with 60 DLDBs located in Kibaha district. The research assistants posed as simulated clients and requested to buy antibiotics from ADDOs and DLDBs after presenting a case scenario or disease condition. Among the diseases presented were those requiring antibiotics and those usually managed only by oral rehydration salt or analgesics. The simulated clients wanted to know the antibiotics that were available at the shop. The posed questions set a convincing ground to the dispenser either to dispense the antibiotic directly, request a prescription, or refer the patient to a health facility. Proportions were used to summarize categorical variables between ADDOs and DLDBs, and the chi-square test was used to test for statistical difference between the two drug-outlet types in terms of antibiotic-dispensing practice.Results: As many as 40% of trained ADDO dispensers no longer worked at the ADDO shops, so some of the shops employed untrained staff. A larger proportion of ADDOs than DLDBs dispensed antibiotics without prescriptions (P = 0.004. The overall results indicate that there was no difference between the two types of shops in terms of adhering to regulations for dispensing antibiotics. However, in some circumstances, eg

  13. Continued Dispensing: what medications do patients believe should be available?

    Directory of Open Access Journals (Sweden)

    Salem Hasn Abukres

    2015-05-01

    Full Text Available Background. Continued Dispensing (CD is a new medication supply method for certain medications in Australia. It aims to prevent treatment interruption as a result of patients’ inability to obtain a new valid prescription. The only currently eligible patients for this service are statin and/or oral contraceptives users who have been using these medications for 6 months or more, have not utilized the CD method during the last 12 months, and cannot obtain an immediate appointment with the prescriber in order to get a new prescription. This study aimed to investigate patients’ attitudes towards potential extension and expansion of this medication supply method.Methods. A randomly selected 301 users of these medications from all Australian States were recruited using Computer Assisted Telephone Interview (CATI.Result. The response rate was 79%. The majority of the participants (73.3% did not agree with current restriction on CD utilization frequency. They also supported, to varying degrees, inclusion of all the proposed medications (support ranged from 44.2–78.4%. In this regard, participants who suffered from a specific disease did not differ significantly from those without the disease except in case of patients with depression (p = 0.001.Conclusions. Participants of this study strongly supported both CD extension and expansion. A future critical review of the current version of CD is highly recommended in order to enhance CD capability to achieve its goals.

  14. Microfluidic Dispensing Device Using Wettability Gradient and Electrowetting

    Science.gov (United States)

    Yasuda, Takashi; Harada, Shouhei; Daimon, Katsuya

    We have designed a novel microfluidic dispensing device using automatic droplet transportation on a wettability gradient surface that is sequentially followed by electrowetting-based liquid handling. While a droplet moves along the wettability gradient in a main channel, a portion of the droplet is drawn into a side channel and stored in a reservoir temporarily. Next, the stored liquid is dispensed into a mixing channel when a voltage is applied between two electrodes. The fabricated device succeeded in dispensing two liquids of different nanoscale volumes after extracting them from a microscale volume droplet.

  15. Is increased joint loading detrimental to obese patients with knee osteoarthritis? A secondary data analysis from a randomized trial

    DEFF Research Database (Denmark)

    Henriksen, Marius; Hunter, D J; Dam, E B

    2013-01-01

    To investigate whether increased knee joint loading due to improved ambulatory function and walking speed following weight loss achieved over 16 weeks accelerates symptomatic and structural disease progression over a subsequent 1 year weight maintenance period in an obese population with knee...

  16. A Randomized Trial about Glycemic Index and Glycemic Load Improves Outcomes among Adults with Type 2 Diabetes

    Science.gov (United States)

    Miller, Carla K.; Gutschall, Melissa

    2009-01-01

    Glycemic index (GI) represents the postprandial glucose response of carbohydrate foods, and glycemic load (GL) represents the quantity and quality of carbohydrate consumed. A diet lower in GI and GL may improve diabetes management. A 9-week intervention regarding GI and GL was evaluated among adults in the age range of 40-70 years who had had type…

  17. Three Months of Progressive High-Load Versus Traditional Low-Load Strength Training Among Patients With Rotator Cuff Tendinopathy: Primary Results From the Double-Blind Randomized Controlled RoCTEx Trial.

    Science.gov (United States)

    Ingwersen, Kim Gordon; Jensen, Steen Lund; Sørensen, Lilli; Jørgensen, Hans Ri; Christensen, Robin; Søgaard, Karen; Juul-Kristensen, Birgit

    2017-08-01

    Progressive high-load exercise (PHLE) has led to positive clinical results in patients with patellar and Achilles tendinopathy. However, its effects on rotator cuff tendinopathy still need to be investigated. To assess the clinical effects of PHLE versus low-load exercise (LLE) among patients with rotator cuff tendinopathy. Randomized controlled trial; Level of evidence, 1. Patients with rotator cuff tendinopathy were recruited and randomized to 12 weeks of PHLE or LLE, stratified for concomitant administration of corticosteroid injection. The primary outcome measure was change from baseline to 12 weeks in the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, assessed in the intention-to-treat population. A total of 100 patients were randomized to PHLE (n = 49) or LLE (n = 51). Mean changes in the DASH questionnaire were 7.11 points (95% CI, 3.07-11.16) and 8.39 points (95% CI, 4.35-12.44) in the PHLE and LLE groups, respectively; this corresponded to a statistically nonsignificant adjusted mean group difference of -1.37 points (95% CI, -6.72 to 3.99; P = .61). Similar nonsignificant results were seen for pain, range of motion, and strength. However, a significant interaction effect was found between the 2 groups and concomitant corticosteroid use ( P = .028), with the largest positive change in DASH in favor of PHLE for the group receiving concomitant corticosteroid. The study results showed no superior benefit from PHLE over traditional LLE among patients with rotator cuff tendinopathy. Further investigation of the possible interaction between exercise type and corticosteroid injection is needed to establish optimal and potentially synergistic combinations of these 2 factors. NCT01984203 (ClinicalTrials.gov identifier): Rotator Cuff Tendinopathy Exercise Trial (RoCTEx).

  18. Foreign private capital inflows in Nigeria's democratic dispensation ...

    African Journals Online (AJOL)

    FPCI) in Nigeria in the current democratic dispensation with a view to finding out whether the inflows have recorded significant increase since the institution of Democracy in the country. Relevant theories and empirical data were reviewed.

  19. Controllable evaporation of cesium from a dispenser oven.

    Science.gov (United States)

    Fantz, U; Friedl, R; Fröschle, M

    2012-12-01

    This instrument allows controlled evaporation of the alkali metal cesium over a wide range of evaporation rates. The oven has three unique features. The first is an alkali metal reservoir that uses a dispenser as a cesium source. The heating current of the dispenser controls the evaporation rate allowing generation of an adjustable and stable flow of pure cesium. The second is a blocking valve, which is fully metallic as is the body of the oven. This construction both reduces contamination of the dispenser and enables the oven to be operated up to 300 °C, with only small temperature variations (dispenser oven can be easily transferred to the other alkali-metals.

  20. Office organization and experiences with hearing aid dispensing.

    Science.gov (United States)

    Bailey, H A; Pappas, J J; Graham, S S; Winston, M E; Parrott, P

    1979-01-01

    Roles of the otolaryngologist and the audiologist in providing hearing health care are expanding as a result of current trends in amplification technology, legislation, and patient populations. Within clinic dispensing of hearing aids has become a part of this role expansion. Requirements for setting up a dispensary, fitting procedures, fee analysis, and statistical results of 4 1/2 years' experience are discussed. On the basis of the benefits described, direct dispensing is advocated.

  1. Prevalence of opioid dispensings and concurrent gastrointestinal medications in Quebec

    OpenAIRE

    Williams, Rachel E.; Nevzeta Bosnic; Sweeney, Carolyn T; Duncan, Ashlee W.; Levine, Kristen B; Michael Brogan; Cook, Suzanne F.

    2008-01-01

    BACKGROUND: Opioids are frequently prescribed for moderate to severe pain. A side effect of opioid usage is the inhibition of gastrointestinal (GI) motility, known as opioid-induced bowel dysfunction (OBD). OBD is typically treated prophylactically with laxatives and/or acid suppressants.AIM: The present study describes the prevalence of outpatient opioid dispensing, opioid patient demographics, and concomitant dispensing of opioids and GI medications in the Quebec Public Prescription Drug In...

  2. Effects of treadmill training with load addition on non-paretic lower limb on gait parameters after stroke: A randomized controlled clinical trial.

    Science.gov (United States)

    Ribeiro, Tatiana S; Silva, Emília M G S; Silva, Isaíra A P; Costa, Mayara F P; Cavalcanti, Fabrícia A C; Lindquist, Ana R

    2017-05-01

    The addition of load on the non-paretic lower limb for the purpose of restraining this limb and stimulating the use of the paretic limb has been suggested to improve hemiparetic gait. However, the results are conflicting and only short-term effects have been observed. This study aims to investigate the effects of adding load on non-paretic lower limb during treadmill gait training as a multisession intervention on kinematic gait parameters after stroke. With this aim, 38 subacute stroke patients (mean time since stroke: 4.5 months) were randomly divided into two groups: treadmill training with load (equivalent to 5% of body weight) on the non-paretic ankle (experimental group) and treadmill training without load (control group). Both groups performed treadmill training during 30min per day, for two consecutive weeks (nine sessions). Spatiotemporal and angular gait parameters were assessed by a motion system analysis at baseline, post-training (at the end of 9days of interventions) and follow-up (40days after the end of interventions). Several post-training effects were demonstrated: patients walked faster and with longer paretic and non-paretic steps compared to baseline, and maintained these gains at follow-up. In addition, patients exhibited greater hip and knee joint excursion in both limbs at post-training, while maintaining most of these benefits at follow-up. All these improvements were observed in both groups. Although the proposal gait training program has provided better gait parameters for these subacute stroke patients, our data indicate that load addition used as a restraint may not provide additional benefits to gait training. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Description of load progression and pain response during progressive resistance training early after total hip arthroplasty: secondary analyses from a randomized controlled trial.

    Science.gov (United States)

    Mikkelsen, Lone R; Petersen, Annemette K; Mechlenburg, Inger; Mikkelsen, Søren; Søballe, Kjeld; Bandholm, Thomas

    2017-01-01

    To describe a progressive resistance training intervention implemented shortly after total hip arthroplasty, including a detailed description of load progression, pain response and adverse events to the training. Secondary analyses of data from the intervention group in a randomized controlled trial. This study reports data from the intervention group ( n = 37). The protocol described supervised progressive resistance training of the operated leg two days/week in addition to home-based exercise five days/week and for 10 weeks. The relative load progressed from 12 repetition maximum to 8 repetition maximum during 10 weeks for the exercises: knee extension, hip abduction, -flexion and -extension. Training load in kilograms (kg) for each exercise, hip pain during, before and after exercise using the Visual Analog Scale and adverse events during the initial four weeks of training. The majority of patients experienced only moderate hip pain during exercise (range in median across exercises and sessions: 5-35 mm Visual Analog Scale) and mild pain at rest (median: 1-18 mm Visual Analog Scale), both of which decreased over time ( p training load (67%-166 % across exercises, p training sessions, short term pain response (an increase >20 mm Visual Analog Scale) occurred in 13 patients in 24 training sessions. Progressive resistance training as described in the present study can be implemented shortly following total hip arthroplasty with substantial load progression and no overall exacerbation of postoperative pain. Some patients may experience a short term pain response. Trial Registration (primary trial): NCT01214954.

  4. A new manual dispensing system for in meso membrane protein crystallization with using a stepping motor-based dispenser.

    Science.gov (United States)

    Hato, Masakatsu; Hosaka, Toshiaki; Tanabe, Hiroaki; Kitsunai, Tokuji; Yokoyama, Shigeyuki

    2014-09-01

    A reliable and easy to use manual dispensing system has been developed for the in meso membrane protein crystallization method. The system consists of a stepping motor-based dispenser with a new microsyringe system for dispensing, which allows us to deliver any desired volume of highly viscous lipidic mesophase in the range from ~50 to at least ~200 nl. The average, standard deviation, and coefficient of variation of 20 repeated deliveries of 50 nl cubic phase were comparable to those of a current robotic dispensing. Moreover, the bottom faces of boluses delivered to the glass crystallization plate were reproducibly circular in shape, and their centers were within about 100 μm from the center of the crystallization well. The system was useful for crystallizing membrane and soluble proteins in meso.

  5. Lobesia botrana IPM: electrospun polyester microfibers serve as biodegradable sex pheromone dispensers.

    Science.gov (United States)

    Hummel, Hans E; Langner, S S

    2013-01-01

    Modern insect pest management is faced with an increasingly sophisticated set of requirements. Control agent/dispenser combinations must be at the same time safe, nontoxic, inexpensive, reproducibly efficacious, environmentally compatible, biodegradable, and sustainable, and should be based on renewable resources. The methods employed preferably should be suitable for the growing and tightly controlled organic growing sector as well. All this calls for a level of sophistication and reproducibility previously unknown. Only very few systems can offer this kind of performance, but fortunately can be found in the area of suitable pheromone/dispenser combinations. This report is an attempt to adapt electrospun Ecoflex polyester micro fibers of the Greiner-Wendorff type to the very specific needs of the grape growing industry. Specifically required are "semi-intelligent" dispenser materials. On a weight basis, the electrospun product should achieve as high a proportion as possible of "retainable" sex pheromone (E,Z)-7,9-dodecadienyl acetate of Lobesia botrana (Lep.: Tortricidae) and should release it as uniformly as possible into the surrounding airspace. Using the Doye bioassay, some progress indeed has recently been achieved with electrospun Ecoflex microfibers of 0.5-3.5 microm diameter. They were employed as dispensers for programmed sex pheromone release with an effective mating disruption duration of up to seven weeks. With one microfiber/pheromone treatment, this covers one entire flight period of the trivoltine L. botrana. Mechanical application of this microfiber/pheromone preparation (with the option of automation) is possible. Disruption effects are comparable with those of commercially available dispensers of the Isonet type. Exposed under vineyard conditions, Ecoflex polyester fibers are a spider silk like material which is biodegradable within half a year. Thus, after releasing its pheromone load, it does not need removal, which saves one cultivation step

  6. Construction of a Smart Medication Dispenser with High Degree of Scalability and Remote Manageability

    OpenAIRE

    JuGeon Pak; KeeHyun Park

    2012-01-01

    We propose a smart medication dispenser having a high degree of scalability and remote manageability. We construct the dispenser to have extensible hardware architecture for achieving scalability, and we install an agent program in it for achieving remote manageability. The dispenser operates as follows: when the real-time clock reaches the predetermined medication time and the user presses the dispense button at that time, the predetermined medication is dispensed from the medication dispens...

  7. A randomized controlled trial comparing interim acrylic prostheses with and without cast metal base for immediate loading of dental implants in the edentulous mandible.

    Science.gov (United States)

    Thomé, Eloana; Lee, Hyung Joo; Sartori, Ivete Aparecida de Mattias; Trevisan, Roseli Latenek; Luiz, Jaques; Tiossi, Rodrigo

    2015-12-01

    This randomized controlled trial used resonance frequency analysis (RFA) to assess the effects of the presence or absence of a cast rigid bar splinting multiple implants in the stability of immediately loaded implants. Twenty-nine edentulous patients were randomly divided into two groups: G1 with full-arch implant-fixed prostheses and G2 with multiple implant splinting via acrylic resin denture bases. All implants were immediately loaded. RFA measurements assessed implant stability at three different times (T0--at baseline, T1--4 months, and T2--8 months. Wilcoxon and Friedman tests and a multivariate model with repeated measures for longitudinal data were used for statistical comparison (α = 0.05). Twenty-nine patients were assessed (G1 = 15 and G2 = 14). Implant and prostheses survival rates were 100% for both groups after the 8-month observation period and no significant differences in the mean ISQ values were found at the different implant stability assessment times (P > 0.05). The different splinting protocols did not appear to affect implant stability during the 8-month observation period. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  8. Immediately loaded platform-switched implants in the anterior mandible with fixed prostheses: a randomized, split-mouth, masked prospective trial.

    Science.gov (United States)

    Romanos, Georgios E; Malmstrom, Hans; Feng, Changyong; Ercoli, Carlo; Caton, Jack

    2014-12-01

    Platform-switched implants have been demonstrated to maintain marginal bone-level stability after immediate loading. The present study evaluated crestal bone loss and soft tissue stability around ANKYLOS plus® implants (A-implants) and Certain® PREVAIL(TM) (B-implants). Patients were identified to receive three A- or three B-implants on each side of their mandibles, with randomization. All implants were loaded immediately after their insertion and splinted with a cemented provisional prosthesis. Final prostheses were delivered 3 months after implantation. Peri-implant crestal bone loss, gingival recession, and other soft tissue changes were evaluated throughout a 2-year follow-up. A total of one hundred seven implants were placed in 18 patients. Two of the group A-implants and one group B-implant failed. At the final 24-month assessment, bone loss of at least 2 mm (mesially or distally) was recorded at 5 of the 44 surviving A-implants (11%) and 33 of the 47 B-implants (70%), a success rate of 88.63% for the A- and 29.78% for the B-implants. Significant changes in the level of the crestal bone loss around immediately loaded platform-switched dental implants seem to be related to the platform shape and size, as well as the implant-abutment connection, when abutments are not removed. © 2013 Wiley Periodicals, Inc.

  9. Immediate versus delayed loading of strategic mini dental implants for the stabilization of partial removable dental prostheses: a patient cluster randomized, parallel-group 3-year trial.

    Science.gov (United States)

    Mundt, Torsten; Al Jaghsi, Ahmad; Schwahn, Bernd; Hilgert, Janina; Lucas, Christian; Biffar, Reiner; Schwahn, Christian; Heinemann, Friedhelm

    2016-07-30

    Acceptable short-term survival rates (>90 %) of mini-implants (diameter implants as strategic abutments for a better retention of partial removable dental prosthesis (PRDP) are not available. The purpose of this study is to test the hypothesis that immediately loaded mini-implants show more bone loss and less success than strategic mini-implants with delayed loading. In this four-center (one university hospital, three dental practices in Germany), parallel-group, controlled clinical trial, which is cluster randomized on patient level, a total of 80 partially edentulous patients with unfavourable number and distribution of remaining abutment teeth in at least one jaw will receive supplementary min-implants to stabilize their PRDP. The mini-implant are either immediately loaded after implant placement (test group) or delayed after four months (control group). Follow-up of the patients will be performed for 36 months. The primary outcome is the radiographic bone level changes at implants. The secondary outcome is the implant success as a composite variable. Tertiary outcomes include clinical, subjective (quality of life, satisfaction, chewing ability) and dental or technical complications. Strategic implants under an existing PRDP are only documented for standard-diameter implants. Mini-implants could be a minimal invasive and low cost solution for this treatment modality. The trial is registered at Deutsches Register Klinischer Studien (German register of clinical trials) under DRKS-ID: DRKS00007589 ( www.germanctr.de ) on January 13(th), 2015.

  10. Supplementation with a Polyphenol-Rich Extract, PerfLoad®, Improves Physical Performance during High-Intensity Exercise: A Randomized, Double Blind, Crossover Trial

    Directory of Open Access Journals (Sweden)

    Julien Cases

    2017-04-01

    Full Text Available Workout capacity is energy-production driven. To produce peak metabolic power outputs, the organism predominantly relies more on anaerobic metabolism, but this undoubtedly has a negative and limiting impact on muscle function and performance. The aim of the study was to evaluate if an innovative polyphenol-based food supplement, PerfLoad®, was able to improve metabolic homeostasis and physical performance during high-intensity exercises under anaerobic conditions. The effect of a supplementation has been investigated on fifteen recreationally-active male athletes during a randomized, double-blind and crossover clinical investigation. The Wingate test, an inducer of an unbalanced metabolism associated to oxidative stress, was used to assess maximum anaerobic power during a high-intensity exercise on a cycle ergometer. Supplementation with PerfLoad® correlated with a significant increase in total power output (5%, maximal peak power output (3.7%, and average power developed (5%, without inducing more fatigue or greater heart rate. Instead, oxidative homeostasis was stabilized in supplemented subjects. Such results demonstrated that PerfLoad® is a natural and efficient solution capable of, similarly to training benefits, helping athletes to improve their physical performance, while balancing their metabolism and reducing exercise-induced oxidative stress.

  11. Beneficial effects of a high-protein, low-glycemic-load hypocaloric diet in overweight and obese women with polycystic ovary syndrome: a randomized controlled intervention study.

    Science.gov (United States)

    Mehrabani, Homeira Hamayeli; Salehpour, Saghar; Amiri, Zohreh; Farahani, Sara Jalali; Meyer, Barbara J; Tahbaz, Farideh

    2012-04-01

    The recommended composition of a hypocaloric diet for obese women with polycystic ovary syndrome (PCOS) is unclear. The aim of this study was to investigate the effects of a high-protein, low-glycemic-load diet compared with a conventional hypocaloric diet on reproductive hormones, inflammatory markers, lipids, glucose, and insulin levels in obese women with PCOS. A total of 60 overweight and obese women with PCOS who did not use insulin-sensitizing agents were recruited and randomly assigned to 1 of the 2 hypocaloric diet groups for a single-blind clinical trial. The groups included a conventional hypocaloric diet (CHCD) (15% of daily energy from protein) and a modified hypocaloric diet (MHCD) with a high-protein, low-glycemic load (30% of daily energy from protein plus low-glycemic-load foods selected from a list) that was prescribed via counseling visits weekly during 12 weeks of study. Anthropometric assessments and biochemical measurements including reproductive hormones, inflammatory factors, lipids, glucose, and insulin were performed on fasting blood samples at baseline and after 12 weeks of dietary intervention. Weight loss was significant and similar in the 2 groups. Mean of testosterone in the MHCD and CHCD groups decreased from 1.78 ± 0.32 to 1.31 ± 0.26 ng/ml and from 1.51 ± 0.12 to 1.15 ± 0.11 ng/ml, respectively (p diets significantly led to reduced body weight and androgen levels in these two groups of women with PCOS. The combination of high-protein and low-glycemic-load foods in a modified diet caused a significant increase in insulin sensitivity and a decrease in hsCRP level when compared with a conventional diet.

  12. Immediate Loading of Two Dental Implants, in Edentulous Mandibles, with Locator® Attachments or Dolder® Bars: First Results from a Prospective Randomized Clinical Study.

    Science.gov (United States)

    Kappel, Stefanie; Eberhard, Lydia; Giannakopoulos, Nikolaos Nikitas; Rammelsberg, Peter; Eiffler, Constantin

    2015-08-01

    The study aims to evaluate survival and the incidence of complications for pairs of implants placed in the frontal area of edentulous mandibles and immediately loaded with either bar or Locator® (Zest Anchors LLC, Escondido, CA, USA) attachments. Forty-six patients (mean age 69.4 years; 73.9% male) with edentulous mandibles each received two immediately loaded implants in the interforaminal area of the symphysis. Immediately after implant placement, Dolder® bar (Sub-Tec Wirobond; BEGO Implant Systems GmbH & Co. KG, Bremen, Germany) or Locator® attachments, allocated randomly, were attached, and both clips and a framework were incorporated into the denture by the dental technician. The implants were loaded within 72 hours. During a mean observation period of 6 months (maximum 24 months, SD 0.43) eight implants in five patients were lost. Survival was 93.5% for the Locator® group and 89.1% for the bar group. Estimated cumulative survival after 1 year of function was 93.4% for the Locator® group and 87.1% for the bar group. During the observation period, 12 prosthetic complications required aftercare. No superstructure was lost or had to be remade for prosthetic reasons, but five dentures had to be removed or reworked after implant failure. Survival of the original dentures was, therefore, 95.7% for the Locator® group and 93.5% for the bar group. Within the limitations of this study, immediate loading of two implants in the edentulous mandible with either Locator® or bar attachments did hardly differ. Ease of repair and cleaning, in particular, might be arguments for choosing the single attachment system. © 2013 Wiley Periodicals, Inc.

  13. Marginal Bone Response Around Immediate- and Delayed-Loading Implants Supporting a Locator-Retained Mandibular Overdenture: A Randomized Controlled Study.

    Science.gov (United States)

    Schincaglia, Gian Pietro; Rubin, Satoko; Thacker, Sejal; Dhingra, Ajay; Trombelli, Leonardo; Ioannidou, Effie

    2016-01-01

    Implant-supported mandibular overdentures (OVDs) have been proposed as the gold standard for the treatment of edentulous mandibles. There is limited evidence on the clinical outcomes of immediate loading of two unsplinted implants supporting a mandibular OVD. The purpose of this randomized controlled trial was to evaluate the performance of two unsplinted implants supporting a Locator-retained mandibular OVD over 12 months loaded immediately or after a delay. Each patient received two implants 4.0 mm in diameter and 8 to 15 mm long. Locator-retained mandibular OVDs were connected to the implants either immediately (IL) or 3 months postsurgery (DL). The primary response variable was radiographic bone loss (RBL) at 6 and 12 months postsurgery. Implant length, insertion torque, implant failure, prevalence of maintenance visits, and prosthetic complications were also recorded. Thirty participants (15 in the IL and 15 in the DL groups) were evaluated at 12 months. The implant cumulative survival rates were 100% and 93% for DL and IL, respectively. The mean RBL from baseline to 1 year was 0.54 (± 0.5) mm and 0.25 (± 0.5) mm for DL and IL, respectively. A statistically significant difference was observed at 12 months, with less RBL in the IL group. Insertion torque and implant length were not correlated with RBL. Also, no difference in frequency of maintenance visits and prosthetic complications was reported between the groups. Immediate loading of two unsplinted implants supporting a Locator-retained mandibular OVD seems to be a suitable treatment option. Significantly less RBL was observed after 1 year of loading around IL implants than around DL implants. Furthermore, neither implant length nor insertion torque seemed to affect RBL 1 year after surgical placement.

  14. High-load strength training improves outcome in patients with plantar fasciitis: A randomized controlled trial with 12-month follow-up.

    Science.gov (United States)

    Rathleff, M S; Mølgaard, C M; Fredberg, U; Kaalund, S; Andersen, K B; Jensen, T T; Aaskov, S; Olesen, J L

    2015-06-01

    The aim of this study was to investigate the effectiveness of shoe inserts and plantar fascia-specific stretching vs shoe inserts and high-load strength training in patients with plantar fasciitis. Forty-eight patients with ultrasonography-verified plantar fasciitis were randomized to shoe inserts and daily plantar-specific stretching (the stretch group) or shoe inserts and high-load progressive strength training (the strength group) performed every second day. High-load strength training consisted of unilateral heel raises with a towel inserted under the toes. Primary outcome was the foot function index (FFI) at 3 months. Additional follow-ups were performed at 1, 6, and 12 months. At the primary endpoint, at 3 months, the strength group had a FFI that was 29 points lower [95% confidence interval (CI): 6-52, P = 0.016] compared with the stretch group. At 1, 6, and 12 months, there were no differences between groups (P > 0.34). At 12 months, the FFI was 22 points (95% CI: 9-36) in the strength group and 16 points (95% CI: 0-32) in the stretch group. There were no differences in any of the secondary outcomes. A simple progressive exercise protocol, performed every second day, resulted in superior self-reported outcome after 3 months compared with plantar-specific stretching. High-load strength training may aid in a quicker reduction in pain and improvements in function. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  15. Qualification, knowledge and experience of dispensers working at community pharmacies in Pakistan

    Directory of Open Access Journals (Sweden)

    Hussain A

    2011-06-01

    Full Text Available Pharmacies are managed by a variety of dispensers in terms of qualification, knowledge and experience in Pakistan.Objective: The study aimed to document the state of knowledge, experience and qualification of dispensers working at community pharmacies in Pakistan.Methods: A comparative cross sectional study was conducted at a randomly selected sample of 371 pharmacies in the three cities of Pakistan. A structured questionnaire for data collection was developed and finalized by focused group discussions and pilot testing. The data was coded, entered and analyzed by using SPSS Version 16. Kruskal-Wallis and Mann-Whitney tests (p=0.05 were performed to find out differences.Results: Out of total sample of 371 pharmacies, 31.8 % (118 were in Islamabad, 32.4 % (120 in Peshawar and 35.8 % (133 were in Lahore. Fifty percent of the respondents had correct knowledge of range of room temperature at which medicines should be stored. Only 11.1% (41 of the respondents knew about OTC (over the counter drugs which can be sold without prescription while 5.9 % (22 of the respondents were aware of POM (prescription only medicines which can be only sold on a valid prescription. While 87.6% (325, 88.1% (327, 58.7% (318 and 95.7 % (355 of the respondents did not know the meaning of the dispensing abbreviations such as ‘h.s’, ‘q.d’, ‘sos’ and ‘p.r.n’. The respondents did not know correctly the status of Deltacortil® (Prednisolone, Septran® (Sulfamethoxazole and Fansidar® (Pyrimethamine and Sulfadoxine either as OTC or POM in 26.7% (99, 64.2% (238, and 44.5 % (165 of the cases, respectively. There was a significant difference (p=0.05 in knowledge of dispensers regarding storage temperature, prescription terminologies and status of medicines having different level of qualification and experience.Conclusions: The overall knowledge and training of dispensers working at community pharmacies is inadequate in Pakistan. However, pharmacists had relatively

  16. Qualification, knowledge and experience of dispensers working at community pharmacies in Pakistan.

    Science.gov (United States)

    Hussain, Azhar; Ibrahim, Mohamed Izham M

    2011-04-01

    Pharmacies are managed by a variety of dispensers in terms of qualification, knowledge and experience in Pakistan. The study aimed to document the state of knowledge, experience and qualification of dispensers working at community pharmacies in Pakistan. A comparative cross sectional study was conducted at a randomly selected sample of 371 pharmacies in the three cities of Pakistan. A structured questionnaire for data collection was developed and finalized by focused group discussions and pilot testing. The data was coded, entered and analyzed by using SPSS Version 16. Kruskal-Wallis and Mann-Whitney tests (p≤0.05) were performed to find out differences. Out of total sample of 371 pharmacies, 31.8 % (118) were in Islamabad, 32.4 % (120) in Peshawar and 35.8 % (133) were in Lahore. Fifty percent of the respondents had correct knowledge of range of room temperature at which medicines should be stored. Only 11.1% (41) of the respondents knew about OTC (over the counter drugs) which can be sold without prescription while 5.9 % (22) of the respondents were aware of POM (prescription only medicines) which can be only sold on a valid prescription. While 87.6% (325), 88.1% (327), 58.7% (318) and 95.7 % (355) of the respondents did not know the meaning of the dispensing abbreviations such as 'h.s', 'q.d', 'sos' and 'p.r.n'. The respondents did not know correctly the status of Deltacortil® (Prednisolone), Septran® (Sulfamethoxazole) and Fansidar® (Pyrimethamine and Sulfadoxine) either as OTC or POM in 26.7% (99), 64.2% (238), and 44.5 % (165) of the cases, respectively. There was a significant difference (p≤0.05) in knowledge of dispensers regarding storage temperature, prescription terminologies and status of medicines having different level of qualification and experience. The overall knowledge and training of dispensers working at community pharmacies is inadequate in Pakistan. However, pharmacists had relatively better knowledge regarding storage temperature

  17. The K-1 Active Dispenser for Orbit Transfer

    Science.gov (United States)

    Lai, G.; Cochran, D.; Curtis, R.

    2002-01-01

    Kistler Aerospace Corporation is building the K-1, the world's first fully reusable launch vehicle. The two-stage K- 1 is designed primarily to service the market for low-earth orbit (LEO) missions, due to Kistler's need to recover both stages. For customers requiring payload delivery to high-energy orbits, Kistler can outfit the payload with a K- 1 Active Dispenser (an expendable third stage). The K-1 second stage will deploy the Active Dispenser mated with its payload into a 200 km circular LEO parking orbit. From this orbit, the Active Dispenser would use its own propulsion to place its payload into the final desired drop-off orbit or earth-escape trajectory. This approach allows Kistler to combine the low-cost launch services offered by the reusable two-stage K-1 with the versatility of a restartable, expendable upper stage. Enhanced with an Active Dispenser, the K-1 will be capable of delivering 1,500 kg to a geosynchronous transfer orbit or up to approximately 1,000 kg into a Mars rendezvous trajectory. The list price of a K-1 Active Dispenser launch is 25 million (plus the price of mission unique integration services) significantly less than the price of any launch vehicle service in the world with comparable capability.

  18. Measurement and analysis of thermal photoemission from a dispenser cathode

    Directory of Open Access Journals (Sweden)

    Kevin L. Jensen

    2003-08-01

    Full Text Available Photocathodes for free electron lasers (FELs are required to produce nano-Coulomb pulses in picosecond time scales with demonstrable reliability, lifetime, and efficiency. Dispenser cathodes, traditionally a rugged and long-lived thermionic source, are under investigation to determine their utility as a photocathode and have shown promise. The present study describes theoretical models under development to analyze experimental data from dispenser cathodes and to create predictive time-dependent models to predict their performance as an FEL source. Here, a steady-state model of a dispenser cathode with partial coverage of a low work function coating and surface nonuniformity is developed. Quantitative agreement is found for experimental data, especially with regard to temperature, field, laser intensity, and quantum efficiency versus laser wavelength dependence. In particular, for long wavelength incident lasers of sufficient intensity, the majority of the absorbed energy heats the electron gas and background lattice, and photoemission from the heated electron distribution constitutes the emitted current.

  19. Do Pregnant Women Report Use of Dispensed Medications?

    DEFF Research Database (Denmark)

    Olesen, Charlotte; Søndergaard, Charlotte; Thrane, Nana

    2001-01-01

    Surveillance of drug safety in pregnancy often draws on administrative prescription registries. Noncompliance in the use of prescribed medication may be frequent among pregnant women owing to their fear of fetotoxic side effects. To estimate compliance in the use of prescription drugs dispensed...... during pregnancy, we compared prescription data from the North Jutland Prescription Database with information on drug use provided by pregnant women to the Danish National Birth Cohort (DNBC), which is a health interview survey. We used the North Jutland Prescription Database to identify all prescription...... drugs dispensed during pregnancy for the 2,041 women who were enrolled in the DNBC in the County of North Jutland, Denmark. Compliance was defined as the probability of reporting drug use in DNBC after purchasing a dispensed prescription drug. The overall compliance to drugs purchased within 120 days...

  20. Triple-Loaded Single-Row Versus Suture-Bridge Double-Row Rotator Cuff Tendon Repair With Platelet-Rich Plasma Fibrin Membrane: A Randomized Controlled Trial.

    Science.gov (United States)

    Barber, F Alan

    2016-05-01

    To compare the structural healing and clinical outcomes of triple-loaded single-row with suture-bridging double-row repairs of full-thickness rotator cuff tendons when both repair constructs are augmented with platelet-rich plasma fibrin membrane. A prospective, randomized, consecutive series of patients diagnosed with full-thickness rotator cuff tears no greater than 3 cm in anteroposterior length were treated with a triple-loaded single-row (20) or suture-bridging double-row (20) repair augmented with platelet-rich plasma fibrin membrane. The primary outcome measure was cuff integrity by magnetic resonance imaging (MRI) at 12 months postoperatively. Secondary clinical outcome measures were American Shoulder and Elbow Surgeons, Rowe, Simple Shoulder Test, Constant, and Single Assessment Numeric Evaluation scores. The mean MRI interval was 12.6 months (range, 12-17 months). A total of 3 of 20 single-row repairs and 3 of 20 double-row repairs (15%) had tears at follow-up MRI. The single-row group had re-tears in 1 single tendon repair and 2 double tendon repairs. All 3 tears failed at the original attachment site (Cho type 1). In the double-row group, re-tears were found in 3 double tendon repairs. All 3 tears failed medial to the medial row near the musculotendinous junction (Cho type 2). All clinical outcome measures were significantly improved from the preoperative level (P plasma fibrin membrane. No difference could be demonstrated between these repairs on clinical outcome scores. I, Prospective randomized study. Copyright © 2016 Arthroscopy Association of North America. All rights reserved.

  1. Is there influence of the load addition during treadmill training on cardiovascular parameters and gait performance in patients with stroke? A randomized clinical trial.

    Science.gov (United States)

    Ribeiro, Tatiana Souza; Chaves da Silva, Tállyta Camyla; Carlos, Renata; de Souza E Silva, Emília Márcia Gomes; Lacerda, Matheus Oliveira; Spaniol, Ana Paula; Lindquist, Ana Raquel Rodrigues

    2017-01-01

    Although exercises involving both lower limbs are indicated for aerobic training, stroke patients have shown expressive asymmetry between the paretic and non-paretic lower limb (NPLL). Performing activities that stimulate the paretic limb during aerobic exercise may optimize training results. To evaluate if there is influence of load addition on NPLL during treadmill training on cardiovascular parameters and gait performance of subacute stroke patients. Thirty-eight stroke subjects with gait deficits were randomized into experimental group, which underwent treadmill training with a mass attached on NPLL, and control group, which underwent only treadmill training. Interventions lasted 2 weeks (9 sessions). Main outcomes were heart rate, arterial blood pressure, gait speed and distance covered. Assessments occurred at rest, 10th and 20th minutes of the session and immediately after each session. There was improvement in speed and walking distance in both groups. All cardiovascular parameters had showed no changes compared to 1st and 9th sessions and there were no differences between groups within each session. Load addition on NPLL did not alter cardiovascular parameters and gait training provide better gait performance of subacute stroke patients, which indicates this therapy can be considered useful and safe for these patients.

  2. Effect of low glycemic load diet with and without wheat bran on glucose control in gestational diabetes mellitus: A randomized trial

    Directory of Open Access Journals (Sweden)

    Ahmad Afaghi

    2013-01-01

    Full Text Available Background: A low-glycemic index diet is effective in blood glucose control of diabetic subjects, reduces insulin requirement in women with gestation diabetes mellitus (GDM and improves pregnancy outcomes when used from beginning of the second trimester. However there are limited reports to examine the effect of low glycemic load (LGL diet and fiber on blood glucose control and insulin requirement of women with GDM. Therefore, the aim of this study was to examine the effect of low glycemic load diet with and without fiber on reducing the number of women with GDM requiring insulin. Materials and Methods: All GDM women (n = 31 were randomly allocated to consume either a LGL diet with Fiber or LGL diet. Results: We found that 7 (38.9% of 18 women with GDM in Fiber group and 10 (76.9% in "Without Fiber" group required insulin treatment. Conclusion: The LGL diet with added fiber for women with GDM dramatically reduced the number needing for insulin treatment.

  3. Dispensing of non-prescribed antibiotics in Jordan

    Directory of Open Access Journals (Sweden)

    Almaaytah A

    2015-09-01

    Full Text Available Ammar Almaaytah,1 Tareq L Mukattash,2 Julia Hajaj2 1Department of Pharmaceutical Technology, 2Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan Objective: Current regulations in Jordan state that antibiotics cannot be sold without a medical prescription. This study aimed to assess the percentage of pharmacies that dispense antibiotics without a medical prescription in the Kingdom of Jordan and identify and highlight the extent and seriousness of such practices among Jordanian pharmacies. Methods: A prospective study was performed, and five different clinical scenarios were simulated at pharmacies investigated including sore throat, otitis media, acute sinusitis, diarrhea, and urinary tract infection in childbearing-aged women. Three levels of demand were used to convince the pharmacists to sell an antibiotic. Results: A total of 202 total pharmacies in Jordan were visited in the present study. The majority of pharmacies (74.3% dispensed antibiotics without prescription with three different levels of demand. The percentage of pharmacies dispensing antibiotics without a prescription for the sore throat scenario was 97.6%, followed by urinary tract infection (83.3%, diarrhea (83%, and otitis media (68.4%. The lowest percentage of antibiotic dispensing was for the acute sinusitis simulation at 48.5%. Among the pharmacies that dispensed antibiotics, the pharmacists provided an explanation as the number of times per day the drug should be taken in 95.3% of the cases, explained the duration of treatment in 25.7%, and inquired about allergies prior to the sale of the antibiotic in only 17.3%. Only 52 pharmacies (25.7% refused to dispense any kind of antibiotics, the majority (61.5% of this refusal response came from acute sinusitis cases, while the minority (2.4% came from the sore throat cases. Conclusion: The results of this study demonstrate that antibiotics continue to be dispensed

  4. Adherence to a flexible extended regimen for oral hormonal contraception provided in a blister packaging compared with an adherence-supporting digital tablet dispenser: historical comparison of data from two clinical studies

    Directory of Open Access Journals (Sweden)

    Elliesen J

    2016-08-01

    Full Text Available Jörg Elliesen, Dietmar Trummer Bayer Pharma AG, Berlin, Germany Background: The Clyk™ digital pill dispenser helps ensure correct and consistent administration of a flexible extended regimen of the combined oral contraceptive, ethinylestradiol (EE 20 µg/drospirenone 3 mg (EE/drospirenoneFlex; YAZ® Flex, guiding users through the intake cycle and 4-day pill break and providing visible and acoustic daily reminders when pill intake is due. A study showed that the audible alarm function of the dispenser could help reduce the number of missed pills, but it lacked an appropriate “non-dispenser” group for a meaningful assessment of the impact of the dispenser on adherence. This study indirectly assessed the overall effect of the digital dispenser on adherence by comparing data from a treatment with standard blister packaging.Materials and methods: One-year adherence data were compared from two similarly designed, Phase III, open-label, randomized trials of EE/drospirenoneFlex. In study 1, women used diary cards to record adherence with EE/drospirenoneFlex dispensed in blister packs (n=640, and in study 2 the dispenser was used with the alarm activated (n=250 or deactivated (n=248 in addition to using diary cards.Results: A mean (±SD of 4.3 (±4.24 missed pills over 1 year were recorded in diary cards among women who dispensed their pills from the blister packages (study 1 compared with 1.0 (±2.4 recorded by the alarm-activated dispenser (study 2. In study 2, a mean of 1.9 (±4.2 missed pills were reported in the diaries over 1 year compared with 4.4 (±9.1 from automatic recording by the dispenser (both arms of study 2, indicating underreporting of missed pills in diary cards vs the digital dispenser. Adjusting for this rate of underreporting, an estimated mean of ten pills were missed over 1 year by women using EE/drospirenoneFlex in blister packs, or ten times more than with the digital dispenser with activated acoustic alarm

  5. Adherence to a flexible extended regimen for oral hormonal contraception provided in blister packaging compared with an adherence-supporting digital tablet dispenser: historical comparison of data from two clinical studies.

    Science.gov (United States)

    Elliesen, Jörg; Trummer, Dietmar

    2016-01-01

    The Clyk™ digital pill dispenser helps ensure correct and consistent administration of a flexible extended regimen of the combined oral contraceptive, ethinylestradiol (EE) 20 μg/drospirenone 3 mg (EE/drospirenone ; YAZ(®) Flex Flex), guiding users through the intake cycle and 4-day pill break and providing visible and acoustic daily reminders when pill intake is due. A study showed that the audible alarm function of the dispenser could help reduce the number of missed pills, but it lacked an appropriate "non-dispenser" group for a meaningful assessment of the impact of the dispenser on adherence. This study indirectly assessed the overall effect of the digital dispenser on adherence by comparing data from a treatment with standard blister packaging. One-year adherence data were compared from two similarly designed, Phase III, open-label, randomized trials of EE/drospirenoneFlex. In study 1, women used diary cards to record adherence with EE/drospirenoneFlex dispensed in blister packs (n=640), and in study 2 the dispenser was used with the alarm activated (n=250) or deactivated (n=248) in addition to using diary cards. A mean (±SD) of 4.3 (±4.24) missed pills over 1 year were recorded in diary cards among women who dispensed their pills from the blister packages (study 1) compared with 1.0 (±2.4) recorded by the alarm-activated dispenser (study 2). In study 2, a mean of 1.9 (±4.2) missed pills were reported in the diaries over 1 year compared with 4.4 (±9.1) from automatic recording by the dispenser (both arms of study 2), indicating underreporting of missed pills in diary cards vs the digital dispenser. Adjusting for this rate of underreporting, an estimated mean of ten pills were missed over 1 year by women using EE/drospirenoneFlex in blister packs, or ten times more than with the digital dispenser with activated acoustic alarm. The digital dispenser helps reduce the number of missed pills and increases adherence.

  6. Construction of a smart medication dispenser with high degree of scalability and remote manageability.

    Science.gov (United States)

    Pak, JuGeon; Park, KeeHyun

    2012-01-01

    We propose a smart medication dispenser having a high degree of scalability and remote manageability. We construct the dispenser to have extensible hardware architecture for achieving scalability, and we install an agent program in it for achieving remote manageability. The dispenser operates as follows: when the real-time clock reaches the predetermined medication time and the user presses the dispense button at that time, the predetermined medication is dispensed from the medication dispensing tray (MDT). In the proposed dispenser, the medication for each patient is stored in an MDT. One smart medication dispenser contains mainly one MDT; however, the dispenser can be extended to include more MDTs in order to support multiple users using one dispenser. For remote management, the proposed dispenser transmits the medication status and the system configurations to the monitoring server. In the case of a specific event such as a shortage of medication, memory overload, software error, or non-adherence, the event is transmitted immediately. All these operations are performed automatically without the intervention of patients, through the agent program installed in the dispenser. Results of implementation and verification show that the proposed dispenser operates normally and performs the management operations from the medication monitoring server suitably.

  7. Construction of a Smart Medication Dispenser with High Degree of Scalability and Remote Manageability

    Directory of Open Access Journals (Sweden)

    JuGeon Pak

    2012-01-01

    Full Text Available We propose a smart medication dispenser having a high degree of scalability and remote manageability. We construct the dispenser to have extensible hardware architecture for achieving scalability, and we install an agent program in it for achieving remote manageability. The dispenser operates as follows: when the real-time clock reaches the predetermined medication time and the user presses the dispense button at that time, the predetermined medication is dispensed from the medication dispensing tray (MDT. In the proposed dispenser, the medication for each patient is stored in an MDT. One smart medication dispenser contains mainly one MDT; however, the dispenser can be extended to include more MDTs in order to support multiple users using one dispenser. For remote management, the proposed dispenser transmits the medication status and the system configurations to the monitoring server. In the case of a specific event such as a shortage of medication, memory overload, software error, or non-adherence, the event is transmitted immediately. All these operations are performed automatically without the intervention of patients, through the agent program installed in the dispenser. Results of implementation and verification show that the proposed dispenser operates normally and performs the management operations from the medication monitoring server suitably.

  8. Sagittal lumbopelvic alignment in patients with low back pain and the effects of a high-load lifting exercise and individualized low-load motor control exercises-a randomized controlled trial.

    Science.gov (United States)

    Berglund, Lars; Aasa, Björn; Michaelson, Peter; Aasa, Ulrika

    2017-07-28

    Assessment of posture and lumbopelvic alignment is often the main focus in the classification and treatment of patients with low back pain (LBP). However, little is known regarding the effects of motor control interventions on objective measures of lumbopelvic alignment. The primary aim of this study was to describe the variation of sagittal lumbopelvic alignment in patients with nociceptive mechanical LBP. The secondary aim was to compare the effects of a high-load lifting exercise (HLL) and low-load motor control exercises (LMC) on the change in lumbopelvic alignment with a special emphasis on patients with high and low degrees of lumbar lordosis (lu) and sacral angle (sa). This study is a secondary analysis of a randomized controlled trial evaluating the effects of HLL and LMC. Patients from the primary study, that is, patients categorized with nociceptive mechanical LBP, who agreed to participate in the radiographic examination were included (n=66). Lateral plain radiographic images were used to evaluate lumbopelvic alignment regarding the lumbar lordosis and the sacral angle as outcomes, with posterior bend as an explanatory variable. The participants were recruited to the study from two occupational health-care facilities. They were randomized to either the HLL or the LMC intervention group and offered 12 supervised exercise sessions. Outcome measures were collected at baseline and following the end of intervention period 2 months after baseline. Between- and within-group analyses of intervention groups and subgroups based on the distribution of the baseline values for the lumbar lordosis and the sacral angle, respectively (LOW, MID, and HIGH), were performed using both parametric and non-parametric statistics. The ranges of values for the present sample were 26.9-91.6° (M=59.0°, standard deviation [SD]=11.5°) for the lumbar lordosis and 18.2-72.1° (M=42.0°, SD=9.6°) for the sacral angle. There were no significant differences between the intervention

  9. Effect of diets differing in glycemic index and glycemic load on cardiovascular risk factors: review of randomized controlled-feeding trials.

    Science.gov (United States)

    Kristo, Aleksandra S; Matthan, Nirupa R; Lichtenstein, Alice H

    2013-03-28

    Despite a considerable amount of data available on the relationship between dietary glycemic index (GI) or load (GL) and cardiovascular disease (CVD) risk factors, in aggregate, the area remains unsettled. The aim of the present review was to summarize the effect of diets differing in GI/GL on CVD risk factors, by examining randomized controlled-feeding trials that provided all food and beverages to adult participants. The studies included a low and high GI/GL diet phase for a minimum of four weeks duration, and reported at least one outcome related to CVD risk; glucose homeostasis, lipid profile or inflammatory status. Ten publications representing five trials were identified. The low GI/GL compared to the high GI/GL diet unexpectedly resulted in significantly higher fasting glucose concentrations in two of the trials, and a lower area under the curve for glucose and insulin in one of the two studies during an oral glucose tolerance test. Response of plasma total, low density lipoprotein and high density lipoprotein cholesterol concentrations was conflicting in two of the studies for which data were available. There was either weak or no effect on inflammatory markers. The results of the five randomized controlled trials satisfying the inclusion criteria suggest inconsistent effects of the GI/GL value of the diet on CVD risk factors.

  10. Effect of Diets Differing in Glycemic Index and Glycemic Load on Cardiovascular Risk Factors: Review of Randomized Controlled-Feeding Trials

    Directory of Open Access Journals (Sweden)

    Alice H. Lichtenstein

    2013-03-01

    Full Text Available Despite a considerable amount of data available on the relationship between dietary glycemic index (GI or load (GL and cardiovascular disease (CVD risk factors, in aggregate, the area remains unsettled. The aim of the present review was to summarize the effect of diets differing in GI/GL on CVD risk factors, by examining randomized controlled-feeding trials that provided all food and beverages to adult participants. The studies included a low and high GI/GL diet phase for a minimum of four weeks duration, and reported at least one outcome related to CVD risk; glucose homeostasis, lipid profile or inflammatory status. Ten publications representing five trials were identified. The low GI/GL compared to the high GI/GL diet unexpectedly resulted in significantly higher fasting glucose concentrations in two of the trials, and a lower area under the curve for glucose and insulin in one of the two studies during an oral glucose tolerance test. Response of plasma total, low density lipoprotein and high density lipoprotein cholesterol concentrations was conflicting in two of the studies for which data were available. There was either weak or no effect on inflammatory markers. The results of the five randomized controlled trials satisfying the inclusion criteria suggest inconsistent effects of the GI/GL value of the diet on CVD risk factors.

  11. Long-term use of minimal footwear on pain, self-reported function, analgesic intake, and joint loading in elderly women with knee osteoarthritis: A randomized controlled trial.

    Science.gov (United States)

    Trombini-Souza, Francis; Matias, Alessandra B; Yokota, Mariane; Butugan, Marco K; Goldenstein-Schainberg, Claudia; Fuller, Ricardo; Sacco, Isabel C N

    2015-12-01

    Efforts have been made to retard the progressive debilitating pain and joint dysfunction in patients with knee osteoarthritis. We aimed to evaluate the therapeutic effect of a low-cost minimalist footwear on pain, function, clinical and gait-biomechanical aspects of elderly women with knee osteoarthritis. Throughout a randomized, parallel and controlled clinical trial, fifty-six patients with medial knee osteoarthritis were randomly allocated to an intervention (n=28) or control group (n=28), and assessed at baseline and after three and six months. The intervention involved wearing Moleca(®) footwear for at least 6h/day, 7 days/week, over 6 months. The pain subscale of the Western Ontario and McMaster Universities Osteoarthritis Index was the primary outcome. The secondary outcomes were the other subscales, Lequesne score, distance walked in 6 min, knee oedema and effusion, knee adduction moment and paracetamol intake. Intention-to-treat analysis was performed using two-way casewise ANOVA (knee adduction moment impulse (p=.017) during gait wearing Moleca(®). The analgesic intake was lower in the intervention group. The long-term use of Moleca(®) footwear relieves pain, improves self-reported function, reduces the knee loading while wearing Moleca(®), refrains the increase of analgesic intake in elderly women with knee osteoarthritis and can be considered as a conservative mechanical treatment option. ClinicalTrials.gov (NCT01342458). Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. The link between obesity and vitamin D in bariatric patients with omega-loop gastric bypass surgery - a vitamin D supplementation trial to compare the efficacy of postoperative cholecalciferol loading (LOAD): study protocol for a randomized controlled trial.

    Science.gov (United States)

    Luger, Maria; Kruschitz, Renate; Marculescu, Rodrig; Haslacher, Helmuth; Hoppichler, Friedrich; Kallay, Enikö; Kienbacher, Christian; Klammer, Carmen; Kral, Melanie; Langer, Felix; Luger, Eva; Prager, Gerhard; Trauner, Michael; Traussnigg, Stefan; Würger, Tanja; Schindler, Karin; Ludvik, Bernhard

    2015-08-05

    Beyond its classical role in calcium homoeostasis and bone metabolism, vitamin D deficiency has been found to be associated with several diseases, including diabetes, non-alcoholic fatty liver disease, and even obesity itself. Importantly, there are limited data on therapeutic strategies for vitamin D deficiency in bariatric patients, and the procedure-specific guidelines may not be sufficient. To improve long-term outcomes, nutritional screening and appropriate supplementation to prevent nutrient deficiencies are urgently needed. Therefore, the aim of this study is to examine effects and safety of a forced dosing regimen of vitamin D versus conventional dose supplementation on vitamin D levels and other parameters in bariatric patients. The study includes loading plus repeat dosing compared with repeated administration of vitamin D without a loading dose, according to guidelines, in a prospective, double-blind, randomized controlled trial. Up to a triple oral loading dose is given on day 1, then 2 and 4 weeks after surgery (100,000 IU dose each time), followed by an oral maintenance dose (3420 IU/day). The control group (n = 25) will receive placebo, followed by administration of a standard dose (3420 IU/day). We hypothesize that a significant increase in vitamin D levels will occur in patients in the treatment group (n = 25) by 24 weeks after surgery. Further measurements are aimed at evaluating changes in inflammation, bone turnover, insulin resistance, blood pressure, liver, mental health, and gut microbiota of patients undergoing omega-loop gastric bypass surgery. Furthermore, possible associations between concentrations of vitamin D, the involved enzymes, or vitamin D receptor in adipose and/or liver tissues will be determined. To our knowledge, this trial is the first of its kind with this type of vitamin D supplementation in bariatric patients. Its major strength is the design and implementation of evaluation of influencing factors such as liver

  13. Experimental Evaluation of Novel Master-Slave Configurations for Position Control under Random Network Delay and Variable Load for Teleoperation

    Directory of Open Access Journals (Sweden)

    Ahmet Kuzu

    2014-01-01

    Full Text Available This paper proposes two novel master-slave configurations that provide improvements in both control and communication aspects of teleoperation systems to achieve an overall improved performance in position control. The proposed novel master-slave configurations integrate modular control and communication approaches, consisting of a delay regulator to address problems related to variable network delay common to such systems, and a model tracking control that runs on the slave side for the compensation of uncertainties and model mismatch on the slave side. One of the configurations uses a sliding mode observer and the other one uses a modified Smith predictor scheme on the master side to ensure position transparency between the master and slave, while reference tracking of the slave is ensured by a proportional-differentiator type controller in both configurations. Experiments conducted for the networked position control of a single-link arm under system uncertainties and randomly varying network delays demonstrate significant performance improvements with both configurations over the past literature.

  14. Influence of heat and moisture exchanger respiratory load on transcutaneous oxygenation in laryngectomized individuals: a randomized crossover study.

    Science.gov (United States)

    Zuur, J Karel; Muller, Sara H; Sinaasappel, Michiel; Hart, Guus A M; van Zandwijk, Nico; Hilgers, Frans J M

    2007-12-01

    High-resistance heat and moisture exchangers (HMEs) have been reported to increase transcutaneous oxygenation (tcpO(2)) values in laryngectomized individuals and to negatively influence patient compliance. The goal of the present study was to validate earlier published results on short-term transcutaneous oxygenation changes by high-resistance HMEs. We conducted a randomized crossover study, monitoring the influence of an HME on tcpO(2) over a 2-hour time interval in 20 subjects. No evidence of an immediate HME effect (95% CI: -14.9-13.3 mm Hg, p = .91), or a time-dependent HME effect (95% CI: -.121 - .172 mm Hg/minute, p = .74), on tcpO(2) was found. After fitting the statistical model without time dependency, again no evidence of HME presence was seen (95% CI: -.5 mm Hg - 3.6 mm Hg, p = .15). In contrast to earlier suggestions, there is no evidence of increased tcpO(2) levels by high-resistance HMEs in laryngectomized individuals. Thus, using such HMEs has no added clinical value in this respect.

  15. Switching HIV treatment in adults based on CD4 count versus viral load monitoring: a randomized, non-inferiority trial in Thailand.

    Directory of Open Access Journals (Sweden)

    Gonzague Jourdain

    2013-08-01

    Full Text Available Viral load (VL is recommended for monitoring the response to highly active antiretroviral therapy (HAART but is not routinely available in most low- and middle-income countries. The purpose of the study was to determine whether a CD4-based monitoring and switching strategy would provide a similar clinical outcome compared to the standard VL-based strategy in Thailand.The Programs for HIV Prevention and Treatment (PHPT-3 non-inferiority randomized clinical trial compared a treatment switching strategy based on CD4-only (CD4 monitoring versus viral-load (VL. Consenting participants were antiretroviral-naïve HIV-infected adults (CD4 count 50-250/mm(3 initiating non-nucleotide reverse transcriptase inhibitor (NNRTI-based therapy. Randomization, stratified by site (21 public hospitals, was performed centrally after enrollment. Clinicians were unaware of the VL values of patients randomized to the CD4 arm. Participants switched to second-line combination with confirmed CD4 decline >30% from peak (within 200 cells from baseline in the CD4 arm, or confirmed VL >400 copies/ml in the VL arm. Primary endpoint was clinical failure at 3 years, defined as death, new AIDS-defining event, or CD4 400 copies/ml at switch was 7.2 months (5.8-8.0 in VL versus 15.8 months (8.5-20.4 in CD4 (p=0.002. FDO scores were not significantly different at time of switch. No adverse events related to the monitoring strategy were reported.The 3-year rates of clinical failure and loss of treatment options did not differ between strategies although the longer-term consequences of CD4 monitoring would need to be investigated. These results provide reassurance to treatment programs currently based on CD4 monitoring as VL measurement becomes more affordable and feasible in resource-limited settings.ClinicalTrials.govNCT00162682 Please see later in the article for the Editors' Summary.

  16. Feasibility study of a biocompatible pneumatic dispensing system using mouse 3T3-J2 fibroblasts

    Science.gov (United States)

    Lee, Sangmin; Kim, Hojin; Kim, Joonwon

    2017-12-01

    This paper presents results for dispensing living cells using a pneumatic dispensing system to verify the feasibility of using this system to fabricate biomaterials. Living cells (i.e., mouse 3T3-J2 fibroblast) were dispensed with different dispensing pressures in order to evaluate the effect of dispensing process on cell viability and proliferation. Based on the results of a live-dead assay, more than 80% of cell viability has been confirmed which was reasonably similar to that in the control group. Furthermore, measurement of cell metabolic activity after dispensing confirmed that the dispensed cell proliferated at a rate comparable to that of the control group. These results demonstrate that the pneumatic dispensing system is a promising tool for fabrication of biomaterials.

  17. Refusals by pharmacists to dispense emergency contraception: a critique.

    Science.gov (United States)

    Wall, L Lewis; Brown, Douglas

    2006-05-01

    Over the past several months, numerous instances have been reported in the United States media of pharmacists refusing to fill prescriptions written for emergency postcoital contraceptives. These pharmacists have asserted a "professional right of conscience" not to participate in what they interpret as an immoral act. In this commentary, we examine this assertion and conclude that it is not justifiable, for the following reasons: 1) postcoital contraception does not interfere with an implanted pregnancy and, therefore, does not cause an abortion; 2) because pharmacists do not control the therapeutic decision to prescribe medication but only exercise supervisory control over its dispensation, they do not possess the "professional right" to refuse to fill a legitimate prescription; 3) even if one were to grant pharmacists the "professional right" not to dispense prescriptions based on their own personal values and opinions, pharmacists "at the counter" lack the fundamental prerequisites necessary for making clinically sound ethical decisions, that is, they do not have access to the patient's complete medical background or the patient's own ethical preferences, have not discussed relevant quality-of-life issues with the patient, and do not understand the context in which the patient's clinical problem is occurring. We conclude that a policy that allows pharmacists to dispense or not dispense medications to patients on the basis of their personal values and opinions is inimical to the public welfare and should not be permitted.

  18. ZNF 197L is dispensable in mouse development | Tang | African ...

    African Journals Online (AJOL)

    ZNF 197L is dispensable in mouse development. R Tang, G Xu, A Kimi, J Shen, Z Li, K Yamamura, H Tang. Abstract. The gene trap technique is a newly powerful approach for characterizing and mutating genes in mouse. We used gene trap method to identify mice gene of unknown function and to establish their mouse line ...

  19. Dispensing of drugs with and without a prescription from private ...

    African Journals Online (AJOL)

    There is little literature available on dispensing patterns and unsupervised sale of medicines from pharmacies in Tanzania. The present study assessed the patterns of drug acquisition from pharmacies by customers: whether by prescription, recommended by pharmacist, or requested by a customer without a prescription.

  20. 21 CFR 866.2500 - Microtiter diluting and dispensing device.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Microtiter diluting and dispensing device. 866.2500 Section 866.2500 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES IMMUNOLOGY AND MICROBIOLOGY DEVICES Microbiology Devices § 866.2500...

  1. Aspects of microbial contamination of tablets dispensed in hospitals ...

    African Journals Online (AJOL)

    Purpose: A research was carried out to investigate the incidence of microflora in tablets dispensed from large container packages used in hospitals and community pharmacies. It was designed to provide base-line data on the common biodegrading microorganisms associated with tablets in retail containers and to highlight ...

  2. 40 CFR 86.146-96 - Fuel dispensing spitback procedure.

    Science.gov (United States)

    2010-07-01

    ... Complete Heavy-Duty Vehicles; Test Procedures § 86.146-96 Fuel dispensing spitback procedure. (a) The vehicle is fueled at a rate of 10 gal/min to test for fuel spitback emissions. All liquid fuel spitback... collecting spitback emissions to the nearest 0.01 gram. (d) Drain the fuel tank(s) and fill with test fuel...

  3. Exploring Some Issues In Commercial Drug Dispensing In A ...

    African Journals Online (AJOL)

    Responses to a self-report questionnaire of 85 Commercial drug dispensers in Uyo township of South-Eastern Nigeria were used to analyze some issues in drug abuse control in Nigeria. Among other things, the findings revealed that; (1) self medication is reported to be widespread among clients;(2) over and under dose of ...

  4. Antiprotozoal dispensing patterns in South Africa, with the focus on ...

    African Journals Online (AJOL)

    The primary aim was to determine the dispensing patterns of antimalarial medicine in a community pharmacy patient population in South Africa. A retrospective, cross-sectional drug utilisation study was conducted on a 2013 pharmacy database. Medicines reimbursed by private medical aid schemes and private purchases ...

  5. Dispensing apparatus for use in a cued food delivery task

    Science.gov (United States)

    Deweese, Menton M.; Claiborne, Kimberly N.; Ng, Jennifer; Dirba, Danika D.; Stewart, Hannah L.; Schembre, Susan M.; Versace, Francesco

    2015-01-01

    Neurobiological models of obesity postulate that obese individuals have difficulty regulating food intake partly because they attribute excessive salience to stimuli signaling food availability. Typically, human studies that investigate the relationship between brain responses to food-related stimuli and obesity present food cues without subsequent delivery of food. However, in order to identify the brain correlates of cue reactivity, we must record brain responses to food-related cues signaling food availability. Therefore, we have developed a dispensing apparatus for use in a cued-food delivery task in which event-related potentials (ERPs) to food-related images predicting food delivery and images not predicting food delivery can be recorded. Here, we describe a method where:•The experimental apparatus dispenses an edible item (i.e., a chocolate candy) which may or may not be eaten, or a non-edible control item (e.g., a plastic bead).•Deposit boxes are available to store uneaten candies and the non-edible control items.•The dispensing mechanism is capable of recording the exact timestamp when each delivery event occurs (e.g., release from the dispenser, arrival in the receptacle, storage in the deposit box). PMID:26870667

  6. Do pregnant women report use of dispensed medications?

    NARCIS (Netherlands)

    Olesen, C; Sondergaard, C; Thrane, N; Nielsen, GL; de Jong-van den Berg, L; Olsen, J

    Surveillance of drug safety in pregnancy often draws on administrative prescription registries. Noncompliance in the use of prescribed medication may be frequent among pregnant women owing to their fear of fetotoxic side effects. To estimate compliance in the use of prescription drugs dispensed

  7. Dispensing of vitamin products by retail pharmacies in South Africa ...

    African Journals Online (AJOL)

    Objective: The objective of this study was to analyse the dispensing patterns of vitamins (Anatomical Therapeutic Chemical (ATC) group A11) over a one-year period in a group of community pharmacies in South Africa. Design and setting: A retrospective drug utilisation study was conducted on community pharmacy ...

  8. 40 CFR 165.82 - Scope of pesticide dispensing areas included.

    Science.gov (United States)

    2010-07-01

    ... liquid pesticide or equal to or greater than 4,000 pounds (1,818 kilograms) of dry pesticide for any purpose, including refilling or emptying for cleaning. This applies when pesticide is dispensed from the...) The pesticide dispensing area is used solely for dispensing pesticide from a rail car which does not...

  9. Crestal Bone Loss under Delayed Loading of Full Thickness Versus Flapless Surgically Placed Dental Implants in Controlled Type 2 Diabetic Patients: A Parallel Group Randomized Clinical Trial.

    Science.gov (United States)

    Yadav, Rohit; Agrawal, Kaushal Kishor; Rao, Jitendra; Anwar, Mohd; Alvi, Habib Ahmed; Singh, Kalpana; Himanshu, D

    2016-10-12

    To compare crestal bone loss around dental implants using a delayed loading protocol. Bone loss was compared in patients following conventional full thickness flap and flapless surgery in controlled type 2 diabetic patients. Eighty-eight type 2 diabetic patients satisfying predetermined inclusion and exclusion criteria were selected for this single center, parallel group study after obtaining institutional review board approval and informed consent. These patients were randomly divided into two groups. Group I consisted of patients undergoing full thickness flap surgery for implant placement, and group II consisted of patients undergoing flapless surgery for implant placement. The mean age, duration of diabetes, glycosylated hemoglobin levels, and male-to-female ratio in both groups were matched and compared statistically. Dental implants were placed followed by delayed loading (4 months) in both groups. Crestal bone loss was assessed with intraoral periapical radiographs with the help of computer software (DBSWIN viewer). Actual implant length acted as the radiographic index, and implant-abutment junctions were used as a reference point for all measurements. Mesial and distal bone levels at baseline, 6, and 12 months post implant placement of the two groups were determined. Mesial and distal crestal bone loss from baseline to 6 and 12 months were calculated and compared with Tukey test using SPSS v15.0 statistical analysis software. Tukey test revealed similar (not statistically different) mean mesial crestal bone loss between the two groups after 6 months (0.47 ± 0.08 mm vs. 0.36 ± 0.13 mm, p = 0.576) and after 12 months (1.56 ± 0.25 mm vs. 1.50 ± 0.22 mm, p = 0.891). The mean distal bone loss resulting between the two groups was not statistically different at 6 months (0.44 ± 0.08 mm vs. 0.35 ± 0.12 mm, p = 0.687) and at 12 months (1.57 ± 0.23 mm vs. 1.61 ± 0.22 mm, p = 0.947). The results of this clinical randomized control trial indicated that in

  10. Immediate function on the day of surgery compared with a delayed implant loading process in the mandible: a randomized clinical trial over 5 years

    Science.gov (United States)

    Jokstad, Asbjorn; Alkumru, Hassan

    2014-01-01

    Objectives To appraise the feasibility of loading four implants with a pre-existing denture converted to a fixed dental prosthesis (FDP) on the day of implant surgery compared with waiting for 3- to 4-month healing. Methods Patients with an edentulous, fully healed mandible were recruited in a faculty clinic to partake in a blinded two-arm parallel randomized controlled trial (RCT). The participants received four parallel intraforamina mandibular implants with a moderately rough titanium surface (Brånemark System Mk III or Mk IV TiUnite; Nobel Biocare AB, Göteborg, Sweden). The implants were loaded on the same day by converting the participants' pre-existing denture in the experimental group. The implants were placed using a one-stage surgery procedure, and the participants' pre-existing denture were soft-relined in the control group. For both groups, the permanent 10- to 12-unit FDP consisting of a type-3 cast precious alloy veneered with acrylic and artificial teeth was placed 3–4 months after implant surgery. All participants have been recalled annually for 5 years for appraisal of bone loss and registration of adverse events. Results Thirty-five of the original 42 participants (83%) returned for clinical and radiological examinations at the 5-year follow-up recall. No selective dropout or specific reasons for dropout was identified in the two study arms; leaving n = 17 (Intention-to-treat group, ITT) in the experimental group, alternatively n = 13 as per protocol group (PP), and n = 18 participants in the control group (ITT = PP). At study commencement, five of the participants assigned to the experimental group did not receive their planned intervention. In the control group, one implant failed to osseointegrate and another failed due to bone loss after 5 years. The crestal bone level changes over 5 years were identical in the experimental and control groups, that is, 1.2 mm (SD = 0.7). There were no differences between the two study arms

  11. Extent of dispensing prescription-only medications without a prescription in community drug retail outlets in Addis Ababa, Ethiopia: a simulated-patient study

    Directory of Open Access Journals (Sweden)

    Erku DA

    2016-07-01

    Full Text Available Daniel Asfaw Erku,1 Abebe Basazn Mekuria,2 Abdrrahman Shemsu Surur,1 Begashaw Melaku Gebresillassie3 1Department of Pharmaceutical Chemistry, 2Department of Pharmacology, 3Department of Clinical Pharmacy, School of Pharmacy, University of Gondar, Gondar, Ethiopia Purpose: This study was aimed at assessing the extent of dispensing prescription-only medications without a prescription in community drug retail outlets (CDROs of Addis Ababa, Ethiopia.Methods: A descriptive cross-sectional observational study design was used to sample 31 pharmacies, 25 drug stores, and two rural drug vendors from August 11, 2015, to October 21, 2015, through a simple random sampling method. A simulated-patient method of visit was implemented to collect data. Requests of six tracer prescription-only medicines (amoxicillin + clavulanic acid capsule, amitriptyline, captopril, glibenclamide [also known as glyburide], omeprazole capsule, and sildenafil citrate and upper respiratory tract infection were selected as the simulated clinical scenario.Results: Amoxicillin–clavulanic acid capsule was dispensed when requested in 87.93% of the dispensaries. All of the CDROs dispensed omeprazole upon request. Sildenafil citrate (Viagra was in stock in 96.55% of the CDROs, all of which issued the requested number of tablets without asking why or for whom the drug was needed. Amitriptyline, captopril, and glibenclamide (glyburide were dispensed in 84.48%, 89.65%, and 87.93% of CDROs upon the provision of an empty container. Antibiotics were obtained from 75.86% of CDROs for presentation of upper respiratory tract infection symptoms. Among the dispensed antibiotics, the most common was amoxicillin (93.18%, followed by amoxicillin–clavulanic acid capsule (72.72%, and azithromycin (50%. Only 4.5% of the dispensaries asked about drug allergies, and 15.9% of the CDROs informed the simulated patient about the possible side effects of the drugs.Conclusion: This study revealed a very high

  12. Preoperative carbohydrate load and intraoperatively infused omega-3 polyunsaturated fatty acids positively impact nosocomial morbidity after coronary artery bypass grafting: a double-blind controlled randomized trial.

    Science.gov (United States)

    Feguri, Gibran Roder; de Lima, Paulo Ruiz Lúcio; de Cerqueira Borges, Danilo; Toledo, Laura Ramos; Batista, Larissa Nadaf; E Silva, Thaís Carvalho; Segri, Neuber José; de Aguilar-Nascimento, José Eduardo

    2017-04-20

    A strategy of limited preoperative fasting, with carbohydrate (CHO) loading and intraoperative infusion of omega-3 polyunsaturated fatty acids (ω-3 PUFA), has seldom been tried in cardiovascular surgery. Brief fasting, followed by CHO intake 2 h before anesthesia, may improve recovery from CABG procedures and lower perioperative vasoactive drug requirements. Infusion of ω-3 PUFA may reduce occurrences of postoperative atrial fibrillation (POAF) and shorten hospital stays. The aim of this study was to assess morbidity (especially POAF) in ICU patients after coronary artery bypass grafting (CABG)/cardiopulmonary bypass (CPB) in combination, if preoperative fasts are curtailed in favor of CHO loading, and ω-3 PUFA are infused intraoperatively. Fifty-seven patients undergoing CABG were randomly assigned to receive 12.5% maltodextrin (200 ml, 2 h before anesthesia), without infusing ω-3 PUFA (CHO, n = 14); water (200 ml, 2 h before anesthesia), without infusing ω-3 PUFA (controls, n = 14); 12.5% maltodextrin (200 ml, 2 h before anesthesia) plus intraoperative ω-3 PUFA (0.2 mcg/kg) (CHO + W3, n = 15); or water (200 ml, 2 h before anesthesia) plus intraoperative ω-3 PUFA (0.2 mcg/kg) (W3, n = 14). Perioperative clinical variables and mortality were analyzed, examining the incidence of POAF, as well as the need for inotropic vasoactive drugs during surgery and in ICU. Two deaths occurred (3.5%), but there were no instances of bronchoaspiration and mediastinitis. Neither ICU stays nor total postoperative stays differed by group (P > 0.05). Patients given preoperative CHO loads (CHO and CHO + W3 groups) experienced fewer instances of hospital infection (RR = 0.29, 95%CI 0.09-0.94; P = 0.023) and were less reliant on vasoactive amines during surgery (RR = 0.60, 95% CI 0.38-0.94; P = 0.020). Similarly, the number of patients requiring vasoactive drugs while recovering in ICU differed significantly by group (P = 0

  13. Impact of loaded sit-to-stand exercises at different speeds on the physiological cost of walking in children with spastic diplegia: A single-blind randomized clinical trial.

    Science.gov (United States)

    Kusumoto, Yasuaki; Nitta, Osamu; Takaki, Kenji

    2016-10-01

    In the present study, we aimed to determine whether similarly loaded sit-to-stand exercises at different speeds improve the physiological cost of walking in children with spastic diplegia. This design was a single-blind randomized clinical trial. Sixteen children with cerebral palsy (CP), aged 12-18 years, with a diagnosis of spastic diplegia, were randomly allocated to a slow loaded sit-to-stand exercise group (n=8) and a self-paced loaded sit-to-stand exercise group (n=8). Loaded sit-to-stand exercise was conducted at home for 15min, 4 sets per day, 3-4days per week, for 6 weeks. The patients were evaluated immediately before the intervention and after the training. Lower limb muscle strength using a hand-held dynamometer, selective voluntary motor control using SCALE, 6-min walk distance (6MWD), and Physiological Cost Index (PCI) were measured. The 6MWD showed a significant difference before and after intervention. PCI showed a significant difference between the two groups and the two time points. 6MWD and the PCI improved after intervention in the slow sit-to-stand exercise group. Compared to loaded sit-to-stand exercise at a regular speed, slow low-loaded sit-to-stand exercise improved the 6MWD and PCI in children with CP, suggesting that this decrease in speed during exercise improves the physiological cost of walking in these children. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. Pharmacy Professionals’ Dispensing Practice, Knowledge, and Attitude towards Emergency Contraceptives in Gondar Town, Northwestern Ethiopia: A Cross-Sectional Study

    Directory of Open Access Journals (Sweden)

    Sewunet Admasu Belachew

    2017-01-01

    Full Text Available Background. Pharmacy professionals, as the most available members of medical team, have an important role in educating patients about the effective and appropriate use of contraceptives. The purpose of this study was to assess pharmacy professionals’ dispensing practice, knowledge, and attitude towards emergency contraceptives use in Gondar town, northwestern Ethiopia. Methods. An institution based cross-sectional study was employed from May 14 to June 14, 2016, on 60 pharmacy professionals, who have been working in 8 randomly selected pharmacies and 6 drug stores. The collected data was entered to and analyzed using Statistical Packages for Social Sciences (SPSS version 20. Result. More than half 33 (55.0% of the participants were druggist with 5–9 years of experience. About 56 (93.3% of the participants knew about the dosing schedule (when and how much to take and side effects of emergency contraceptives. More than two-thirds of the participants (39, 65% agreed that the existence of emergency contraceptives is a positive thing and considered their use is ethical (42, 63.3%. The majority of participants (51, 85% also reported that they counsel all women when dispensing emergency contraceptive pills (ECPs. Conclusion. This study revealed that knowledge, attitude, and dispensing practice of emergency contraceptives are very good even though there were variations with respect to different factors. Findings suggested that additional training and proper counseling technique on emergency contraceptives will improve the service delivery.

  15. Black Tea Increases Circulating Endothelial Progenitor Cells and Improves Flow Mediated Dilatation Counteracting Deleterious Effects from a Fat Load in Hypertensive Patients: A Randomized Controlled Study.

    Science.gov (United States)

    Grassi, Davide; Draijer, Richard; Schalkwijk, Casper; Desideri, Giovambattista; D'Angeli, Anatolia; Francavilla, Sandro; Mulder, Theo; Ferri, Claudio

    2016-11-16

    (1) Background: Endothelial dysfunction predicts cardiovascular events. Circulating angiogenic cells (CACs) maintain and repair the endothelium regulating its function. Tea flavonoids reduce cardiovascular risk. We investigated the effects of black tea on the number of CACs and on flow-mediated dilation (FMD) before and after an oral fat in hypertensives; (2) Methods: In a randomized, double-blind, controlled, cross-over study, 19 patients were assigned to black tea (150 mg polyphenols) or a placebo twice a day for eight days. Measurements were obtained in a fasted state and after consuming whipping cream, and FMD was measured at baseline and after consumption of the products; (3) Results: Compared with the placebo, black tea ingestion increased functionally active CACs (36 ± 22 vs. 56 ± 21 cells per high-power field; p = 0.006) and FMD (5.0% ± 0.3% vs. 6.6% ± 0.3%, p Tea further increased FMD 1, 2, 3, and 4 h after consumption, with maximal response 2 h after intake (p tea consumption counteracted FMD impairment (p tea by increasing the number of CACs and preventing endothelial dysfunction induced by acute oral fat load in hypertensive patients. Considering that tea is the most consumed beverage after water, our findings are of clinical relevance and interest.

  16. Pharmacy Malpractice: The rate and prevalence of dispensing high-risk prescription-only medications at community pharmacies in Saudi Arabia.

    Science.gov (United States)

    Alshammari, Thamir M; Alhindi, Salman A; Alrashdi, Ahmed M; Benmerzouga, Imaan; Aljofan, Mohamad

    2017-07-01

    To assess the compliance of community pharmacies with the regulations that prohibit the dispensing of prescription-only medications in the absence of a physician prescription in Saudi Arabia. A cross-sectional study was conducted in the period between October 2014 and January 2015. A list of 10 prescription-only medications were selected to be studied. 150 community pharmacies were visited across 6 major regions in Saudi Arabia to assess the prevalence of non-compliance among community pharmacies. Pharmacies were selected in random and researchers (disguised as patients) requested to purchase prescription-only medications in the absence of a prescription. Not all medications were purchased at once. Data were recorded per pharmacy, where pharmacies that approved dispense of the selected drug were scored as non-compliant and the pharmacies that rejected dispense of the selected drug were scored as compliant. Compliance rate was calculated per region per drug. Pharmacies based in governmental hospitals were visited in parallel. A total of 20 were visited. Data and statistical analysis were performed using Statistical Analyses Software (SAS 9.3). A total of 150 pharmacies were visited over a period of 3 months. On average, the percent approved dispense of prescription-only drugs across 6 regions in Saudi Arabia is 63% and the percent rejected dispense is 37% representing a significant non-compliance rate regarding the selected list of medications in this study. The frequency of dispense per medication across 6 major regions in Saudi Arabia is as follows: Isosorbide dinitrate (86%), Enoxaparin (82%), nitroglycerin (74%), Propranolol (73%), Verapamil (70%), Warfarin (65%), Methyldopa (64%), Ciprofloxacin (57%) and Codeine (4%). Non-compliance of community pharmacies with the law of pharmaceutical practice is at an alarming rate in the Kingdom of Saudi Arabia and authoritative figures must intervene to impede and combat such activities .

  17. Dispensing practice in the community pharmacies in the Turkish Republic of Northern Cyprus.

    Science.gov (United States)

    Gokcekus, Laika; Toklu, Hale Zerrin; Demirdamar, Rumeysa; Gumusel, Bulent

    2012-04-01

    Good pharmacy practice is the process of supplying the accurate drug to the right patient for an adequate period of time with the lowest cost to the patient and the community. Pharmacist have a crucial role in promoting good pharmacy practice. To assess the dispensing practice of the community pharmacists in the Turkish Republic of Northern Cyprus (TRNC) regarding RDU and to evaluate the quality of dispensing. Setting Community pharmacies in TRNC. Method The study consists of two parts: a face to face interview and a simulated patient visit to these pharmacies. Rationality indicators (average dispensing time, stock availability and adequate labelling), presence of the pharmacist on the premises, dispenser characteristics, prescription checking, and the provided patient information. The majority of the prescriptions (73.3%) were dispensed by the pharmacists. None of the pharmacy employees had pharmacy based training. Eighty nine percent of the pharmacists believed that their employees could very well dispense drugs on their own. The declared average dispensing time for a prescription of a single drug was 233 s while the measured one was 149 s. Few dispensers in reality warned the patient about potential interactions. The difference between the average dispensing scores of the pharmacists and the non-pharmacist dispensers was not significant. The dispensing practice in the community pharmacies in the Turkish part of Cyprus seems inadequate in terms of GPP.

  18. Effect of varying dispenser point source density on mating disruption of Grapholita molesta (Lepidoptera: Tortricidae).

    Science.gov (United States)

    De Lame, Frédérique M; Epstein, David; Gut, Larry J; Goldfarb, Heidi; Miller, James R

    2010-08-01

    Hand-applied dispensers are successfully used in mating disruption programs, but cost of labor to apply these dispensers limits their adoption. Creating hand-applied dispensers that release larger amounts of pheromone and that can be applied at lower densities per hectare could reduce the cost of mating disruption and increase its use. The effect of reducing the number of point sources per hectare while keeping the amount of pheromone applied per hectare constant on the success of Grapholita molesta (Busck) (Lepidoptera: Tortricidae) mating disruption was investigated with Confuse-OFM, paraffin disk, and Isomate-M Rosso dispensers. For all dispensers, as point source density decreased, numbers of moths captured increased, percentage of orientation disruption to traps decreased, and variability in these measures increased. Decreasing point source density, even while keeping the amount of pheromone applied per hectare constant is not a viable option for reducing the cost of G. molesta mating disruption with hand-applied dispensers. Puffers (aerosol dispensers) are applied at 2.5-5 dispensers per ha for G. molesta control. However, hand-applied dispensers fail when clumped at such low numbers of release sites. Potential explanations for the success of Puffers and the failure of hand-applied dispensers at very low point source densities are presented. The utility of paraffin disk dispensers as experimental devices also is discussed.

  19. Piezoelectric dispenser based on a piezoelectric-metal-cavity actuator.

    Science.gov (United States)

    Lam, K H; Sun, C L; Kwok, K W; Chan, H L W

    2009-07-01

    A piezoelectric dispenser has been fabricated based on the idea of a piezoelectric-metal-cavity (PMC) actuator. The PMC actuator consists of a metal ring sandwiched between two identical piezoelectric unimorphs. The radial contraction of the piezoelectric ceramic is converted into a flextensional motion of the unimorph, causing a large flexural displacement in the center part of the actuator. With the PMC actuator as a fluid chamber, the large flexural actuation can be used to produce the displacement needed to eject fluid. By applying an appropriate voltage to the piezoelectric unimorphs, a drop-on-demand ejection of ink or water can be achieved. The efficiency of fluid ejection can be enhanced after installing a valve in the fluid chamber. With the simple PMC structure, the dispenser can be operated with a low driving voltage of 12-15 V.

  20. Fabrication and Measurement of Low Work Function Cesiated Dispenser Photocathodes

    CERN Document Server

    Moody, Nathan A; Jensen, Kevin

    2005-01-01

    Photoinjector performance is a limiting factor in the continued development of high powered FELs and electron beam-based accelerators. Presently available photocathodes are plagued with limited efficiency and short lifetime in an RF-gun environment, due to contamination or evaporation of a photosensitive surface layer. An ideal photocathode should have high efficiency at long wavelengths, long lifetime in practical vacuum environments, and prompt emission. Cathodes with high efficiency typically have limited lifetime, and vice versa, and the needs of the photocathode are generally at odds with those of the drive laser. A potential solution is the low work function dispenser cathode, where lifetime issues are overcome by periodic in situ regeneration that restores the photosensitive surface layer, analogous to those used in the microwave power tube industry. This work reports on the fabrication techniques and performance of cesiated metal photocathodes and cesiated dispenser cathodes, with a focus on understan...

  1. Effect of pheromone dispenser density on timing and duration of approaches by peachtree borer.

    Science.gov (United States)

    Teixeira, Luís A F; Grieshop, Matthew J; Gut, Larry J

    2010-10-01

    The timing and duration of approaches by male peachtree borer Synanthedon exitiosa Say (Lepidoptera: Sesiidae) to commercial pheromone dispensers placed singly or at high density in peach orchards was determined by using field-deployed video cameras and digital video recorders. Cameras were trained on one dispenser, and one standard lure was placed in a peach orchard, and on 12 dispensers in a separate orchard where dispensers for mating disruption had been placed at 371 per hectare. Male moth approaches were video recorded at the peak of peachtree borer annual flight, from 13 to 18 August 2009. The mean approach timing (h:min:sec±SD) during the study period was 11:33:12 ± 00:46:43, 11:43:52 ± 00:45:58, and 11:41:21 ± 00:45:54 AM with the single dispenser, high-density dispensers, and lure, respectively. Day-to-day variability in approach timings suggested that there were no biologically significant differences among treatments. The frequency distribution of approach durations varied among treatments, as the high-density dispensers had mostly short approaches, while the distribution of approaches to the single dispenser and lure was wider. The median (interquartile range) approach duration was 3 (2-4), 1 (1-2), and 4 (2-6) seconds with the single dispenser, high-density dispensers, and lure, respectively. The relative rank of median approach durations was constant throughout the period, indicating differences among treatments. This study showed that the presence of pheromone dispensers for mating disruption did not cause an advancement of peachtree borer diel rhythm of response. Shorter approaches to dispensers placed at high density than singly suggest that dispenser retentiveness is not constant with peachtree borer, which may bias estimates of disruption activity as a function of dispenser density.

  2. A systematic review of the nature of dispensing errors in hospital pharmacies

    Directory of Open Access Journals (Sweden)

    Aldhwaihi K

    2016-01-01

    Full Text Available Khaled Aldhwaihi, Fabrizio Schifano, Cinzia Pezzolesi, Nkiruka Umaru Department of Pharmacy, University of Hertfordshire, Hatfield, UK Background: Dispensing errors are common in hospital pharmacies. Investigating dispensing errors is important for identifying the factors involved and developing strategies to reduce their occurrence. Objectives: To review published studies exploring the incidence and types of dispensing errors in hospital pharmacies and factors contributing to these errors. Methods: Electronic databases including PubMed, Scopus, Ovid, and Web of Science were searched for articles published between January 2000 and January 2015. Inclusion criteria were: studies published in English, and studies investigating type, incidence and factors contributing to dispensing errors in hospital pharmacies. One researcher searched for all relevant published articles, screened all titles and abstracts, and obtained complete articles. A second researcher assessed the titles, abstracts, and complete articles to verify the reliability of the selected articles. Key findings: Fifteen studies met the inclusion criteria all of which were conducted in just four countries. Reviewing incident reports and direct observation were the main methods used to investigate dispensing errors. Dispensing error rates varied between countries (0.015%–33.5% depending on the dispensing system, research method, and classification of dispensing error types. The most frequent dispensing errors reported were dispensing the wrong medicine, dispensing the wrong drug strength, and dispensing the wrong dosage form. The most common factors associated with dispensing errors were: high workload, low staffing, mix-up of look-alike/sound-alike drugs, lack of knowledge/experience, distractions/interruptions, and communication problems within the dispensary team. Conclusion: Studies relating to dispensing errors in hospital pharmacies are few in number and have been conducted in

  3. Justice dispensation through the alternative dispute resolution system in India

    OpenAIRE

    Krishna Agrawal

    2014-01-01

    The Law Commission of India in its 222nd report emphasized the need for Alternative Disputes Resolution (ADR) for the dispensation of justice, because the courts are inaccessible owing to various factors, e.g., poverty, social and political backwardness, illiteracy, ignorance, procedural formalities and inordinate delay in judgments. During the ancient period the disputes were resolved in an informal manner by neutral third persons or people’s court in villages and it continued till the middl...

  4. [Design and piloting of a structured service medication dispensing process].

    Science.gov (United States)

    Abaurre, Raquel; García-Delgado, Pilar; Maurandi, M Dolores; Arrebola, Cristóbal; Gastelurrutia, Miguel Ángel; Martínez-Martínez, Fernando

    2015-01-01

    The aim of this article is to design and pilot a protocol for the dispensing of medications service. Using the requirements proposed in the Ministry of Health Pharmaceutical Care Consensus, a literature search was made applying qualitative consensus techniques. An observational, cross-sectional study was conducted from March to June 2009. A total of 53 community pharmacies from 24 Spanish counties. Patients who requested one or more particular medications with or without medical prescription for their own use or for someone in their care. The personalised medication information (IPM), the problems associated with the medications (PRM), and the negative results associated with the medication (RNM), detected by the pharmacist each time medication was dispensed, as well as the perception of the pharmacist on the operability of the protocol were recorded. A total of 870 medications were dispensed, with 423 (48.6%) cases of lack of personalised medication information (IPM) being detected. PRM were detected in 10.11% of the dispensed medications, as well as 68 (7.81%) suspected RNM: safety (n = 35; 51.5%), effectiveness (n = 29; 42.6%) and necessity (n = 4; 5.8%). Almost two-thirds (65.21%) of the pharmacists said that the protocol is in operation. The designed protocol helped to detect deficiencies in the information to the patients about their medications, as well as the PRM and RNM, and is shown to be tool that is easy to use and apply. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

  5. [Dispensing antibiotics to outpatients in a Colombian population].

    Science.gov (United States)

    Machado-Alba, Jorge E; González-Santos, Diana M

    2009-10-01

    Analysing how systemic antibiotic agents were dispensed to outpatients in a Colombian population between January 2005 and December 2006 and assessing their economic cost as antibiotic use and abuse have been related to serious bacterial resistance. This was a descriptive observational study of antibiotic drug use; a database was compiled from medication usage records maintained by dispensing pharmacies in 10 Colombian cities regarding the total of users who had received some type of antibiotic. The defined daily dose (DDD) and cost per 1,000 inhabitants/day were assessed. The commonly used antibiotic associations were analysed. DDD was 1.58 per 1,000 inhabitants per day. The antibiotics most frequently prescribed were penicillin (amoxiciline; dicloxaciline), followed by first-generation cephalosporines and sulphonamides. Injectable antibiotic use was 10.4 % in 2005 and 9.3 % in 2006; an association of anti-bacterial agents was used for 11 % of the patients. Total antibiotic dispensation cost in 2005 was US$ 1,708,350 and cost per 1,000 inhabitants per day was US$ 1.13 in 2005 and US$ 1 in 2006. DDD per 1,000 inhabitants per day and cost per inhabitant per day was low compared to other countries.

  6. Direct-Dispense Polymeric Waveguides Platform for Optical Chemical Sensors

    Directory of Open Access Journals (Sweden)

    Mohamad Hajj-Hassan

    2008-12-01

    Full Text Available We describe an automated robotic technique called direct-dispense to fabricate a polymeric platform that supports optical sensor arrays. Direct-dispense, which is a type of the emerging direct-write microfabrication techniques, uses fugitive organic inks in combination with cross-linkable polymers to create microfluidic channels and other microstructures. Specifically, we describe an application of direct-dispensing to develop optical biochemical sensors by fabricating planar ridge waveguides that support sol-gelderived xerogel-based thin films. The xerogel-based sensor materials act as host media to house luminophore biochemical recognition elements. As a prototype implementation, we demonstrate gaseous oxygen (O2 responsive optical sensors that operate on the basis of monitoring luminescence intensity signals. The optical sensor employs a Light Emitting Diode (LED excitation source and a standard silicon photodiode as the detector. The sensor operates over the full scale (0%-100% of O2 concentrations with a response time of less than 1 second. This work has implications for the development of miniaturized multisensor platforms that can be cost-effectively and reliably mass-produced.

  7. Experimental characterization of droplet dispensing in electrowetting-based microfluidics

    Science.gov (United States)

    Ahmadi, Mohammad Khorsand; Shokoohi, Mehrdad; Passandideh-Fard, Mohammad

    2017-07-01

    In this study, the effect of various parameters on the dispensed droplet size in microchannels based on the electrowetting on dielectric technique is experimentally investigated. A printed circuit board (PCB)-based microfluidic chip is used as a platform for the experiments. A crescent configuration for the channel electrodes is fabricated, which leads to a higher electrowetting force which improves the motion of the droplet. In addition, two electrode designs are proposed, which provide a nearly constant overlapping length on the reservoir electrode. The focus of this paper is on the geometry of the reservoir and the channel electrode; therefore, the channel dimensions, surface conditions, and applied voltage are kept constant. The experiments are performed for various reservoir liquid volumes and different electrode shapes of the reservoir and the microchannel. The results show that decreasing the length of the small reservoir electrode reduces the size of the dispensed droplet. It is also observed that using a channel electrode curved in the opposite direction of the droplet motion leads to a smaller dispensed droplet.

  8. Quality of drug interaction alerts in prescribing and dispensing software.

    Science.gov (United States)

    Sweidan, Michelle; Reeve, James F; Brien, Jo-anne E; Jayasuriya, Pradeep; Martin, Jennifer H; Vernon, Graeme M

    2009-03-02

    To investigate the quality of drug interaction decision support in selected prescribing and dispensing software systems, and to compare this information with that found in a range of reference sources. A comparative study, conducted between June 2006 and February 2007, of the support provided for making decisions about 20 major and 20 minor drug interactions in six prescribing and three dispensing software systems used in primary care in Australia. Five electronic reference sources were evaluated for comparison. Sensitivity, specificity and quality of information; for major interactions: whether information on clinical effects, timeframe and pharmacological mechanism was included, whether management advice was helpful, and succinctness. Six of the nine software systems had a sensitivity rate > or = 90%, detecting most of the major interactions. Only 3/9 systems had a specificity rate of > or = 80%, with other systems providing inappropriate or unhelpful alerts for many minor interactions. Only 2/9 systems provided adequate information about clinical effects for more than half the major drug interactions, and 1/9 provided useful management advice for more than half of these. The reference sources had high sensitivity and in general provided more comprehensive clinical information than the software systems. Drug interaction decision support in commonly used prescribing and dispensing software has significant shortcomings.

  9. Applications and mechanisms of wax-based semiochemical dispenser technology for disruption of grape root borer mating.

    Science.gov (United States)

    Sanders, W R; Liburd, O E; Mankin, R W; Meyer, W L; Stelinski, L L

    2011-06-01

    Grape root borer, Vitacea polistiformis (Harris) (Lepidoptera: Sesiidae), is an important pest of cultivated grapes (Vitis spp.) in the eastern United States from Michigan to Florida. There are few registered insecticides for control of this pest, and their efficacy is limited. Pheromone-based mating disruption is a potential alternative to insecticides for management of V. polistiformis. Wax-based Specialized Pheromone & Lure Application Technology (SPLAT) was tested as a mating disruption method. Deployment densities of 150 dispensers per ha dosed with 5 mg of V. polistiformis pheromone were sufficient to achieve 95% mating disruption during a 7-wk trapping period. The disruption mechanism was determined to be competitive attraction. The release rate of pheromone from these dispensers was quantified to be approximately linear, 77.4 microg/g SPLAT/d. At this release rate, a minimum initial load of 5.4 mg of pheromone per dispenser would be needed to maintain disruption over a 9-10-wk V. polistiformis flight season, approximately 19 August to 21 October in central Florida. It should be noted, however, that the main pheromone component alone, (E,Z)-2,13-octadecadienyl acetate (ODDA), was effective (presumably by a noncompetitive mechanism) at higher loads per area of crop. Due to the cost of synthesis of highly pure isomers of the V. polistiformis pheromone components, mating disruption of V. polistiformis may be more practical with higher doses of commercially produced Zeuzera pyrina L. blend [95% (E,Z)-2,13-ODDA:5% (E,Z)-3,13-octadecadien-1-ol] or with (E,Z)-2,13-ODDA alone than with the V. polistiformis blend at lower rates.

  10. Evaluating the Impact of Drug Dispensing Systems on the Safety and Efficiency in a Singapore Outpatient Pharmacy

    Directory of Open Access Journals (Sweden)

    Peter Ong Yong Sheng

    2014-01-01

    Full Text Available Purpose: Automation of pharmacy workflow can reduce medication errors as well as improve efficiency of the medication picking, packing and labeling process. Since September 2012, two drug dispensing systems (DDS began operations in the Singapore General Hospital Specialist Outpatient Clinic Pharmacy. This study sought to evaluate the impact of the DDS on safety and efficiency in the pharmacy. Methods: The primary outcome was the rate of prevented dispensing incidents contributed by DDS or manual picking of medications defined as the number of prevented dispensing incidents per 1000 medications picked. The secondary outcome was the productivity of each full time equivalent (FTE when assigned to either the DDS or manual picking stations. Data pertaining to the primary and secondary outcomes between January and December 2013 were collected and analyzed. The rate of prevented dispensing incidents was expressed in median (interquartile range and compared using Mann-Whitney U test. Other continuous variables were expressed in mean ± standard deviation and compared using independent samples t-test. Results: An average of 59494 medications was picked every month in the pharmacy. DDS accounted for 21.1 percent while manual picking accounted for 78.9 percent of all the medications picked. The median rate of prevented dispensing incidents per month committed by manual picking (2.73 was significantly higher than the DDS (0.00. DDS had greater productivity with each FTE in the DDS having an average of 6175 picks per month which was significantly higher than each FTE in the manual picking stations which had an average of 4867 picks per month. Conclusion: Installation of DDS in an outpatient pharmacy improved safety of the pharmacy workflow by automating the medication picking, packing and labeling process and minimizing human errors. Efficiency of the medication picking, packing and labeling process was also improved by the DDS as there were continuous

  11. Evaluation of a liquid dispenser for assay development and enzymology in 1536-well format.

    Science.gov (United States)

    Butendeich, Heike; Pierret, Noëlle M; Numao, Shin

    2013-06-01

    Although developments in liquid dispensers have made the use of 1536-well plates for high-throughput screening (HTS) standard, there is still a gap in dispenser technology for performing matrix experiments with several components. Experiments such as those performed during assay development and enzymological studies are therefore still performed by manual pipetting in lower-density plates. We have evaluated a new dispenser, the Certus liquid dispenser (Gyger Fluidics GmbH, Switzerland), that is capable of flexible dispensing in 1536-well format, with a dead volume of less than 200 µL. Taking advantage of the precision of the dispenser for volumes down to 50 nL, we have created concentration gradients on plates by dispensing different volumes of reagent and then backfilling with buffer. Using this method and the flexibility of the dispenser software, we have performed several multidimensional experiments varying two to three components, including an assay development for an HTS, a mode of inhibition study, and a cofactor optimization, in which we determined 32 KM values. Overall, the flexibility of the plate layout for multiple components, the accuracy to dispense volumes ranging 2 log orders, and minimal reagent usage enable this dispenser for complex biochemical experiments.

  12. The effect of iron loading and iron chelation on the innate immune response and subclinical organ injury during human endotoxemia: a randomized trial

    Science.gov (United States)

    van Eijk, Lucas T.; Heemskerk, Suzanne; van der Pluijm, Rob W.; van Wijk, Susanne M.; Peters, Wilbert H.M.; van der Hoeven, Johannes G.; Kox, Matthijs; Swinkels, Dorine W; Pickkers, Peter

    2014-01-01

    In this double-blind randomized placebo-controlled trial involving 30 healthy male volunteers we investigated the acute effects of iron loading (single dose of 1.25 mg/kg iron sucrose) and iron chelation therapy (single dose of 30 mg/kg deferasirox) on iron parameters, oxidative stress, the innate immune response, and subclinical organ injury during experimental human endotoxemia. The administration of iron sucrose induced a profound increase in plasma malondialdehyde 1 h after administration (433±37% of baseline; PP=0.34) and the iron chelation group (P=0.008). Endotoxemia resulted in an initial increase in serum iron levels and transferrin saturation that was accompanied by an increase in labile plasma iron, especially when transferrin saturation reached levels above 90%. Thereafter, serum iron decreased to 51.6±9.7% of baseline at T=8 h in the placebo group versus 84±15% and 60.4±8.9% of baseline at 24 h in the groups treated with iron sucrose and deferasirox, respectively. No significant differences in the endotoxemia-induced cytokine response (TNF-α, IL-6, IL-10 and IL-1RA), subclinical vascular injury and kidney injury were observed between groups. However, vascular reactivity to noradrenalin was impaired in the 6 subjects in whom labile plasma iron was elevated during endotoxemia as opposed to those in whom no labile plasma iron was detected (P=0.029). In conclusion, a single dose of iron sucrose does not affect the innate immune response in a model of experimental human endotoxemia, but may impair vascular reactivity when labile plasma iron is formed. (Clinicaltrials.gov identifier:01349699) PMID:24241495

  13. Assessment of an automatic robotic arm for dispensing of chemotherapy in a 2500-bed medical center.

    Science.gov (United States)

    Chen, Wen-Hwei; Shen, Li-Jiuan; Guan, Ru-Jiun; Wu, Fe-Lin Lin

    2013-04-01

    Automation has long been awaited in parenteral drug dispensing. Pharmacists can benefit much in theory from a good automated device to handle the hazardous drugs used in chemotherapy. This paper describes the performance of the first chemotherapy-dispensing robot in the oncology pharmacy of a 2500-bed medical center. The objective of this paper is two-fold: (1) to assess the robot's performance in terms of its success rate and to summarize the causes of failure, and (2) to find out if the robot can decrease the full-time equivalents (FTEs) of the oncology pharmacy. We used the computer-generated log from the first week of May 2010 to that of July 2010, supplemented with the pharmacists' notes on the causes of failure, to determine the success rate and to analyze the incidences of failure. We also assessed the FTEs before and after implementing the robot. Data showed that the success rate rose slowly from 76.8% to 95.3% over the 2-month recording period. The major mechanical problems encountered were air, clamping, and waste bin problems. Manual errors, such as loading wrong drugs or syringes, also caused failures. In terms of manpower saving, CytoCare failed to decrease the number of FTE pharmacists/technicians in our oncology pharmacy practice. We conclude that even though CytoCare could ease the risk of chemotherapy exposure and increase the precision of dosing, it was not able to improve the FTE pharmacists/technicians in our hospital. Copyright © 2012. Published by Elsevier B.V.

  14. Impact assessment of an automated drug-dispensing system in a tertiary hospital

    Directory of Open Access Journals (Sweden)

    Débora de-Carvalho

    Full Text Available OBJECTIVE: To evaluate the costs and patient safety of a pilot implementation of an automated dispensing cabinet in a critical care unit of a private tertiary hospital in São Paulo/Brazil. METHODS: This study considered pre- (January-August 2013 and post- (October 2013-October 2014 intervention periods. We considered the time and cost of personnel, number of adverse events, audit adjustments to patient bills, and urgent requests and returns of medications to the central pharmacy. Costs were evaluated based on a 5-year analytical horizon and are reported in Brazilian Reals (R$ and US dollars (USD. RESULTS: The observed decrease in the mean number of events reported with regard to the automated drug-dispensing system between pre- and post-implementation periods was not significant. Importantly, the numbers are small, which limits the power of the mean comparative analysis between the two periods. A reduction in work time was observed among the nurses and administrative assistants, whereas pharmacist assistants showed an increased work load that resulted in an overall 6.5 hours of work saved/day and a reduction of R$ 33,598 (USD 14,444 during the first year. The initial investment (R$ 206,065; USD 88,592 would have been paid off in 5 years considering only personnel savings. Other findings included significant reductions of audit adjustments to patient hospital bills and urgent requests and returns of medications to the central pharmacy. CONCLUSIONS: Evidence of the positive impact of this technology on personnel time and costs and on other outcomes of interest is important for decision making by health managers.

  15. [Monitoring medication errors in personalised dispensing using the Sentinel Surveillance System method].

    Science.gov (United States)

    Pérez-Cebrián, M; Font-Noguera, I; Doménech-Moral, L; Bosó-Ribelles, V; Romero-Boyero, P; Poveda-Andrés, J L

    2011-01-01

    To assess the efficacy of a new quality control strategy based on daily randomised sampling and monitoring a Sentinel Surveillance System (SSS) medication cart, in order to identify medication errors and their origin at different levels of the process. Prospective quality control study with one year follow-up. A SSS medication cart was randomly selected once a week and double-checked before dispensing medication. Medication errors were recorded before it was taken to the relevant hospital ward. Information concerning complaints after receiving medication and 24-hour monitoring were also noted. Type and origin error data were assessed by a Unit Dose Quality Control Group, which proposed relevant improvement measures. Thirty-four SSS carts were assessed, including 5130 medication lines and 9952 dispensed doses, corresponding to 753 patients. Ninety erroneous lines (1.8%) and 142 mistaken doses (1.4%) were identified at the Pharmacy Department. The most frequent error was dose duplication (38%) and its main cause inappropriate management and forgetfulness (69%). Fifty medication complaints (6.6% of patients) were mainly due to new treatment at admission (52%), and 41 (0.8% of all medication lines), did not completely match the prescription (0.6% lines) as recorded by the Pharmacy Department. Thirty-seven (4.9% of patients) medication complaints due to changes at admission and 32 matching errors (0.6% medication lines) were recorded. The main cause also was inappropriate management and forgetfulness (24%). The simultaneous recording of incidences due to complaints and new medication coincided in 33.3%. In addition, 433 (4.3%) of dispensed doses were returned to the Pharmacy Department. After the Unit Dose Quality Control Group conducted their feedback analysis, 64 improvement measures for Pharmacy Department nurses, 37 for pharmacists, and 24 for the hospital ward were introduced. The SSS programme has proven to be useful as a quality control strategy to identify Unit

  16. A randomized cross-over trial to detect differences in arm volume after low- and heavy-load resistance exercise among patients receiving adjuvant chemotherapy for breast cancer at risk for arm lymphedema

    DEFF Research Database (Denmark)

    Bloomquist, Kira; Hayes, Sandi; Adamsen, Lis

    2016-01-01

    BACKGROUND: In an effort to reduce the risk of breast cancer-related arm lymphedema, patients are commonly advised to avoid heavy lifting, impacting activities of daily living and resistance exercise prescription. This advice lacks evidence, with no prospective studies investigating arm volume...... changes after resistance exercise with heavy loads in this population. The purpose of this study is to determine acute changes in arm volume after a session of low- and heavy-load resistance exercise among women undergoing adjuvant chemotherapy for breast cancer at risk for arm lymphedema. METHODS....../DESIGN: This is a randomized cross-over trial. PARTICIPANTS: Women receiving adjuvant chemotherapy for breast cancer who have undergone axillary lymph node dissection will be recruited from rehabilitation centers in the Copenhagen area. INTERVENTION: Participants will be randomly assigned to engage in a low- (two sets of 15...

  17. A new long-life trimedlure dispenser for Mediterranean fruit fly.

    Science.gov (United States)

    Domínguez-Ruiz, Javier; Sanchis, Juan; Navarro-Llopis, Vicente; Primo, Jaime

    2008-08-01

    New agricultural techniques are attempting to reduce the application of synthesized pesticides and replace them with new environmentally friendly methods such as mass trapping, mating disruption, or chemosterilization techniques. All these methods are based on the release of a lure for insect attraction or confusion. The success of the chosen method depends on the quality of the attractant emission from the dispenser. Currently, used dispensers with a polymeric matrix and new dispensers with mesoporous inorganic materials were evaluated to obtain more efficient emission kinetics. In this study, the selected pest was the Mediterranean fruit fly, Ceratitis capitata (Wiedemann) and the lure used was trimedlure (TML). The dispensers were validated by means of a field study comparing insect catches with attractant release values. As a result, we have demonstrated that mesoporous dispensers have a clearly longer lifetime than the polymeric plug. Furthermore, the attractant release rate is less dependent on temperature in mesoporous than in polymeric dispensers.

  18. Method and apparatus for producing drops using a drop-on-demand dispenser

    Science.gov (United States)

    Chen, Alvin U.; Basaran, Osman A.

    2003-01-01

    A method and apparatus for dispensing fluid from a drop-on-demand (DOD) fluid dispenser. The method involves withdrawing fluid in the dispenser for a first duration of time, followed by a second duration of time during which the fluid is propelled toward the orifice of the dispenser. Following the period during which the fluid is propelled, there is a second withdrawing of the fluid into the dispenser. The duration of the propelling period is shorter than the duration of either the first withdrawing or the second withdrawing. The propelling of the fluid results in the extension of a small tongue of fluid from the meniscus of the fluid. The second withdrawing of the fluid results in a retraction of the meniscus into the passageway such that only the small tongue of fluid separates and is ejected from the dispenser.

  19. An automatic pellet dispenser for precise control of feeding topography in granivorous birds

    OpenAIRE

    Berkhoudt, H.; Van Der Reijden, D.; Heijmans, M.

    1987-01-01

    Design and construction of an automatic pellet dispenser for granivorous birds are described. The dispenser permits rapid pneumatic delivery of pellets (five pellets per second maximum) to one controlled position and does not interfere with simultaneous electrophysiological recording. In addition, the device continuously indicates presence or absence of a pellet in the delivery position. This automatic dispenser proved very effective in our studies of stereotyped topographies of feeding in gr...

  20. Effect of dispenser location on taking free condoms in an outpatient cocaine abuse treatment clinic

    Science.gov (United States)

    Carrigan, Danielle R.; Kirby, Kimberly C.; Marlowe, Douglas B.

    1995-01-01

    Crack cocaine use increases risky sexual behavior and HIV exposure; therefore, safe sexual practices should be encouraged during cocaine addiction treatment. Research indicates that placing condom dispensers in private restrooms increases taking free condoms. We investigated two other dispenser locations (a day room vs. counselors' offices) and found that substantially more condoms were taken when dispensers were in the day room. This is an important issue for public health facilities without private restrooms. PMID:16795876

  1. Regulations, Codes, and Standards (RCS) Template for California Hydrogen Dispensing Stations

    Energy Technology Data Exchange (ETDEWEB)

    Rivkin, C.; Blake, C.; Burgess, R.; Buttner, W.; Post, M.

    2012-11-01

    This report explains the Regulations, Codes, and Standards (RCS) requirements for hydrogen dispensing stations in the State of California. The reports shows the basic components of a hydrogen dispensing station in a simple schematic drawing; the permits and approvals that would typically be required for the construction and operation of a hydrogen dispensing station; and a basic permit that might be employed by an Authority Having Jurisdiction (AHJ).

  2. The frequency and potential causes of dispensing errors in a hospital pharmacy.

    Science.gov (United States)

    Beso, Adnan; Franklin, Bryony Dean; Barber, Nick

    2005-06-01

    To determine the frequency and types of dispensing errors identified both at the final check stage and outside of a UK hospital pharmacy, to explore the reasons why they occurred, and to make recommendations for their prevention. A definition of a dispensing error and a classification system were developed. To study the frequency and types of errors, pharmacy staff recorded details of all errors identified at the final check stage during a two-week period; all errors identified outside of the department and reported during a one-year period were also recorded. During a separate six-week period, pharmacy staff making dispensing errors identified at the final check stage were interviewed to explore the causes; the findings were analysed using a model of human error. Percentage of dispensed items for which one or more dispensing errors were identified at the final check stage; percentage for which an error was reported outside of the pharmacy department; the active failures, error producing conditions and latent conditions that result in dispensing errors occurring. One or more dispensing errors were identified at the final check stage in 2.1% of 4849 dispensed items, and outside of the pharmacy department in 0.02% of 194,584 items. The majority of those identified at the final check stage involved slips in picking products, or mistakes in making assumptions about the products concerned. Factors contributing to the errors included labelling and storage of containers in the dispensary, interruptions and distractions, a culture where errors are seen as being inevitable, and reliance on others to identify and rectify errors. Dispensing errors occur in about 2% of all dispensed items. About 1 in 100 of these is missed by the final check. The impact on dispensing errors of developments such as automated dispensing systems should be evaluated.

  3. The impact of automation on workload and dispensing errors in a hospital pharmacy.

    Science.gov (United States)

    James, K Lynette; Barlow, Dave; Bithell, Anne; Hiom, Sarah; Lord, Sue; Pollard, Mike; Roberts, Dave; Way, Cheryl; Whittlesea, Cate

    2013-04-01

    To determine the effect of installing an original-pack automated dispensing system (ADS) on dispensary workload and prevented dispensing incidents in a hospital pharmacy. Data on dispensary workload and prevented dispensing incidents, defined as dispensing errors detected and reported before medication had left the pharmacy, were collected over 6 weeks at a National Health Service hospital in Wales before and after the installation of an ADS. Workload was measured by non-participant observation using the event recording technique. Prevented dispensing incidents were self-reported by pharmacy staff on standardised forms. Median workloads (measured as items dispensed/person/hour) were compared using Mann-Whitney U tests and rate of prevented dispensing incidents were compared using Chi-square test. Spearman's rank correlation was used to examine the association between workload and prevented dispensing incidents. A P value of ≤0.05 was considered statistically significant. Median dispensary workload was significantly lower pre-automation (9.20 items/person/h) compared to post-automation (13.17 items/person/h, P automation (0.28%) than pre-automation (0.64%, P automation (ρ = 0.23, P automation improves dispensing efficiency and reduces the rate of prevented dispensing incidents. It is proposed that prevented dispensing incidents frequently occurred during periods of high workload due to involuntary automaticity. Prevented dispensing incidents occurring after a busy period were attributed to staff experiencing fatigue after-effects. © 2012 The Authors. IJPP © 2012 Royal Pharmaceutical Society.

  4. A Curriculum For Dispensing Optician A Case Study In Vietnam

    Directory of Open Access Journals (Sweden)

    Duong Dieu MD

    2015-08-01

    Full Text Available Until 2011 there had been no full-time training course for dispensing optician diploma in Vietnam. Most of the practicing opticians with no qualification and formal training have learnt their skills through apprentice. In response to the demand of the industry Nguyen Tat Thanh University Vietnam has teamed up with Bradford College United Kingdom to develop a curriculum for a of formal 2-year full-time training for dispensing optician. The curriculum is applied for 4 semesters and graduate gets called Intermediate Professional Diploma level included 4 semesters. In VN after high school students can obtain different many levels of study such as Intermediate Professional Diploma College Bachelor Master and PhD. The 1st semester is basis of Intermediate Professional Diploma level. The 2nd semester is the study of refractive error and primary care each for 4 weeks 100 hours in theory and primary eye care 4 weeks for theory 100 hours. Also in this semester the learners have practiced clinical rotation at the Ophthalmic Hospital Ophthalmic Service in General Hospital for 10 weeks. The 3rd semester is specialized of dispensing Optician included Lenses frame contact lenses and laboratory for optician. In the 4th semester the training concentrates in the management of the eyeglasses shop and practicing in making spectacles for customers are in the 4th semester. The 1st intake of the course was opened started in 2011 and had 30 students graduated in 2013. This paper describes the experience of developing the curriculum in the context of a developing country where the industry is still under regulated and less developed. The first program optician that privileged on primary eye care will be satisfied for community WHO 2020 1 optometrist for 50.000 people and 10 ophthalmologists for 1.000.000 people. Some characteristics of first course students have been noted. The result of this curriculum will be evaluated in the coming time.

  5. The effect of implementing cognitive load theory-based design principles in virtual reality simulation training of surgical skills: a randomized controlled trial

    DEFF Research Database (Denmark)

    Andersen, Steven Arild Wuyts; Mikkelsen, Peter Trier; Konge, Lars

    2016-01-01

    Cognitive overload can inhibit learning, and cognitive load theory-based instructional design principles can be used to optimize learning situations. This study aims to investigate the effect of implementing cognitive load theory-based design principles in virtual reality simulation training...

  6. The Effect of a Non-Gaussian Random Loading on High-Cycle Fatigue of a Thermally Post-Buckled Structure

    Science.gov (United States)

    Rizzi, Stephen A.; Behnke, marlana N.; Przekop, Adam

    2010-01-01

    High-cycle fatigue of an elastic-plastic beam structure under the combined action of thermal and high-intensity non-Gaussian acoustic loadings is considered. Such loadings can be highly damaging when snap-through motion occurs between thermally post-buckled equilibria. The simulated non-Gaussian loadings investigated have a range of skewness and kurtosis typical of turbulent boundary layer pressure fluctuations in the vicinity of forward facing steps. Further, the duration and steadiness of high excursion peaks is comparable to that found in such turbulent boundary layer data. Response and fatigue life estimates are found to be insensitive to the loading distribution, with the minor exception of cases involving plastic deformation. In contrast, the fatigue life estimate was found to be highly affected by a different type of non-Gaussian loading having bursts of high excursion peaks.

  7. Guide to Permitting Hydrogen Motor Fuel Dispensing Facilities

    Energy Technology Data Exchange (ETDEWEB)

    Rivkin, Carl [National Renewable Energy Lab. (NREL), Golden, CO (United States); Buttner, William [National Renewable Energy Lab. (NREL), Golden, CO (United States); Burgess, Robert [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2016-03-28

    The purpose of this guide is to assist project developers, permitting officials, code enforcement officials, and other parties involved in developing permit applications and approving the implementation of hydrogen motor fuel dispensing facilities. The guide facilitates the identification of the elements to be addressed in the permitting of a project as it progresses through the approval process; the specific requirements associated with those elements; and the applicable (or potentially applicable) codes and standards by which to determine whether the specific requirements have been met. The guide attempts to identify all applicable codes and standards relevant to the permitting requirements.

  8. Drug dispensing errors in a ward stock system

    DEFF Research Database (Denmark)

    Andersen, Stig Ejdrup

    2010-01-01

    The aim of this study was to determine the frequency of drug dispensing errors in a traditional ward stock system operated by nurses and to investigate the effect of potential contributing factors. This was a descriptive study conducted in a teaching hospital from January 2005 to June 2007. In five...... opportunities for error were identified; error rate of 1.85 errors per 100 opportunities for error (95% CI 1.54-2.20). Omission of a dose was the predominant type of error while vitamins and minerals, drugs for acid-related diseases and antipsychotic drugs were the drugs most frequently affected by errors...

  9. Over-the-counter suboptimal dispensing of antibiotics in Uganda

    Directory of Open Access Journals (Sweden)

    Mukonzo JK

    2013-08-01

    Full Text Available Jackson K Mukonzo,1,2 Proscovia M Namuwenge,1 Gildo Okure,3 Benjamin Mwesige,1 Olivia K Namusisi,4 David Mukanga4 1Center for Operational Research Africa, Kampala, Uganda; 2Department of Pharmacology and Therapeutics, 3School of Public Health, Makerere University, Kampala, Uganda; 4African Field Epidemiologist Network, Kampala, Uganda Background: Overuse and misuse of antibiotics is a serious global problem. While resistance to older antibiotics is increasing, development of newer molecules has stalled. Resistance to the existing antibiotics that is largely driven by their high-volume use is a global public health problem. Uganda is one of the countries where prescription-only drugs, including antibiotics, can be obtained over the counter. We determined the rate of antibiotic dispensing and use in Uganda. Methods: The study utilized a descriptive cross-sectional study design to determine the number of antibiotic "prescribed" daily doses per 1,000 clients. Data were collected from one health center II, eight general/district hospitals, one national referral hospital, and 62 registered community pharmacies. From each study site, data were collected for five consecutive days over the months of November 2011 to January 2012. Results: The overall antibiotic issue rate was 43.2%. Amoxicillin, metronidazole, ciprofloxacin, sulfamethoxazole–trimethoprim, cloxacillin, and ampicillin, belonging to the WHO anatomical therapeutic chemical classifications of penicillin with extended spectra, imidazole derivatives, fluoroquinolones, and sulfonamide–trimethoprim combinations, constituted 70% of the issued antibiotics. About 41% of antibiotics were issued over the counter. At community pharmacies, where 30% of antibiotic dispensing occurred, the number of prescribed daily doses/1,000 antibiotic clients was 4,169 compared to 6,220, 7,350 and 7,500 at general/district hospitals, the national referral hospital, and the health center, respectively. Conclusion

  10. Definitionen af CFC-indkomst og adgangen til dispensation

    DEFF Research Database (Denmark)

    Schmidt, Peter Koerver

    2014-01-01

    I artiklen kommenteres to nyere afgørelser omhandlende CFC-reglerne for selskaber. Først behandles Skatterådets afgørelse i SKM2013.649.SR, der bl.a. angik, hvorvidt et udenlandsk datterselskabs indkomst udgjorde CFC-indkomst i form af vederlag for anvendelse af immaterielle aktiver. Derpå omtale...... kendelsen SKM2014.280.LSR, hvori Landsskatteretten - modsat Skatterådet - kom frem til, at betingelserne for dispensation fra CFC-reglerne var opfyldt....

  11. Prevalence of medication administration errors in two medical units with automated prescription and dispensing

    National Research Council Canada - National Science Library

    Rodriguez-Gonzalez, Carmen Guadalupe; Herranz-Alonso, Ana; Martin-Barbero, Maria Luisa; Duran-Garcia, Esther; Durango-Limarquez, Maria Isabel; Hernández-Sampelayo, Paloma; Sanjurjo-Saez, Maria

    2012-01-01

    To identify the frequency of medication administration errors and their potential risk factors in units using a computerized prescription order entry program and profiled automated dispensing cabinets...

  12. Automatic Control System for Dispensing Precise Amounts of FInely Divided Solids

    Energy Technology Data Exchange (ETDEWEB)

    Osborne, J. M.; McGraw, H. R.; Draut, C. F.

    1973-06-01

    A device for automatic dispensing of precise amounts of finely divided solids has been developed. Precision is a function of dispensing time. Smaller than gram quantities may be dispensed at a rate of about 1/3 g/min with a precision corresponding to a weight range of about 0.001 g for a series. The process consists in moving the material with the effect of the vibratory motion of a miniature air-powered vibrator. Operation is automatically controlled by the electronic system of the weighing unit interfaced to the pneumatic dispensing device via a combination fluidic and pneumatic control system.

  13. Immediate and delayed loading of two-piece reduced-diameter implants with locator-analog attachments in edentulous mandibles: One-year results from a randomized clinical trial examining clinical outcome and patient expectation.

    Science.gov (United States)

    Giannakopoulos, Nikolaos Nikitas; Ariaans, Kirsten; Eberhard, Lydia; Klotz, Anna-Luisa; Oh, Keunyoung; Kappel, Stefanie

    2017-08-01

    Prosthetic management of thin alveolar ridges in the edentulous mandibles of elderly patients, especially the time of loading, the number of implants needed, and patient expectations and perception, is a challenge in implant dentistry. Survival of conventionally and immediately loaded 2-piece reduced-diameter implants in the interforaminal region of the edentulous mandible supporting locator-analog attachments was evaluated. Prosthetic complications and peri-implant hygiene were also studied, and patient expectation and subjective evaluation of the treatment were documented. Twenty-five patients with adapted complete dentures received 4 reduced-diameter implants. All anterior implants were immediately loaded. Three months later, patients were allocated by randomization to 1 of 2 treatment groups: 2 locator-analog attachments on the anterior implants (Group A); or 4 locator-analog attachments (Group B). After another 3 months patient allocation was changed (crossover design) for the next 3 months. Questionnaires with Likert scales and numeric rating scales were used to assess patients' expectations and subjective overdenture-related variables, respectively. One implant was lost in the immediate-loading group. Survival was 98% and 100% for immediate and delayed loading, respectively. During 12-month observation, 8 complications required aftercare. At the beginning of treatment, patients' expectations were highly positive. Subjective assessment of overdenture-related variables 3 months after immediate loading of 2 implants revealed a statistically significant improvement for most of the variables studied; this was maintained 1 year later. In the subjective assessments, there were no statistically significant differences between Groups A and B. Immediate loading of reduced-diameter implants supporting locator-analog attachments resulted in high implant survival, few prosthetic complications, good oral hygiene, and improvement of subjective denture perception in the

  14. Dispensable chromosomes in Fusarium oxysporum f. sp. lycopersici.

    Science.gov (United States)

    Vlaardingerbroek, Ido; Beerens, Bas; Schmidt, Sarah M; Cornelissen, Ben J C; Rep, Martijn

    2016-12-01

    The genomes of many filamentous fungi consist of a 'core' part containing conserved genes essential for normal development as well as conditionally dispensable (CD) or lineage-specific (LS) chromosomes. In the plant-pathogenic fungus Fusarium oxysporum f. sp. lycopersici, one LS chromosome harbours effector genes that contribute to pathogenicity. We employed flow cytometry to select for events of spontaneous (partial) loss of either the two smallest LS chromosomes or two different core chromosomes. We determined the rate of spontaneous loss of the 'effector' LS chromosome in vitro at around 1 in 35 000 spores. In addition, a viable strain was obtained lacking chromosome 12, which is considered to be a part of the core genome. We also isolated strains carrying approximately 1-Mb deletions in the LS chromosomes and in the dispensable core chromosome. The large core chromosome 1 was never observed to sustain deletions over 200 kb. Whole-genome sequencing revealed that some of the sites at which the deletions occurred were the same in several independent strains obtained for the two chromosomes tested, indicating the existence of deletion hotspots. For the core chromosome, this deletion hotspot was the site of insertion of the marker used to select for loss events. Loss of the core chromosome did not affect pathogenicity, whereas loss of the effector chromosome led to a complete loss of pathogenicity. © 2016 THE AUTHORS. MOLECULAR PLANT PATHOLOGY PUBLISHED BY BRITISH SOCIETY FOR PLANT PATHOLOGY AND JOHN WILEY & SONS LTD.

  15. PROJECT OF COAGULANT DISPENSER IN PULVERIZATION AERATOR WITH WIND DRIVE

    Directory of Open Access Journals (Sweden)

    Ewa Osuch

    2017-09-01

    Full Text Available Lakes are one of most important freshwater ecosystems, playing significant role in functioning of nature and human economy. Swarzędzkie Lake is good example of ecosystem, which in last half-century was exposed to the influence of strong anthropopressure. Direct inflow of sewage with large number of biogens coming to the lake with water of inflows caused distinct disturbance of its functioning. In autumn 2011 restoration begined on Swarzędzkie Lake for reduction of lake trophy and improvement of water quality. For achieving better and quicker effect, simultaneously combination of some methods was applied, among others method of oxygenation of over-bottom water with help of pulverization aerator and method of precise inactivation of phosphorus in water depths. Characterization and analysis of improved coagulant dispenser applying active substance only during work of pulverization aerator is the aim of this thesis. Principle of dispenser work, its structure and location in pulverization aerator were explained. It was stated, that introduction to water a factor initiating process of phosphorus inactivation causes significant reduction of mineral phosphorus in water and size of coagulant dose correlates with intensity of work of pulverization aerator with wind drive.

  16. Can the design of glove dispensing boxes influence glove contamination?

    Science.gov (United States)

    Assadian, O; Leaper, D J; Kramer, A; Ousey, K J

    2016-11-01

    Few studies have explored the microbial contamination of glove boxes in clinical settings. The objective of this observational study was to investigate whether a new glove packaging system in which single gloves are dispensed vertically, cuff end first, has lower levels of contamination on the gloves and on the surface around the box aperture compared with conventional glove boxes. Seven participating sites were provided with vertical glove dispensing systems (modified boxes) and conventional boxes. Before opening glove boxes, the surface around the aperture was sampled microbiologically to establish baseline levels of superficial contamination. Once the glove boxes were opened, the first pair of gloves in each box was sampled for viable bacteria. Thereafter, testing sites were visited on a weekly basis over a period of six weeks and the same microbiological assessments were made. The surface near the aperture of the modified boxes became significantly less contaminated over time compared with the conventional boxes (Pcontamination around the aperture. Overall, gloves from modified boxes showed significantly less colony-forming unit contamination than gloves from conventional boxes (Pcontamination. This simple improvement to glove box design reduces contamination of unused gloves. Such modifications could decrease the risk of microbial cross-transmission in settings that use gloves. However, such advantages do not substitute for strict hand hygiene compliance and appropriate use of non-sterile, single-use gloves. Copyright © 2016 The Healthcare Infection Society. All rights reserved.

  17. An assessment of dispensing practices in private pharmacies in Dar-es-Salaam, Tanzania.

    Science.gov (United States)

    Kagashe, Godeliver A B; Minzi, Omary; Matowe, Lloyd

    2011-02-01

    To assess medicine dispensing practices in private pharmacies in Dar-es-Salaam, Tanzania and recommend interventions to improve practice. A cross-sectional survey and observational study of dispensing practices among 70 pharmacies in metropolitan Dar-es-Salaam, Tanzania. There were 1479 dispensing encounters recorded across the 70 pharmacies. This translated to 1573 medicines dispensed. Of the medicines dispensed, 16% were anti-infectives; 45% of the dispensed medicines were requested by the client, 32% were recommended by the dispenser and only 23% were on prescriptions. The main reasons for pharmacy consultations were coughs (62%), general pain (62%) and 'flu and colds. Malaria constituted 21% of the private pharmacy visits. Of the cough encounters, 30% received antibiotics. In addition, oral antibiotics were given to 81% of the clients with diarrhoea and to 95% of those with eye and ear problems. Of the 628 clients who requested specific medicines without a prescription, only 29% were asked questions on why the medicines were required. Of the clients who bought antibiotics, 20% bought incomplete doses. In total, 1180 clients were interviewed. Of these, 35% could not repeat the instructions given to them by the dispenser. Of the 70 dispensers who gave dosage instructions, only 20% gave them according to guidelines. In Tanzania, an overwhelming proportion of medicines sold in pharmacies are dispensed without a prescription. The majority of medicines dispensed without a prescription are either requested by the client or recommended by the dispenser. When dispensing medicines, dispensers seldom give dosage instructions; when they do, the instructions are often not consistent with guidelines. A high proportion of clients seeking management of coughs and colds or for diarrhoea from private pharmacies receive antibiotics. Interventions that build the capacity of dispensers, improve the rational use of antibiotics and the management of diarrhoea in private pharmacies in

  18. The challenge of responsible dispensing: formal education versus professional practice

    Directory of Open Access Journals (Sweden)

    Nadine Judith Bezzegh

    2011-03-01

    Full Text Available The aim of the present study was to evaluate the education of Pharmaceutical Technicians for the activity of responsible dispensing. Based on a questionnaire with open and closed questions, the study sought to characterize the students, identify knowledge and attitudes regarding the Rational Use of Medications while addressing the limits and possibilities of professional and ethical dispensing in practice. In addition, a group dynamics session - focus group - was held as a forum for debate on responsible dispensing. The results showed that students tended to be mature, currently employed and were predominately women. Displaying adequate knowledge on Rational Use of Medications and of the corresponding legislation, the students reported difficulties exercising compatible practice. While the diagnosis pointed to the need for student preparation to enable ethical dispensing, the Focus Group highlighted the possibility for inclusion of a forum for reflection and debate on the ethics of dispensing as part of the Pharmaceutical Technician training.O presente trabalho tem como proposta avaliar a formação do Técnico em Farmácia para o exercício da dispensação responsável. A partir de um questionário com perguntas fechadas e abertas, o estudo envolveu a caracterização dos alunos, a identificação de conhecimentos e atitudes em relação ao Uso Racional dos Medicamentos com vistas ao delineamento dos limites e possibilidades do exercício profissional ético na dispensação. Além disso, foi realizada uma dinâmica grupal - grupo focal - com o objetivo de apreciar a constituição de um espaço de reflexão sobre a dispensação responsável. Os resultados evidenciaram um alunato de maior idade, inserido no mercado de trabalho e predominância de mulheres. Dispondo de conhecimento adequado sobre o Uso Racional dos Medicamentos e da legislação correspondente os alunos fazem referência às dificuldades no exercício de uma pr

  19. Exploring the rice dispensable genome using a metagenome-like assembly strategy.

    Science.gov (United States)

    Yao, Wen; Li, Guangwei; Zhao, Hu; Wang, Gongwei; Lian, Xingming; Xie, Weibo

    2015-09-07

    The dispensable genome of a species, consisting of the dispensable sequences present only in a subset of individuals, is believed to play important roles in phenotypic variation and genome evolution. However, construction of the dispensable genome is costly and labor-intensive at present, and so the influence of the dispensable genome in genetic and functional genomic studies has not been fully explored. We construct the dispensable genome of rice through a metagenome-like de novo assembly strategy based on low-coverage (1-3×) sequencing data of 1483 cultivated rice (Oryza sativa L.) accessions. Thousands of protein-coding genes are successfully assembled, including most of the known agronomically important genes absent from the Nipponbare rice reference genome. We develop an integration approach based on alignment and linkage disequilibrium, which is able to assign genomic positions relative to the reference genome for more than 78.2 % of the dispensable sequences. We carry out association mapping studies for rice grain width and 840 metabolic traits using 0.46 million polymorphisms between the dispensable sequences of different rice accessions. About 23.5 % of metabolic traits have more significant association signals with polymorphisms from dispensable sequences than with SNPs from the reference genome, and 41.6 % of trait-associated SNPs have concordant genomic locations with associated dispensable sequences. Our results suggest the feasibility of building a species' dispensable genome using low-coverage population sequencing data. The constructed sequences will be helpful for understanding the rice dispensable genome and are complementary to the reference genome for identifying candidate genes associated with phenotypic variation.

  20. Pharmacists' role in opioid overdose: Kentucky pharmacists' willingness to participate in naloxone dispensing.

    Science.gov (United States)

    Freeman, Patricia R; Goodin, Amie; Troske, SuZanne; Strahl, Audra; Fallin, Amanda; Green, Traci C

    To assess pharmacists' willingness to initiate the dispensing of naloxone. As of 2015, Kentucky law permits certified pharmacists to dispense naloxone under a physician-approved protocol. Electronic survey (e-mail) gauging perception of pharmacists' role in opioid overdose and attitudes toward, and barriers to, naloxone dispensing. All Kentucky pharmacists with active licenses in 2015. Ordinal logistic regression was used to estimate the impact of pharmacist characteristics and attitudes on willingness to initiate naloxone dispensing, where the dependent variable was operationalized as a Likert-type question on a scale of 1 (not at all willing) to 6 (very willing). Of 4699 practicing Kentucky pharmacists, 1282 responded, of which 834 were community practitioners (response rate 27.3%). Pharmacists reported varying willingness to initiate naloxone dispensing, with 37.3% very willing (score 5 or 6) and 27.9% not willing (score 1 or 2). However, a majority of pharmacists reported willingness to dispense naloxone with a valid prescription (54.0%, score 5 or 6). Women pharmacists were 1.3 times more likely than men to be willing to initiate naloxone dispensing (95% confidence interval [CI] 1.0-1.6). Those who reported confidence in identifying individuals at risk for overdose were 1.2 times more likely to initiate dispensing, and those who reported confidence in ability to educate patients about overdose were 1.6 times more likely to express willingness to initiate naloxone dispensing (95% CIs, respectively, 1.0-1.3 and 1.4-1.8). Community pharmacists reported barriers to naloxone access at higher rates than pharmacists from other practice settings. Kentucky pharmacists are divided in their willingness to initiate naloxone dispensing; however, those who are confident in their ability to identify overdose risks are more willing. Increasing pharmacist confidence through appropriately designed education programs could facilitate pharmacist participation in naloxone

  1. 21 CFR 1304.50 - Disclosure requirements for Web sites of nonpharmacy practitioners that dispense controlled...

    Science.gov (United States)

    2010-04-01

    ... nonpharmacy practitioners that dispense controlled substances by means of the Internet. 1304.50 Section 1304... that dispense controlled substances by means of the Internet. For a Web site to identify itself as being exempt from the definition of an online pharmacy by virtue of section 102(52)(B)(ii) of the Act...

  2. 21 CFR 866.2440 - Automated medium dispensing and stacking device.

    Science.gov (United States)

    2010-04-01

    ... SERVICES (CONTINUED) MEDICAL DEVICES IMMUNOLOGY AND MICROBIOLOGY DEVICES Microbiology Devices § 866.2440... stacking device is a device intended for medical purposes to dispense a microbiological culture medium into... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Automated medium dispensing and stacking device...

  3. MANUAL FOOD AND BEVERAGE DISPENSING EQUIPMENT. NATIONAL SANITATION FOUNDATION STANDARD NO. 18.

    Science.gov (United States)

    National Sanitation Foundation, Ann Arbor, MI.

    THIS STANDARD COVERS THE SANITATION REQUIREMENTS FOR EQUIPMENT AND DEVICES WHICH DISPENSE FOOD OR BEVERAGE EITHER IN BULK OR PORTIONS. VENDING MACHINES OR BULK MILK DISPENSING EQUIPMENT ARE NOT COVERED IN THIS STANDARD. ITEMS COVERED INCLUDE THE BASIC PRINCIPLES OF DESIGN AND CONSTRUCTION, FOOD PROTECTION AND FREEDOM FROM HARBORAGES. MINIMUM…

  4. 21 CFR 1307.11 - Distribution by dispenser to another practitioner or reverse distributor.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Distribution by dispenser to another practitioner or reverse distributor. 1307.11 Section 1307.11 Food and Drugs DRUG ENFORCEMENT ADMINISTRATION... Substances § 1307.11 Distribution by dispenser to another practitioner or reverse distributor. (a) A...

  5. Occurrence of non-fermenting gram negative bacteria in drinking water dispensed from point-of-use microfiltration devices

    Directory of Open Access Journals (Sweden)

    Franza Zanetti

    2014-03-01

    Full Text Available Introduction and objective. Many devices have been marketed in order to improve the organoleptic characteristics of tap water resulting from disinfection with chlorine derivates. The aim of the presented study was to assess the degree of contamination by non-fermenting Gram-negative bacteria (NF-GNB of drinking water dispensed from microfiltration devices at point-of-use. Methods. Water samples were collected from 94 point-of-use water devices fitted with a filter (0.5μm pore size containing powdered activated carbon. The microbiological contamination of water entering and leaving the microfiltered water dispensers was compared. The NF-GNB loads were correlated to Total Heterotrophic Counts (HPCs at 37 and 22 °C, residua chlorine, and some structural and functional features of the devices. Results. NF-GNB were detected from 23% of supply water samples, 33% of still unchilled water, 33% of still chilled water and 18% of carbonated chilled water. The most frequent isolates were Pseudomonadaceae: Steno.maltophilia 30.2% of isolates, Pseudomonas 20.5%, Delftia acidovorans 13.4%, while the species more largely distributed was Ps. aeruginosa recovered from 13% of samples. The distribution of the various NF-GNB was different in the water entering and in that leaving the devices. Ps.aeruginosa and Steno.maltophilia were the predominant species in water leaving the microfiltration dispensers, probably due to their capacity to colonize the circuits and to prevail over the others. Recovery of NF-GNB was favoured by the reduction in residual chlorine of the supply water, occasional use, the absence of a bacteriostatic element in the filter and inadequate disinfection of the water lines. Conclusions. The presence of high concentrations of potentially pathogenic species of NF-GNB (Ps.aeruginosa, Steno. maltophilia, Burkhol.cepacia in the water dispensed from microfiltration devices represents a risk of waterborne infections for vulnerable individuals. When

  6. Occurrence of non-fermenting gram negative bacteria in drinking water dispensed from point-of-use microfiltration devices.

    Science.gov (United States)

    Zanetti, Franza; de Luca, Giovanna; Leoni, Erica; Sacchetti, Rossella

    2014-01-01

    Many devices have been marketed in order to improve the organoleptic characteristics of tap water resulting from disinfection with chlorine derivates. The aim of the presented study was to assess the degree of contamination by non-fermenting Gram-negative bacteria (NF-GNB) of drinking water dispensed from microfiltration devices at point-of-use. Water samples were collected from 94 point-of-use water devices fitted with a filter (0.5 μm pore size) containing powdered activated carbon. The microbiological contamination of water entering and leaving the microfiltered water dispensers was compared. The NF-GNB loads were correlated to Total Heterotrophic Counts (HPCs) at 37 and 22 °C, residua chlorine, and some structural and functional features of the devices. NF-GNB were detected from 23% of supply water samples, 33% of still unchilled water, 33% of still chilled water and 18% of carbonated chilled water. The most frequent isolates were Pseudomonadaceae: Steno.maltophilia 30.2% of isolates, Pseudomonas 20.5%, Delftia acidovorans 13.4%, while the species more largely distributed was Ps. aeruginosa recovered from 13% of samples. The distribution of the various NF-GNB was different in the water entering and in that leaving the devices. Ps.aeruginosa and Steno.maltophilia were the predominant species in water leaving the microfiltration dispensers, probably due to their capacity to colonize the circuits and to prevail over the others. Recovery of NF-GNB was favoured by the reduction in residual chlorine of the supply water, occasional use, the absence of a bacteriostatic element in the filter and inadequate disinfection of the water lines. The presence of high concentrations of potentially pathogenic species of NF-GNB (Ps.aeruginosa, Steno. maltophilia, Burkhol.cepacia) in the water dispensed from microfiltration devices represents a risk of waterborne infections for vulnerable individuals. When these devices are used in environments such as hospitals, nursing homes

  7. The effect on knee-joint load of instruction in analgesic use compared with neuromuscular exercise in patients with knee osteoarthritis: study protocol for a randomized, single-blind, controlled trial (the EXERPHARMA trial).

    Science.gov (United States)

    Clausen, Brian; Holsgaard-Larsen, Anders; Søndergaard, Jens; Christensen, Robin; Andriacchi, Thomas P; Roos, Ewa M

    2014-11-15

    Knee osteoarthritis (OA) is a mechanically driven disease, and it is suggested that medial tibiofemoral knee-joint load increases with pharmacologic pain relief, indicating that pharmacologic pain relief may be positively associated with disease progression. Treatment modalities that can both relieve pain and reduce knee-joint load would be preferable. The knee-joint load is influenced by functional alignment of the trunk, pelvis, and lower-limb segments with respect to the knee, as well as the ground-reaction force generated during movement. Neuromuscular exercise can influence knee load and decrease knee pain. It includes exercises to improve balance, muscle activation, functional alignment, and functional knee stability. The primary objective of this randomized controlled trial (RCT) is to investigate the efficacy of a NEuroMuscular EXercise (NEMEX) therapy program, compared with optimized analgesics and antiinflammatory drug use, on the measures of knee-joint load in people with mild to moderate medial tibiofemoral knee osteoarthritis. One hundred men and women with mild to moderate medial knee osteoarthritis will be recruited from general medical practices and randomly allocated (1:1) to one of two 8-week treatments, either (a) NEMEX therapy twice a week or (b) information on the recommended use of analgesics and antiinflammatory drugs (acetaminophen and oral NSAIDs) via a pamphlet and video materials. The primary outcome is change in knee load during walking (the Knee Index, a composite score of the first external peak total reaction moment on the knee joint from all three planes based on 3D movement analysis) after 8 weeks of intervention. Secondary outcomes include changes in the external peak knee-adduction moment and impulse and functional performance measures, in addition to changes in self-reported pain, function, health status, and quality of life. These findings will help determine whether 8 weeks of neuromuscular exercise is superior to optimized use

  8. Interstate dispensing: a case for uniform, intuitive legislation.

    Science.gov (United States)

    Bernaitis, Nijole L; King, Michelle A; Hope, Denise L

    2014-09-01

    Australian health practitioner registration is national, whereas legislation regarding the handling of medicines is governed by individual States and Territories. To align with the July 2010 national registration scheme some legislative modifications were made concerning scheduled drugs and poisons, but many differences between jurisdictions remain. In Queensland, the Health (Drugs and Poisons) Regulation 1996 (Qld) allows for dispensing of controlled drugs written by interstate prescribers but not lower scheduled specified restricted and regulated restricted drugs. The aim of this study was to assess awareness of seemingly counterintuitive legislation by pharmacists practising in South-East Queensland. Of 125 Gold Coast pharmacies contacted, 54 (43.2%) agreed to participate. The majority of pharmacists (88.9%) had good knowledge regarding controlled drugs. In contrast, they demonstrated confusion regarding specified restricted and regulated restricted drugs (51.9% correct awareness). Uniform legislation between jurisdictions or more intuitive legislation would ease practitioner confusion.

  9. Spill-Resistant Alkali-Metal-Vapor Dispenser

    Science.gov (United States)

    Klipstein, William

    2005-01-01

    A spill-resistant vessel has been developed for dispensing an alkali-metal vapor. Vapors of alkali metals (most commonly, cesium or rubidium, both of which melt at temperatures slightly above room temperature) are needed for atomic frequency standards, experiments in spectroscopy, and experiments in laser cooling. Although the present spill-resistant alkali-metal dispenser was originally intended for use in the low-gravity environment of outer space, it can also be used in normal Earth gravitation: indeed, its utility as a vapor source was confirmed by use of cesium in a ground apparatus. The vessel is made of copper. It consists of an assembly of cylinders and flanges, shown in the figure. The uppermost cylinder is a fill tube. Initially, the vessel is evacuated, the alkali metal charge is distilled into the bottom of the vessel, and then the fill tube is pinched closed to form a vacuum seal. The innermost cylinder serves as the outlet for the vapor, yet prevents spilling by protruding above the surface of the alkali metal, no matter which way or how far the vessel is tilted. In the event (unlikely in normal Earth gravitation) that any drops of molten alkali metal have been shaken loose by vibration and are floating freely, a mesh cap on top of the inner cylinder prevents the drops from drifting out with the vapor. Liquid containment of the equivalent of 1.2 grams of cesium was confirmed for all orientations with rubbing alcohol in one of the prototypes later used with cesium.

  10. Recommendations and requirements for soap and hand rub dispensers in healthcare facilities.

    Science.gov (United States)

    Assadian, Ojan; Kramer, Axel; Christiansen, Bärbel; Exner, Martin; Martiny, Heike; Sorger, Arno; Suchomel, Miranda

    2012-01-01

    Hand hygiene is one of the most important measures to prevent transmission of infectious agents and plays a major role in prevention of infection in any type of healthcare setting. While requirements for the efficacy of hand disinfectants are defined in European testing norms such as the EN 1500 for hygienic hand disinfection or EN 12791 for surgical hand preparation, no specific recommendations for hand rub dispensers and liquid soap dispensers have been given yet. Therefore, the intention of the present recommendation on soap and hand rub dispensers in healthcare facilities is to close this gap and to enhance future improvement of dispenser functionality and design. Regardless of manufacture and design of a hand rub or liquid soap dispensers the following requirements shall be met in healthcare facilities:Triggering the dispenser must be possible without using hands. Sensor- or elbow-operated dispensers both fulfill this requirement. Dispensers must be only refillable in a modality where the content, be it a hand rub or liquid soap, cannot be contaminated. This is achieved best by using replaceable cartridge systems. Refilling through "top-up" must not be possible. The disperser should allow usage of different types of cartridges made by different manufacturers. Dispensers must be operated and maintained such that a microbial contamination of the pump nozzle may easily be avoided. It must be possible to identify the products used in a dispenser easily and without any manipulation. Identifying the type of product, be it a hand rub or a liquid soap, as well as reading the product's name and critical manufacturers' warnings must be possible at any time. The disperser must allow identification of the level of the used product without any further manipulation at any time. The design of the dispenser must allow easy cleaning and disinfection the outside and inside of the dispenser. The manufacturer of the dispenser must provide the user with information on applicable

  11. Handling test of eye drop dispenser--comparison of unit-dose pipettes with conventional eye drop bottles.

    Science.gov (United States)

    Parkkari, Minna; Latvala, Terho; Ropo, Auli

    2010-06-01

    The aims of this study were to investigate how elderly people handle single-use eye drop dispensers (unit-dose pipettes) and to compare the performance with conventional eye drop bottles. In this open-label study, the handling of unit-dose pipettes and conventional eye drop bottles was compared in 41 elderly people who had little or no prior regular use of eye drop dispensers. The participants tested both types of dispenser once, and the following 7 variables were studied: ease/difficulty of opening the dispenser; influence of the size for handling of the dispenser; influence of the shape for handling of the dispenser; observation of the contents in the dispenser; the feeling of the dispenser in the hand; ease/difficulty of drop instillation on the eye from the dispenser; and overall performance of the eye drop dispenser. The dispensers contained isotonic saline, and a visual analog scale was used for assessment of each of the above variables. The mean age of the participants was 73 years. A statistically significant difference in favor of the unit-dose pipettes was found with respect to observation of the contents in the dispenser, ease of administration, and the overall performance. Women regarded the unit-dose pipettes generally better than the bottles, but such a difference was not seen in men. The study participants managed the unit-dose pipettes at least as well as the conventional eye drop bottles. If anything, the unit-dose pipettes appeared to be easier to use.

  12. Effects of diets differing in glycemic index and glycemic load on cardiovascular risk factors: review of randomized controlled-feeing trials

    Science.gov (United States)

    Despite a considerable amount of data available on the relationship between dietary glycemic index (GI) or load (GL) and cardiovascular disease (CVD) risk factors, in aggregate, the area remains unsettled. The aim of the present review was to summarize the effect of diets differing in GI/GL on CVD r...

  13. Effects of a direct refill program for automated dispensing cabinets on medication-refill errors.

    Science.gov (United States)

    Helmons, Pieter J; Dalton, Ashley J; Daniels, Charles E

    2012-10-01

    The effects of a direct refill program for automated dispensing cabinets (ADCs) on medication-refill errors were studied. This study was conducted in designated acute care areas of a 386-bed academic medical center. A wholesaler-to-ADC direct refill program, consisting of prepackaged delivery of medications and bar-code-assisted ADC refilling, was implemented in the inpatient pharmacy of the medical center in September 2009. Medication-refill errors in 26 ADCs from the general medicine units, the infant special care unit, the surgical and burn intensive care units, and intermediate units were assessed before and after the implementation of this program. Medication-refill errors were defined as an ADC pocket containing the wrong drug, wrong strength, or wrong dosage form. ADC refill errors decreased by 77%, from 62 errors per 6829 refilled pockets (0.91%) to 8 errors per 3855 refilled pockets (0.21%) (p error type detected before the intervention was the incorrect medication (wrong drug, wrong strength, or wrong dosage form) in the ADC pocket. Of the 54 incorrect medications found before the intervention, 38 (70%) were loaded in a multiple-drug drawer. After the implementation of the new refill process, 3 of the 5 incorrect medications were loaded in a multiple-drug drawer. There were 3 instances of expired medications before and only 1 expired medication after implementation of the program. A redesign of the ADC refill process using a wholesaler-to-ADC direct refill program that included delivery of prepackaged medication and bar-code-assisted refill significantly decreased the occurrence of ADC refill errors.

  14. Fatigue life estimation of welded joints of an aluminium alloy under superimposed random load waves (follow-up report). Effects of high frequency components; Jujo random kajuka ni okeru aluminium gokin yosetsu tsugite no hiro jumyo suitei (zokuho). Koshuha seibun no eikyo

    Energy Technology Data Exchange (ETDEWEB)

    Takahashi, I.; Maenaka, H.; Takada, A. [Ship Research Inst., Tokyo (Japan)

    1996-12-31

    In order to examine fatigue behavior of boxing welded joints of anticorrosion aluminum A 5083 P-O alloy, the residual stress measurements, static loading tests, elastic finite element analyses, constant amplitude fatigue tests, and random fatigue tests were conducted. For a load wave in the random loading fatigue tests, a direct current component, a zero-mean narrow band random process, and a high frequency component were combined and superimposed, to examine the effect of the high frequency component and the effect of the stress cycle count method and the mean stress correction on the life estimation. For the fatigue analysis, a reference stress, such as that considering the structural stress concentration, was proved effective in reducing the amount of scattering in the fatigue test results and in improving the life estimation accuracy. Accordingly, for the actual scale measurements, it is insufficient only to measure the stress at points far from the crack initiation place. It is required to analyze the fatigue by measuring the reference stress same as the basic data acquisition tests in the laboratory. 4 refs., 21 figs., 4 tabs.

  15. Evaluation of crestal bone loss and stability of immediate functional loading versus immediate non-functional loading of single-mandibular posterior implants: A pilot randomized controlled clinical trial.

    Science.gov (United States)

    Mantena, Satyanarayana Raju; Sivagami, G; Gottumukkala, Sruthima Nvs

    2014-09-01

    The aim of this study is to evaluate and compare the crestal bone loss and stability of single mandibular posterior dental implants placed in immediate functional loading (IFL) and immediate nonfunctional loading (INFL) during 6 months after placement. Forty single piece root form titanium implants were placed in 20 patients using IFL and INFL techniques. The change in the level of crestal bone was measured on standardized digital periapical radiographs using SOPRO imaging software and stability of implants using resonance frequency analyser taken at the baseline, 1, 3, and 6 months. The measurements were statistically analyzed using the independent and paired t-test (P implant stability quotient (ISQ) values at first and third months were lower than those at the baseline for both the groups. However, the ISQ values at the sixth month were similar to baseline for both the groups. The crestal bone changes and the ISQ values when compared between the groups showed no statistically significant difference. IFL of dental implants have equivalent results and success rate as that of immediately provisionalized implants within the limitations of this study.

  16. Evaluation of crestal bone loss and stability of immediate functional loading versus immediate non-functional loading of single-mandibular posterior implants: A pilot randomized controlled clinical trial

    Directory of Open Access Journals (Sweden)

    Satyanarayana Raju Mantena

    2014-01-01

    Full Text Available Background: The aim of this study is to evaluate and compare the crestal bone loss and stability of single mandibular posterior dental implants placed in immediate functional loading (IFL and immediate nonfunctional loading (INFL during 6 months after placement. Materials and Methods: Forty single piece root form titanium implants were placed in 20 patients using IFL and INFL techniques. The change in the level of crestal bone was measured on standardized digital periapical radiographs using SOPRO imaging software and stability of implants using resonance frequency analyser taken at the baseline, 1, 3, and 6 months. The measurements were statistically analyzed using the independent and paired t-test (P < 0.05, statistically significant. Results: The mean change in the crestal bone level from baseline to 6 months was significant in both techniques. The implant stability quotient (ISQ values at first and third months were lower than those at the baseline for both the groups. However, the ISQ values at the sixth month were similar to baseline for both the groups. The crestal bone changes and the ISQ values when compared between the groups showed no statistically significant difference. Conclusion: IFL of dental implants have equivalent results and success rate as that of immediately provisionalized implants within the limitations of this study.

  17. Bacterial hand contamination and transfer after use of contaminated bulk-soap-refillable dispensers.

    Science.gov (United States)

    Zapka, Carrie A; Campbell, Esther J; Maxwell, Sheri L; Gerba, Charles P; Dolan, Michael J; Arbogast, James W; Macinga, David R

    2011-05-01

    Bulk-soap-refillable dispensers are prone to extrinsic bacterial contamination, and recent studies demonstrated that approximately one in four dispensers in public restrooms are contaminated. The purpose of this study was to quantify bacterial hand contamination and transfer after use of contaminated soap under controlled laboratory and in-use conditions in a community setting. Under laboratory conditions using liquid soap experimentally contaminated with 7.51 log(10) CFU/ml of Serratia marcescens, an average of 5.28 log(10) CFU remained on each hand after washing, and 2.23 log(10) CFU was transferred to an agar surface. In an elementary-school-based field study, Gram-negative bacteria on the hands of students and staff increased by 1.42 log(10) CFU per hand (26-fold) after washing with soap from contaminated bulk-soap-refillable dispensers. In contrast, washing with soap from dispensers with sealed refills significantly reduced bacteria on hands by 0.30 log(10) CFU per hand (2-fold). Additionally, the mean number of Gram-negative bacteria transferred to surfaces after washing with soap from dispensers with sealed-soap refills (0.06 log(10) CFU) was significantly lower than the mean number after washing with contaminated bulk-soap-refillable dispensers (0.74 log(10) CFU; P soap (P soap from bulk-soap-refillable dispensers can increase the number of opportunistic pathogens on the hands and may play a role in the transmission of bacteria in public settings.

  18. The accuracy and timeliness of neuraminidase inhibitor dispensing data for predicting laboratory-confirmed influenza.

    Science.gov (United States)

    Papenburg, J; Charland, K M; DE Serres, G; Buckeridge, D L

    2016-06-01

    Neuraminidase inhibitor (NI) dispensing has emerged as a possible automated data source for influenza surveillance. We aimed to evaluate its timeliness, correlation, and predictive accuracy in relation to influenza activity in Quebec, Canada, 2010-2013. Our secondary objective was to use the same metrics to compare NI dispensing to visits for influenza-like illness (ILI) in emergency departments (EDs). Provincial weekly counts of positive influenza laboratory tests were used as a reference measure for the level of influenza circulation. We applied ARIMA models to account for serial correlation. We computed cross-correlations to measure the strengths of association and lead-lag relationships between NI dispensing, ILI ED visits, and our reference indicator. Finally, using an ARIMA model, we evaluated the ability of NI dispensing and ILI ED visits to predict laboratory-confirmed influenza. NI dispensing was significantly correlated (R = 0·68) with influenza activity with no lag. The maximal correlation of ILI ED visits was not as strong (R = 0·50). Both NI dispensing and ILI ED visits were significant predictors of laboratory-confirmed influenza in a multivariable model; predictive potential was greatest when NI counts were lagged to precede laboratory surveillance by 2 weeks. We conclude that NI dispensing data provides timely and valuable information for influenza surveillance.

  19. Dispensing processes impact apparent biological activity as determined by computational and statistical analyses.

    Directory of Open Access Journals (Sweden)

    Sean Ekins

    Full Text Available Dispensing and dilution processes may profoundly influence estimates of biological activity of compounds. Published data show Ephrin type-B receptor 4 IC50 values obtained via tip-based serial dilution and dispensing versus acoustic dispensing with direct dilution differ by orders of magnitude with no correlation or ranking of datasets. We generated computational 3D pharmacophores based on data derived by both acoustic and tip-based transfer. The computed pharmacophores differ significantly depending upon dispensing and dilution methods. The acoustic dispensing-derived pharmacophore correctly identified active compounds in a subsequent test set where the tip-based method failed. Data from acoustic dispensing generates a pharmacophore containing two hydrophobic features, one hydrogen bond donor and one hydrogen bond acceptor. This is consistent with X-ray crystallography studies of ligand-protein interactions and automatically generated pharmacophores derived from this structural data. In contrast, the tip-based data suggest a pharmacophore with two hydrogen bond acceptors, one hydrogen bond donor and no hydrophobic features. This pharmacophore is inconsistent with the X-ray crystallographic studies and automatically generated pharmacophores. In short, traditional dispensing processes are another important source of error in high-throughput screening that impacts computational and statistical analyses. These findings have far-reaching implications in biological research.

  20. Sex pheromone dispenser type and trap design affect capture of dogwood borer.

    Science.gov (United States)

    Zhang, Aijun; Leskey, Tracy C; Bergh, J Christopher; Walgenbach, James F

    2013-03-01

    Using a ternary sex pheromone blend [86:6:6 v:v:v (Z,Z)-3,13-octadecadienyl acetate: (E,Z)-2,13-octadecadienyl acetate: (Z,E)-3,13-octadecadienyl acetate], we tested the effect of dispenser type and trap design for capture of dogwood borer (DWB), Synanthedon scitula Harris (Lepidoptera: Sesiidae) in apple orchards in West Virginia, Virginia, and North Carolina. Wing-style sticky traps baited with polyethylene vial pheromone dispensers captured more male DWB over the first 2 months than traps baited with rubber septum pheromone dispensers. However, catches in vial-baited traps decreased considerably after the first 2 months, possibly due to the antagonistic effect of 3,5-di-tert-butyl-4-hydroxy acetophenone that diffused from the polyethylene vials. By contrast, traps baited with rubber septum dispensers captured DWB males for at least 6 months; over the last four months of the flight season, catches in traps baited with a rubber septum were greater than those in traps baited with a vial dispenser. Therefore, the rubber septum dispenser is recommended for season-long monitoring of DWB. A release-rate study, using laboratory and field-aged dispensers, demonstrated that desorption of DWB sex pheromone from polyethylene vial or rubber septum dispensers followed first order kinetics, with half-lives of 1.6 and 10.7 months, respectively. Several trap designs, including wing-and delta-style sticky traps, and white and green "bucket-style" traps, baited with rubber septum dispensers were compared in commercial apple orchards for catch of DWB. Bucket traps caught more moths when moth populations were high, because the sticky surfaces of the 1C and delta traps likely became saturated. However, among the commercially available traps tested, no particular design gave consistently higher catches. Further work is needed to explore capture mechanisms and maintenance needs of different trap types.

  1. Temporal patterns of medications dispensed to children and adolescents in a national insured population.

    Directory of Open Access Journals (Sweden)

    Karen L Olson

    Full Text Available UNLABELLED: This study aimed to comprehensively describe prevalence and temporal dispensing patterns for medications prescribed to children and adolescents in the United States. Participants were 1.6 million children (49% female under 18 years old enrolled in a nation-wide, employer-provided insurance plan. All medication claims from 1999-2006 were reviewed retrospectively. Drugs were assigned to 16 broad therapeutic categories. Effects of trend over time, seasonality, age and gender on overall and within category prevalence were examined. RESULTS: Mean monthly prevalence for dispensed medications was 23.5% (range 19.4-27.5, with highest rates in winter and lowest in July. The age group with the highest prevalence was one-year-old children. On average each month, 17.1% of all children were dispensed a single drug and 6.4% were dispensed two or more. Over time, prevalence for two or more drugs did not change, but the proportion of children dispensed a single drug decreased (slope -.02%, p= .001. Overall, boys had higher monthly rates than girls (average difference 0.9%, p= .002. However, differences by gender were greatest during middle childhood, especially for respiratory and central nervous system agents. Contraceptives accounted for a large proportion of dispensed medication to older teenage girls. Rates for the drugs with the highest prevalence in this study were moderately correlated (average Pearson r.66 with those from a previously published national survey. CONCLUSION: On average, nearly one quarter of a population of insured children in the United States was dispensed medication each month. This rate decreased somewhat over time, primarily because proportionally fewer children were dispensed a single medication. The rate for two or more drugs dispensed simultaneously remained steady.

  2. Parenteral medication prescriptions, dispensing and administration habits in Mongolia.

    Directory of Open Access Journals (Sweden)

    Gereltuya Dorj

    Full Text Available High levels of injection prescribing were reported in Mongolia. Understanding the factors influencing the injection prescribing is essential to reduce their inappropriate use. The study evaluated the views, experiences and attitudes of community members associated with the prescribing of injections in Mongolia. A structured questionnaire focusing on respondents' characteristics, experiences and views about injections was developed and administered face-to-face to community members in Ulaanbaatar, Mongolia. Standard descriptive statistics were used to summarize demographic data and responses to the questionnaires. Dependent variables were compared using Kruskal-Wallis Tests for independence. Statistical analyses were performed using SPSS Version 21.0. Six hundred participants were approached and the response rate was 79% (n = 474. Almost half of the respondents were aged between 31 and 50 (n = 228, 48.1% and 40.9% of respondents were male (n = 194. Most respondents were from Ulaanbaatar city (n = 407, 85.7%. All respondents had received injections in the past and 268 (56.5% had received injection in the past year. The most common reason for having an injection in the past year was reported as treatment of a disease (n = 163, 60.8%, or for administration of vitamins (n = 70, 26.1%. Injections were prescribed by a doctor (n = 353, 74.9%, dispensed by a pharmacist (n = 283, 59.7% and administered by a nurse (n = 277, 54.9%. Only 16% of all respondents had the expectation of receiving injections when they visited a doctor (n = 77. An important perception regarding injections was that they hastened the recovery process (n = 269, 56.8%. When asked their opinion about therapeutic injections, 40% of all respondents agreed that injections were a better medicine (n = 190 than oral medications, with older respondents strongly agreeing (p<0.001. Based on this total sample, approximately 1891 injections per 1000 patients were administered. The excessive

  3. Enhancement of a modified Mediterranean-style, low glycemic load diet with specific phytochemicals improves cardiometabolic risk factors in subjects with metabolic syndrome and hypercholesterolemia in a randomized trial

    Directory of Open Access Journals (Sweden)

    Babish John G

    2008-11-01

    Full Text Available Abstract Background As the worldwide dietary pattern becomes more westernized, the metabolic syndrome is reaching epidemic proportions. Lifestyle modifications including diet and exercise are recommended as first-line intervention for treating metabolic syndrome. Previously, we reported that a modified Mediterranean-style, low glycemic load diet with soy protein and phytosterols had a more favorable impact than the American Heart Association Step 1 diet on cardiovascular disease (CVD risk factors. Subsequently, we screened for phytochemicals with a history of safe use that were capable of increasing insulin sensitivity through modulation of protein kinases, and identified hops rho iso-alpha acid and acacia proanthocyanidins. The objective of this study was to investigate whether enhancement of a modified Mediterranean-style, low glycemic load diet (MED with specific phytochemicals (soy protein, phytosterols, rho iso-alpha acids and proanthocyanidins; PED could improve cardiometabolic risk factors in subjects with metabolic syndrome and hypercholesterolemia. Methods Forty-nine subjects with metabolic syndrome and hypercholesterolemia, aged 25–80, entered a randomized, 2-arm, 12-week intervention trial; 23 randomized to the MED arm; 26 to the PED arm. Forty-four subjects completed at least 8 weeks [MED (n = 19; PED (n = 25]. All subjects were instructed to follow the same aerobic exercise program. Three-day diet diaries and 7-day exercise diaries were assessed at each visit. Fasting blood samples were collected at baseline, 8 and 12 weeks for analysis. Results Both arms experienced equal weight loss (MED: -5.7 kg; PED: -5.9 kg. However, at 12 weeks, the PED arm experienced greater reductions (P P P P P Conclusion These results demonstrate that specific phytochemical supplementation increased the effectiveness of the modified Mediterranean-style low glycemic load dietary program on variables associated with metabolic syndrome and CVD.

  4. Enhancement of a modified Mediterranean-style, low glycemic load diet with specific phytochemicals improves cardiometabolic risk factors in subjects with metabolic syndrome and hypercholesterolemia in a randomized trial.

    Science.gov (United States)

    Lerman, Robert H; Minich, Deanna M; Darland, Gary; Lamb, Joseph J; Schiltz, Barbara; Babish, John G; Bland, Jeffrey S; Tripp, Matthew L

    2008-11-04

    As the worldwide dietary pattern becomes more westernized, the metabolic syndrome is reaching epidemic proportions. Lifestyle modifications including diet and exercise are recommended as first-line intervention for treating metabolic syndrome. Previously, we reported that a modified Mediterranean-style, low glycemic load diet with soy protein and phytosterols had a more favorable impact than the American Heart Association Step 1 diet on cardiovascular disease (CVD) risk factors. Subsequently, we screened for phytochemicals with a history of safe use that were capable of increasing insulin sensitivity through modulation of protein kinases, and identified hops rho iso-alpha acid and acacia proanthocyanidins. The objective of this study was to investigate whether enhancement of a modified Mediterranean-style, low glycemic load diet (MED) with specific phytochemicals (soy protein, phytosterols, rho iso-alpha acids and proanthocyanidins; PED) could improve cardiometabolic risk factors in subjects with metabolic syndrome and hypercholesterolemia. Forty-nine subjects with metabolic syndrome and hypercholesterolemia, aged 25-80, entered a randomized, 2-arm, 12-week intervention trial; 23 randomized to the MED arm; 26 to the PED arm. Forty-four subjects completed at least 8 weeks [MED (n = 19); PED (n = 25)]. All subjects were instructed to follow the same aerobic exercise program. Three-day diet diaries and 7-day exercise diaries were assessed at each visit. Fasting blood samples were collected at baseline, 8 and 12 weeks for analysis. Both arms experienced equal weight loss (MED: -5.7 kg; PED: -5.9 kg). However, at 12 weeks, the PED arm experienced greater reductions (P phytochemical supplementation increased the effectiveness of the modified Mediterranean-style low glycemic load dietary program on variables associated with metabolic syndrome and CVD.

  5. The children and sunscreen study: a crossover trial investigating children's sunscreen application thickness and the influence of age and dispenser type.

    Science.gov (United States)

    Diaz, Abbey; Neale, Rachel E; Kimlin, Michael G; Jones, Lee; Janda, Monika

    2012-05-01

    To measure the thickness at which primary schoolchildren apply sunscreen on school day mornings and to compare it with the thickness (2.00 mg/cm(2)) at which sunscreen is tested during product development, as well as to investigate how application thickness was influenced by age of the child (school grades 1-7) and by dispenser type (500-mL pump, 125-mL squeeze bottle, or 50-mL roll-on). A crossover quasiexperimental study design comparing 3 sunscreen dispenser types. Children aged 5 to 12 years from public primary schools (grades 1-7) in Queensland, Australia. Children (n=87) and their parents randomly recruited from the enrollment lists of 7 primary schools. Each child provided up to 3 observations (n=258). Children applied sunscreen during 3 consecutive school weeks (Monday through Friday) for the first application of the day using a different dispenser each week. Thickness of sunscreen application (in milligrams per square centimeter). The dispensers were weighed before and after use to calculate the weight of sunscreen applied. This was divided by the coverage area of application (in square centimeters), which was calculated by multiplying the children's body surface area by the percentage of the body covered with sunscreen. Children applied their sunscreen at a median thickness of 0.48 mg/cm(2). Children applied significantly more sunscreen when using the pump (0.75 mg/cm(2)) and the squeeze bottle (0.57 mg/cm(2)) compared with the roll-on (0.22 mg/cm(2)) (Pdispensers seem to facilitate thicker application than others.

  6. Towards more reliable automated multi-dose dispensing: retrospective follow-up study on medication dose errors and product defects.

    Science.gov (United States)

    Palttala, Iida; Heinämäki, Jyrki; Honkanen, Outi; Suominen, Risto; Antikainen, Osmo; Hirvonen, Jouni; Yliruusi, Jouko

    2013-03-01

    To date, little is known on applicability of different types of pharmaceutical dosage forms in an automated high-speed multi-dose dispensing process. The purpose of the present study was to identify and further investigate various process-induced and/or product-related limitations associated with multi-dose dispensing process. The rates of product defects and dose dispensing errors in automated multi-dose dispensing were retrospectively investigated during a 6-months follow-up period. The study was based on the analysis of process data of totally nine automated high-speed multi-dose dispensing systems. Special attention was paid to the dependence of multi-dose dispensing errors/product defects and pharmaceutical tablet properties (such as shape, dimensions, weight, scored lines, coatings, etc.) to profile the most suitable forms of tablets for automated dose dispensing systems. The relationship between the risk of errors in dose dispensing and tablet characteristics were visualized by creating a principal component analysis (PCA) model for the outcome of dispensed tablets. The two most common process-induced failures identified in the multi-dose dispensing are predisposal of tablet defects and unexpected product transitions in the medication cassette (dose dispensing error). The tablet defects are product-dependent failures, while the tablet transitions are dependent on automated multi-dose dispensing systems used. The occurrence of tablet defects is approximately twice as common as tablet transitions. Optimal tablet preparation for the high-speed multi-dose dispensing would be a round-shaped, relatively small/middle-sized, film-coated tablet without any scored line. Commercial tablet products can be profiled and classified based on their suitability to a high-speed multi-dose dispensing process.

  7. Satisfaction and Clinical Outcomes Among Patients with Immediately Loaded Mandibular Overdentures Supported by One or Two Dental Implants: Results of a 5-Year Prospective Randomized Clinical Trial.

    Science.gov (United States)

    Kronstrom, Mats; Davis, Ben; Loney, Robert; Gerrow, Jack; Hollender, Lars

    The purpose of this study was to evaluate patient satisfaction and clinical outcomes among subjects with mandibular overdentures supported by one or two immediately placed dental implants 5 years after loading. Thirty-six subjects (16 men and 20 women) received one or two dental implants in the anterior mandible, and all implants were loaded the day of surgery. Subjects were scheduled for follow-up 3-, 6-, and 12 months after implant placement and thereafter annually for 4 more years. Patient satisfaction scores were measured with the Oral Health Impact Profile-EDENT (OHIPEDENT) questionnaire. Seventeen subjects (7 male and 10 female) with a mean age of 59.4 years (range, 44 to 74 years) were available for the 5-year follow-up examination. Nine subjects with 10 failing implants were excluded during the first year and nine subjects were lost to follow-up. No implants failed between the 12- and 60-month follow-up examinations, and the need for denture maintenance was low. Mean peri-implant bone change was 0.92 mm, and the Spearman test failed to show correlation between the insertion torque value and implant stability quotient. Patient satisfaction scores increased significantly when compared with baseline values and continued to be high for both groups, with no significant differences. Ten implants in nine subjects failed early, but no failures were observed after the 12-month examination. No significant differences were found between subjects in the two groups with respect to implant survival rates and peri-implant bone loss, and patient satisfaction scores continued to be high. Although patient satisfaction and implant success were high during the 12- to 60-month period, the results should be interpreted with caution because of the high number of failing implants and patients lost to follow-up. More research is needed to study outcomes of treatment with immediately loaded mandibular implant overdentures.

  8. A simple low-cost of liquid I-131 dispenser for routine radiopharmaceutical dispensing at nuclear medicine department, Institut Kanser Negara

    Energy Technology Data Exchange (ETDEWEB)

    Said, M. A.; Suhaimi, N. E. F. [Fakulti Sains dan Teknologi, Universiti Kebangsaan Malaysia, 43600 UKM, Bangi Selangor (Malaysia); Ashhar, Z. N., E-mail: aminhpj@gmail.com [Institut Kanser Negara, No 4, Jalan P7, Presint 7, 62250 Putrajaya (Malaysia); Zainon, R. [Advanced Medical & Dental Institute, Universiti Sains Malaysia, Bertam, 13200, Kepala Batas, Pulau Pinang (Malaysia)

    2016-01-22

    In routine radiopharmaceutical Iodine-131 ({sup 131}I) dispensing, the amount of radiation dose received by the personnel depends on the distance between the personnel and the source, the time spent manipulating the source and the amount of shielding used to reduce the dose rate from the source. The novel iRAD-I131 dispenser using recycle {sup 131}I liquid lead pot will lead into low cost production, less maintenance and low dose received by the personnel that prepared the {sup 131}I. The new fabricated of low cost {sup 131}I dispenser was tested and the dose received by personnel were evaluated. The body of lead material is made from 2.5 cm lead shielded coated with epoxy paint to absorb the radiation dose up to 7.4 GBq of {sup 131} I. The lead pot was supported with two stainless steel rod. The Optically Stimulated Luminescence (OSL) nanodot was used in this study to measure the dose rate at both extremities for every personnel who prepared the {sup 131}I. Each OSL nanodot was attached at the fingertip. Three different personnel (experienced between one to ten years above in preparing the radiopharmaceuticals) were participated in this study. The average equivalent dose at right and left hand were 122.694 ± 121.637 µSv/GBq and 77.281 ± 62.146 µSv/GBq respectively. This study found that the dose exposure received using iRAD-I131 was less up to seven times compared to the conventional method. The comparison of experimental data using iRAD-I131 and established radiopharmaceutical dispenser was also discussed. The innovation of {sup 131}I dispenser is highly recommended in a small radiopharmaceutical facility with limited budget. The novel iRAD-I131 enables implementation of higher output liquid dispensing with low radiation dose to the personnel.

  9. Piwi genes are dispensable for normal hematopoiesis in mice.

    Directory of Open Access Journals (Sweden)

    Mona J Nolde

    Full Text Available Hematopoietic stem cells (HSC must engage in a life-long balance between self-renewal and differentiation to sustain hematopoiesis. The highly conserved PIWI protein family regulates proliferative states of stem cells and their progeny in diverse organisms. A Human piwi gene (for clarity, the non-italicized "piwi" refers to the gene subfamily, HIWI (PIWIL1, is expressed in CD34⁺ stem/progenitor cells and transient expression of HIWI in a human leukemia cell line drastically reduces cell proliferation, implying the potential function of these proteins in hematopoiesis. Here, we report that one of the three piwi genes in mice, Miwi2 (Piwil4, is expressed in primitive hematopoetic cell types within the bone marrow. Mice with a global deletion of all three piwi genes, Miwi, Mili, and Miwi2, are able to maintain long-term hematopoiesis with no observable effect on the homeostatic HSC compartment in adult mice. The PIWI-deficient hematopoetic cells are capable of normal lineage reconstitution after competitive transplantation. We further show that the three piwi genes are dispensable during hematopoietic recovery after myeloablative stress by 5-FU. Collectively, our data suggest that the function of the piwi gene subfamily is not required for normal adult hematopoiesis.

  10. Ghrelin is dispensable for embryonic pancreatic islet development and differentiation

    Science.gov (United States)

    Hill, Jonathon T.; Mastracci, Teresa L.; Vinton, Carol; Doyle, Michelle L.; Anderson, Keith R.; Loomis, Zoe L.; Schrunk, Jessica M.; Minic, Angela D.; Prabakar, Kamalaveni R.; Pugliese, Alberto; Sun, Yuxian; Smith, Roy G.; Sussel, Lori

    2009-01-01

    Ghrelin is a peptide hormone that has been implicated in the regulation of food intake and energy homeostasis. Ghrelin is predominantly produced in the stomach, but is also expressed in many other tissues where its functions are not well characterized. In the rodent and human pancreas, ghrelin levels peak at late gestation and gradually decline postnatally. Several studies have suggested that ghrelin regulates beta cell function during embryonic development and in the adult. In addition, in a number of mouse models, ghrelin cells appear to replace insulin and glucagon-producing cells in the islet. In this analysis, we investigated whether the absence or overexpression of ghrelin influenced the development and differentiation of the pancreatic islet during embryonic development. These studies revealed that ghrelin is dispensable for normal pancreas development during gestation. Conversely, we demonstrated that elevated ghrelin in the Nkx2.2 null islets is not responsible for the absence of insulin- and glucagon-producing cells. Finally, we have also determined that in absence of insulin, ghrelin cells form in their normal numbers and ghrelin is expressed at wild type levels. PMID:19268691

  11. Implementation of Advanced Inventory Management Functionality in Automated Dispensing Cabinets.

    Science.gov (United States)

    Findlay, Russell; Webb, Aaron; Lund, Jim

    2015-07-01

    Automated dispensing cabinets (ADCs) are an integral component of distribution models in pharmacy departments across the country. There are significant challenges to optimizing ADC inventory management while minimizing use of labor and capital resources. The role of enhanced inventory control functionality is not fully defined. The aim of this project is to improve ADC inventory management by leveraging dynamic inventory standards and a low inventory alert platform. Two interventional groups and 1 historical control were included in the study. Each intervention group consisted of 6 ADCs that tested enhanced inventory management functionality. Interventions included dynamic inventory standards and a low inventory alert messaging system. Following separate implementation of each platform, dynamic inventory and low inventory alert systems were applied concurrently to all 12 ADCs. Outcome measures included number and duration of daily stockouts, ADC inventory turns, and number of phone calls related to stockouts received by pharmacy staff. Low inventory alerts reduced both the number and duration of stockouts. Dynamic inventory standards reduced the number of daily stockouts without changing the inventory turns and duration of stockouts. No change was observed in number of calls related to stockouts made to pharmacy staff. Low inventory alerts and dynamic inventory standards are feasible mechanisms to help optimize ADC inventory management while minimizing labor and capital resources.

  12. A new microfluidics-based droplet dispenser for ICPMS.

    Science.gov (United States)

    Verboket, Pascal E; Borovinskaya, Olga; Meyer, Nicole; Günther, Detlef; Dittrich, Petra S

    2014-06-17

    In this work, a novel droplet microfluidic sample introduction system for inductively coupled plasma mass spectrometry (ICPMS) is proposed and characterized. The cheap and disposable microfluidic chip generates droplets of an aqueous sample in a stream of perfluorohexane (PFH), which is also used to eject them as a liquid jet. The aqueous droplets remain intact during the ejection and can be transported into the ICP with >50% efficiency. The transport is realized via a custom-built system, which includes a membrane desolvator necessary for the PFH vapor removal. The introduction system presented here can generate highly monodisperse droplets in the size range of 40-60 μm at frequencies from 90 to 300 Hz. These droplets produced very stable signals with a relative standard deviation (RSD) comparable to the one achieved with a commercial droplet dispenser. Using the current system, samples with a total volume of <1 μL can be analyzed. Moreover, the capabilities of the setup for introduction and quantitative elemental analysis of single cells were described using a test system of bovine red blood cells. In the future, other modules of the modern microfludics can be integrated in the chip, such as on-chip sample pretreatment or parallel introduction of different samples.

  13. Patterning of dispenser cathode surfaces to a controlled porosity

    Science.gov (United States)

    Garner, Charles E.; Deininger, William D.; Gibson, John; Thomas, Richard

    1989-01-01

    A process to pattern slots approximately 1.25 microns in width into 25-micron-thick W films that have been deposited onto flat or concave surfaces is discussed. A 25-micron-thick W film with a high degree of (100) orientation is chemically vapor deposited (CVD) onto a flat or concave Mo mandrel. A 5-micron-thick Al film is deposited onto the CVD W, followed by 2 microns of photoresist. On concave cathodes, XeCl2 laser ablation or X-ray lithography is used to pattern the photoresist, whereas on flat cathodes deep UV lithography can be used. The patterned photoresist serves as the mask in a Cl ion-beam-assisted etching (IBAE) process to pattern the Al. An alternative process is to deposit Al2O3 films onto the W and pattern the Al2O3 using laser ablation. The W film is then patterned to 3-6-micron slot widths using IBAE + ClF3 with the patterned Al or Al2O3 as the mask. Finally, a sputter deposition step is required to close up the slots to approximately 1 micron. The process described is capable of patterning concave dispenser cathodes to a controlled and precise porosity.

  14. All-printed capacitors with continuous solution dispensing technology

    Science.gov (United States)

    Ge, Yang; Plötner, Matthias; Berndt, Andreas; Kumar, Amit; Voit, Brigitte; Pospiech, Doris; Fischer, Wolf-Joachim

    2017-09-01

    Printed electronics have been introduced into the commercial markets in recent years. Various printing technologies have emerged aiming to process printed electronic devices with low cost, environmental friendliness, and compatibility with large areas and flexible substrates. The aim of this study is to propose a continuous solution dispensing technology for processing all-printed thin-film capacitors on glass substrates using a leading-edge printing instrument. Among all printing technologies, this study provides concrete proof of the following outstanding advantages of this technology: high tolerance to inks, high throughput, low cost, and precise pattern transfers. Ag nanoparticle ink based on glycol ethers was used to print the electrodes. To obtain dielectric ink, a copolymer powder of poly(methyl methacrylate-co-benzoylphenyl methacrylate) containing crosslinkable side groups was dissolved in anisole. Various layouts were designed to support multiple electronic applications. Scanning electron microscopy and atomic force microscopy were used to investigate the all-printed capacitor layers formed using the proposed process. Additionally, the printed capacitors were electrically characterized under direct current and alternating current. The measured electrical properties of the printed capacitors were consistent with the theoretical results.

  15. Enhanced Adherence in Patients Using an Automated Home Medication Dispenser.

    Science.gov (United States)

    Hoffmann, Charles; Schweighardt, Anne; Conn, Kelly M; Nelson, Dallas; Barbano, Richard; Marshall, Frederick; Brown, Jack

    2017-07-24

    Many factors contribute to medication nonadherence including psychological and memory disorders, aging, and pill burden. The Automated Home Medication Dispenser (AHMD) is a medication management system intended to help solve unintentional medication nonadherence. The purpose of this study was to determine if use of the AHMD improved medication adherence. We conducted a 6-month prospective, feasibility study assessing use of the AHMD in 21 patient-caregiver dyads. Patients were referred by their physician because of poor medication adherence and included if they resided in Rochester, NY and on at least two medications in pill form. Pill counts were performed at baseline to assess previous adherence. Prospective medication adherence was assessed using AHMD recorded dosing information. A paired t-test was used to compare previous and prospective adherence. The mean age of patients was 75.1 years. Fifteen patients (71.4%) and eight caregivers (38.1%) were women; half (47.6%) of caregivers lived with the patient. The most common patient comorbidities were hypertension (76.2%) and memory disorder (61.9%). Mean adherence increased from 49.0% at baseline to 96.8% after 6 months of AHMD use (p < .001). In a cohort of unintentionally nonadherent patients, use of the AHMD for 6 months significantly improved medication adherence.

  16. Nano- and pico-dispensing of fluids on planar substrates using SAW

    OpenAIRE

    Wixforth, Achim

    2004-01-01

    Nano- and pico-dispensing of fluids on planar substrates using SAW / C. J. Strobl, Z. von Guttenberg, A. Wixforth. – In: IEEE transactions on ultrasonics ferroelectrics and frequency control. 51. 2004. S. 1432-1436

  17. Linking community pharmacy dispensing data to prescribing data of general practitioners.

    NARCIS (Netherlands)

    Florentinus, S.R.; Souverein, P.C.; Griens, F.A.M.G.; Groenewegen, P.P.; Leufkens, H.G.M.; Heerdink, E.R.

    2006-01-01

    BACKGROUND: Databases are frequently used for pharmacoepidemiological research. However, most of these databases consist either of prescribing, dispensing or administrative data and therefore lack insight in the interaction between the several health professionals around the patient. METHODS: To

  18. Concepts for a theoretical and experimental study of lifting rotor random loads and vibrations. Phase 5B: Analysis of gust alleviation methods and rotor dynamic stability

    Science.gov (United States)

    Hohenemser, K. H.; Yin, S. K.

    1971-01-01

    The effects of various gust alleviation methods on the random blade response in flapping were studied analytically, assuming a rigid rotor support. The analytical model assumes rigid flapping blades with elastic root restraints. Linearized equations which are approximately valid at low lift conditions were used. Because of the interblade coupling from the feedback devices, the method of multiblade generalized coordinates was most convenient and was extended to include coning, differential coning, and warping of the rotor. The numerical examples cover the dynamic stability characteristics as affected by feedback gains of three- to six-bladed rotors. The number of blades had large effects on stability limits and modal time functions at these limits. The random flapping response of the blades to atmospheric turbulence was determined at 1.6 rotor advance ratio using feedback gains below the stability limit. The most effective reduction of the flapping response per unit gain was achieved with a rotor coning angle feedback.

  19. Spironolactone loaded nanostructured lipid carrier gel for effective treatment of mild and moderate acne vulgaris: A randomized, double-blind, prospective trial.

    Science.gov (United States)

    Kelidari, Hamid Reza; Saeedi, Majid; Hajheydari, Zohreh; Akbari, Jafar; Morteza-Semnani, Katayoun; Akhtari, Javad; Valizadeh, Hadi; Asare-Addo, Kofi; Nokhodchi, Ali

    2016-10-01

    Spironolactone (SP) known as an anti-androgen drug, has been proven to be effective in treatment of acne. The quest to minimize the unnecessary systemic side effects associated with the oral drug administration of spironolactone, has led to a growing interest of loading SP on lipid nanoparticles to deliver the drug in a topical formulation. The aim of the current investigation was to prepare and compare the performance of SP loaded nanostructured lipid carrier (SP-NLC) and SP alcoholic gels (SP-ALC) on two groups of respective patient populations, group A and group B in the treatment of mild to moderate acne vulgaris. The results showed that SP-NLCs were spherical in shape with an average diameter of ∼240nm. The polydispersity index (PI) and zeta potential of these nanoparticles were 0.286 and -21.4 respectively. The gels showed non-Newtonian independent pseudoplastic and shear thinning behavior. The SP-NLCs was not toxic to fibroblast cell strains at the 24 and 48h periods. Results showed that the mean number of total lesions (37.66±9.27) and non-inflammatory lesions (29.26±7.99) in group A significantly decreased to 20.31±6.58 (ptreatment with SP-NLC for 8 weeks, the water content of the skin significantly (pacne vulgaris with skin care benefits. Copyright © 2016 Elsevier B.V. All rights reserved.

  20. Efficacy of vitamin D loading doses on serum 25-hydroxy vitamin D levels in school going adolescents: an open label non-randomized prospective trial.

    Science.gov (United States)

    Garg, M K; Marwaha, Raman K; Khadgawat, Rajesh; Ramot, Rekha; Obroi, Avneet Kaur; Mehan, Neena; Gupta, Nandita; Madan, Renu

    2013-01-01

    Vitamin D deficiency (VDD) among adolescents is a major health problem in India. The aim of this study was to assess the efficacy of therapeutic/loading doses of vitamin D supplementation on serum 25-hydroxy vitamin D (25OHD) levels in vitamin D deficient adolescents. A total of 482 out of the 511 subjects recruited for the study were divided into three groups, each group receiving 60,000 IU of vitamin D3 weekly for 4, 6 and 8 weeks followed by 600 IU daily for 12 weeks, respectively. Clinical evaluation was followed by estimation of biochemical markers and serum 25OHD levels. VDD was observed in 94.8% of adolescents. All three vitamin D loading doses were equally efficacious in achieving vitamin D sufficiency >75 nmol/L (>30 ng/mL) in more than 90% subjects in the three groups. Mean 25OHD levels in groups 2 and 3 following maintenance therapy were 67.5±16.5 nmol/L (27.0±6.6 ng/mL) and 70.0±21.8 nmol/L (28.0±8.7 ng/mL), respectively. Supplementing 60,000 IU of vitamin D3 per week for 4-8 weeks, followed by 600 IU daily through fortified milk, is an effective strategy for achieving vitamin D sufficiency in Indian adolescents.

  1. A Randomized Case-Series Study Comparing the Stability of Implant with Two Different Surfaces Placed in Fresh Extraction Sockets and Immediately Loaded

    Directory of Open Access Journals (Sweden)

    Leonardo Vanden Bogaerde

    2016-01-01

    Full Text Available Background. Hydrophilic and moderately rough implant surfaces have been proposed to enhance the osseointegration response. Aim. The aim of this study was to compare early changes of stability for two implants with identical macrodesign but with different surface topographies. Materials and Methods. In 11 patients, a total of 22 implants (11 bimodal (minimally rough, control and 11 proactive (moderately rough and hydrophilic, test, Neoss Ltd., Harrogate, UK were immediately placed into fresh extraction sockets and immediately loaded. The peak insertion torque (IT was measured in Ncm at placement. Resonance Frequency Analysis (RFA measurements were made at baseline and 2, 4, 6, and 12 weeks after surgery. Results. The two implant types showed similar IT and RFA values at placement (NS. A dip of RFA values after 2 weeks followed by an increase was observed, where the test implant showed a less pronounced decrease and a more rapid recovery than the control implant. The test implants were significantly more stable than the control ones after 12 weeks. Conclusions. The results from the present study indicated that the hydrophilic and rougher test implant was more resistant to immediate loading and showed a significantly higher stability than the smoother control implant after 12 weeks.

  2. Effect of neutral-cushioned running shoes on plantar pressure loading and comfort in athletes with cavus feet: a crossover randomized controlled trial.

    Science.gov (United States)

    Wegener, Caleb; Burns, Joshua; Penkala, Stefania

    2008-11-01

    High injury rates observed in athletes with cavus feet are thought to be associated with elevated plantar pressure loading. Neutral-cushioned running shoes are often recommended to manage and prevent such injuries. To investigate in-shoe plantar pressure loading and comfort during running in 2 popular neutral-cushioned running shoes recommended for athletes with cavus feet. Controlled laboratory study. Plantar pressures were collected using the in-shoe Novel Pedar-X system during overground running in 22 athletes with cavus feet in 2 neutral-cushioned running shoes (Asics Nimbus 6 and Brooks Glycerin 3) and a control condition (Dunlop Volley). Comfort was measured using a validated visual analog scale. Compared with the control, both neutral-cushioned running shoes significantly reduced peak pressure and pressure-time integrals by 17% to 33% (P shoes reduced force at the forefoot by 6% and increased it at the midfoot by 12% to 17% (P shoes (P comfortable, although both neutral-cushioned running shoes were significantly more comfortable than the control (P shoes were effective at reducing plantar pressures in athletes with cavus feet. Regional differences in pressure reduction suggest neutral-cushioned running shoe recommendation should shift from being categorical in nature to being based on location of injury or elevated plantar pressure.

  3. Conversion of cold beverage dispenser's refrigeration system to R744 refrigerant

    OpenAIRE

    Visek, Matej; Elbel, Stefan; Hrnjak, Pega

    2016-01-01

    Cold beverage dispensers belong to the group of light commercial refrigeration machines that includes beverage coolers, ice machines and storage units for food items. Beverage dispensers use a vapor compression system to charge a thermal storage, usually an ice bank, which is used to indirectly cool tap water and beverage concentrate. For these machines, R290 (propane) and R744 (carbon dioxide) are among the favorite candidates to completely replace high GWP HFC refrigerants in the future. Be...

  4. The association between lifting an administrative restriction on antidepressant dispensing and treatment patterns in Iceland

    DEFF Research Database (Denmark)

    Thengilsdottir, G; Gardarsdottir, H; Almarsdóttir, Anna Birna

    2013-01-01

    On March 1st 2009, restrictions on the dispensing of selective serotonin reuptake inhibitors (SSRI) in Iceland were lifted. Incident rates and changes in early discontinuation and switching before and after the change were investigated.......On March 1st 2009, restrictions on the dispensing of selective serotonin reuptake inhibitors (SSRI) in Iceland were lifted. Incident rates and changes in early discontinuation and switching before and after the change were investigated....

  5. Multi-dose drug dispensing is a challenge across the primary-secondary care interface

    DEFF Research Database (Denmark)

    Reuther, Lene Orskov; Lysen, Charlotte; Faxholm, Mette

    2011-01-01

    Multi-dose drug dispensing (MDDD) signifies that the patient's medicine is packed in disposable bags corresponding to the dose that should be taken. The purpose of the present study was to investigate how a hospital MDDD instruction was followed.......Multi-dose drug dispensing (MDDD) signifies that the patient's medicine is packed in disposable bags corresponding to the dose that should be taken. The purpose of the present study was to investigate how a hospital MDDD instruction was followed....

  6. Chemical Degradation of TMR Multilure Dispensers for Fruit Fly Detection Weathered Under California Climatic Conditions.

    Science.gov (United States)

    Vargas, Roger I; Souder, Steven K; Morse, Joseph G; Grafton-Cardwell, Elizabeth E; Haviland, David R; Kabashima, John N; Faber, Ben A; Mackey, Bruce; Nkomo, Eddie; Cook, Peter J; Stark, John D

    2017-08-01

    Degradation models for multilure fruit fly trap dispensers were analyzed to determine their potential for use in large California detection programs. Solid three-component male lure TMR (trimedlure [TML], methyl eugenol [ME], raspberry ketone [RK]) dispensers impregnated with DDVP (2, 2-dichlorovinyl dimethyl phosphate) insecticide placed inside Jackson traps were weathered during summer (8 wk) and winter (12 wk) in five citrus-growing areas. Additionally, TMR wafers without DDVP, but with an insecticidal strip, were compared to TMR dispensers with DDVP. Weathered dispensers were sampled weekly and chemically analyzed. Percent loss of TML, the male lure for Ceratitis capitata (Wiedemann) Mediterranean fruit fly; ME, the male lure for Bactrocera dorsalis (Hendel), oriental fruit fly; RK, the male lure for Bactrocera cucurbitae (Coquillett), melon fly; and DDVP was measured. Based on regression analyses for the male lures, TML degraded the fastest followed by ME. Degradation of the more chemically stable RK was discontinuous, did not fit a regression model, but followed similar seasonal patterns. There were few location differences for all three male lures and DDVP. Dispensers degraded faster during summer than winter. An asymptotic regression model provided a good fit for % loss (ME, TML, and DDVP) for summer data. Degradation of DDVP in TMR dispensers was similar to degradation of DDVP in insecticidal strips. Based on these chemical analyses and prior bioassay results with wild flies, TMR dispensers could potentially be used in place of three individual male lure traps, reducing costs of fruit fly survey programs. Use of an insecticidal tape would not require TMR dispensers without DDVP to be registered with US-EPA. Published by Oxford University Press on behalf of Entomological Society of America 2017. This work is written by US Government employees and is in the public domain in the US.

  7. ARAS: an automated radioactivity aliquoting system for dispensing solutions containing positron-emitting radioisotopes.

    Science.gov (United States)

    Dooraghi, Alex A; Carroll, Lewis; Collins, Jeffrey; van Dam, R Michael; Chatziioannou, Arion F

    2016-12-01

    Automated protocols for measuring and dispensing solutions containing radioisotopes are essential not only for providing a safe environment for radiation workers but also to ensure accuracy of dispensed radioactivity and an efficient workflow. For this purpose, we have designed ARAS, an automated radioactivity aliquoting system for dispensing solutions containing positron-emitting radioisotopes with particular focus on fluorine-18 ((18)F). The key to the system is the combination of a radiation detector measuring radioactivity concentration, in line with a peristaltic pump dispensing known volumes. The combined system demonstrates volume variation to be within 5 % for dispensing volumes of 20 μL or greater. When considering volumes of 20 μL or greater, the delivered radioactivity is in agreement with the requested amount as measured independently with a dose calibrator to within 2 % on average. The integration of the detector and pump in an in-line system leads to a flexible and compact approach that can accurately dispense solutions containing radioactivity concentrations ranging from the high values typical of [(18)F]fluoride directly produced from a cyclotron (~0.1-1 mCi μL(-1)) to the low values typical of batches of [(18)F]fluoride-labeled radiotracers intended for preclinical mouse scans (~1-10 μCi μL(-1)).

  8. Linking community pharmacy dispensing data to prescribing data of general practitioners

    Directory of Open Access Journals (Sweden)

    Leufkens Hubert GM

    2006-04-01

    Full Text Available Abstract Background Databases are frequently used for pharmacoepidemiological research. However, most of these databases consist either of prescribing, dispensing or administrative data and therefore lack insight in the interaction between the several health professionals around the patient. Methods To determine the success rate of linking records from the dispensing database of the Foundation for Pharmaceutical Statistics to the prescribing database of the second Dutch national survey of general practice, conducted by NIVEL (Netherlands Institute for Health Services Research, a deterministic record linkage approach was used with patient and prescription characteristics as matching variables between the two databases. Results The catchment area included 123 community pharmacies, 90 GP practices and approximately 170,000 unique patients. Overall 110,102 (64.8% unique patients were linked using the matching variables patient's gender, year of birth, the 4-digit part of the postal code, date of dispensing/prescribing and ATC-code. The final database contains of the 110,102 both prescribing data from 83 GP practices and dispensing data of 112 community pharmacies. Conclusion This study shows that linkage of dispensing to prescribing data is feasible with a combination of patient characteristics, such as gender, year of birth and postal code, and prescription characteristics like prescription date and ATC-code. We obtained a linkage proportion of 64.8% resulting in complete prescribing and dispensing history of 110,102 patients. This offers an opportunity to gain insight in the mechanisms and factors influencing drug utilisation in general practice.

  9. Understanding private retail drug outlet dispenser knowledge and practices in tuberculosis care in Tanzania.

    Science.gov (United States)

    Rutta, E; Tarimo, A; Delmotte, E; James, I; Mwakisu, S; Kasembe, D; Konduri, N; Silumbe, R; Kakanda, K; Valimba, R

    2014-09-01

    Private sector accredited drug dispensing outlets in Morogoro and pharmacies in Dar es Salaam, Tanzania. To assess 1) the level of knowledge about tuberculosis (TB) among dispensers in Tanzania's retail pharmaceutical sector; 2) practices related to identification of patients with suspected TB; 3) the availability of educational materials and training; and 4) the availability of first- and second-line anti-tuberculosis treatment in retail drug outlets. A cross-sectional descriptive study involving the administration of a structured questionnaire among drug dispensers in 122 pharmacies and 173 accredited drug dispensing outlets. Private retail drug outlets are convenient; most are open at least 12 h per day, 7 days/week. Although 95% of dispensers identified persistent cough as a symptom of TB, only 1% had received TB-related training in the previous 3 years; 8% of outlets stocked first-line anti-tuberculosis medicines, which are legally prohibited from being sold at retail outlets. The majority of respondents reported seeing clients with TB-like symptoms, and of these 95% reported frequently referring clients to nearby health facilities. Private retail pharmaceutical outlets can potentially contribute to TB case detection and treatment; however, a coordinated effort is needed to train dispensers and implement appropriate referral procedures.

  10. Effects of randomized whey-protein loads on energy intake, appetite, gastric emptying, and plasma gut-hormone concentrations in older men and women.

    Science.gov (United States)

    Giezenaar, Caroline; Trahair, Laurence G; Luscombe-Marsh, Natalie D; Hausken, Trygve; Standfield, Scott; Jones, Karen L; Lange, Kylie; Horowitz, Michael; Chapman, Ian; Soenen, Stijn

    2017-09-01

    Background: Protein- and energy-rich supplements are used widely for the management of malnutrition in the elderly. Information about the effects of protein on energy intake and related gastrointestinal mechanisms and whether these differ between men and women is limited.Objective: We determined the effects of whey protein on energy intake, appetite, gastric emptying, and gut hormones in healthy older men and women.Design: Eight older women and 8 older men [mean ± SEM age: 72 ± 1 y; body mass index (in kg/m2): 25 ± 1] were studied on 3 occasions in which they received protein loads of 30 g (120 kcal) or 70 g (280 kcal) or a flavored water control drink (0 kcal). At regular intervals over 180 min, appetite (visual analog scales), gastric emptying (3-dimensional ultrasonography), and blood glucose and plasma gut-hormone concentrations [insulin, glucagon, ghrelin, cholecystokinin, gastric inhibitory polypeptide (GIP), glucagon-like peptide 1 (GLP-1), and peptide tyrosine tyrosine (PYY)] were measured, and ad libitum energy intake was quantified from a buffet meal (180-210 min; energy intake, appetite, and gastric emptying in the men have been published previously).Results: Energy intake at the buffet meal was ∼80% higher in older men than in older women (P protein compared with the control in men or women (P > 0.05). There was no effect of sex on gastric emptying, appetite, gastrointestinal symptoms, glucose, or gut hormones (P > 0.05). There was a protein load-dependent slowing of gastric emptying, an increase in concentrations of insulin, glucagon, cholecystokinin, GIP, GLP-1, and PYY, and an increase in total energy intake (drink plus meal: 12% increase with 30 g and 32% increase with 70 g; P protein drinks load-dependently slow gastric emptying and alter gut hormone secretion compared with a control but have no suppressive effect on subsequent ad libitum energy intake. This trial was registered at www.anzctr.org.au as ACTRN12612000941864. © 2017 American

  11. Prescribed 3-D Direct Writing of Suspended Micron/Sub-micron Scale Fiber Structures via a Robotic Dispensing System.

    Science.gov (United States)

    Yuan, Hanwen; Cambron, Scott D; Keynton, Robert S

    2015-06-12

    A 3-axis dispensing system is utilized to control the initiating and terminating fiber positions and trajectory via the dispensing software. The polymer fiber length and orientation is defined by the spatial positioning of the dispensing system 3-axis stages. The fiber diameter is defined by the prescribed dispense time of the dispensing system valve, the feed rate (the speed at which the stage traverses from an initiating to a terminating position), the gauge diameter of the dispensing tip, the viscosity and surface tension of the polymer solution, and the programmed drawing length. The stage feed rate affects the polymer solution's evaporation rate and capillary breakup of the filaments. The dispensing system consists of a pneumatic valve controller, a droplet-dispensing valve and a dispensing tip. Characterization of the direct write process to determine the optimum combination of factors leads to repeatedly acquiring the desired range of fiber diameters. The advantage of this robotic dispensing system is the ease of obtaining a precise range of micron/sub-micron fibers onto a desired, programmed location via automated process control. Here, the discussed self-assembled micron/sub-micron scale 3D structures have been employed to fabricate suspended structures to create micron/sub-micron fluidic devices and bioengineered scaffolds.

  12. Static self-directed sample dispensing into a series of reaction wells on a microfluidic card for parallel genetic detection of microbial pathogens.

    Science.gov (United States)

    Stedtfeld, Robert D; Liu, Yen-Cheng; Stedtfeld, Tiffany M; Kostic, Tanja; Kronlein, Maggie; Srivannavit, Onnop; Khalife, Walid T; Tiedje, James M; Gulari, Erdogan; Hughes, Mary; Etchebarne, Brett; Hashsham, Syed A

    2015-10-01

    A microfluidic card is described for simultaneous and rapid genetic detection of multiple microbial pathogens. The hydrophobic surface of native acrylic and a novel microfluidic mechanism termed "airlock" were used to dispense sample into a series of 64 reaction wells without the use of valves, external pumping peripherals, multiple layers, or vacuum assistance. This airlock mechanism was tested with dilutions of whole human blood, saliva, and urine, along with mock samples of varying viscosities and surface tensions. Samples spiked with genomic DNA (gDNA) or crude lysates from clinical bacterial isolates were tested with loop mediated isothermal amplification assays (LAMP) designed to target virulence and antibiotic resistance genes. Reactions were monitored in real time using the Gene-Z, which is a portable smartphone-driven system. Samples loaded correctly into the microfluidic card in 99.3% of instances. Amplification results confirmed no carryover of pre-dispensed primer between wells during sample loading, and no observable diffusion between adjacent wells during the 60 to 90 min isothermal reaction. Sensitivity was comparable between LAMP reactions tested within the microfluidic card and in conventional vials. Tests demonstrate that the airlock card works with various sample types, manufacturing techniques, and can potentially be used in many point-of-care diagnostics applications.

  13. Effects of reservoir dispenser height on efficacy of mating disruption of codling moth (Lepidoptera: Tortricidae) in apple.

    Science.gov (United States)

    Epstein, David L; Stelinski, Lukasz L; Miller, James R; Grieshop, Matthew J; Gut, Larry J

    2011-08-01

    The effect of varying the height of reservoir dispensers for mating disruption of codling moth, Cydia pomonella (L.), was investigated. The goal was to improve the effectiveness of C. pomonella mating disruption through improved understanding of adult distribution within the tree canopy and the impact of pheromone dispenser placement on disruption. Two dispensers per tree were placed at 2 m and 4 m and/or one dispenser at each height on the tree at a label rate of 1000 units ha(-1) . Monitoring traps and tethered female moths were deployed in plots at 2 and 4 m heights to assess treatment effects by catches or matings respectively. Fewest male moths were captured with all dispensers placed at 4 m. Female mating was lowest, and with least variation between females tethered at 2 and 4 m, when dispensers were placed simultaneously at 2 and 4 m (28% mated). Mating was 32% with both dispensers at 4 m, 38% with both dispensers at 2 m and 46% in the no disruption control. Mating was highest across treatments when females were tethered at 2 m and dispensers placed at 4 m (40%), and when females were tethered at 4 m with dispensers placed at 2 m (46%). Traps at 4 m in trees captured more male moths than traps at 2 m, regardless of disruption dispenser positioning. Female mating was lowest when dispensers were placed simultaneously at 2 and 4 m, suggesting that current recommendations for placement of reservoir dispensers in tree crowns may be suboptimal. Copyright © 2011 Society of Chemical Industry.

  14. Justice Dispensation through the Alternative Dispute Resolution System in India

    Directory of Open Access Journals (Sweden)

    Krishna Agrawal

    2014-01-01

    Full Text Available The Law Commission of India in its 222nd report emphasized the need for Alternative Disputes Resolution (ADR for the dispensation of justice, because the courts are inaccessible owing to various factors, e.g., poverty, social and political backwardness, illiteracy, ignorance, procedural formalities and inordinate delay in judgments. During the ancient period the disputes were resolved in an informal manner by neutral third persons or people’s court in villages and it continued till the middle of the 20th century. Unfortunately, after the Independence of India in 1947, this system was dissuaded and the government permitted to continue the adversarial system of justice. In 1980, a committee was set up. It recommended Lok Adalats (People’s Courts. In 1987, the Legal Services Authorities Act was enacted. This Act obligates the states to provide free legal aid to poor persons. Besides this, the Act provides for the establishment of permanent Lok Adalats.This is one of the important modes of ADR. Lok Adalats have been established in all the districts of the country. They bring conciliatory settlement in complicated cases arising out of matrimonial, landlord-tenants, property, insurance and commercial disputes. There are four methods of ADR, viz., negotiation, mediation, conciliation and arbitration. Mediation and arbitration are widely preferred. They are alternatives to litigation. The Arbitration Act for the first time was enacted in 1889 and it was subsequently amended many times. On the objections raised by the Supreme Court of India and also on the adoption of UNCITRAL Model Law on International Commercial Arbitration, in 1996 Arbitration and Conciliation Act was enacted. This law is almost the same as is almost in all the countries.Further, the Government of India established International Centre for Alternative Disputes Resolution (CADR with the objectives of promotion, propagation, and popularizing the settlement of domestic and

  15. Back bombardment for dispenser and lanthanum hexaboride cathodes

    Directory of Open Access Journals (Sweden)

    Mahmoud Bakr

    2011-06-01

    Full Text Available The back bombardment (BB effect limits wide usage of thermionic rf guns. The BB effect induces not only ramping-up of a cathode’s temperature and beam current, but also degradation of cavity voltage and beam energy during a macropulse. This paper presents a comparison of the BB effect for the case of dispenser tungsten-base (DC and lanthanum hexaboride (LaB_{6} thermionic rf gun cathodes. For each, particle simulation codes are used to simulate the BB effect and electron beam dynamics in a thermionic rf gun cathode. A semiempirical equation is also used to investigate the stopping range and deposited heat power of BB electrons in the cathode material. A numerical simulation method is used to calculate the change of the cathode temperature and current density during a single macropulse. This is done by solving two differential equations for the rf gun cavity equivalent circuit and one-dimensional thermal diffusion equation. High electron emission and small beam size are required for generation of a high-brightness electron beam, and so in this work the emission properties of the cathode are taken into account. Simulations of the BB effect show that, for a pulse of 6  μs duration, the DC cathode experiences a large change in the temperature compared with LaB_{6}, and a change in current density 6 times higher. Validation of the simulation results is performed using experimental data for beam current beyond the gun exit. The experimental data is well reproduced using the simulation method.

  16. Type I IFN Signaling Is Dispensable during Secondary Viral Infection.

    Directory of Open Access Journals (Sweden)

    Martin P Hosking

    2016-08-01

    Full Text Available Innate immune responses in general, and type I interferons (T1IFNs in particular, play an important and often essential role during primary viral infections, by directly combatting the virus and by maximizing the primary adaptive immune response. Several studies have suggested that T1IFNs also contribute very substantially to the secondary (recall response; they are thought (i to be required to drive the early attrition of memory T cells, (ii to support the subsequent expansion of surviving virus-specific memory cells, and (iii to assist in the suppression and clearance of the infectious agent. However, many of these observations were predicated upon models in which T1IFN signaling was interrupted prior to a primary immune response, raising the possibility that the resulting memory cells might be intrinsically abnormal. We have directly addressed this by using an inducible-Cre model system in which the host remains genetically-intact during the primary response to infection, and in which T1IFN signaling can be effectively ablated prior to secondary viral challenge. We report that, in stark contrast to primary infection, T1IFN signaling is not required during the recall response. IFNαβR-deficient memory CD8+ and CD4+ memory T cells undergo attrition and expansion with kinetics that are indistinguishable from those of receptor-sufficient cells. Moreover, even in the absence of functional T1IFN signaling, the host's immune capacity to rapidly suppress, and then to eradicate, a secondary infection remains intact. Thus, this study shows that T1IFN signaling is dispensable during the recall response to a virus infection. Moreover, two broader implications may be drawn. First, a T cell's requirement for a cytokine is highly dependent on the cell's maturation / differentiation status. Consequently, second, these data underscore the importance of evaluating a gene's impact by modulating its expression or function in a temporally-controllable manner.

  17. MINIMAL LOSS RECONFIGURATION CONSIDERING RANDOM LOAD: APPLICATIONS TO REAL NETWORKS RECONFIGURACIÓN A MÍNIMAS PÉRDIDAS, CONSIDERANDO LA ALEATORIEDAD DE LA CARGA: APLICACIÓN A SISTEMAS

    Directory of Open Access Journals (Sweden)

    Hugo Opazo Mora

    2008-06-01

    Full Text Available This paper approaches the minimal loss reconfiguration problem, taking into account the load variations of the systems, through a stochastic reconfiguration process. The Monte Carlo method is used to consider the natural load variation. A normal probability function is used to generate aleatory load levels in the nodes. The results of this work show the existence of a set of branches that are frequently eliminated. This generates a tree branch set that best represents the universal randomness of the load. We call it "Expected Branch Set (EBS". The topology associated to the EBS coincides with that obtained using the average demand values. This makes it unnecessary to generate a considerable number of tests to find that topology that best considers the load variation. The proposed algorithm was applied to two test networks and to a large real network.Este trabajo se plantea la reconfiguración a mínimas pérdidas, tomando en cuenta las variaciones de carga del sistema, a través de un proceso de reconfiguración estocástico. El Método de Monte Carlo es usado para considerar las variaciones naturales de la carga, utilizando una función de probabilidad normal para generar niveles aleatorios de carga en los nudos. Los resultados de este trabajo muestran la existencia de un conjunto de ramas que son frecuentemente eliminadas en el proceso de reconfiguración. Esto genera un conjunto de ramas de un árbol, las que mejor representan aleatoriedad universal de la carga. La topología obtenida la denominamos "Conjunto de Ramas Esperadas" (Expected Branch Set, EBS. La topología asociada al EBS es casi similar a la topología obtenida usando los valores de demanda promedio. Esto hace innecesario el realizar un considerable número de pruebas para encontrar la topología que mejor considera las variaciones de carga. El algoritmo propuesto fue aplicado a dos sistemas de prueba y a un sistema real de gran envergadura.

  18. Prevention of overuse injuries by a concurrent exercise program in subjects exposed to an increase in training load: a randomized controlled trial of 1020 army recruits

    DEFF Research Database (Denmark)

    Brushøj, Christoffer; Larsen, Klaus; Albrecht-Beste, Elisabeth

    2008-01-01

    BACKGROUND: It is unknown whether an exercise program can prevent overuse injuries in the lower extremity. An often encountered and important risk factor for the development of lower extremity overuse injuries is an abrupt increase in activity level. HYPOTHESIS: A preventive training program based...... on a literature review of intrinsic risk factors, and performed concurrent with an increase in physical activity, can reduce the incidence of overuse knee injuries and medial tibial stress syndrome, as well as increase running distance. STUDY DESIGN: Randomized controlled trial; Level of evidence, 1. METHODS......: A total of 1020 soldiers aged 20.9 years (range, 19-26 years) undergoing 3 months of basic military training consecutively enrolled from December 2004 to December 2005. The prevention program consisted of an exercise program of 15 minutes' duration 3 times a week, including 5 exercises for strength...

  19. Immediate Loading of Dental Implants in Edentulous Mandibles by Use of Locator® Attachments or Dolder® Bars: Two-Year Results from a Prospective Randomized Clinical Study.

    Science.gov (United States)

    Kappel, Stefanie; Giannakopoulos, Nikolaos Nikitas; Eberhard, Lydia; Rammelsberg, Peter; Eiffler, Constantin

    2016-08-01

    The study aims to evaluate survival and incidence of complications for pairs of implants placed in the front region of edentulous mandibles and immediately loaded with either bar or Locator attachments. Forty-six patients with edentulous mandibles (mean age 69.4 years at inclusion in the study; 73.9% male) received two implants in the interforaminal area of the symphysis. Dolder bar or Locator attachments, allocated randomly, were then attached immediately, and both clips and a framework were fastened to the denture by the dental technician within 72 hours. During the first 3 months of the 2-year period of observation, eight implants in five patients were lost, and were removed. Survival was 89.1% and 93.5% for the bar and Locator groups, respectively. During the entire period of observation, 38 prosthetic complications required aftercare. Five dentures had to be removed or reworked after implant failure, but no superstructure was lost or had to be remade for prosthetic reasons. Survival of the original dentures was 93.5% and 95.7% for the bar and Locator groups, respectively. Within the limitations of this study, results from immediate loading of two implants in the edentulous mandible with either Locator or bar attachments hardly differed. Prosthetic complications and aftercare measures in the Locator group were frequent but easy to handle. Ease of repair and cleaning, in particular, might be reasons for choosing the single-attachment system. © 2015 Wiley Periodicals, Inc.

  20. Randomized controlled multicenter study comparing short dental implants (6 mm) versus longer dental implants (11-15 mm) in combination with sinus floor elevation procedures. Part 2: clinical and radiographic outcomes at 1 year of loading.

    Science.gov (United States)

    Schincaglia, Gian Pietro; Thoma, Daniel S; Haas, Robert; Tutak, Marcin; Garcia, Abel; Taylor, Thomas D; Hämmerle, Christoph H F

    2015-11-01

    To compare, clinically and radiographically, short dental implants (6 mm) to long implants (11-15 mm) placed with sinus grafting. Participants with 5-7 mm of bone height in the posterior maxilla were randomly allocated to receive short implants (GS) or long implants with sinus grafting (GG). Implants were loaded with single crowns 6 months after placement (PR). Patients were re-evaluated 12 months after loading (FU-1). Outcome variables included: Implant survival rate (CSR), marginal bone level alteration (MBL), periodontal probing depth (PPD), bleeding on probing (BoP), plaque control record (PCR) and crown-to-implant ratios (C/I). Statistical analysis was performed using parametric tests. In 97 subjects, 132 implants were re-evaluated at FU-1. The CSR was 100%. The MBL from implant placement (IP) to (PR) was -0.22 ± 0.4 mm for GG and -0.3 ± 0.45 mm for GS (p 0.05), PPD (p = 1) and PCR (p = 0.09). BoP was higher in the GS (p = 0.04). The C/I was 0.99 ± 0.17 for GG and 1.86 ± 0.23 for GS (p < 0.001). No correlation was observed between C/I and MBL, (GG: p = 0.13; GS: p = 0.38). Both treatment modalities provided similar outcomes. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  1. Pharmacists' training, perceived roles, and actions associated with dispensing controlled substance prescriptions.

    Science.gov (United States)

    Fleming, Marc L; Barner, Jamie C; Brown, Carolyn M; Shepherd, Marv D; Strassels, Scott A; Novak, Suzanne

    2014-01-01

    To examine situations that prompt pharmacists to access a prescription drug monitoring program (PDMP) database and management of opioid abuse/addiction; assess pharmacists' actions when abuse is suspected; describe pharmacists' tasks when dispensing controlled substance prescriptions (CSPs); and their continuing pharmacy education (CPE). DESIGN Cross-sectional mail survey of 1,000 randomly selected pharmacists. Texas from February 2012 to April 2012. 1,000 Texas community pharmacists. Mail survey instrument. Prompts to use a PDMP and pharmacists' views actions, and related CPE programs. RESULTS The usable response rate was 26.2%. Pharmacists were more supportive of mandated PDMP use by physicians than by pharmacists (mean ± SD 4.1 ± 1.2 versus 3.2 ± 1.5; P mistakes (68.1%) or the patient requests an early refill (66.3%). Bivariate statistics showed that men pharmacists, those with BSPharm degrees, and pharmacists ≥50 years of age reported a greater number of CPE hours related to prescription opioid abuse and pain management. An analysis of variance showed that pharmacy owners reported significantly more (P CPE compared with manager and staff pharmacists. Older pharmacists with a BSPharm degree may be more willing to provide counseling to patients with opioid addiction based on their work experience and additional CPE related to controlled substances. As PDMP use becomes more prevalent, pharmacists should be prepared to interact and counsel patients identified with aberrant controlled prescription drug use and properly deliver pain management care. Additionally, schools of pharmacy curricula must prepare new pharmacists to prevent abuse and diversion, as well as intervene when aberrant use is identified.

  2. A Research Based on the metering and detecting Device for Industrial dispenser of non-contact technology

    Science.gov (United States)

    Chen, Xin; Li, Jingjing; Wang, Jingying

    2017-12-01

    Based on the non-contact detection technology, for the needs of on-site measurement for industrial dispenser, the dispenser device is designed and utilized non-contact laser measuring technology with high precision for measurement of length and speed to measure the coordination of displacement stroke and speed. According to “GBT 26799-2011 technical conditions for General Dispenser”, several key parameters are detected by comparing the experimental results, to meet the metering requirements of industrial dispenser.

  3. Effectiveness of a long-term use of a minimalist footwear versus habitual shoe on pain, function and mechanical loads in knee osteoarthritis: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Trombini-Souza Francis

    2012-07-01

    Full Text Available Abstract Background Recent studies have shown an important reduction of joint overload during locomotion in elderly women with knee osteoarthritis (OA after short-term use of minimalist shoes. Our aim is to investigate the chronic effect of inexpensive and minimalist footwear on the clinical and functional aspects of OA and gait biomechanics of elderly women with knee OA. Methods/Design Fifty-six elderly women with knee OA grade 2 or 3 (Kellgren and Lawrence are randomized into blocks and allocated to either the intervention group, which will use flexible, non-heeled shoes— Moleca®—for six months for at least six hours daily, or the control group, which could not use these shoes. Neither group is undergoing physical therapy treatment throughout the intervention period. Moleca® is a women’s double canvas, flexible, flat walking shoe without heels, with a 5-mm anti-slip rubber sole and a 3-mm internal wedge of ethylene vinyl acetate. Both groups will be followed for six months and will be assessed at baseline condition, after three months, and after six months (end of intervention. All the assessments will be performed by a physiotherapist that is blind to the group allocation. The primary outcome is the pain Western Ontario and McMaster Universities Osteoarthritis (WOMAC score. The secondary outcomes are global WOMAC score; joint stiffness and disability WOMAC scores; knee pain with a visual analogue scale; walking distance in the six-minute walk test; Lequesne score; amount and frequency (number of days of paracetamol (500 mg intake over six months; knee adduction moment during gait; global medical assessment score; and global patient auto-assessment score. At baseline, all patients receive a diary to record the hours of daily use of the footwear intervention; every two weeks, the same physiotherapist makes phone calls to all patients in order to verify adherence to treatment. The statistical analysis will be based on intention

  4. A combined digital and stereophotogrammetric technique for rehabilitation with immediate loading of complete-arch, implant-supported prostheses: A randomized controlled pilot clinical trial.

    Science.gov (United States)

    Peñarrocha-Diago, María; Balaguer-Martí, José Carlos; Peñarrocha-Oltra, David; Balaguer-Martínez, José Francisco; Peñarrocha-Diago, Miguel; Agustín-Panadero, Rubén

    2017-11-01

    Traditional impressions for complete-arch restorations are complex and time-consuming, and they can be uncomfortable for the patient. New digital techniques such as stereophotogrammetry may mitigate this. The purpose of this randomized controlled pilot clinical trial was to compare the patient and dentist satisfaction and work times of traditional impressions (control group) and digital impressions with stereophotogrammetry in complete-arch, implant-supported prostheses. Success rates, implant survival, marginal bone loss around the dental implants, and prosthesis survival were also analyzed. This randomized controlled pilot clinical trial included 18 participants who received 131 dental implants. Implant impressions in the experimental group were made with stereophotogrammetry (8 participants with 66 implants), while traditional impressions were made in the control group (10 participants with 65 implants). Working times were measured in minutes starting from removal of the healing abutments to their replacement after the impression. Patient and dentist satisfaction was analyzed using a questionnaire with a visual analog scale, and implant success was assessed using the Buser success criteria. Prosthesis survival was defined as the presence of the prosthesis in the mouth, without screw loosening or fracture. The work times were 15.6 (experimental group) and 20.5 minutes (control group) (Pcontrol group (P=.02). The dentist satisfaction scores were 9.1 in the experimental group and 8.5 in the control group (P=.03). The implant success rate was 100% in both groups. Marginal bone loss was 0.6 ±0.5 mm (experimental group) and 0.6 ±0.2 mm (control group) (P=.72). Digital impressions using stereophotogrammetry may be an alternative to traditional impressions. Patient and dentist satisfaction improved, and the work time was reduced in the experimental group. No statistically significant differences were found in terms of the implant success rate, implant survival

  5. Effectiveness of a long-term use of a minimalist footwear versus habitual shoe on pain, function and mechanical loads in knee osteoarthritis: a randomized controlled trial

    Science.gov (United States)

    2012-01-01

    Background Recent studies have shown an important reduction of joint overload during locomotion in elderly women with knee osteoarthritis (OA) after short-term use of minimalist shoes. Our aim is to investigate the chronic effect of inexpensive and minimalist footwear on the clinical and functional aspects of OA and gait biomechanics of elderly women with knee OA. Methods/Design Fifty-six elderly women with knee OA grade 2 or 3 (Kellgren and Lawrence) are randomized into blocks and allocated to either the intervention group, which will use flexible, non-heeled shoes— Moleca®—for six months for at least six hours daily, or the control group, which could not use these shoes. Neither group is undergoing physical therapy treatment throughout the intervention period. Moleca® is a women’s double canvas, flexible, flat walking shoe without heels, with a 5-mm anti-slip rubber sole and a 3-mm internal wedge of ethylene vinyl acetate. Both groups will be followed for six months and will be assessed at baseline condition, after three months, and after six months (end of intervention). All the assessments will be performed by a physiotherapist that is blind to the group allocation. The primary outcome is the pain Western Ontario and McMaster Universities Osteoarthritis (WOMAC) score. The secondary outcomes are global WOMAC score; joint stiffness and disability WOMAC scores; knee pain with a visual analogue scale; walking distance in the six-minute walk test; Lequesne score; amount and frequency (number of days) of paracetamol (500 mg) intake over six months; knee adduction moment during gait; global medical assessment score; and global patient auto-assessment score. At baseline, all patients receive a diary to record the hours of daily use of the footwear intervention; every two weeks, the same physiotherapist makes phone calls to all patients in order to verify adherence to treatment. The statistical analysis will be based on intention-to-treat analysis, as well as

  6. Trends in the dispensation of antidepressant drugs over the past decade (2000-2010) in Andalusia, Spain.

    Science.gov (United States)

    González-López, M C; Rodríguez-López, C M; Parrón-Carreño, T; Luna, J D; Del Pozo, E

    2015-05-01

    To study antidepressant drug dispensation in the Spanish region of Andalusia and in the Almeria Health Area (AHA) over the past decade, analyzing the variability, trends, and influential factors. We conducted an observational ecological study of antidepressant drug dispensation between 2000 and 2010 in Andalusia. Dispensation was measured as Defined Daily Dose (DDD) per 1,000 inhabitants per day. A multilevel analysis (STATA 11.1) was performed to determine the variability among the basic health zones (BHZs) (2004-2010) and influential factors. Between 2000 and 2010, the total dispensation of antidepressant drugs increased by more than 100 % in Andalusia and in the AHA. This increase was primarily caused by the greater dispensation of selective serotonin reuptake inhibitors (ATC-N06AB) and other antidepressants (ATC-N06AX). Multilevel analysis revealed a wide variability in the levels and trends of antidepressant dispensation among BHZs. Urbanicity and the percentage of immigrants in the BHZ were negatively associated with their dispensation, which was positively influenced by a higher proportion of women and over 65-year-olds in the population. The elevated dispensation of several groups of antidepressant drugs in this study population indicates the need for health policies to rationalize their use. Further research is required into the differences in antidepressant dispensations between immigrant and native populations and the implications for public health policies.

  7. Impact of Formulation Properties and Process Parameters on the Dispensing and Depositioning of Drug Nanosuspensions Using Micro-Valve Technology.

    Science.gov (United States)

    Bonhoeffer, Bastian; Kwade, Arno; Juhnke, Michael

    2017-04-01

    Flexible manufacturing processes with continuously adjustable dose strengths are considered particularly innovative and interesting for applications in personalized medicine, continuous manufacturing, or early drug development. A piezo-actuated micro-valve has been investigated for the dispensing and depositioning of drug nanosuspensions onto substrates to facilitate the manufacturing of solid oral dosage forms. The investigated micro-valve has been characterized regarding dispensing behavior, mass flow, accuracy, and robustness. The amount of dispensed drug compound during 1 dispensing event could be continuously adjusted from a few micrograms to several milligrams with high accuracy. Fluid properties, dispensing parameters of the micro-valve, and the resulting steady state mass flow could be correlated adequately for low-viscous drug nanosuspensions. High-speed imaging was used to investigate the dispensing behavior of the micro-valve regarding the evolution of the dispensed drug nanosuspension after ejection from the nozzle and the behavior during impact on flat and dry solid substrates. The experimentally determined breakup length of the dispensed liquid jet could be correlated with a semiempirical equation. From image sequences of the jet impact, We-Re phase diagrams could be established, providing a profound understanding and systematic guidance for the controlled depositioning of the entire dispensed drug nanosuspension onto the substrate. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

  8. Patient preferences for direct hearing aid provision by a private dispenser. A discrete choice experiment.

    Science.gov (United States)

    Grutters, Janneke P C; Joore, Manuela A; Kessels, Alfons G H; Davis, Adrian C; Anteunis, Lucien J C

    2008-08-01

    Our objective was to elicit patient preferences for transferring elements of hearing aid provision from the medical sector [Ear Nose and Throat (ENT) specialists and audiological centers] to private hearing aid dispensers, and to understand the trade-offs between different elements of hearing aid provision. A discrete choice experiment was administered from 150 hearing-impaired persons in the Netherlands. Mean age was 71 (range 18-95) and 57% were male. Participants preferred the initial assessment at the dispenser, higher accuracy in identifying persons in need of medical care, shorter duration of the total hearing aid provision, and a follow-up at the ENT specialist. They required compensation of at least euro 17 per 2 mo extra duration, euro 54 for an initial assessment at the ENT specialist, euro 119 per 10% decrease in accuracy, and euro 227 to forgo the follow-up at the ENT specialist. Preferences were influenced by sex, age, educational level, and experience with hearing aid provision. Hearing-impaired persons are receptive to transferring elements of hearing aid provision from the medical sector to private dispensers. Although safety and efficiency issues should also be considered, from the present study we can conclude that in the organization of hearing aid provision hearing-impaired persons prefer an initial assessment at a private dispenser when the dispenser is at least 95% as accurate as the ENT specialist, and prefer a follow-up visit at the ENT specialist.

  9. A prospective surveillance of drug prescribing and dispensing in a teaching hospital in western Nepal.

    Science.gov (United States)

    Ghimire, Saurav; Nepal, Sushil; Bhandari, Sushil; Nepal, Prabha; Palaian, Subish

    2009-10-01

    To evaluate the drug dispensing practices and patients' knowledge on drug use among the outpatients and to identify and analyze the problems in drug prescribing and dispensing. A prospective cross-sectional descriptive study was conducted using World Health Organization (WHO) core drug use indicators from July 13, 2008 to August 15, 2008 in Manipal Teaching Hospital, Pokhara, Nepal. A total of 4231 prescriptions were encountered with the total of 10591 drugs prescribed. The average number of drug per prescription was 2.5. Only 13% (n=10591) of drugs were prescribed by generic name. Percentage of drug prescribed from WHO model list of Essential drugs, Essential drug list of Nepal and Nepalese National Formulary was 21.7%, 32.8% and 42.3% respectively. Antibiotics and injections encountered were 28.3% and 3.1% respectively. Average cost per prescription was found to be Nepalese Rupees (NRs) 285.99 (US $ 3.73). Patient knowledge on correct use of drugs and appropriate labeling was found to be 81% and 1.4% respectively. Average dispensing time per prescription was 52 seconds. The finding from current study shows a trend towards irrational prescribing and dispensing. Hence, there is a need for effective intervention programme to encourage the physicians and dispensing pharmacists in promoting more rational drug use.

  10. Prevention of overuse injuries by a concurrent exercise program in subjects exposed to an increase in training load: a randomized controlled trial of 1020 army recruits.

    Science.gov (United States)

    Brushøj, Christoffer; Larsen, Klaus; Albrecht-Beste, Elisabeth; Nielsen, Michael Bachmann; Løye, Finn; Hölmich, Per

    2008-04-01

    It is unknown whether an exercise program can prevent overuse injuries in the lower extremity. An often encountered and important risk factor for the development of lower extremity overuse injuries is an abrupt increase in activity level. A preventive training program based on a literature review of intrinsic risk factors, and performed concurrent with an increase in physical activity, can reduce the incidence of overuse knee injuries and medial tibial stress syndrome, as well as increase running distance. Randomized controlled trial; Level of evidence, 1. A total of 1020 soldiers aged 20.9 years (range, 19-26 years) undergoing 3 months of basic military training consecutively enrolled from December 2004 to December 2005. The prevention program consisted of an exercise program of 15 minutes' duration 3 times a week, including 5 exercises for strength, flexibility, and coordination; the placebo program consisted of 5 exercises for the upper body. During the observation period, 223 subjects sustained an injury, with 50 and 48 of these fulfilling the study criteria for overuse knee injuries or medial tibial stress syndrome, respectively. There were no significant differences in incidence of injury between the prevention group and the placebo group (incidence, 0.22 vs 0.19; P = .162; relative risk = 1.05 [range, 0.98-1.11]). The soldiers in the prevention group had the greater improvement in running distance in 12-minute run tests (82 vs 43 m; P = .037). An exercise program with an emphasis on muscular strengthening, coordination, and flexibility based on intrinsic risk factors identified through a literature review did not influence the risk of developing overuse knee injuries or medial tibial stress syndrome in subjects undergoing an increase in physical activity. The program increased maximal running distance in a 12-minute test.

  11. Retrospective, multicohort analysis of the Clinical Practice Research Datalink (CPRD) to determine differences in the cost of medication wastage, dispensing fees and prescriber time of issuing either short (prescription lengths in primary care for common, chronic conditions in the UK.

    Science.gov (United States)

    Doble, Brett; Payne, Rupert; Harshfield, Amelia; Wilson, Edward C F

    2017-12-04

    To investigate patterns of early repeat prescriptions and treatment switching over an 11-year period to estimate differences in the cost of medication wastage, dispensing fees and prescriber time for short (prescription lengths from the perspective of the National Health Service in the UK. Retrospective, multiple cohort study of primary care prescriptions from the Clinical Practice Research Datalink. Five random samples of 50 000 patients each prescribed oral drugs for (1) glucose control in type 2 diabetes mellitus (T2DM); (2) hypertension in T2DM; (3) statins (lipid management) in T2DM; (4) secondary prevention of myocardial infarction; and (5) depression. The volume of medication wastage from early repeat prescriptions and three other types of treatment switches was quantified and costed. Dispensing fees and prescriber time were also determined. Total unnecessary costs (TUC; cost of medication wastage, dispensing fees and prescriber time) associated with prescriptions, standardised to a 120-day period, were then compared. Longer prescription lengths were associated with more medication waste per prescription. However, when including dispensing fees and prescriber time, longer prescription lengths resulted in lower TUC. This finding was consistent across all five cohorts. Savings ranged from £8.38 to £12.06 per prescription per 120 days if a single long prescription was issued instead of multiple short prescriptions. Prescriber time costs accounted for the largest component of TUC. Shorter prescription lengths could potentially reduce medication wastage, but they may also increase dispensing fees and/or the time burden of issuing prescriptions. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  12. Dispensing patterns for antidiabetic agents in New Zealand: are the guidelines being followed?

    Science.gov (United States)

    Murray, Peter; Norris, Hew; Metcalfe, Scott; Betty, Bryan; Young, Vanessa; Locke, Bronwyn

    2017-11-10

    Type 2 diabetes mellitus (T2DM) is a significant public health issue in New Zealand. Effective management and glycaemic control is critical for reducing diabetes-related complications. Treatment guidelines are well established in New Zealand. Using dispensing data as a proxy for prescribing data, this paper aims to describe the pattern of first- and second-line antidiabetic agent (AA) dispensing for T2DM in New Zealand and assess adherence with treatment guidelines. Analysis of national dispensing data for AA medications using the Pharmaceutical Collection database from 2007/08 to 2015/16. Metformin monotherapy remains the most commonly prescribed first-line T2DM medication prescribed, accounting for 85% of initial agents prescribed. Sulfonylureas are the most common second-line agents used, accounting for 70% of all second-line agents. There is a high degree of adherence with the T2DM treatment guidelines in New Zealand.

  13. Electronic vending machines for dispensing rapid HIV self-testing kits: a case study.

    Science.gov (United States)

    Young, Sean D; Klausner, Jeffrey; Fynn, Risa; Bolan, Robert

    2014-02-01

    This short report evaluates the feasibility of using electronic vending machines for dispensing oral, fluid, rapid HIV self-testing kits in Los Angeles County. Feasibility criteria that needed to be addressed were defined as: (1) ability to find a manufacturer who would allow dispensing of HIV testing kits and could fit them to the dimensions of a vending machine, (2) ability to identify and address potential initial obstacles, trade-offs in choosing a machine location, and (3) ability to gain community approval for implementing this approach in a community setting. To address these issues, we contracted a vending machine company who could supply a customized, Internet-enabled machine that could dispense HIV kits and partnered with a local health center available to host the machine onsite and provide counseling to participants, if needed. Vending machines appear to be feasible technologies that can be used to distribute HIV testing kits.

  14. [Dispensing prescriptions to persons affiliated with the Seguro Popular de Salud de México].

    Science.gov (United States)

    Garrido-Latorre, Francisco; Hernández-Llamas, Héctor; Gómez-Dantés, Octavio

    2008-01-01

    Measure and compare the percentage of prescriptions fully dispensed to persons with and without Popular Health Insurance (SPS in Spanish) who use ambulatory and general hospital services associated with the Mexico State Health Services (SESA in Spanish), and taking into account insurance status. SESA user satisfaction was also measured with respect to access to medication. Information for the study was taken from four surveys of SESA ambulatory and hospital units that included probabilistic samples with state representativity. Samples of ambulatory units were selected by stratification according to level of care and association to the SPS service network. The findings indicate that the percentage of prescriptions fully dispensed in SESA ambulatory units has improved, reaching approximately 90%, especially among those units offering services to persons affiliated with SPS. Nevertheless, these percentages continue to be lower than those of ambulatory units associated with social security institutions. Percentages of prescriptions fully dispensed have also improved in SESA hospital units, but continue to be relatively low. In nearly all states, as the percentage of prescriptions fully dispensed has increased, user satisfaction with access to medication has also improved. In 2006 more than 50% of the states had high levels of fully dispensed prescriptions among persons with SPS (> or =90%). The more significant problem exists among hospitals, since only 44% of users who received a prescription in SESA hospitals in 2006 had their prescriptions fully dispensed. This finding requires a review of SPS medication policies, which have favored highly prescribed low-cost medications at ambulatory services at the expense of higher cost and more therapeutically effective medications for hospital care, the latter having a greater impact on household budgets.

  15. Association of emergency department albuterol dispensing with pediatric asthma revisits and readmissions.

    Science.gov (United States)

    Hall, A Brad; Novotny, April; Bhisitkul, Donna M; Melton, James; Regan, Tim; Leckie, Maureen

    2017-06-01

    Although pediatric asthma continues to be a highly studied disease, data to suggest clear strategies to decrease asthma related revisits or readmissions is lacking. The purpose of our study was to assess the effect of emergency department (ED) direct dispensing of beta-agonist metered dose inhalers on pediatric asthma ED revisit and readmission rates. We conducted a retrospective cohort study of pediatric patients discharged from the pediatric ED with a diagnosis of asthma. Our primary outcome measured the rate of asthma revisits to the ED or admissions to the hospital within 28 days. Logistic regression analysis was used to assess ED beta-agonist MDI dispensing and revisit and/or readmission as the outcome. A total of 853 patients met eligibility for inclusion in the study, with 657 enrolled in the Baseline group and 196 enrolled in the ED-MDI group. The Baseline group experienced a revisit and readmission rate of 7.0% (46/657) versus 2.6% (5/196) in the ED-MDI group, (p = 0.026). ED direct dispensing of MDIs was found to be independently associated with a decreased risk of revisit or readmission (odds ratio 0.37; 95% confidence interval 0.14-0.95). In our study, ED direct dispensing of beta-agonist MDIs resulted in a reduction in 28-day revisit and readmission to the hospital. Further studies should be performed to evaluate the economic impact of reducing these revisits and readmissions against the costs of maintaining a dispensing program. Our findings may support modification of asthma programs to include dispensing MDIs from the emergency department.

  16. Spectacle dispensing in Timor-Leste: tiered-pricing, cross-subsidization and financial viability.

    Science.gov (United States)

    Ramke, Jacqueline; Brian, Garry; Palagyi, Anna

    2012-08-01

    To examine the financial viability of the Timor-Leste National Spectacle Program as it increases spectacle availability, affordability and uptake, particularly for Timor's poor. In rural areas, three models of ready-made spectacles were dispensed according to a tiered pricing structure of US$3.00, 1.00, 0.10 and 0.00. In addition, custom-made spectacles were available in the capital, Dili. Spectacle costs, dispensing data and income for the National Spectacle Program for 18 months from March 2007 were analyzed. Rural services dispensed 3415 readymade spectacles: 47.1% to women, and 51.4% at subsidized prices, being 39.8% at US$0.10 and 11.6% free. A profit of US$1,529 was generated, mainly from the sale of US$3.00 spectacles. Women (odds ratio, OR, 1.3, 95% confidence interval, CI, 1.1-1.4) and consumers aged ≥65 years (OR 2.1; 95% CI 1.7-2.6) were more likely to receive subsidized spectacles. Urban services dispensed 2768 spectacles; mostly US$3.00 readymade (52.8%) and custom-made single vision (29.6%) units. Custom-made spectacles accounted for 36.7% of dispensing, but 73.1% of the US$12,264 urban profit. The combined rural and urban profit covered all rural costs, leaving US$2,200 to meet administration and other urban expenses. It is instructive and encouraging that a national spectacle dispensing program in one of the ten poorest countries of the world can use tiered-pricing based on willingness-to-pay information to cover spectacle stock replacement costs and produce profit, while using cross-subsidization to provide spectacles to the poor.

  17. Effects of intensive diet and exercise on knee joint loads, inflammation, and clinical outcomes among overweight and obese adults with knee osteoarthritis: the IDEA randomized clinical trial.

    Science.gov (United States)

    Messier, Stephen P; Mihalko, Shannon L; Legault, Claudine; Miller, Gary D; Nicklas, Barbara J; DeVita, Paul; Beavers, Daniel P; Hunter, David J; Lyles, Mary F; Eckstein, Felix; Williamson, Jeff D; Carr, J Jeffery; Guermazi, Ali; Loeser, Richard F

    2013-09-25

    Knee osteoarthritis (OA), a common cause of chronic pain and disability, has biomechanical and inflammatory origins and is exacerbated by obesity. To determine whether a ≥10% reduction in body weight induced by diet, with or without exercise, would improve mechanistic and clinical outcomes more than exercise alone. Single-blind, 18-month, randomized clinical trial at Wake Forest University between July 2006 and April 2011. The diet and exercise interventions were center-based with options for the exercise groups to transition to a home-based program. Participants were 454 overweight and obese older community-dwelling adults (age ≥55 years with body mass index of 27-41) with pain and radiographic knee OA. Intensive diet-induced weight loss plus exercise, intensive diet-induced weight loss, or exercise. Mechanistic primary outcomes: knee joint compressive force and plasma IL-6 levels; secondary clinical outcomes: self-reported pain (range, 0-20), function (range, 0-68), mobility, and health-related quality of life (range, 0-100). Three hundred ninety-nine participants (88%) completed the study. Mean weight loss for diet + exercise participants was 10.6 kg (11.4%); for the diet group, 8.9 kg (9.5%); and for the exercise group, 1.8 kg (2.0%). After 18 months, knee compressive forces were lower in diet participants (mean, 2487 N; 95% CI, 2393 to 2581) compared with exercise participants (2687 N; 95% CI, 2590 to 2784, pairwise difference [Δ](exercise vs diet )= 200 N; 95% CI, 55 to 345; P = .007). Concentrations of IL-6 were lower in diet + exercise (2.7 pg/mL; 95% CI, 2.5 to 3.0) and diet participants (2.7 pg/mL; 95% CI, 2.4 to 3.0) compared with exercise participants (3.1 pg/mL; 95% CI, 2.9 to 3.4; Δ(exercise vs diet + exercise) = 0.39 pg/mL; 95% CI, -0.03 to 0.81; P = .007; Δ(exercise vs diet )= 0.43 pg/mL; 95% CI, 0.01 to 0.85, P = .006). The diet + exercise group had less pain (3.6; 95% CI, 3.2 to 4.1) and better function (14.1; 95% CI

  18. Assessment of an automatic robotic arm for dispensing of chemotherapy in a 2500-bed medical center

    OpenAIRE

    Chen, Wen-Hwei; Shen, Li-Jiuan; Guan, Ru-Jiun; Lin Wu, Fe-Lin

    2013-01-01

    Automation has long been awaited in parenteral drug dispensing. Pharmacists can benefit much in theory from a good automated device to handle the hazardous drugs used in chemotherapy. This paper describes the performance of the first chemotherapy-dispensing robot in the oncology pharmacy of a 2500-bed medical center. The objective of this paper is two-fold: (1) to assess the robot’s performance in terms of its success rate and to summarize the causes of failure, and (2) to find out if the rob...

  19. Homogeneous Crystallization of Micro-DispensedTIPS-Pentacene Using a Two-Solvent System toEnable Printed Inverters on Foil Substrates

    Directory of Open Access Journals (Sweden)

    Indranil Bose

    2015-08-01

    Full Text Available We report on a micro-dispensing system for 6,13-Bis(triisopropylsilylethynylpentacene (TIPS-pentacene to enable homogenous crystallization and uniform filmmorphology of the dispensed droplets using a two-solvent mixture along with the use of aninsulating binder. This solution composition results in a controlled evaporation of the dropletin ambient air such that the Marangoni flow counteracts the outward convective flow toenable uniform radial crystal growth from the edge towards the center of the drops.The consequence of this process is the high degree of uniformity in the crystallization of thedrops, which results in a reduction in the performance spread of the organic field effecttransistors (OFET created using this process. The addition of the insulating binder furtherimproves the reduction in the spread of the results as a trade-off to the reduction in mobilityof the transistors. The transfer curves of the OFETs show a tight grouping due to thecontrolled self-alignment of the TIPS-pentacene crystals; this repeatability was furtherhighlighted by fabricating p-type inverters with driver to load ratios of 8:1, wherein theoutput inverter curves were also grouped tightly while exhibiting a gain of greater than 4 inthe switching region. Therefore, the reliability and repeatability of this process justifies itsuse to enable large area solution-processed printed circuits at the cost of reduced mobility.

  20. Adverse Selection? A Multi-Dimensional Profile of People Dispensed Opioid Analgesics for Persistent Non-Cancer Pain

    Science.gov (United States)

    Rogers, Kris D.; Kemp, Anna; McLachlan, Andrew J.; Blyth, Fiona

    2013-01-01

    Objectives This study investigates utilisation patterns for prescription opioid analgesics in the Australian community and how these are associated with a framework of individual-level factors related to healthcare use. Methods Self-reported demographic and health information from participants in the 45 and Up Study cohort were linked to pharmaceutical claims from 2006–2009. Participants comprised 19,816 people with ≥1 opioid analgesic dispensing in the 12-months after recruitment to the cohort and 79,882 people not dispensed opioid analgesics. All participants were aged ≥45 years, were social security pharmaceutical beneficiaries, with no history of cancer. People dispensed opioid analgesics were classified as having acute (dispensing period osteoarthritis treatment, paracetamol use, and poor physical function were the strongest predictors for all opioid analgesic users. Conclusions People dispensed opioid analgesics were in poorer health, reported higher levels of distress and poorer functioning than people not receiving opioid analgesics. Varying dispensing profiles were evident among people dispensed opioid analgesics for persistent pain, with those receiving episodic and long-term treatment dispensed the strongest opioid analgesics. The findings highlight the broad range of factors associated with longer term opioid analgesics use. PMID:24312456

  1. Assessing the optimal location for alcohol-based hand rub dispensers in a patient room in an intensive care unit

    NARCIS (Netherlands)

    Boog, M.C.; Erasmus, V.; De Graaf, J.M.; Van Beeck, E.H.E.; Melles, M.; Van Beeck, E.F.

    2013-01-01

    Background The introduction of alcohol-based hand rub dispensers has had a positive influence on compliance of healthcare workers with the recommended guidelines for hand hygiene. However, establishing the best location for alcohol-based hand rub dispensers remains a problem, and no method is

  2. Assessing the optimal location for alcohol-based hand rub dispensers in a patient room in an intensive care unit

    NARCIS (Netherlands)

    M.C. Boog (Matthijs); V. Erasmus (Vicky); J.M. de Graaf (Jitske); E.A.H.E. van Beeck (Elise); M. Melles (Marijke); E.F. van Beeck (Ed)

    2013-01-01

    textabstractBackground: The introduction of alcohol-based hand rub dispensers has had a positive influence on compliance of healthcare workers with the recommended guidelines for hand hygiene. However, establishing the best location for alcohol-based hand rub dispensers remains a problem, and no

  3. Carbohydrate Loading.

    Science.gov (United States)

    Csernus, Marilyn

    Carbohydrate loading is a frequently used technique to improve performance by altering an athlete's diet. The objective is to increase glycogen stored in muscles for use in prolonged strenuous exercise. For two to three days, the athlete consumes a diet that is low in carbohydrates and high in fat and protein while continuing to exercise and…

  4. Comparison of three dispenser distribution patterns for pheromone mating disruption of Paralobesia viteana (Lepidoptera: Tortricidae) in vineyards.

    Science.gov (United States)

    Isaacs, Rufus; Mason, Keith S; Teixeira, Luis A F; Loeb, Greg; Hesler, Steve; Weigle, Tim; Muza, Andy; Timer, Jody; Saunders, Michael

    2012-06-01

    Over two growing seasons, Isomate GBM-Plus tube-type dispensers releasing the major pheromone component of grape berry moth, Paralobesia viteana (Clemens) (Lepidoptera: Tortricidae), were evaluated in vineyards (Vitis spp.) in Michigan, New York, and Pennsylvania. Dispensers were deployed in three different density-arrangement treatments: 124 dispensers per ha, 494 dispensers per ha, and a combined treatment with 124 dispensers per ha in the vineyard interior and 988 dispensers per ha at the vineyard border, equivalent to an overall density of 494 dispensers per ha. Moth captures and cluster infestation levels were compared at the perimeter and interior of vineyards receiving these different pheromone treatments and in vineyards receiving no pheromone. Orientation of male moths to pheromone-baited traps positioned at the perimeter and interior of vineyards was reduced as a result of mating disruption treatments compared with the nontreated control. These findings were consistent over both years of the study. Disruption of male moth captures in traps varied from 93 to 100% in treated vineyards, with the 494 dispensers per ha application rates providing significantly higher level of disruption than the 124 dispensers per ha rate, but only in 2007. Measurements of percentage of cluster infestation indicated much higher infestation at perimeters than in the interior of the vineyards in all three regions, but in both sample positions there was no significant effect of dispenser density on cluster infestation levels in either year. The contrasting results of high disruption of moth orientation to traps in vineyards that also had low levels of crop protection from this pheromone treatment are discussed in the context of strategies to improve mating disruption of this tortricid pest.

  5. Epinephrine dispensing for the out-of-hospital treatment of anaphylaxis in infants and children: a population-based study.

    Science.gov (United States)

    Simons, F E; Peterson, S; Black, C D

    2001-06-01

    Epinephrine is life-saving in the treatment of anaphylaxis. A limited number of fixed-dose epinephrine formulations are available for out-of-hospital treatment of this disorder. To examine dispensing patterns for epinephrine formulations over 4 consecutive years in a population of 279,638 infants, children, and adolescents (from birth up to but not including the 17th birthday). We used the Drug Programs Information Network, an administrative claims database for prescriptions dispensed in ambulatory care settings, developed from real-time computer links with retail pharmacies in the province of Manitoba, Canada. We studied the specific epinephrine formulation dispensed and the precise age of the infant or child at the time it was dispensed. Epinephrine formulations were dispensed for 1.2% of the pediatric population (3,340 children). Boys comprised 59.5% of the recipients. Of all epinephrine formulations, 38.6% were dispensed as EpiPen Jr (0.15 mg), and 57.4% were dispensed as EpiPen (0.3 mg). EpiPen Jr was dispensed for patients ranging in age from 2 months to 16 years, 10 months, inclusive. EpiPen was dispensed for patients ranging in age from 1 year, 8 months to 16 years, 11 months, inclusive. During the 4 years studied, a subgroup of children transitioned from EpiPen Jr to EpiPen auto-injectors at a mean age of 6 years, 6 months +/- 2 years, 8 months (range 1 year, 10 months to 16 years, 11 months). Both EpiPen Jr and EpiPen auto-injectors were dispensed over almost the entire age range of the pediatric population. Physicians should consider a child's age more carefully when prescribing these auto-injectors. Additional concentrations of epinephrine are needed in these fixed-dose formulations.

  6. Automated dose dispensing in Danish primary health care - a technology under construction

    Directory of Open Access Journals (Sweden)

    Herborg H

    2008-06-01

    Full Text Available Objectives: The purpose of this study was to conduct a health technology assessment (HTA of automated dose dispensing in the Danish primary health care sector. The present article answers the sub question of how various groups of actors spoke about and understood the shaping of automated dose dispensing (positioning in discourses.Methods: The project utilized two methods: 11 qualitative research interviews with selected key actors and a net-based qualitative questionnaire of 97 selected practitioners.Results: Three main types of discourse were identified with respect to the development of automated dose dispensing, namely ‘optimistic’, ‘sceptical’ and ‘pragmatic’. A wide diversity of opinion about automated dose dispensing was identified among the three discourses and their attendant scenarios. A number of factors are found in all three types of discourse, and are therefore considered to express common recommendations for decision makers and practitioners. These factors are described in the article.Conclusions: The article argues in favour of HTA, which to a great extent clarifies and initiates the perspectives of various groups of actors about the same technology. Our analyses show that conscious strategies must be employed to make the technology work successfully with the actors involved. The preferences, ideas and proposals for future actions and initiatives identified in the project could be the basis for defining future development strategies.

  7. Differentiation in the Amsterdam methadone dispensing circuit: determinants of methadone dosage and site of methadone prescription

    NARCIS (Netherlands)

    Langendam, M. W.; van Haastrecht, H. J.; van Brussel, G. H.; Reurs, H.; van den Hoek, A. A.; Coutinho, R. A.; van Ameijden, E. J.

    1998-01-01

    To evaluate the Methadone Dispensing Circuit in Amsterdam by identifying determinants of methadone dosage and client characteristics in the different types of methadone programmes. Four hundred and forty-four participants of a cohort study of drug users in Amsterdam who had consented to link data of

  8. Close up of the glue dispenser. The white lines on the green frames are theapplied glue.

    CERN Multimedia

    Bernd Surrow

    1999-01-01

    The gantry motion control along with the pneumatic glue dispenser system allows precise control of the amount of glue applied to theframe. The glue is a special room temperature cure silicone basedglue chosen to minimize surface stresses on the silicon sensors dueto differential temperature contraction.

  9. Smart DNA Fabrication Using Sound Waves: Applying Acoustic Dispensing Technologies to Synthetic Biology.

    Science.gov (United States)

    Kanigowska, Paulina; Shen, Yue; Zheng, Yijing; Rosser, Susan; Cai, Yizhi

    2016-02-01

    Acoustic droplet ejection (ADE) technology uses focused acoustic energy to transfer nanoliter-scale liquid droplets with high precision and accuracy. This noncontact, tipless, low-volume dispensing technology minimizes the possibility of cross-contamination and potentially reduces the costs of reagents and consumables. To date, acoustic dispensers have mainly been used in screening libraries of compounds. In this paper, we describe the first application of this powerful technology to the rapidly developing field of synthetic biology, for DNA synthesis and assembly at the nanoliter scale using a Labcyte Echo 550 acoustic dispenser. We were able to successfully downscale PCRs and the popular one-pot DNA assembly methods, Golden Gate and Gibson assemblies, from the microliter to the nanoliter scale with high assembly efficiency, which effectively cut the reagent cost by 20- to 100-fold. We envision that acoustic dispensing will become an instrumental technology in synthetic biology, in particular in the era of DNA foundries. © 2015 Society for Laboratory Automation and Screening.

  10. Medication incidents related to automated dose dispensing in community pharmacies and hospitals - a reporting system study

    NARCIS (Netherlands)

    Cheung, K.C.; Bemt, P.M. van den; Bouvy, M.L.; Wensing, M.J.; Smet, P.A. de

    2014-01-01

    INTRODUCTION: Automated dose dispensing (ADD) is being introduced in several countries and the use of this technology is expected to increase as a growing number of elderly people need to manage their medication at home. ADD aims to improve medication safety and treatment adherence, but it may

  11. Medication incidents related to automated dose dispensing in community pharmacies and hospitals - A reporting system study

    NARCIS (Netherlands)

    Cheung, Ka Chun; Van Den Bemt, Patricia M L A; Bouvy, Marcel L.; Wensing, Michel; De Smet, Peter A G M

    2014-01-01

    Introduction: Automated dose dispensing (ADD) is being introduced in several countries and the use of this technology is expected to increase as a growing number of elderly people need to manage their medication at home. ADD aims to improve medication safety and treatment adherence, but it may

  12. A 'time and motion' evaluation of automated dispensing machines in the emergency department.

    Science.gov (United States)

    Roman, Cristina; Poole, Susan; Walker, Catherine; Smit, De Villiers; Dooley, Michael J

    2016-05-01

    There has been limited assessment of the impact that automated medication dispensing machines have on the medication administration process, particularly in Australian emergency departments. The aim of this study is to examine the change in medication retrieval times, number of medications retrieved and staff perceptions before and after the installation of automated dispensing machines in an Australian emergency and trauma centre. A time and motion method recorded the time taken and number of medications retrieved from the medication room by emergency department staff, before and after the installation of two automated dispensing machines. Surveys were administered to staff members to elicit the perceived impact on clinical practice, utilising 5-point Likert scales. A total of 954 medication retrievals (1030 medications) were recorded in the pre-implementation period and 842 (991 medications) in the post-implementation period. The mean time taken to retrieve any medication was significantly longer in the post-implementation period (+5.7s; ptime increased by 26.9s (pmachines improve knowledge of medications on imprest (p=0.03) and reduced medication retrieval time (pmachines for Schedules 2, 3, 4 and unscheduled medications, but quicker for Schedule 8 and 11 medications in an Australian emergency and trauma centre. Although retrieving medications took slightly longer overall, staff believed automated dispensing machines save time. Copyright © 2016 College of Emergency Nursing Australasia. Published by Elsevier Ltd. All rights reserved.

  13. Evaluation of a digital dispenser for direct curve dilutions in a vaccine potency assay.

    Science.gov (United States)

    Roselle, Christopher; Whitehouse, Dana; Follmer, Thy; Ansbro, Fran; Bouaraphan, Silikhone; Guan, Liming; Wang, Sha-Ke; Shank-Retzlaff, Mary; Verch, Thorsten

    2017-03-01

    Dilutions are a common source of analytical error, both in terms of accuracy and precision, and a common source of analyst mistakes. When serial dilutions are used, errors compound, even when employing laboratory automation. Direct point dilutions instead of serial dilutions can reduce error but is often impractical as they require either large diluent volumes or very small sample volumes when performed with traditional liquid handling equipment. We evaluated preparation of dilution curves using a picoliter digital dispenser, the HP, Inc. / TECAN D300 which is capable of accurately delivering picoliter volumes directly into sample wells filled with assay diluent. Dilution linearity and variability of the direct dilutions were similar to or less than those generated with a traditional liquid handler as measured using a fluorophore assay and an ELISA used to measure vaccine potency. Minimum concentrations for detergent in the dispensed sample were identified but no correlation with detergent characteristics was observed. The tolerance to protein in the sample was evaluated as well with up to 5% BSA having no impact on dispense linearity and precision. We found the digital dispenser to reduce automation complexity while maintaining or improving assay performance in addition to facilitating complex plate lay-outs. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. 21 CFR 1306.07 - Administering or dispensing of narcotic drugs.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Administering or dispensing of narcotic drugs. 1306.07 Section 1306.07 Food and Drugs DRUG ENFORCEMENT ADMINISTRATION, DEPARTMENT OF JUSTICE... (including prescribe) any Schedule III, IV, or V narcotic drug approved by the Food and Drug Administration...

  15. Efficacy of a Feed Dispenser for Horses in Decreasing Cribbing Behaviour

    Directory of Open Access Journals (Sweden)

    Silvia Mazzola

    2016-01-01

    Full Text Available Cribbing is an oral stereotypy, tends to develop in captive animals as a means to cope with stress, and may be indicative of reduced welfare. Highly energetic diets ingested in a short time are one of the most relevant risk factors for the development of cribbing. The aim of this study was to verify whether feeding cribbing horses through a dispenser that delivers small quantities of concentrate when activated by the animal decreases cribbing behaviour, modifies feeding behaviour, or induces frustration. Ten horses (mean age 14 y, balanced for sex, breed, and size (mean height 162 cm, were divided into two groups of 5 horses each: Cribbing and Control. Animals were trained to use the dispenser and videorecorded continuously for 15 consecutive days from 1 h prior to feeding to 2 h after feeding in order to measure their behaviours. The feed dispenser, Quaryka®, induced an increase in time necessary to finish the ration in both groups of horses (P<0.05. With Quaryka, cribbers showed a significant reduction of time spent cribbing (P<0.05. After removal of the feed dispenser (Post-Quaryka, cribbing behaviour significantly increased. The use of Quaryka may be particularly beneficial in horses fed high-energy diets and ingesting the food too quickly.

  16. Efficacy of a Feed Dispenser for Horses in Decreasing Cribbing Behaviour.

    Science.gov (United States)

    Mazzola, Silvia; Palestrini, Clara; Cannas, Simona; Fè, Eleonora; Bagnato, Gaia Lisa; Vigo, Daniele; Frank, Diane; Minero, Michela

    2016-01-01

    Cribbing is an oral stereotypy, tends to develop in captive animals as a means to cope with stress, and may be indicative of reduced welfare. Highly energetic diets ingested in a short time are one of the most relevant risk factors for the development of cribbing. The aim of this study was to verify whether feeding cribbing horses through a dispenser that delivers small quantities of concentrate when activated by the animal decreases cribbing behaviour, modifies feeding behaviour, or induces frustration. Ten horses (mean age 14 y), balanced for sex, breed, and size (mean height 162 cm), were divided into two groups of 5 horses each: Cribbing and Control. Animals were trained to use the dispenser and videorecorded continuously for 15 consecutive days from 1 h prior to feeding to 2 h after feeding in order to measure their behaviours. The feed dispenser, Quaryka®, induced an increase in time necessary to finish the ration in both groups of horses (P < 0.05). With Quaryka, cribbers showed a significant reduction of time spent cribbing (P < 0.05). After removal of the feed dispenser (Post-Quaryka), cribbing behaviour significantly increased. The use of Quaryka may be particularly beneficial in horses fed high-energy diets and ingesting the food too quickly.

  17. 30 CFR 57.4262 - Underground transformer stations, combustible liquid storage and dispensing areas, pump rooms...

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Underground transformer stations, combustible... and Control Firefighting Equipment § 57.4262 Underground transformer stations, combustible liquid storage and dispensing areas, pump rooms, compressor rooms, and hoist rooms. Transformer stations, storage...

  18. Pseudo-outbreak of Phaeoacremonium parasiticum from a hospital ice dispenser.

    Science.gov (United States)

    Blake, Molly; Embil, John M; Trepman, Elly; Adam, Heather; Myers, Renelle; Mutcher, Pam

    2014-08-01

    In 31 patients, Phaeoacremonium parasiticum was recovered from bronchoscopy specimens (biopsies and aspirates). The pseudo-outbreak was caused by contaminated ice used to control hemorrhage during bronchoscopy and was associated with deficiencies in equipment cleaning. The bronchoscopy technique was modified, the ice dispenser was disinfected, bronchoscope reprocessing was improved, and there were no recurrences.

  19. Dispenser and trap design affect the effectiveness of sex pheromone on trap capture of dogwood borer

    Science.gov (United States)

    The capture of dogwood borer (DWB), Synanthedon scitula Harris (Lepidoptera: Sesiidae), was evaluated in field trapping studies using wing-style sticky traps baited with rubber septum or polyethylene vial dispensers containing the most effective sex pheromone ternary blend [86:6:6 v:v:v (Z,Z)-3,13-o...

  20. Design and fabrication of a passive droplet dispenser for portable high resolution imaging system

    Science.gov (United States)

    Kamal, Tahseen; Watkins, Rachel; Cen, Zijian; Rubinstein, Jaden; Kong, Gary; Lee, Woei Ming

    2017-01-01

    Moldless lens manufacturing techniques using standard droplet dispensing technology often require precise control over pressure to initiate fluid flow and control droplet formation. We have determined a series of interfacial fluid parameters optimised using standard 3D printed tools to extract, dispense and capture a single silicone droplet that is then cured to obtain high quality lenses. The dispensing process relies on the recapitulation of liquid dripping action (Rayleigh-Plateau instability) and the capturing method uses the interplay of gravitational force, capillary forces and liquid pinning to control the droplet shape. The key advantage of the passive lens fabrication approach is rapid scale-up using 3D printing by avoiding complex dispensing tools. We characterise the quality of the lenses fabricated using the passive approach by measuring wavefront aberration and high resolution imaging. The fabricated lenses are then integrated into a portable imaging system; a wearable thimble imaging device with a detachable camera housing, that is constructed for field imaging. This paper provides the full exposition of steps, from lens fabrication to imaging platform, necessary to construct a standalone high resolution imaging system. The simplicity of our methodology can be implemented using a regular desktop 3D printer and commercially available digital imaging systems.

  1. Drug use of children in the community assessed through pharmacy dispensing data

    NARCIS (Netherlands)

    Schirm, E; van den Berg, P; Gebben, H; Sauer, P; de Jong-van den Berg, L

    2000-01-01

    Aims To determine the extent of drug use in children and the types of drugs that children use. Methods Cross-sectional study and cohort study, using computerized pharmacy dispensing records for all children aged 0-16 years in the northern part of The Netherlands in 1998. The main outcome measures

  2. A Disposable Dispensing Valve for Non-Contact Microliter Applications in a 96-Well Plate Format

    Directory of Open Access Journals (Sweden)

    Sabrina Kartmann

    2015-04-01

    Full Text Available We present a miniaturized, disposable, normally-closed electromagnetic dispensing valve for the microliter range to process 96-well plates. The novel injection-molded valve is designed to fit into a 9 mm grid to realize an eight channel dispensing head, enabling the serial processing of well plates row-by-row. The presented dispensing valve design originates from a miniaturization study of a previously developed functional model. The outer diameter of the valve, including all actuating components, was reduced by 8 mm to an overall diameter of 8.5 mm without compromising the performance. Additionally, the actuation current of the valve could be reduced to 5 A. The valve is characterized for a volume range between 840 nL and 5.3 μL. The performance of the injection molded valve is competitive to commercially available dispensing valves, featuring the advantages of low fabrication costs, disposability, low mounting size, easy handling, and super silent actuation.

  3. Trends in adrenaline (EpiPen) dispensing in Israel in 1997-2004.

    Science.gov (United States)

    Levy, Yael; Segal, Nirit; Danon, Yehuda L

    2007-02-01

    The prevalence of allergic diseases has increased over the last 20 years in the Western world. Reports on the growing use of adrenaline auto-injectors (EpiPen and EpiPen Jr) in several countries may point to increased rates of anaphylactic reactions, increased awareness of the risk of anaphylaxis or both. To evaluate the dispensing rate of EpiPen units in Israel from 1997 to 2004. The database of the General Health Services (Clalit) was searched to determine the number of EpiPen units dispensed each year from 1997 to 2004. Data on mortality from anaphylaxis were derived from the Central Bureau of Statistics using International Classification of Diseases, 10th revision codes. The dispensing rate of EpiPen units rose gradually from 1689 in 1997 to 2981 in 2004; an overall increase of 76%. No case of death from anaphylaxis was reported from 1998 to 2000. The dispensing rate of adrenaline auto-injectors has increased considerably over the last 8 years in Israel, although to a lesser degree than in other countries. This is probably a reflection of updated medical policies, in accordance with the clinical guidelines for the management of anaphylaxis and improved public education. Further studies are needed to determine the prevalence of anaphylactic reactions in Israel.

  4. Implementation and evaluation of carousel dispensing technology in a university medical center pharmacy.

    Science.gov (United States)

    Temple, Jack; Ludwig, Brad

    2010-05-15

    The implementation of carousel dispensing technology (CDT) at a university medical center pharmacy and the associated changes in drug distribution are described. An evaluation of CDT was conducted in three phases: before implementation, during implementation, and after implementation. The preimplementation phase consisted of data collection and facility planning leading up to the physical installation. The implementation phase included the physical installation, carousel medication assignment, and user training. The postimplementation phase included data collection and analysis. The data collected were used to compare preimplementation and postimplementation time studies, labor requirements, inventory turns, and accuracy rates. The estimated labor savings comparing the preimplementation and postimplementation time studies for automated dispensing cabinet (ADC) refills, first-dose requests, supplemental cart fill, and medication procurement totaled 2.6 full-time equivalents (FTEs). After departmental reorganization, a net reduction of 2.0 technician FTEs was achieved. The average turnaround time for stat medication requests using CDT was 7.19 minutes, and the percentage of doses filled in less than 20 minutes was 95.1%. After implementing CDT, the average accuracy rate for all dispense requests increased from 99.02% to 99.48%. The inventory carrying cost was reduced by $25,059. CDT improved the overall efficiency and accuracy of medication dispensing in a university medical center pharmacy. Workflow efficiencies achieved in ADC refill, first-dose dispensing, supplemental cart fill, and the medication procurement process allowed the department to reduce the amount of technician labor required to support the medication distribution process, as well as reallocate technician labor to other areas in need.

  5. Population prevalence of high dose paracetamol in dispensed paracetamol/opioid prescription combinations: an observational study

    Science.gov (United States)

    2012-01-01

    Background Paracetamol (acetaminophen) is generally considered a safe medication, but is associated with hepatotoxicity at doses above doses of 4.0 g/day, and even below this daily dose in certain populations. Methods The Nova Scotia Prescription Monitoring Program (NSPMP) in the Canadian province of Nova Scotia is a legislated organization that collects dispensing information on all out-of-hospital prescription controlled drugs dispensed for all Nova Scotia residents. The NSPMP provided data to track all paracetamol/opioids redeemed by adults in Nova Scotia, from July 1, 2005 to June 30, 2010. Trends in the number of adults dispensed these prescriptions and the numbers of prescriptions and tablets dispensed over this period were determined. The numbers and proportions of adults who filled prescriptions exceeding 4.0 g/day and 3.25 g/day were determined for the one-year period July 1, 2009 to June 30, 2010. Data were stratified by sex and age (paracetamol/opioid prescription was lower in each successive one-year period. From July 2009 to June 2010, one in 12 adults (n = 59,197) filled prescriptions for over 13 million paracetamol/opioid tablets. Six percent (n = 3,786) filled prescriptions that exceeded 4.0 g/day and 18.6% (n = 11,008) exceeded 3.25 g/day of paracetamol at least once. These findings exclude non-prescription paracetamol and paracetamol–only prescribed medications. Conclusions A substantial number of individuals who redeem prescriptions for paracetamol/opioid combinations may be at risk of paracetamol-related hepatotoxicity. Healthcare professionals must be vigilant when prescribing and dispensing these medications in order to reduce the associated risks. PMID:22709372

  6. International Space Station USOS Potable Water Dispenser On-Orbit Functionality vs Design

    Science.gov (United States)

    Toon, Katherine P.; Lovell, Randal W.

    2009-01-01

    The International Space Station (ISS) currently provides potable water dispensing for rehydrating crewmembers food and drinking packages with one system located in the United States On-orbit Segment (USOS) and one system in the Russian Segment. The USOS Potable Water Dispenser (PWD) was delivered to ISS on ULF2, Shuttle Mission STS-126, and was subsequently activated in November 2008. The PWD activation on ISS is capable of supporting an ISS crew of six but nominally supplies only half the crew. The PWD is designed to provide incremental quantities of hot and ambient temperature potable water to US style food packages. PWD receives iodinated water from the US Laboratory Fuel Cell Water Bus, which is fed from the Water Processing Assembly (WPA). The PWD removes the biocidal iodine to make the water potable prior to dispensing. A heater assembly contained within the unit supplies up to 2.0 liters of hot water (65 to 93oC) every thirty minutes. This quantity supports three to four crewmembers to rehydrate their food and beverages from this location during a single meal. The unit is designed to remain functional for up to ten years with replacement of limited life items such as filters. To date, the PWD on-orbit performance has been acceptable. Since activation of the PWD, there have been several differences between on-orbit functionality and expected performance of hardware design. The comparison of on-orbit functionality to performance of hardware design is outlined for the following key areas: microbiology, PWD to food package water leakage, no-dispense scenarios, under-dispense scenarios, and crewmember feedback on actual on-orbit use.

  7. Investigation and improvement of the dispenser printing of electrical interconnections for smart fabric applications

    Science.gov (United States)

    Ahmed, Z.; Torah, R.; Yang, K.; Beeby, S.; Tudor, J.

    2016-10-01

    Electrical interconnections are essential for the integration of electronic functions in a fabric. These interconnects can be dispenser printed on a fabric; however printing directly on a breathable woven fabric surface is challenging due to the high surface variation and porosity defined by the weave. This paper, for the first time, experimentally shows that fabric surface variation leads to inconsistent printed structures which adversely affects the electrical properties of printed conductive tracks. It investigates a solution of overcoming the fabric surface variation in the form of dispenser printing an interface layer between the conductive ink and the fabric surface. Four dielectric inks DuPont 5018, Electra EFV4/4965, Fabinks-UV-IF-1004 and Fabinks-UV-TC0233 are quantitatively evaluated, as interface materials, in terms of surface consistency, thickness consistency, repeatability, flexibility, thermal stability and the electrical characteristics of conductive tracks printed on them. All four of the evaluated interface materials significantly reduced the fabric surface variation by more than 95% and provided a suitable low variation surface for printing subsequent electronic layers. Conductive tracks, dispenser printed on the four interface materials, produced ∼90% lower electrical resistivity compared to tracks printed directly on the fabric and similar resistivity to dispenser printed tracks on Kapton, a traditional printed electronic substrate. An increased focus on low powered electronics especially for wearables requires the electrical interconnections to dissipate minimum power. The innovative interface layer approach allows fabrication of low resistance electrical interconnections on fabric substrates reducing interconnect power dissipation, making this approach highly suitable for smart fabric applications. Reported details of dispenser printing of interface materials can be used for replicating these results on a range of fabric substrates. The

  8. International Space Station USOS Potable Water Dispenser On-Orbit Functionality Versus Design

    Science.gov (United States)

    Toon, Katherine P.; Lovell, Randal W.

    2010-01-01

    The International Space Station (ISS) currently provides potable water dispensing for rehydrating crewmember food and drinking packages. There is one system located in the United States On-orbit Segment (USOS) and one system in the Russian Segment. Shuttle mission STS-126 delivered the USOS Potable Water Dispenser (PWD) to ISS on ULF2; subsequent activation occurred on November 2008. The PWD is capable of supporting an ISS crew of six, but nominally supplies only half this crew size. The PWD design provides incremental quantities of hot and ambient temperature potable water to US food and beverage packages. PWD receives iodinated water from the US Water Recovery System (WRS) Fuel Cell Water Bus, which feeds from the Water Processing Assembly (WPA). The PWD removes the biocidal iodine to make the water potable prior to dispensing. A heater assembly contained within the unit supplies up to 2.0 L of hot water (65 to 93 ?C) every 30 min. During a single meal, this quantity of water supports three to four crewmembers? food rehydration and beverages. The unit design has a functional life expectancy of 10 years, with replacement of limited life items, such as filters. To date, the PWD on-orbit performance is acceptable. Since activation of the PWD, there were several differences between on-orbit functionality and expected performance of hardware design. The comparison of on-orbit functionality to performance of hardware design is discussed for the following key areas: 1) microbial contamination, 2) no-dispense and water leakage scenarios, and 3) under-dispense scenarios.

  9. 3D chip stacking with through silicon-vias (TSVs) for vertical interconnect and underfill dispensing

    Science.gov (United States)

    Le, Fuliang; Lee, Shi-Wei Ricky; Zhang, Qiming

    2017-04-01

    3D chip stacking with through silicon vias (TSVs) has been identified as one of the major technologies for achieving higher silicon packaging density and shorter interconnect. The test vehicle presented in this paper is a 3D chip stack package. Each layer of the test vehicle has two silicon flip chips mounted at the bottom of a silicon interposer with solder bumps. The flip chip has the equivalent dimensions and pad patterns as commercial memory chips. The interposer, with multiple interconnect TSVs for electrical connection and a central TSV for underfill dispensing, can function as a logic chip or as a redistribution chip in a real application. The assembly steps of the test vehicle include conductive adhesive filling for the interconnect TSVs, bonding two bumped flip chips on an interposer (to form a single layer), vertical stacking of the single layers and underfill dispensing. For the filling of the interconnect TSVs, an auger-dispensing method is first adopted to overfill the interconnect TSVs, followed by removing the excessive adhesive beyond the interconnect TSVs by squeegeeing. A jet valve continuously dispenses free dots of an underfill encapsulant into the central TSVs. The central TSVs function as an entrance for underfill dispensing and an uninterrupted point-source to provide fluid for each layer. The free dots form a capillary flow to fill the under-chip spaces of the test vehicle. The usage of TSVs rather than chip edges eliminates the presence of a wide edge reservoir, resulting in smaller ‘keep-out’ area occupation on the substrate.

  10. Antibiotic dispensation by Lebanese pharmacists: a comparison of higher and lower socio-economic levels.

    Science.gov (United States)

    Farah, Rita; Lahoud, Nathalie; Salameh, Pascale; Saleh, Nadine

    2015-01-01

    Indiscriminate use of antibiotics contributes to a global spread of antimicrobial resistance. Previous studies showed an excessive consumption of antibiotics purchased without medical prescription from community pharmacies, mainly in developing countries. There is a shortage of studies revealing the role of community pharmacists in the overuse of antibiotics. Our objective is to study the dispensing policy of non-medical prescription antibiotics in community pharmacies, assessing the possible influence of the socio-economic level of the area over this practice. A cross-sectional study was conducted between February and May 2011 among 100 pharmacists working in Beirut's pharmacies and its suburbs. Pharmacies were divided into 2 groups according to the socio-economic level of the population living in the pharmacy area. A self-administered questionnaire was filled by pharmacists. Over-the-counter antibiotic availability existed in both higher and lower socio-economic areas: on the whole, 32% of antibiotics were dispensed without medical prescription, with higher frequency in lower socio-economic areas (p=0.003). Dispensing injectable antibiotics without medical prescription was significantly higher in lower socio-economic areas (p=0.021), as well as dispensing an association of 2 antibiotics without medical prescription (p=0.001). Pharmacists working in lower socio-economic areas recommended more frequent antibiotics to children and the elderly (p<0.001 and p=0.004, respectively). Dispensing antibiotics without medical prescription in Beirut community pharmacies is a common practice, particularly in lower socioeconomic areas. This public health problem should be addressed at the social, educational, and legislative levels. Copyright © 2014 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

  11. Psychotropic drug dispensing in people with and without cancer in France.

    Science.gov (United States)

    Verger, Pierre; Cortaredona, Sébastien; Tournier, Marie; Rey, Dominique; Bendiane, Marc-Karim; Peretti-Watel, Patrick; Verdoux, Hélène

    2017-02-01

    To compare annual and monthly prevalence of psychotropic drug (PD) dispensing and the number and duration of psychotropic treatment episodes among people with and without cancer over a 2-year follow-up. We studied the following two cohorts of adult patients affiliated with the National Health Insurance Fund (NHIF): cancer patients followed for 2 years after diagnosis and individuals without cancer matched to cancer patients. Using information about anxiolytic, hypnotic, antidepressant, and antipsychotic dispensing in community pharmacies, we applied conditional log-binomial regressions to estimate adjusted relative risks for monthly dispensing of PDs. Annual prevalence of PD dispensing-all categories included-among cancer patients was significantly higher for almost all the categories we studied than among individuals without cancer. Monthly prevalence of anxiolytic/hypnotic dispensing started to rise several months before diagnosis and peaked immediately after. Among patients with cancer and their matched controls, treatment duration exceeded 1 month for hypnotics in 40 and 35 %, respectively (p < 0.01), and 3 months for anxiolytics in 23 and 23 % (p = 0.8); it was less than 6 months for antidepressants in 76 and 75 % (p = 0.5). Prevalence of psychotropic treatment was higher among cancer patients than among persons without cancer. Psychotropic treatment duration was not in line with recommendations for significant fractions of cancer patients or their controls. Training of health professionals involved in cancer supportive care should be reinforced and specific guidelines developed to help them address psychological distress of cancer survivors.

  12. Heavy-Load Lifting

    DEFF Research Database (Denmark)

    Bloomquist, Kira; Oturai, Peter; Steele, Megan L

    2017-01-01

    PURPOSE: Despite a paucity of evidence, prevention guidelines typically advise avoidance of heavy lifting in an effort to protect against breast cancer-related lymphedema. This study compared acute responses in arm swelling and related symptoms after low- and heavy-load resistance exercise among...... women at risk of lymphedema while receiving adjuvant taxane-based chemotherapy. METHODS: This is a randomized, cross-over equivalence trial. Women receiving adjuvant taxane-based chemotherapy for breast cancer who had undergone axillary lymph node dissection (n=21) participated in low- (60-65% 1...... repetition maximum (RM), two sets of 15-20 repetitions) and heavy-load (85-90% 1RM, three sets of 5-8 repetition) upper-extremity resistance exercise separated by a one-week wash-out period. Swelling was determined by bioimpedance spectroscopy and dual energy x-ray absorptiometry, with breast cancer...

  13. Deterministic bead-in-droplet ejection utilizing an integrated plug-in bead dispenser for single bead-based applications

    Science.gov (United States)

    Kim, Hojin; Choi, In Ho; Lee, Sanghyun; Won, Dong-Joon; Oh, Yong Suk; Kwon, Donghoon; Sung, Hyung Jin; Jeon, Sangmin; Kim, Joonwon

    2017-04-01

    This paper presents a deterministic bead-in-droplet ejection (BIDE) technique that regulates the precise distribution of microbeads in an ejected droplet. The deterministic BIDE was realized through the effective integration of a microfluidic single-particle handling technique with a liquid dispensing system. The integrated bead dispenser facilitates the transfer of the desired number of beads into a dispensing volume and the on-demand ejection of bead-encapsulated droplets. Single bead-encapsulated droplets were ejected every 3 s without any failure. Multiple-bead dispensing with deterministic control of the number of beads was demonstrated to emphasize the originality and quality of the proposed dispensing technique. The dispenser was mounted using a plug-socket type connection, and the dispensing process was completely automated using a programmed sequence without any microscopic observation. To demonstrate a potential application of the technique, bead-based streptavidin-biotin binding assay in an evaporating droplet was conducted using ultralow numbers of beads. The results evidenced the number of beads in the droplet crucially influences the reliability of the assay. Therefore, the proposed deterministic bead-in-droplet technology can be utilized to deliver desired beads onto a reaction site, particularly to reliably and efficiently enrich and detect target biomolecules.

  14. Deterministic bead-in-droplet ejection utilizing an integrated plug-in bead dispenser for single bead–based applications

    Science.gov (United States)

    Kim, Hojin; Choi, In Ho; Lee, Sanghyun; Won, Dong-Joon; Oh, Yong Suk; Kwon, Donghoon; Sung, Hyung Jin; Jeon, Sangmin; Kim, Joonwon

    2017-01-01

    This paper presents a deterministic bead-in-droplet ejection (BIDE) technique that regulates the precise distribution of microbeads in an ejected droplet. The deterministic BIDE was realized through the effective integration of a microfluidic single-particle handling technique with a liquid dispensing system. The integrated bead dispenser facilitates the transfer of the desired number of beads into a dispensing volume and the on-demand ejection of bead-encapsulated droplets. Single bead–encapsulated droplets were ejected every 3 s without any failure. Multiple-bead dispensing with deterministic control of the number of beads was demonstrated to emphasize the originality and quality of the proposed dispensing technique. The dispenser was mounted using a plug-socket type connection, and the dispensing process was completely automated using a programmed sequence without any microscopic observation. To demonstrate a potential application of the technique, bead-based streptavidin–biotin binding assay in an evaporating droplet was conducted using ultralow numbers of beads. The results evidenced the number of beads in the droplet crucially influences the reliability of the assay. Therefore, the proposed deterministic bead-in-droplet technology can be utilized to deliver desired beads onto a reaction site, particularly to reliably and efficiently enrich and detect target biomolecules. PMID:28393911

  15. Counteracting Age-related Loss of Skeletal Muscle Mass: a clinical and ethnological trial on the role of protein supplementation and training load (CALM Intervention Study): study protocol for a randomized controlled trial.

    Science.gov (United States)

    Bechshøft, Rasmus Leidesdorff; Reitelseder, Søren; Højfeldt, Grith; Castro-Mejía, Josué Leonardo; Khakimov, Bekzod; Ahmad, Hajar Fauzan Bin; Kjær, Michael; Engelsen, Søren Balling; Johansen, Susanne Margrete Bølling; Rasmussen, Morten Arendt; Lassen, Aske Juul; Jensen, Tenna; Beyer, Nina; Serena, Anja; Perez-Cueto, Frederico Jose Armando; Nielsen, Dennis Sandris; Jespersen, Astrid Pernille; Holm, Lars

    2016-08-09

    Aging is associated with decreased muscle mass and functional capacity, which in turn decrease quality of life. The number of citizens over the age of 65 years in the Western world will increase by 50 % over the next four decades, and this demographic shift brings forth new challenges at both societal and individual levels. Only a few longitudinal studies have been reported, but whey protein supplementation seems to improve muscle mass and function, and its combination with heavy strength training appears even more effective. However, heavy resistance training may reduce adherence to training, thereby attenuating the overall benefits of training. We hypothesize that light load resistance training is more efficient when both adherence and physical improvement are considered longitudinally. We launched the interdisciplinary project on Counteracting Age-related Loss of Skeletal Muscle Mass (CALM) to investigate the impact of lifestyle changes on physical and functional outcomes as well as everyday practices and habits in a qualitative context. We will randomize 205 participants older than 65 years to be given 1 year of two daily nutrient supplements with 10 g of sucrose and 20 g of either collagen protein, carbohydrates, or whey. Further, two groups will perform either heavy progressive resistance training or light load training on top of the whey supplement. The primary outcome of the CALM Intervention Study is the change in thigh cross-sectional area. Moreover, we will evaluate changes in physical performance, muscle fiber type and acute anabolic response to whey protein ingestion, sensory adaptation, gut microbiome, and a range of other measures, combined with questionnaires on life quality and qualitative interviews with selected subjects. The CALM Intervention Study will generate scientific evidence and recommendations to counteract age-related loss of skeletal muscle mass in elderly individuals. ClinicalTrials.gov NCT02034760 . Registered on 10 January 2014

  16. Impact of Escalating Loading Dose Regimens of Ticagrelor in Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention: Results of a Prospective Randomized Pharmacokinetic and Pharmacodynamic Investigation.

    Science.gov (United States)

    Franchi, Francesco; Rollini, Fabiana; Cho, Jung Rae; Bhatti, Mona; DeGroat, Christopher; Ferrante, Elisabetta; Dunn, Elizabeth C; Nanavati, Amit; Carraway, Edward; Suryadevara, Siva; Zenni, Martin M; Guzman, Luis A; Bass, Theodore A; Angiolillo, Dominick J

    2015-09-01

    The goal of this study was to assess the pharmacokinetic (PK) and pharmacodynamic (PD) profiles of escalating ticagrelor loading dose (LD) regimens in primary percutaneous coronary intervention (PPCI). Patients with ST-segment elevation myocardial infarction undergoing PPCI frequently have suboptimal platelet inhibition in the early hours after ticagrelor LD. The use of high ticagrelor LD regimens has been hypothesized to optimize platelet inhibition in PPCI. This was a prospective, randomized study of escalating ticagrelor LD regimens (180 mg, 270 mg, or 360 mg) in PPCI (N = 52). PK/PD analyses were performed before and 30 min, 1, 2, 4, 8, and 24 h post-LD. PK assessments included exposure to ticagrelor and its metabolite (AR-C124910XX). PD assessments included P2Y12 reaction units (PRU) measured by VerifyNow P2Y12 and platelet reactivity index (PRI) measured by vasodilator-stimulated phosphoprotein (VASP). Platelet reactivity was elevated during the first 2 h post-LD. There were no differences in PRU between groups during the study time course (p = 0.179). There were no significant differences in PRU levels across groups at all time points, except at 1 h (p = 0.017) where platelet reactivity was lowest with a 270-mg LD. No differences were found between the 180-mg and 360-mg groups (primary endpoint; p > 0.999). High on-treatment platelet reactivity rates were not different across groups, except at 1 hour (p = 0.038). Parallel PD findings were observed with VASP-PRI. PK analysis showed a delay in ticagrelor absorption and generation of AR-C124910XX, irrespective of dose. Although morphine was associated with a delay in ticagrelor PK/PD, it was not an independent predictor of high on-treatment platelet reactivity. ST-segment elevation myocardial infarction patients undergoing PPCI frequently exhibit impaired response to ticagrelor in the early hours after drug administration, which cannot be overcome by increasing LD regimens. These PD findings are largely

  17. Early loading of splinted implants supporting a two-unit fixed partial denture in the posterior maxilla: 13-month results from a randomized controlled clinical trial of two different implant systems.

    Science.gov (United States)

    Ryu, Hyo-Sook; Namgung, Cheol; Heo, Young-Ku; Lee, Jong-Ho; Lim, Young-Jun

    2016-08-01

    The aim of this study was to evaluate early-loaded implants supporting a two-unit fixed dental prosthesis in the posterior maxilla and to compare the clinical and radiological outcomes of two different implant systems in terms of success rates, implant stability quotient (ISQ) values, and peri-implant parameters. Thirty patients with the unilateral loss of two consecutive maxillary posterior teeth were randomly assigned to two different implant systems: SLActive Bone level implant (Institut Straumann AG, Basel, Switzerland) in the control group and CMI IS-II active implant (Neobiotech Co., Seoul, Korea) in the experimental group. The patients received provisional and definitive two-unit fixed prostheses at 4 weeks and 6 months after implant surgery, respectively. The peak insertion torque was recorded at surgery. The stability of each implant was evaluated during surgery and at 2, 3, and 4 weeks and 6 and 13 months after implant placement by means of ISQ values. In addition, periapical radiographs and peri-implant parameters were taken throughout the trial. Overall, comparable results were obtained between the control and experimental groups in terms of insertion torque, ISQ values, marginal bone loss, and peri-implant soft tissue parameters. All 60 implants had 100% of success rate. The average insertion torque was 36.83 ± 6.09 (control) and 35.33 ± 3.20 (test) Ncm. The ISQ values remained steady until 4 weeks and then increased with statistical significance during 4 weeks to 13 months after surgery. Both groups exhibited no stability dip during the early phase of healing. The average marginal bone loss from the baseline of implant placement for the control and experimental groups was 0.38 and 0.45 mm after 4 weeks and 0.98 and 0.61 mm after 13 months. All of the soft tissue parameters were within normal limits. The results of this study indicate that the concept of early loading at 4 weeks after placement in the posterior maxilla can be an effective

  18. Reassessment of the dementia diagnosis of Alzheimer's disease in patients enrolled on the cholinesterase inhibitors dispensation program

    Directory of Open Access Journals (Sweden)

    Magda Cristina Flaitt Sanches Piovesana

    Full Text Available ABSTRACT Objective: Reassess the diagnosis of Alzheimer's Disease (AD in patients treated with anti-cholinesterases dispensed by High Cost Drug stores (Exceptional Drugs Program. Methods: A prospective study to reassess the diagnosis of probable Alzheimer's Disease was conducted (AD. The patients were submitted to the protocol of dementia investigation at the Neurogeriatric Outpatient Clinic of the Teaching Hospital de Base de São José do Rio Preto. Groups were classified using the criteria of the National Institute of Neurologic and Communicative Diseases and Vascular Cerebral Accident and Alzheimer Disease Related Association (NINCDS-ADRDA. The study was completed by applying the Disability Assessment for Dementia (DAD. The significance level was set at 5%. Results: 106 patients participated, selected randomly from a group of 390 patients contacted when receiving their medication at the High Cost Drug store. Two groups were formed: the first, containing 52 patients who fulfilled criteria for AD (FC Group; and a second, with 54 patients not fulfilling criteria (NFC. The FC Group had older age, worse performance on the Mini-Mental State Exam (MMSE and poorer performance on the DAD. Also, treatment time was longer and drugs doses higher in the FC Group. Conclusion: Study results showed a high number of patients using anti-cholinesterases that did not fulfill the diagnosis criteria for probable AD. Comparison of the two groups revealed different behavior between them, corroborating the hypothesis of inadequate inclusion of the NFC Group patients in the Exceptional Drugs Program.

  19. Reformulation of controlled-release oxycodone and pharmacy dispensing patterns near the US–Canada border

    Science.gov (United States)

    Gomes, Tara; Paterson, J Michael; Juurlink, David N; Dhalla, Irfan A; Mamdani, Muhammad M

    2012-01-01

    Background In August 2010, a tamper-resistant formulation of controlled-release oxycodone (OxyContin-OP) was introduced in the United States but not in Canada. Our objective was to determine whether introduction of OxyContin-OP in the United States influenced prescription volumes for the original controlled-release oxycodone formulation (OxyContin) at Canadian pharmacies near the international border. Methods We conducted a population-based, serial, cross-sectional study of prescriptions dispensed from pharmacies in the 3 cities with the highest volume of US–Canada border crossings in Ontario: Niagara Falls, Windsor and Sarnia. We analyzed data on all outpatient prescriptions for OxyContin dispensed by Canadian pharmacies near each border crossing between 2010 Apr. 1 and 2012 Feb. 29. We calculated and compared monthly prescription rates, adjusted per 1000 population and stratified by tablet strength. Results The number of tablets dispensed near 4 border crossings in the 3 Canadian cities remained stable over the study period. However, the rate of dispensing at pharmacies near the Detroit–Windsor Tunnel increased roughly 4-fold between August 2010 and February 2011, from 505 to 1969 tablets per 1000 population. By April 2011, following warnings to prescribers and pharmacies regarding drug-seeking behaviour, the dispensing rate declined to 1683 tablets per 1000 population in this area. By November 2011, the rate had returned to levels observed in early 2010. Our analyses suggest that 242 075 excess OxyContin tablets were dispensed near the Detroit–Windsor Tunnel between August 2010 and October 2011. Conclusions Prescribing of the original formulation of controlled-release oxycodone rose substantially near a major international border crossing following the introduction of a tamper-resistant formulation in the United States. It is possible that the restriction of this finding to the area surrounding the Detroit–Windsor Tunnel reflects specific

  20. Reformulation of controlled-release oxycodone and pharmacy dispensing patterns near the US-Canada border.

    Science.gov (United States)

    Gomes, Tara; Paterson, J Michael; Juurlink, David N; Dhalla, Irfan A; Mamdani, Muhammad M

    2012-01-01

    In August 2010, a tamper-resistant formulation of controlled-release oxycodone (OxyContin-OP) was introduced in the United States but not in Canada. Our objective was to determine whether introduction of OxyContin-OP in the United States influenced prescription volumes for the original controlled-release oxycodone formulation (OxyContin) at Canadian pharmacies near the international border. We conducted a population-based, serial, cross-sectional study of prescriptions dispensed from pharmacies in the 3 cities with the highest volume of US-Canada border crossings in Ontario: Niagara Falls, Windsor and Sarnia. We analyzed data on all outpatient prescriptions for OxyContin dispensed by Canadian pharmacies near each border crossing between 2010 Apr. 1 and 2012 Feb. 29. We calculated and compared monthly prescription rates, adjusted per 1000 population and stratified by tablet strength. The number of tablets dispensed near 4 border crossings in the 3 Canadian cities remained stable over the study period. However, the rate of dispensing at pharmacies near the Detroit-Windsor Tunnel increased roughly 4-fold between August 2010 and February 2011, from 505 to 1969 tablets per 1000 population. By April 2011, following warnings to prescribers and pharmacies regarding drug-seeking behaviour, the dispensing rate declined to 1683 tablets per 1000 population in this area. By November 2011, the rate had returned to levels observed in early 2010. Our analyses suggest that 242 075 excess OxyContin tablets were dispensed near the Detroit-Windsor Tunnel between August 2010 and October 2011. Prescribing of the original formulation of controlled-release oxycodone rose substantially near a major international border crossing following the introduction of a tamper-resistant formulation in the United States. It is possible that the restriction of this finding to the area surrounding the Detroit-Windsor Tunnel reflects specific characteristics of this border crossing, including its high

  1. Predictors of epinephrine dispensing and allergy follow-up after emergency department visit for anaphylaxis.

    Science.gov (United States)

    Motosue, Megan; Bellolio, M Fernanda; Van Houten, Holly K; Shah, Nilay D; Campbell, Ronna L

    2017-11-01

    National guidelines recommend that patients with anaphylaxis be prescribed an epinephrine auto-injector (EAI) and referred to an allergy/immunology (A/I) specialist. To evaluate guideline concordance and identify predictors of EAI dispensing and A/I follow-up in patients with anaphylaxis treated in the emergency department (ED). We identified patients seen in the ED for anaphylaxis from 2010 through 2014 from an administrative claims database using an expanded International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code algorithm. Of 7,790 patients identified, 46.5% had an EAI dispensed and 28.8% had A/I follow-up within 1 year after discharge. On multivariable analysis, those 65 years or older (odds ratio [OR] 0.35, 95% confidence interval [CI] 0.30-0.41) and with a medication trigger (OR 0.24, 95% CI 0.21-0.28) had a lower likelihood of EAI dispensing. Those younger than 5 years (OR 2.67, 95% CI 2.15-3.32) and with food (OR 1.40, 95% CI 1.24-1.59) or venom (OR 4.48, 95% CI 3.51-5.72) triggers had a higher likelihood of EAI dispensing. Similarly, for A/I follow-up, the likelihood was lower for age 65 years or older (OR 0.46, 95% CI 0.39-0.54) and medication trigger (OR 0.66, 95% CI 0.56-0.78) and higher for age younger than 5 years (OR 3.15, 95% CI 2.63-3.77) and food trigger (OR 1.39, 95% CI 1.22-1.58). Overall, 46.5% of patients with anaphylaxis in the ED had EAI dispensing and 28.8% had A/I follow-up. Patient age and triggers were associated with likelihood of EAI dispensing and A/I follow-up. Post-ED visit anaphylaxis management can be improved, with the potential to decrease future morbidity and mortality risk. Copyright © 2017 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  2. Effect of volume loading with 1 liter intravenous infusions of 0.9% saline, 4% succinylated gelatine (Gelofusine) and 6% hydroxyethyl starch (Voluven) on blood volume and endocrine responses: a randomized, three-way crossover study in healthy volunteers.

    Science.gov (United States)

    Lobo, Dileep N; Stanga, Zeno; Aloysius, Mark M; Wicks, Catherine; Nunes, Quentin M; Ingram, Katharine L; Risch, Lorenz; Allison, Simon P

    2010-02-01

    To study the changes in blood volume and hormones controlling sodium and water homeostasis after infusions of 0.9% saline, Gelofusine (4% succinylated gelatin in 0.7% saline, weight-average molecular weight 30 kD), and Voluven (6% hydroxyethyl starch in 0.9% saline, weight-average molecular weight 130 kD) in healthy volunteers. Randomized, three-way crossover study. University teaching hospital. Ten healthy adult male volunteers. Volunteers received 1-L infusions of 0.9% saline, Gelofusine, and Voluven over 1 hr on three occasions. Body weight, hematocrit, serum biochemistry, and plasma concentrations of vasopressin, aldosterone, brain natriuretic peptide, and total renin were measured before infusion and hourly thereafter for 6 hrs. Changes in body water, blood volume, and extravascular fluid volume were calculated. Although changes in body weight (total body water) after the infusions were similar, blood volume expansion by the two colloids was significantly greater than that produced by 0.9% saline (p < .01). At the end of infusions, 68%, 21%, and 16% of the infused volumes of 0.9% saline, Gelofusine, and Voluven, respectively, had escaped from the intravascular space to the extravascular space. Over the 6 hrs, the magnitude and duration of blood volume expansion by the two colloids were similar (p = .70). There were no significant differences in urinary volume, osmolality, and sodium content after the three infusions. Hormonal changes were similar after the three infusions, with the increase in natriuretic peptide being transient. The reduction in aldosterone and total renin concentrations was more sustained. The effects of Gelofusine and Voluven were similar despite the 100 kD difference in weight-average molecular weight. Excretion of an acute fluid load containing sodium and chloride may be dependent on a sustained suppression of the renin-angiotensin-aldosterone system rather than on natriuretic peptides.

  3. Picoliter Drop-On-Demand Dispensing for Multiplex Liquid Cell Transmission Electron Microscopy

    Energy Technology Data Exchange (ETDEWEB)

    Patterson, Joseph P.; Parent, Lucas R.; Cantlon, Joshua; Eickhoff, Holger; Bared, Guido; Evans, James E.; Gianneschi, Nathan C.

    2016-05-03

    Abstract

    Liquid cell transmission electron microscopy (LCTEM) provides a unique insight into the dynamics of nanomaterials in solution. Controlling the addition of multiple solutions to the liquid cell remains a key hurdle in our ability to increase throughput and to study processes dependent on solution mixing including chemical reactions. Here, we report that a piezo dispensing technique allows for mixing of multiple solutions directly within the viewing area. This technique permits deposition of 50 pL droplets of various aqueous solutions onto the liquid cell window, before assembly of the cell in a fully controlled manner. This proof-of-concept study highlights the great potential of picoliter dispensing in combination with LCTEM for observing nanoparticle mixing in the solution phase and the creation of chemical gradients.

  4. TopSpot Vario: a novel microarrayer system for highly flexible and highly parallel picoliter dispensing.

    Science.gov (United States)

    Steinert, Chris P; Kalkandjiev, Kiril; Zengerle, Roland; Koltay, Peter

    2009-08-01

    The standard TopSpot technology has been successfully used in the recent years for the highly parallel nanoliter dispensing of bio-chemical substances for microarray printing. It is based on a pneumatically actuated printhead which enables non-contact microarray fabrication at a pitch of typically 500 microm. This paper reports on a new and improved way of operating the printheads termed TopSpot Vario technology, using an incompressible material between the piezo actuator and the dispensing medium. The advantage of the incompressible medium is the direct relation between the displacement amplitude and the ejected liquid volume. Earlier reports stated that the filling of the printheads is a key issue. In this paper we report on the implementation and characterization of a new printhead design including microchannels for bubble free priming of blind channels. Microarray fabrication was successfully conducted with four different types of protein.

  5. A novel approach on fluid dispensing for a DNA/RNA extraction chip package

    Science.gov (United States)

    Xie, Ling; Premachandran, C. S.; Chew, Michelle; Yao, Qiang; Xu, Diao; Pinjala, D.

    2008-02-01

    Micro fluidic package with integrated reservoirs has been developed for DNA /RNA extraction application. A membrane based pump which consists of a reservoir to store reagents and a pin valve to control the fluid is developed to dispense the reagents into the chip. A programmable external actuator is fabricated to dispense the fluid from the membrane pump into the DNA chip. An elastic and high elongation thin rubber membrane is used to seal the membrane pump and at the same time prevent actuator from mixing with different reagents in the micro fluidic package. Break displacement during actuation of membrane pump sealing material is studied with different ratios of PDMS and other types of rubber materials. The fluid flow from the reservoir to the chip is controlled by a pin valve which is activated during the external actuation. A CFD simulation is performed to study the pumping action dusting the external actuation and is validated with experimental results.

  6. Digital Imaging and Piezo-dispenser Actuator in Automatic Flocculation Control

    Directory of Open Access Journals (Sweden)

    Jani TOMPERI

    2012-01-01

    Full Text Available This study presents an image-based on-line control system for a coiled pipe flocculator. A digital imaging technique developed previously is utilized to measure the characteristic floc size and a high-pressure piezo-dispenser is introduced for accurate dosing and rapid mixing of the flocculant. The controller is a conventional PI controller. Step change experiments on feed water quality, flow rate and desired floc size have been carried out for controller tuning and testing. The paper shows that the piezo-dispenser provides better flocculation results than a conventional dosing pump, and the flocculation result can be automatically controlled even when the feed water quality rapidly changes. The proposed flocculator is a simple, inexpensive and practical system for long-term laboratory tests to investigate the functionality of flocculants on varying feed waters.

  7. Accurate, consistent, and fast droplet splitting and dispensing in electrowetting on dielectric digital microfluidics

    Science.gov (United States)

    Nikapitiya, N. Y. Jagath B.; Nahar, Mun Mun; Moon, Hyejin

    2017-12-01

    This letter reports two novel electrode design considerations to satisfy two very important aspects of EWOD operation—(1) Highly consistent volume of generated droplets and (2) Highly improved accuracy in the generated droplet volume. Considering the design principles investigated two novel designs were proposed; L-junction electrode design to offer high throughput droplet generation and Y-junction electrode design to split a droplet very fast while maintaining equal volume of each part. Devices of novel designs were fabricated and tested, and the results are compared with those of conventional approach. It is demonstrated that inaccuracy and inconsistency of droplet volume dispensed in the device with novel electrode designs are as low as 0.17 and 0.10%, respectively, while those of conventional approach are 25 and 0.76%, respectively. The dispensing frequency is enhanced from 4 to 9 Hz by using the novel design.

  8. Measurement of Low Workfunction Cesiated Metals for Use in Dispenser Photocathodes

    CERN Document Server

    Moody, N A; O'Shea, P G

    2005-01-01

    Photoinjector performance is a limiting factor in the continued development of high powered FELs. Presently available photocathodes have limited efficiency and short lifetime in an RF-gun environment, due to contamination or evaporation of a photosensitive surface layer. An ideal photocathode should have high efficiency at visible wavelengths, long lifetime in practical vacuum environments, and prompt emission. High efficiency cathodes typically have limited lifetime, and the needs of the photocathode are generally at odds with those of the drive laser. A potential solution is the low work function dispenser cathode, where short lifetimes are overcome by periodic in situ regeneration that restores the photosensitive surface layer, analogous to methods used in the power tube industry. This work reports on the fabrication techniques and performance of cesiated metal photocathodes and cesiated dispenser cathodes, with a focus on understanding and improving quantum efficiency and lifetime, analyzing issues of emi...

  9. SURVEY ON PROTOTHECA SPP. OCCURRENCE IN RAW MILK FROM AUTOMATIC DISPENSER: PUBLIC HEALTH CONCERN

    Directory of Open Access Journals (Sweden)

    G. Cammi

    2011-01-01

    Full Text Available Prototheca spp. are colorless unicellular algae ubiquitous in nature and opportunistic pathogens for humans and animals. Since Prototheca is an important cause of bovine mastitis, milk, as well as dairy products, can be contaminated and represent a potential mean of transmission of this microorganism to man. We carried out a survey on the automatic milk dispensers in the Emilia-Romagna Region (Northern Italy, to evaluate human exposure to Prototheca through raw milk. Milk samples were collected from 177 automatic dispensers, distributing milk from 117 dairy herds. Prototheca spp. was isolated on 17 milk samples (9,6 % produced by 14 dairy herds. The results of molecular characterization indicate that the isolates were P. zopfii genotipe 2 e P. blaschkeae, both species being associated whit human diseases. Our investigation points out the importance of raw milk as a carrier of microorganisms potentially harmful to humans.

  10. Raw Milk Hygiene at Local Markets and Automatic Milk Dispenser Machines

    OpenAIRE

    Gheorghe Şteţca; Arghir Ilea; Lenuţa Şuteu; Teodora Coldea

    2014-01-01

    In Romania, direct sales of raw milk to the final consumer is developed based on the local regulations. These are in accordance to European Regulation that must meet some quality requirements for the total number of germs, somatic cells, without antibiotics, coming from healthy animals who did not suffer from diseases that can be transmitted to humans through milk. Raw milk is sold in Romania in local markets and by automatic milk dispenser machines. Based on these regulations, a study regard...

  11. Clinical outcomes following the dispensing of ready-made and recycled spectacles: a systematic literature review.

    Science.gov (United States)

    Pearce, Matthew G

    2014-05-01

    Uncorrected refractive error is the leading cause of global visual impairment. Given resource constraints in developing countries, the gold standard method of refractive error correction, custom-made spectacles, is unlikely to be available for some time. Therefore, ready-made and recycled spectacles are in wide use in the developing world. To ensure that refractive error interventions are successful, it is important that only appropriate modes of refractive error correction are used. As a basis for policy development, a systematic literature review was conducted of interventional studies analysing visual function, patient satisfaction and continued use outcomes of ready-made and recycled spectacles dispensed to individuals in developing countries with refractive errors or presbyopia. PubMed and CINAHL were searched by MESH terms and keywords related to ready-made and recycled spectacle interventions, yielding 185 non-duplicated papers. After applying exclusion criteria, eight papers describing seven studies of clinical outcomes of dispensing ready-made spectacles were retained for analysis. The two randomised controlled trials and five non-experimental studies suggest that ready-made spectacles can provide sufficient visual function for a large portion of the world's population with refractive error, including those with astigmatism and/or anisometropia. The follow-up period for many of the studies was too short to confidently comment on patient satisfaction and continued-use outcomes. No studies were found that met inclusion criteria and discussed recycled spectacles. The literature also notes concerns about quality and cost effectiveness of recycled spectacles, as well as their tendency to increase developing countries' reliance on outside sources of help. In light of the findings, the dispensing of ready-made spectacles should be favoured over the dispensing of recycled spectacles in developing countries. © 2014 The Author. Clinical and Experimental Optometry

  12. SURVEY ON PROTOTHECA SPP. OCCURRENCE IN RAW MILK FROM AUTOMATIC DISPENSER: PUBLIC HEALTH CONCERN

    OpenAIRE

    Cammi, G.; Merenda, M.; F. Garilli; Ricchi, M.; Garbarino, C.; Arrigoni, N.; Belletti, G.L.

    2011-01-01

    Prototheca spp. are colorless unicellular algae ubiquitous in nature and opportunistic pathogens for humans and animals. Since Prototheca is an important cause of bovine mastitis, milk, as well as dairy products, can be contaminated and represent a potential mean of transmission of this microorganism to man. We carried out a survey on the automatic milk dispensers in the Emilia-Romagna Region (Northern Italy), to evaluate human exposure to Prototheca through raw milk. Milk samples were collec...

  13. Use of simulated patients to evaluate combined oral contraceptive dispensing practices of community pharmacists.

    Directory of Open Access Journals (Sweden)

    Paulo Roque Obreli-Neto

    Full Text Available BACKGROUND: Combined oral contraceptive (COC use is the most commonly used reversible method of birth control. The incorrect use of COCs is frequent and one of the most common causes of unintended pregnancies. Community pharmacists (CPs are in a strategic position to improve COC use because they are the last health professional to interact with patients before drug use. OBJECTIVE: To evaluate the COC dispensing practices of CPs in a developing country. METHOD: A cross-sectional study was conducted in community pharmacies of Assis and Ourinhos microregions, Brazil, between June 1, 2012, and October 30, 2012. Four simulated patients (SPs (with counseled audio recording visited community pharmacies with a prescription for Ciclo 21(® (a COC containing ethinyl estradiol 30 mcg + levonorgestrel 15 mcg. The audio recording of every SP visit was listened to independently by 3 researchers to evaluate the COC dispensing practice. The percentage of CPs who performed a screening for safe use of COCs (i.e., taking of patients' medical and family history, and measuring of blood pressure and provided counseling, as well as the quality of the screening and counseling, were evaluated. RESULTS: Of the 185 CPs contacted, 41 (22.2% agreed to participate in the study and finished the study protocol. Only 3 CPs asked the SP a question (1 question asked by each professional, and all of the questions were closed-ended, viz., "do you smoke?" (n = 2 and "what is your age?" (n = 1. None of the CPs measured the patient's blood pressure. Six CPs provided counseling when dispensing COCs (drug dosing, 5 CPs; possible adverse effects, 2 CPs, and one CP provided counseling regarding both aspects. CONCLUSION: The CPs evaluated did not dispense COC appropriately and could influence in the occurrence of negatives therapeutic outcomes such as adverse effects and treatment failure.

  14. Exploring the relationship between safety culture and reported dispensing errors in a large sample of Swedish community pharmacies

    National Research Council Canada - National Science Library

    Nordén-Hägg, Annika; Kälvemark-Sporrong, Sofia; Lindblad, Åsa Kettis

    2012-01-01

    .... The aim of this study is to investigate a possible relationship between reported dispensing errors and safety culture, taking into account demographic and pharmacy variables, in Swedish community pharmacies...

  15. 75 FR 28651 - In the Matter of Certain Electronic Paper Towel Dispensing Devices and Components Thereof; Notice...

    Science.gov (United States)

    2010-05-21

    ... From the Federal Register Online via the Government Publishing Office INTERNATIONAL TRADE COMMISSION In the Matter of Certain Electronic Paper Towel Dispensing Devices and Components Thereof; Notice of Investigation AGENCY: International Trade Commission. ACTION: Institution of investigation...

  16. Using nylon strips to dispense mosquito attractants for sampling the malaria vector Anopheles gambiae s.s.

    Science.gov (United States)

    Okumu, F; Biswaro, L; Mbeleyela, E; Killeen, G F; Mukabana, R; Moore, S J

    2010-03-01

    Synthetic versions of human derived kairomones can be used as baits when trapping host seeking mosquitoes. The effectiveness of these lures depends not only on their attractiveness to the mosquitoes but also on the medium from which they are dispensed. We report on the development and evaluation of nylon strips as a method of dispensing odorants attractive to the malaria vector, Anopheles gambiae s.s. (Giles). When a synthetic blend of attractants was dispensed using this method, significantly more mosquitoes were trapped than when two previous methods, open glass vials or low density polyethylene sachets were used. We conclude that the nylon strips are suitable for dispensing odorants in mosquito trapping operations and can be adopted for use in rural and remote areas. The nylon material required is cheap and widely available and the strips can be prepared without specialized equipment or electricity.

  17. Adverse selection? A multi-dimensional profile of people dispensed opioid analgesics for persistent non-cancer pain.

    Directory of Open Access Journals (Sweden)

    Kris D Rogers

    Full Text Available OBJECTIVES: This study investigates utilisation patterns for prescription opioid analgesics in the Australian community and how these are associated with a framework of individual-level factors related to healthcare use. METHODS: Self-reported demographic and health information from participants in the 45 and Up Study cohort were linked to pharmaceutical claims from 2006-2009. Participants comprised 19,816 people with ≥1 opioid analgesic dispensing in the 12-months after recruitment to the cohort and 79,882 people not dispensed opioid analgesics. All participants were aged ≥45 years, were social security pharmaceutical beneficiaries, with no history of cancer. People dispensed opioid analgesics were classified as having acute (dispensing period <90 days, episodic (≥90 days and <3 'authority' prescriptions for increased quantity supply or long-term treatment (≥90 days and ≥3 authority prescriptions. RESULTS: Of participants dispensed opioid analgesic 52% received acute treatment, 25% episodic treatment and 23% long-term treatment. People dispensed opioid analgesics long-term had an average of 14.9 opioid analgesic prescriptions/year from 2.0 doctors compared with 1.5 prescriptions from 1.1 doctors for people receiving acute treatment. People dispensed opioid analgesics reported more need-related factors such as poorer physical functioning and higher psychological distress. Long-term users were more likely to have access-related factors such as low-income and living outside major cities. After simultaneous adjustment, association with predisposing health factors and access diminished, but indicators of need such as osteoarthritis treatment, paracetamol use, and poor physical function were the strongest predictors for all opioid analgesic users. CONCLUSIONS: People dispensed opioid analgesics were in poorer health, reported higher levels of distress and poorer functioning than people not receiving opioid analgesics. Varying dispensing

  18. Raw Milk Hygiene at Local Markets and Automatic Milk Dispenser Machines

    Directory of Open Access Journals (Sweden)

    Gheorghe Şteţca

    2014-11-01

    Full Text Available In Romania, direct sales of raw milk to the final consumer is developed based on the local regulations. These are in accordance to European Regulation that must meet some quality requirements for the total number of germs, somatic cells, without antibiotics, coming from healthy animals who did not suffer from diseases that can be transmitted to humans through milk. Raw milk is sold in Romania in local markets and by automatic milk dispenser machines. Based on these regulations, a study regarding the quality and security to human health of raw milk was conducted on the commercialized milk in local markets and automatic milk dispensers. During May-June 2014 samples of raw milk were collected from Cluj-Napoca local markets and automatic milk dispensers. All samples were kept to refrigeration conditions until the moment of analyze which took place at the sampling day. The following parameters were taken into account: fat content, protein, casein, lactose, nonfat dry matter, pH, milk freezing point, added water, antibiotics residues, milk urea, number of germ cells and somatic cells. All obtained results were verified by the validated methods applied. Our research can be forward conducted in order to verify the hygiene and composition of milk from the whole dairy chain. 

  19. Drugs via enteral feeding tubes in inpatients: dispersion analysis and safe use of dispensers.

    Science.gov (United States)

    Beserra, Milena Pontes Portela; De Oliveira, Cristiani Lopes Capistrano Gonçalves; Portela, Mileyde Ponte; Lopes, Marcos Venícios de Oliveira; Fonteles, Marta Maria de França

    2017-03-30

    This study aimed to improve knowledge about drug administration through enteral feeding tubes (EFTs) in order to minimize efficacy and safety problems. The study was performed in a public secondary care hospital with level II accreditation by the National Accreditation Organization (Organização Nacional de Acreditação ONA), in Fortaleza, Ceará, north-eastern Brazil. One hundred and eight oral solid medications that could be administered through EFTs and were not available in liquid forms were evaluated via transformation of their solid dosage forms into liquid forms. Dispersion times and conditions were assessed to determine which medications should be crushed. We compared the use of dispensers and syringes and their connections to enteral feeding tubes and intravenous devices. Medications whose dispersion occurred within 20 minutes and could be visually perceived and whose content could be expelled without occluding the oral syringe were considered "satisfactory". The dispersion was "satisfactory" in 82 (75.9%) of the medications; they were classified as capable of being dispersed in water in the oral syringe for further administration via EFTs without the need for crushing. Use the dispenser instead of the syringe for drug administration was safer because the dispenser apparatus did not fit into equipment for intravenous drug administration.

  20. Combinatorial dispensing as a fast and efficient means to create complex screens.

    Science.gov (United States)

    Hazes, Bart

    2006-12-01

    Liquid handling robots carry out tasks from simple plate filling to complex operations such as creating reagent cocktails from multiple stock solutions. The latter task is conceptually a combinatorial process where each cocktail is created by combining a subset of stock solutions in user-defined volumes. General-purpose liquid handlers can perform this task, but their hardware lacks the inherent properties needed to exploit the combinatorial nature of the problem at hand. Here we present the use of non-contact dispensing technologies to create complex screens at low volume and high density. Our approach is based on the "inkjet printer principle" where a block of dispensers (print head) travels over a multi-well plate (paper) to deliver the reagents (inks) in a user-defined pattern. Impact-induced mixing and the lack of tip contamination remove the need for extensive tip washing or the use of large numbers of disposable tips. As an example, protein crystallization screening is used to demonstrate the technology. This application requires the creation of complex mixtures from many stock solutions with a great diversity of viscosities and surface tensions. In addition, dispense volumes cover a range from 50 nL to 50 microL, illustrating its utility in low-volume high-density screening.

  1. Differences in race, ethnicity, and socioeconomic status in schoolchildren dispensed injectable epinephrine in 3 Massachusetts school districts.

    Science.gov (United States)

    Hannaway, Paul J; Connelly, Mary Ellen; Cobbett, Roberta M; Dobrow, Paula J

    2005-08-01

    Published surveys depicting the increase in the incidence of food allergy, especially peanut or tree nut allergy, in children have not reported any differences in race, ethnicity, or socioeconomic status. To analyze the demographics of schoolchildren with diverse racial, ethnic, and socioeconomic characteristics dispensed injectable epinephrine. School nurses in 44 schools enrolling 21,875 students recorded the characteristics of students dispensed injectable epinephrine in the 2003-2004 school year. Surveyed school districts included 2 affluent suburban districts enrolling 5,855 students (> 92% white) and 1 urban district enrolling 16,020 students (60% nonwhite). A total of 181 students in all 3 districts were dispensed injectable epinephrine; 118 of these children had peanut or tree nut allergy. Males were more likely to be dispensed injectable epinephrine than females (odds ratio [OR], 1.44; P < .02). Whites were more likely to have been dispensed injectable epinephrine than nonwhites (OR, 4.76; P < .001). Whites were nearly 5 times more likely to be dispensed injectable epinephrine for peanut or tree nut allergy than nonwhites (OR, 4.5; P < .001). Most students (75%) dispensed injectable epinephrine for peanut or tree nut allergy were enrolled in prekindergarten through grade 5 (P < .001). Whites were more likely than nonwhites to be dispensed injectable epinephrine for stinging insect allergy (OR, 8.7; P < .001). This study found significant racial, ethnic, and socioeconomic differences in the prevalence of childhood allergic disorders, especially peanut or tree nut allergy, requiring prescribed injectable epinephrine in a school setting. Additional studies are needed to determine whether minority children are being underdiagnosed or undertreated for allergic disorders requiring injectable epinephrine or whether they truly have a lower incidence of such allergic disorders.

  2. The Reproducibility and Applicability of an EFD(®) Dispenser in the Prosthetic Technology of Maxillofacial Prostheses.

    Science.gov (United States)

    Blokland, L; Borsboom, P C F; Stokman, M A; Reintsema, H; van Oort, R P

    2013-09-01

    A reproducible method of dosing pigments can be beneficial and more efficient in the current colour matching procedure in maxillofacial prosthetics. In this study the reproducibility and applicability for pigment dosing of a commercial available EFD(®) dispenser were tested. The reproducibility of a Performus™ II type EFD(®) dispenser was tested by repeating dosing experiments with a set of eight syringes filled with pigment pastes (Factor 2; Flagstaff, USA). To evaluate conventional colour matching, four conventionally colour matched samples were polymerized and compared to the original ones. To investigate the reproducibility of the dispenser in practice, a fifth recipe was dispensed 10 times and colour differences were evaluated visually and as well calculated from measurements with a colour and translucency meter (CTM, PBSensortechnology bv). All dispensed amounts of pigment pastes showed a coefficient of variation in weight of less than 10 %. Evaluating the reproductions of four skin batches compared to the original batches, a ∆E2000 colour difference of 3-7 was measured. Evaluating ten reproductions of one skin coloured batch made with the dispenser, color difference ∆E2000 values compared to the average L*a*b* values, were less than 2 and no visual colour differences could be estimated. Conform these results, low colour differences could be measured with the CTM, indicating no visually observable consequences. Despite the estimated coefficient of variation, the reproducibility of the EFD(®) dispenser in terms of colour difference ∆E2000 of successive dispensing is applicable for colour reproduction in facial prosthetics. Segregation of the current color pastes in due time needs to be taken into consideration.

  3. An automatic dose dispenser for microtablets--a new concept for individual dosage of drugs in tablet form.

    Science.gov (United States)

    Bredenberg, Susanne; Nyholm, Dag; Aquilonius, Sten Magnus; Nyström, Christer

    2003-08-11

    A new concept for individualising the dosage of drugs in solid form is presented. The principle is based on the use of standardised units (microtablets), each containing a subtherapeutic amount of the active ingredient. The required dose is fine-tuned by counting out a specific number of these units. The microtablets are counted electronically from the attached cassette by the automatic dispensing device. The individual dose is set and the dispenser counts and delivers the correct number of microtablets. The usefulness of the automatic dispenser concept and acceptability of the apparatus were evaluated in patients with Parkinson's disease (PD). After initial instruction on use of the dispenser, 20 patients operated it themselves. All patients were generally satisfied with their management of the automatic dispenser and most would be happy to use the device again. Further technical development is required before use in clinical practice, but the current prototype may be acceptable for some patients. It is concluded that the final version of the automatic dose dispenser concept will offer potential for improvement of drug administration for patients with PD or other diseases requiring individual dosage.

  4. Pediatric burns due to hot water from water dispenser: a neglected issue that should be highly concerned.

    Science.gov (United States)

    Ma, Bing; Xi, Hui-Jun; Wang, Jia-Lin; Yan, Ying; Tang, Hong-Tai; Zhu, Shi-Hui; Lü, Kai-Yang; Xia, Zhao-Fan

    2012-06-01

    More and more Chinese drink hot water from water dispensers while many children were scalded due to this change. The present study aimed to propose a feasible strategy for prevention. A retrospective study was conducted for all water dispensers related pediatric burns admitted to Changhai Hospital from January 2005 to December 2009. The number of new cases and incidences of pediatric burns due to hot water from water dispensers was significantly increasing year after year. In the total 238 involved cases, 175 cases happened on males and 78.9% were at the age of 1 - 4 years. The burn areas were mainly located in upper extremities. All water dispensers in the surveyed families had no isolate protection devices and 85.2% of their locations were easy for children to reach. Nearly half of the children were in the same room with their guardians when injured. Total 196 burned children were playing the taps of water dispensers before injured, unfortunately, 80.6% of them have not been stopped until burned. As the kind of burns is quite serious and with bad outcome, some recommendations should be followed, such as buying water dispensers with protection devices, keeping children from touching them and so on.

  5. Increasing Access to Subsidized Artemisinin-based Combination Therapy through Accredited Drug Dispensing Outlets in Tanzania

    Directory of Open Access Journals (Sweden)

    Gabra Michael

    2011-06-01

    Full Text Available Abstract Background In Tanzania, many people seek malaria treatment from retail drug sellers. The National Malaria Control Program identified the accredited drug dispensing outlet (ADDO program as a private sector mechanism to supplement the distribution of subsidized artemisinin-based combination therapies (ACTs from public facilities and increase access to the first-line antimalarial in rural and underserved areas. The ADDO program strengthens private sector pharmaceutical services by improving regulatory and supervisory support, dispenser training, and record keeping practices. Methods The government's pilot program made subsidized ACTs available through ADDOs in 10 districts in the Morogoro and Ruvuma regions, covering about 2.9 million people. The program established a supply of subsidized ACTs, created a price system with a cost recovery plan, developed a plan to distribute the subsidized products to the ADDOs, trained dispensers, and strengthened the adverse drug reactions reporting system. As part of the evaluation, 448 ADDO dispensers brought their records to central locations for analysis, representing nearly 70% of ADDOs operating in the two regions. ADDO drug register data were available from July 2007-June 2008 for Morogoro and from July 2007-September 2008 for Ruvuma. This intervention was implemented from 2007-2008. Results During the pilot, over 300,000 people received treatment for malaria at the 448 ADDOs. The percentage of ADDOs that dispensed at least one course of ACT rose from 26.2% during July-September 2007 to 72.6% during April-June 2008. The number of malaria patients treated with ACTs gradually increased after the start of the pilot, while the use of non-ACT antimalarials declined; ACTs went from 3% of all antimalarials sold in July 2007 to 26% in June 2008. District-specific data showed substantial variation among the districts in ACT uptake through ADDOs, ranging from ACTs representing 10% of all antimalarial sales

  6. Load testing circuit

    DEFF Research Database (Denmark)

    2009-01-01

    A load testing circuit a circuit tests the load impedance of a load connected to an amplifier. The load impedance includes a first terminal and a second terminal, the load testing circuit comprising a signal generator providing a test signal of a defined bandwidth to the first terminal of the load...

  7. Short-term effects of a hypocaloric diet with low glycemic index and low glycemic load on body adiposity, metabolic variables, ghrelin, leptin, and pregnancy rate in overweight and obese infertile women: a randomized controlled trial.

    Science.gov (United States)

    Becker, Geórgia F; Passos, Eduardo P; Moulin, Cileide C

    2015-12-01

    Obesity is related to hormonal disorders that affect the reproductive system. Low-glycemic index (LGI) diets seem to exert a positive effect on weight loss and on metabolic changes that result from obesity. We investigated the effects of a hypocaloric diet with an LGI and low glycemic load on anthropometric and metabolic variables, ghrelin and leptin concentrations, and the pregnancy rate in overweight and obese infertile women who were undergoing in vitro fertilization (IVF). The study was a randomized block-design controlled trial in which we analyzed 26 overweight or obese infertile women. Patients were assigned to a hypocaloric LGI-diet group or a control group and followed the protocol for 12 wk. Body weight, body mass index (BMI), percentage of body fat, glucose, insulin, homeostasis model assessment of insulin resistance, serum lipids, reproductive hormones, leptin, acylated ghrelin, number of oocytes retrieved in the IVF cycle, and pregnancy rate were determined. There were greater reductions in body mass, BMI, percentage of body fat, waist:hip ratio, and leptin in the LGI-diet group than in the control group (P < 0.05). Despite a change of 18% in mean values, there was no significant increase in acylated ghrelin concentrations in the LGI group compared with the control group (P = 0.215). The LGI-diet group had 85.4% more oocytes retrieved than did the control group (7.75 ± 1.44 and 4.18 ± 0.87, respectively; P = 0.039) in the IVF cycle. Three patients (21.4%) in the LGI group experienced a spontaneous pregnancy during the follow-up, which generated 3 live births. The hypocaloric LGI diet promoted a decrease in BMI, percentage of body fat, and leptin concentrations, which improved oocyte development and pregnancy rate. These results support the clinical recommendation to advise overweight and obese women to lose weight through a balanced diet before being submitted for treatment with assisted reproduction technologies. A hypocaloric diet combined with LGI

  8. A comparison of costs of Medicare Part D prescriptions dispensed at retail and mail order pharmacies.

    Science.gov (United States)

    Carroll, Norman V

    2014-09-01

    Plan sponsors encourage the use of mail order pharmacies because they believe mail order dispensing will lower their prescription drug costs. Health plans and pharmacy benefit management companies (PBMs) usually offer patients substantially lower copayments to incentivize them to use mail order pharmacies. A number of health plans and PBMs now require patients to use these pharmacies for maintenance prescriptions. To (a) compare costs for prescriptions dispensed through mail order and retail pharmacies in Medicare Part D plans and (b) examine whether mail order or retail pharmacies provided lower all third-party costs for each of the top 300 products; the relationship between whether a product was available generically and whether mail order or retail pharmacies provided lower prices; and the generic substitution rates at mail order and retail pharmacies. The sample for this study consisted of 2010 Medicare Part D prescription drug data for the 300 products with the highest sales at mail order pharmacies. The prescriptions included in the study were dispensed in the initial coverage limit phase of Part D by retail or mail order pharmacies to patients who were insured by Part D for 12 months in 2010, who received no Part D subsidies, and who were alive for the full year in 2010. Mean-per-unit costs were calculated for both mail order and retail prescriptions for each of the top 300 products. Products were defined by Medi-Span Generic Product Indentifier. Summary statistics for the overall costs of mail order and retail prescriptions were calculated as the weighted mean-per-unit costs of the top 300 products. The weighting factor for both mail order and retail prescriptions included both the mail order quantity dispensed per prescription and the number of prescriptions dispensed. Weighting both mail and retail prescriptions by mail order quantities dispensed and numbers of prescriptions ensured that the results reflected actual cost differences rather than

  9. Miniature-dispenser-based bioassay to evaluate the compatibility of powder formulations used in an entomovectoring approach.

    Science.gov (United States)

    Mommaerts, Veerle; Put, Kurt; Vandeven, Jessica; Smagghe, Guy

    2012-06-01

    Entomovectoring as a plant protection strategy demands the design of an appropriate bioassay to assess the risks of potential side effects of the powder formulations in the dispenser towards the vectoring insect. This study reports on the development of a laboratory miniature-dispenser-based bioassay. This bioassay system was used to investigate the compatibility of five model products, Prestop-Mix, Signum, kaolin, wheat flour and cellulose, with the bumblebee, Bombus terrestris L. The laboratory one-way miniature-dispenser bioassay showed that the fungicides and the carrier/diluent kaolin caused a worker mortality of > 70% after 5 weeks of exposure, while worker loss with wheat flour and cellulose was no higher than in the blank control (i.e. empty miniature dispenser) (dispenser bioassay comprised separated passageways and demonstrated that only kaolin was toxic (89 ± 11%). These results were also confirmed in a flight-cage experiment. In addition, a negative effect was observed against reproduction/colony development when nests were exposed to kaolin (P dispenser and flight-cage bioassays. In the context of entomovectoring technology, the developed laboratory two-way miniature-dispenser bioassay gives a reliable prediction of the hazards associated with powder products. Additionally, the present data indicate the possibility of using cellulose and kaolin as respective negative and positive control carriers/diluents in future risk assessment experiments. Overall, the results show that, apart from kaolin, the tested fungicides and carriers/diluents are safe to be used with B. terrestris. Copyright © 2011 Society of Chemical Industry.

  10. Random eigenvalue problems revisited

    Indian Academy of Sciences (India)

    The description of real-life engineering structural systems is associated with some amount of uncertainty in specifying material properties, geometric parameters, boundary conditions and applied loads. In the context of structural dynamics it is necessary to consider random eigenvalue problems in order to account for these ...

  11. Simvastatin dose and risk of rhabdomyolysis: nested case-control study based on national health and drug dispensing data.

    Science.gov (United States)

    Parkin, Lianne; Paul, Charlotte; Herbison, G Peter

    2014-06-01

    Two randomised controlled trials have found a higher risk of rhabdomyolysis in users of 80 mg versus 20 mg simvastatin, but there is very limited information about the risk associated with other doses. We undertook a nested case-control study, using routinely collected national health and drug dispensing data, to estimate the relative and absolute risks of rhabdomyolysis resulting in hospital admission or death according to simvastatin dose. The underlying study cohort comprised all patients (n=313,552) who initiated a new episode of simvastatin use in New Zealand between 1 May 2005 and 31 December 2009. Cases (n=29) were patients with a diagnosis of rhabdomyolysis after cohort entry, confirmed by hospital discharge letter or death records. Ten controls, matched by year of birth and sex, were randomly selected from the study cohort using risk set sampling. Current users of 40 mg simvastatin daily were about five times as likely to develop rhabdomyolysis as those taking 20mg; the adjusted odds ratio was 5.3 (95% CI 1.9-15.0). The absolute excess risk of rhabdomyolysis associated with the use of 40 mg versus 20mg was about 10 per 100,000 person-years; the crude incidence rates were 11.5 (95% CI 7.1-17.5) and 2.1 (95% CI 0.7-4.8) per 100,000 person-years respectively. These findings provide reassurance that the absolute risk of rhabdomyolysis in a general population of simvastatin users is very low. Nonetheless, they also raise questions about the optimal simvastatin regimen to maximise cardiovascular benefits and minimise the risk of serious muscle injury. Copyright © 2014 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  12. Understanding the Role of Accredited Drug Dispensing Outlets in Tanzania's Health System.

    Directory of Open Access Journals (Sweden)

    Martha Embrey

    Full Text Available People in many low-income countries access medicines from retail drug shops. In Tanzania, a public-private partnership launched in 2003 used an accreditation approach to improve access to quality medicines and pharmaceutical services in underserved areas. The government scaled up the accredited drug dispensing outlet (ADDO program nationally, with over 9,000 shops now accredited. This study assessed the relationships between community members and their sources of health care and medicines, particularly antimicrobials, with a specific focus on the role ADDOs play in the health care system.Using mixed methods, we collected data in four regions. We surveyed 1,185 households and audited 96 ADDOs and 84 public/nongovernmental health facilities using a list of 17 tracer drugs. To determine practices in health facilities, we interviewed 1,365 exiting patients. To assess dispensing practices, mystery shoppers visited 306 ADDOs presenting one of three scenarios (102 each about a child's respiratory symptoms.Of 614 household members with a recent acute illness, 73% sought outside care-30% at a public facility and 31% at an ADDO. However, people bought medicines more often at ADDOs no matter who recommended the treatment; of the 581 medicines that people had received, 49% came from an ADDO. Although health facilities and ADDOs had similar availability of antimicrobials, ADDOs had more pediatric formulations available (p<0.001. The common perception was that drugs from ADDOs are more expensive, but the difference in the median cost to treat pneumonia was relatively minimal (US$0.26 in a public facility and US$0.30 in an ADDO. Over 20% of households said they had someone with a chronic condition, with 93% taking medication, but ADDOs are allowed to sell very few chronic care-related medicines. ADDO dispensers are trained to refer complicated cases to a health facility, and notably, 99% of mystery shoppers presenting a pneumonia scenario received an

  13. Polymer dispensing and embossing technology for the lens type LED packaging

    Science.gov (United States)

    Chien, Chien-Lin Chang; Huang, Yu-Che; Hu, Syue-Fong; Chang, Chung-Min; Yip, Ming-Chuen; Fang, Weileun

    2013-06-01

    This study presents a ring-type micro-structure design on the substrate and its corresponding micro fabrication processes for a lens-type light-emitting diode (LED) package. The dome-type or crater-type silicone lenses are achieved by a dispensing and embossing process rather than a molding process. Silicone with a high viscosity and thixotropy index is used as the encapsulant material. The ring-type micro structure is adopted to confine the dispensed silicone encapsulant so as to form the packaged lens. With the architecture and process described, this LED package technology herein has three merits: (1) the flexibility of lens-type LED package designs is enhanced; (2) a dome-type package design is used to enhance the intensity; (3) a crater-type package design is used to enhance the view angle. Measurement results show the ratio between the lens height and lens radius can vary from 0.4 to 1 by changing the volume of dispensed silicone. The view angles of dome-type and crater-type packages can reach 155° ± 5° and 175° ± 5°, respectively. As compared with the commercial plastic leaded chip carrier-type package, the luminous flux of a monochromatic blue light LED is improved by 15% by the dome-type package (improved by 7% by the crater-type package) and the luminous flux of a white light LED is improved by 25% by the dome-type package (improved by 13% by the crater-type package). The luminous flux of monochromatic blue light LED and white light LED are respectively improved by 8% and 12% by the dome-type package as compare with the crater-type package.

  14. Steam sterilization and automatic dispensing of [{sup 18}F]fludeoxyglucose (FDG) for injection

    Energy Technology Data Exchange (ETDEWEB)

    Karwath, Pascal [Department of Nuclear Medicine, University of Bonn, Sigmund-Freud-Strasse 25, 53127 Bonn (Germany) and MC-Pharma GmbH (MCP), Bonn (Germany)]. E-mail: p.karwath@uni-bonn.de; Sartor, Johannes [MC-Pharma GmbH (MCP), Bonn (Germany); Gries, Wolfgang [MC-Pharma GmbH (MCP), Bonn (Germany); Wodarski, Christine [MC-Pharma GmbH (MCP), Bonn (Germany); Dittmar, Claus [MC-Pharma GmbH (MCP), Bonn (Germany); Biersack, Hans J. [Department of Nuclear Medicine, University of Bonn, Sigmund-Freud-Strasse 25, 53127 Bonn (Germany); Guhlke, Stefan [Department of Nuclear Medicine, University of Bonn, Sigmund-Freud-Strasse 25, 53127 Bonn (Germany) and MC-Pharma GmbH (MCP), Bonn (Germany)]. E-mail: stefan.guhlke@ukb.uni-bonn.de

    2005-04-01

    For the purpose of implementing steam sterilization of 2-[{sup 18}F]FDG (FDG) in the final container into routine production, we have validated and established a fully automated dispensing and sterilization system, thereby considerably reducing the radiation burden to the personnel. Methods: The commercially available system combines aseptic dispensing of the product solution under a miniaturized laminar flow unit with subsequent steam sterilization, realized by heating of the product in the final containers by an autoclave included in the dispensing unit, thus incorporating current pharmaceutical manufacturing standards for the production of parental radiopharmaceuticals. The efficiency of the used sterilization cycle, the stability of FDG under the conditions of sterilization and the stability of the final product towards radiolysis was investigated with respect to various pH-formulations. Results: The system was found to be fully valid for filling of vials in a laminar flow class A (US-class 100) environment and for sterilization of FDG in the final container. The pH for sterilizing FDG solutions must be slightly acidic to avoid decomposition. A pH of 5.5 appears to be optimal and gives FDG of very high radiochemical purity ({approx}99%). In addition, radiolysis of FDG in solutions of high activity concentration was significantly lower at pH 5.5 than at neutral pH. Conclusion: Terminal sterilization enables the production of FDG in full compliance with GMP-regulations even in Class C or D (US class 10,000 or 100,000) laboratories.

  15. Control of microbial contamination in drinking water from microfiltering dispensers by dialysis ultrafilters

    Directory of Open Access Journals (Sweden)

    Bolelli Luca

    2016-12-01

    Full Text Available Tap water filtering devices are widely employed to improve odor and taste of tap water, or to obtain refrigerated or sparkling drinking water. The presence of disinfectants-resistant bacteria in tap water is responsible of the biofilm formation inside tubes and tanks. The consequent contamination of dispensed water is a well-known hygiene problem because of the quite constant presence of potentially pathogenic bacteria likes P. aeruginosa. In this study, we tested the technical feasibility and effectiveness of the addition to different commercial devices of a packaged polysulphone fibers filter. We aimed to find a simple solution to implement the quality of the delivered water. Water contamination levels were determined in a wide selection of microfiltered water dispensers and we selected among them a representative group of 10 devices, new or in use. The packaged ultrafilter was introduced in about half of them, to monitor, when possible, in parallel the contamination levels and flow rate of a couple of identical units, with and without the filter. The placement of the dialysis filters resulted feasible at different positions along the water circuits of the variously designed filtration units. Delivered water resulted completely free from bacteria when the filter was placed exactly at, or very close to, the outlet in spite of the inner surfaces contamination. This performance was not obtained in presence of a more or less long tract of water circuits downstream the ultrafilter: a significant but not complete reduction of the plate count numbers was observed. The filters worked in continue over the whole study period, ten months, showing exactly the same efficiency. Moreover, the flow rate in presence of the filter was quite unaffected. The addition of this kind of filter to already in use water dispensers was technically easy, and its use can be recommended in all cases a simple but reliable water sanitization is requested.

  16. Comparison of medication error rates and clinical effects in three medication prescription-dispensation systems.

    Science.gov (United States)

    Jiménez Muñoz, Ana Belén; Muiño Miguez, Antonio; Rodriguez Pérez, María Paz; Durán Garcia, María Esther; Sanjurjo Saez, María

    2011-01-01

    Medication errors (MEs) are important in terms of their magnitude and severity, and there are numerous systems in place to reduce their occurrence. However, the ideal system has not yet been identified. The authors' institution uses three different medication prescription-dispensation systems which operate simultaneously. ME rates were compared, overall and by phase (prescription, transcription and administration) and their overall and specific clinical impact. The administration of medicinal products was observed directly and compared with medical and nursing prescriptions. Errors and adverse events were classified by a consensus of experts. In the traditional system the error prevalence rate was 13.59 per cent, (99 per cent CI, 12.15-14.61 per cent), in the single dose system it was 6.43 per cent (99 per cent CI, 5.53-7.32) and in the electronic prescription system it was 8.86 per cent (99 per cent CI, 7.33-10.17). The highest error rates in all phases were found in the traditional system. The phase affected by most errors in all three models was transcription, and the least affected was administration, except for the single dose system, in which prescription was the worst. The effects of errors in the administration phase are greater, although less so than with the automated system. The dispensation phase was not analyzed. A study of errors will enable us to reduce their occurrence if we know the most frequent types and in which phase they are produced, we will be able to prioritise the areas in which to work and select the necessary preventive measures. It is possible that automated medication dispensation systems reduce error rates and the severity of their effects.

  17. Electrical load detection aparatus

    DEFF Research Database (Denmark)

    2010-01-01

    A load detection technique for a load comprising multiple frequency-dependant sub-loads comprises measuring a representation of the impedance characteristic of the load; providing stored representations of a multiplicity of impedance characteristics of the load; each one of the stored representat...

  18. Opticians, Dispensing

    Science.gov (United States)

    ... State & Area Data Explore resources for employment and wages by state and area for opticians. Similar Occupations Compare the job duties, education, job growth, and pay of opticians with similar ...

  19. Evaluation of antibiotics dispensing profile in Tubarão, Santa Catarina, Brazil

    Directory of Open Access Journals (Sweden)

    Claudia Rauber

    2009-12-01

    Full Text Available Antibiotics are drugs widely used in prophylaxis and treatment of a great number of diseases. However, their use must be carefully controlled as acquisition in pharmacies, often without medical prescription, is elevated. The role of pharmacists in these circumstances is to practice dispensation in a rational manner. Through a structured questionnaire with open and closed questions, this study investigated the profile of antibiotics dispensed in pharmacies of Tubarão, Santa Catarina, Brazil. From the responses, it was observed that 85.0% dispense this class of medicine without medical prescription, mainly for treatment of respiratory (62.8% and urinary (12.0% tract disorders. Moreover, pharmacists' guidance was largely focused on posology (66.6% and drug interaction (12.6%, in addition to the interactions with contraceptives, alcohol and milk. The importance of avoiding antibiotics dispensation without medical prescription must be emphasized, as well as the benefits of educating the population to promote the rational use of medicines.Antibióticos são fármacos amplamente utilizados na profilaxia e no tratamento de grande número de doenças. Entretanto, seu uso deve ser cuidadosamente controlado nas farmácias, uma vez que nestas a aquisição sem prescrição médica é elevada. O papel dos farmacêuticos nessas circunstâncias é o de praticar a dispensação de maneira racional. Por meio de questionário estruturado, com questões abertas e fechadas, investigou-se o perfil dos antibióticos dispensados em farmácias de Tubarão, Santa Catarina, Brasil. Pelas respostas, observou-se que 85% das dispensa essa classe de medicamentos sem prescrição médica, principalmente para o tratamento de problemas dos tratos respiratório (62,8% e urinário (12,0%. Além disso, a orientação dos farmacêuticos se focou amplamente na posologia (66,6%e nas interações com fármacos (12,6%, em adição às interações com anticoncepcionais, álcool e

  20. Automating a precision braze paste dispensing operation using non- contact sensing

    Energy Technology Data Exchange (ETDEWEB)

    Schmitt, D; Novak, J [Sandia National Labs., Albuquerque, NM (United States); Maslakowski, J; Thiele, A [Rockwell International Corp., Canoga Park, CA (United States). Rocketdyne Div.

    1993-01-01

    This paper describes a collaborative effort between Sandia National Laboratories and the Rocketdyne Division of Rockwell International Corporation to develop an automated braze paste dispensing system for rocket engine nozzle manufacturing. The motivation for automating this manufacturing process is to reduce the amount of labor and excess material required. A critical requirement for this system is the automatic location of key nozzle features using non-contact sensors. Sandia has demonstrated that the low-cost Multi-Axis Seam Tracking (MAST) capacitive sensor can be used to accurately locate the nozzle surface and tube gaps.

  1. The study of neutron burst shape of a neutron tube driven by dispenser cathode

    Science.gov (United States)

    Grishnyaev, Evgeny; Polosatkin, Sergey

    2016-08-01

    A slim-shaped portable DD-neutron generator is developed at Budker institute of Nuclear Physics. The generator is a combination of Cockcroft-Walton voltage multiplier and a sealed gas-filled neutron tube driven by dispenser cathode. Neutron burst shape in pulsed mode of neutron tube operation is measured with stroboscopic time spectrometry, implemented on scintillation detector, and modeled with Comsol Script 1.3 and Comsol Multiphysics 3.5. Modeling appears to be in good agreement with experimental results. Measured pulse rise and fall times are 110 ns and 100 ns respectively.

  2. The study of neutron burst shape of a neutron tube driven by dispenser cathode

    Energy Technology Data Exchange (ETDEWEB)

    Grishnyaev, Evgeny, E-mail: grishnjaev@mail.ru; Polosatkin, Sergey

    2016-08-21

    A slim-shaped portable DD-neutron generator is developed at Budker institute of Nuclear Physics. The generator is a combination of Cockcroft–Walton voltage multiplier and a sealed gas-filled neutron tube driven by dispenser cathode. Neutron burst shape in pulsed mode of neutron tube operation is measured with stroboscopic time spectrometry, implemented on scintillation detector, and modeled with Comsol Script 1.3 and Comsol Multiphysics 3.5. Modeling appears to be in good agreement with experimental results. Measured pulse rise and fall times are 110 ns and 100 ns respectively.

  3. International Space Station (ISS) Potable Water Dispenser (PWD) Beverage Adapter (BA) Redesign

    Science.gov (United States)

    Edgerly, Rachel; Benoit, Jace; Shindo, David

    2012-01-01

    The Potable Water Dispenser used on the International Space Station (ISS) interfaces with food and drink packages using the Beverage Adapter and Needle. Unexpected leakage has been seen in this interface. The Beverage Adapter used on ]orbit was returned to the ground for Test, Teardown, and Evaluation. The results of that investigation prompted a redesign of the Beverage Adapter and Needle. The Beverage Adapter materials were changed to be more corrosion resistant, and the Needle was redesigned to preclude leakage. The redesigns have been tested and proven.

  4. A model for drug dispensing service based on the care process in the Brazilian health system

    Directory of Open Access Journals (Sweden)

    Luciano Soares

    2013-03-01

    Full Text Available Access to medication emphasizes the availability of the product at the expense of providing a service. The goal of this paper is to propose a theoretical model for a drug dispensing service, beginning with a reflection on the current realities of the Unified Health System and drug dispensation in Brazil. A conceptual analytical research made by a methodological course called disciplined imagination was mainly the approach applied to develop the model. The drug dispensing service is part of the care process, which considers access as an attribute; reception, connection and accountability, management, and clinical pharmaceutical aspects as components; and the rational use of drugs as the purpose. The proposed model addresses access to the dispensing service and demands a reorientation of routines, instruments, and practices.O acesso a medicamentos enfatiza a disponibilidade do produto em detrimento da provisão de um serviço. O objetivo deste trabalho é propor um modelo teórico para um serviço de dispensação de medicamentos, iniciando com uma reflexão sobre a realidade atual do Sistema Único de Saúde e a dispensação de medicamentos no Brasil. Uma pesquisa analítica conceitual realizada por meio de um percurso metodológico chamado de imaginação disciplinada constituiu a estratégia principal para o desenvolvimento do modelo. O serviço de dispensação é parte do processo de cuidado, o qual considera o acesso como um atributo; os aspectos acolhimento, vínculo e responsabilização, gestão e clínica farmacêutica como componentes e o uso racional de medicamentos como o propósito. O modelo proposto direciona o acesso para o serviço de dispensação e demanda a reorientação de rotinas, instrumentos e práticas.

  5. Providers′ knowledge, attitude and dispensing practices of E-Pills in government dispensaries of south district in Delhi, India

    Directory of Open Access Journals (Sweden)

    Kishore Vertika

    2010-01-01

    Full Text Available Background: South Delhi is one of the well developed districts in the capital with best public health care facilities. Knowledge, attitude and dispensing practices of emergency contraceptive pills (E-pills were assessed among health care providers of government dispensaries in South Delhi. Study Design: A descriptive epidemiological study. Materials and Methods: Both medical and paramedical (n = 428 providers in 63 government health care facilities were interviewed between August to December 2007 using a semi-structured interview schedule. Results: Among the different categories of the providers, medical officers were observed to be most knowledgeable about E-pills and the pharmacists were the least. The correct prescribed dose of E-pill was known only to 32% of the providers while 49% knew about its right time of intake. Misconceptions and apprehensions for promoting its use were very much prevalent even among medical officers as majority felt that open access to E-pills would increase promiscuity. The dispensing practice of providers was found positively ( P < 0.05 correlated with their knowledge. Training resulted a significant ( P < 0.05 improvement in knowledge, attitude and dispensing practice of the providers. Knowledge and training combined together contributed 35% to the dispensing practice (R 2 = 0.35. Conclusion: Besides knowledge, behavior change communication strategies should form a part of the training curricula of health care providers that would help to improve the dispensing practice of E-pills.

  6. A Review of the Anthropometric Characteristics, Grading and Dispensation of Junior and Youth Rugby Union Players in Australia.

    Science.gov (United States)

    Patton, Declan Alexander; McIntosh, Andrew Stuart; Denny, Greg

    2016-08-01

    The grading of Australian junior and youth rugby union players has received substantial media attention in recent years. Media reports have focussed on size mismatches observed between players, especially players with Polynesian heritage, and the concerned parents who fear for the safety of their child owing to perceived mismatches. Although such concerns are well meaning, few media reports recognise the need for substantial evidence to determine the best grading system for junior and youth rugby union players. The current study reviewed relevant literature pertinent to the grading and dispensation of junior and youth rugby union players. Using primary and secondary search strategies, a total of 33 articles reporting the anthropometric characteristics of junior and youth rugby players were identified. Anthropometric data from the literature were compared with normative population data and currently used dispensation criteria. Junior and youth rugby players were found to be taller and heavier than normative population data. Current dispensation criteria, in terms of body mass, were found to vary and it is suggested that criteria be revised and standardised across rugby unions throughout Australia. Although it is acknowledged that other factors are important for grading players, anthropometric characteristics should be considered as potential dispensation criteria to supplement current age-based grading for junior and youth rugby union players. Measuring the body mass and stature of each junior player upon pre-season registration is suggested, which would provide data to establish valid dispensation criteria for the following season.

  7. Development of an automated dispenser for the delivery of medicinal or vaccine-laden baits to raccoons (Procyon lotor).

    Science.gov (United States)

    Smyser, Timothy J; Redding, James V; Bevis, Crystal M; Page, L Kristen; Swihart, Robert K

    2015-04-01

    Medicinal baits are distributed to manage zoonotic diseases, including raccoon (Procyon lotor) rabies, but efficient distribution strategies are needed for suburban environments. We developed an automated dispenser that transfers fishmeal polymer baits at user-specified intervals from a magazine to a receptacle fitted with a filter that exploits raccoon dexterity to limit consumption by nontarget species. We introduce the concept of automated dispensers and describe bait removal success rates for raccoons versus nontarget species. We monitored visitation with remote cameras after deploying a dispenser, programmed to present two baits per night, in three disjunct forest patches in northwest Indiana. Raccoons removed 72% of baits; nontarget, white-footed mice (Peromyscus leucopus) removed 11%; Virginia opossums (Didelphis virginiana) removed 9%. Bait removal success varied significantly between raccoons (76%) and opossums (21%), improving bait delivery specificity relative to hand baiting. Accumulation of baits in receptacles resulted in excess (more than one) bait consumption (39% of baits consumed by raccoons were excess), suggesting design improvements are needed to present additional baits only after previous baits have been consumed. Automated dispensers successfully sustained bait availability throughout the operational period. Subsequent research is needed to determine whether a sustained availability of baits achieved with automated dispensers is more effective for the treatment of raccoons in suburban environments than traditional distribution methods.

  8. Safety of dispensing prescribed iron formulation in childresistant containers among pharmacies in Saudi Arabia: a cross-sectional survey

    Directory of Open Access Journals (Sweden)

    Nahar Alruwaili

    2013-04-01

    Full Text Available Iron overdose remains a significant public health threat to young children. Unit dose packaging of potent iron supplements is expected to reduce the frequency of severe pediatric iron overdose incidents. Interna - tional regulations require child-resistant iron packages. We aim to know if iron is dispensed in child-resistant containers (CRCs and to emphasize the importance of using them. A prospective cross-sectional observational study assessing the proper dispensing of ferrous sulfate tablets in CRCs from major city pharmacies. Forty government and private pharmacies were visited. Ferrous sulfates with a total of 600 to 6500 mg elemental iron per package were found. The package of 6000 mg was the most commonly found. Most of the packages with high concentrations are dispensed from the government hospitals and primary healthcare centers pharmacies. None of the pharmacies dispensed iron in CRCs. To conclude, pharmacies dispensed iron in non-CRCs. Public health efforts on increasing awareness and improving packaging are highly needed. Authority regulations to use child-resistant iron packaging are required.

  9. College Cafeteria Signage Increases Water Intake but Water Position on the Soda Dispenser Encourages More Soda Consumption.

    Science.gov (United States)

    Montuclard, Astrid Linn; Park-Mroch, Jennifer; O'Shea, Amy M J; Wansink, Brian; Irvin, Jill; Laroche, Helena H

    2017-10-01

    To evaluate the effects of improved water location visibility and water dispenser position on the soda dispenser on undergraduate students' beverage choices. Two focus groups with pilot intervention surveys before and after, adding a small sign above the soda dispensers' water button for 6 weeks in a large US university's all-you-can-eat, prepaid dining hall (measured with chi-square tests and logistic and ordinal logistic regression). Focus groups included 15 students. Survey participants included 357 students before and 301 after the intervention. After the intervention, more students reported ever having drunk water with the meal (66.4% to 77.0%; P = .003) and water consumption frequency increased (P = .005). Postintervention, the odds of drinking water increased by 1.57. Preference for other drinks was the main reason for not drinking water. A total of 59% of students had ever changed their preference from water to soda. The clear indication of the water's location increased students' reported water consumption. Further investigation is needed into how a non-independent water dispenser influences students' beverage choice. Clearly labeled, independent water dispensers are recommended. Copyright © 2017 Society for Nutrition Education and Behavior. All rights reserved.

  10. Recent trends in the dispensing of 90-day-supply prescriptions at retail pharmacies: implications for improved convenience and access.

    Science.gov (United States)

    Liberman, Joshua N; Girdish, Charmaine

    2011-03-01

    Mail-service pharmacies offer consumers the convenience of prescriptions filled with a 90-day supply of medication. Unlike mail-service pharmacies, retail pharmacies traditionally dispensed maintenance medication prescriptions with a 30-day supply. However, the retail landscape changed in May 2008 with Walmart's announcement of an extension of its $4 Prescription Program to include 90-day-supply prescriptions. To evaluate recent changes in access to and use of 90-day-supply maintenance medications dispensed via retail pharmacy. As of the first quarter of 2007, the proportion of retail-dispensed maintenance medications with a 90-day supply (compared with all maintenance prescriptions dispensed) among Medicare Part D plans, self-insured employers, and private health plans was 5.1%, 5.1%, and 5.0%, respectively. As of December 2009, this ratio had risen to 8.0% for Medicare plans and 8.1% for commercial health plans; the ratio among employers had risen more modestly to 6.1%. Of particular interest and importance, the proportion increased similarly for brand and for generic medications. There has been substantial growth in 90-day prescriptions dispensed via retail pharmacy, a trend that is likely to continue as more insurance providers adopt compatible benefit designs. It is important to continue monitoring these trends and to identify opportunities to rigorously evaluate their impact on medication adherence and healthcare costs.

  11. Distribution load estimation (DLE)

    Energy Technology Data Exchange (ETDEWEB)

    Seppaelae, A.; Lehtonen, M. [VTT Energy, Espoo (Finland)

    1998-08-01

    The load research has produced customer class load models to convert the customers` annual energy consumption to hourly load values. The reliability of load models applied from a nation-wide sample is limited in any specific network because many local circumstances are different from utility to utility and time to time. Therefore there is a need to find improvements to the load models or, in general, improvements to the load estimates. In Distribution Load Estimation (DLE) the measurements from the network are utilized to improve the customer class load models. The results of DLE will be new load models that better correspond to the loading of the distribution network but are still close to the original load models obtained by load research. The principal data flow of DLE is presented

  12. Distribution load estimation - DLE

    Energy Technology Data Exchange (ETDEWEB)

    Seppaelae, A. [VTT Energy, Espoo (Finland)

    1996-12-31

    The load research project has produced statistical information in the form of load models to convert the figures of annual energy consumption to hourly load values. The reliability of load models is limited to a certain network because many local circumstances are different from utility to utility and time to time. Therefore there is a need to make improvements in the load models. Distribution load estimation (DLE) is the method developed here to improve load estimates from the load models. The method is also quite cheap to apply as it utilises information that is already available in SCADA systems

  13. Microfabricated vapor cells filled with a cesium dispensing paste for miniature atomic clocks

    Science.gov (United States)

    Maurice, V.; Rutkowski, J.; Kroemer, E.; Bargiel, S.; Passilly, N.; Boudot, R.; Gorecki, C.; Mauri, L.; Moraja, M.

    2017-04-01

    A method for filling alkali vapor cells with cesium from a dispensing paste is proposed and its compliance with miniature atomic clock applications is evaluated. The paste is an organic-inorganic composition of cesium molybdate, zirconium-aluminum powder, and a hybrid organic-inorganic binder. It is compatible with collective deposition processes such as micro-drop dispensing, which can be done under ambient atmosphere at the wafer-level. After deposition and sealing by anodic bonding, cesium is released from the consolidated paste through local heating with a high power laser. Linear absorption signals have been observed over one year in several cells, showing a stable atomic density. For further validation of this technology for clock applications, one cell has been implemented in a coherent population trapping clock setup to monitor its frequency stability. A fractional frequency aging rate around -4.4 × 10-12 per day has been observed, which is compliant with a clock frequency instability below 1 × 10-11 at one day integration time. This filling method can drastically reduce the cost and the complexity of alkali vapor cell fabrication.

  14. Molecular Epidemiology of a Pseudomonas aeruginosa Hospital Outbreak Driven by a Contaminated Disinfectant-Soap Dispenser

    Science.gov (United States)

    Lanini, Simone; D'Arezzo, Silvia; Puro, Vincenzo; Martini, Lorena; Imperi, Francesco; Piselli, Pierluca; Montanaro, Marco; Paoletti, Simonetta; Visca, Paolo; Ippolito, Giuseppe

    2011-01-01

    Background and Objective Pseudomonas aeruginosa infection represents a main cause of morbidity and mortality among immunocompromised patients. This study describes a fatal epidemic of P. aeruginosa that occurred in a hematology unit in Italy. Methods Retrospective cohort study, prospective surveillance, auditing, extensive testing on healthcare workers and environmental investigation were performed to define the dynamics and potential causes of transmission. RAPD, macrorestriction analyses and sequence typing were used to define relationships between P. aeruginosa isolates. Results Eighteen cases of infection were identified in the different phases of the investigation. Of these, five constitute a significant molecular cluster of infection. A P. aeruginosa strain with the same genetic fingerprint and sequence type (ST175) as clinical isolates strain was also isolated from a heavily contaminated triclosan soap dispenser. Discussion and Conclusions Our results are consistent with the hypothesis that patients became indirectly infected, e.g., during central venous catheter handling through contaminated items, and that the triclosan soap dispenser acted as a common continuous source of P. aeruginosa infection. Since P. aeruginosa is intrinsically unsusceptible to triclosan, the use of triclosan-based disinfectant formulations should be avoided in those healthcare settings hosting patients at high risk of P. aeruginosa infection. PMID:21359222

  15. Prescription opioid dispensing and prescription opioid poisoning: Population data from Victoria, Australia 2006 to 2013.

    Science.gov (United States)

    Berecki-Gisolf, Janneke; Hassani-Mahmooei, Behrooz; Clapperton, Angela; McClure, Roderick

    2017-02-01

    To describe recent trends in opioid prescribing and prescription opioid poisoning resulting in hospitalisation or death in Victoria, Australia. This is a population-based ecological study of residents of Victoria, 2006 - 14. Australian Bureau of Statistics residential population data were combined with Pharmaceutical Benefits Scheme (PBS) opioid prescription data, Victorian Admitted Episodes Data (VAED) and cause of death data. Annual opioid dispensings increased by 78% in 2006 - 13, from 0.33 to 0.58 per population. Opioid use increased with age: in 2013, 14% of Victorian residents aged ≥65 years filled at least one oxycodone prescription. In 2006 - 14, prescription opioid related hospital admissions increased by 6.8% per year, from 107 to 187 /1,000,000 person-years; 56% were due to intentional self-poisoning. Annual deaths increased from 21 to 28 /1,000,000 persons, in 2007 - 11. Admissions and deaths peaked at 25-44 years. Although both opioid prescribing and poisoning have increased, there is discrepancy between the exposed group (dispensings increased with age) and those with adverse consequences (rates peaked at ages 25-44 years). A better understanding is needed of drivers of prescribing and adverse consequences. Together with monitoring of prescribing and poisoning, this will facilitate early detection and prevention of a public health problem. © 2016 The Authors.

  16. Economic evaluation of task-shifting approaches to the dispensing of anti-retroviral therapy

    Directory of Open Access Journals (Sweden)

    Foster Nicola

    2012-09-01

    Full Text Available Abstract Background A scarcity of human resources for health has been identified as one of the primary constraints to the scale-up of the provision of Anti-Retroviral Treatment (ART. In South Africa there is a particularly severe lack of pharmacists. The study aims to compare two task-shifting approaches to the dispensing of ART: Indirectly Supervised Pharmacist’s Assistants (ISPA and Nurse-based pharmaceutical care models against the standard of care which involves a pharmacist dispensing ART. Methods A cross-sectional mixed methods study design was used. Patient exit interviews, time and motion studies, expert interviews and staff costs were used to conduct a costing from the societal perspective. Six facilities were sampled in the Western Cape province of South Africa, and 230 patient interviews conducted. Results The ISPA model was found to be the least costly task-shifting pharmaceutical model. However, patients preferred receiving medication from the nurse. This related to a fear of stigma and being identified by virtue of receiving ART at the pharmacy. Conclusions While these models are not mutually exclusive, and a variety of pharmaceutical care models will be necessary for scale up, it is useful to consider the impact of implementing these models on the provider, patient access to treatment and difficulties in implementation.

  17. Barriers, motivators and enablers for dispensing multifocal contact lenses in Mumbai, India.

    Science.gov (United States)

    Thite, Nilesh; Shah, Ukti; Mehta, Jasmin; Jurkus, Janice

    2015-01-01

    To understand the potential barriers, motivators and enablers in dispensing multifocal contact lenses (MFCL). Two focus group discussions were conducted to design questionnaires regarding the prescribing habits for multifocal contact lenses (MFCL). Questions on potential barriers and motivators were included. The questionnaires were distributed among 133 eye care practitioners across Mumbai, India. Practitioners fitting one or less patient per month with MFCL completed the survey describing potential barriers, while those who prescribed more MFCL's per month completed the survey describing enablers and motivators. Responses from 102 practitioners were received. Most common potential barriers in prescribing MFCL were increased chair time (75%), lack of readily available trials (69%) and limitation in power range (63%). Lack of awareness among patients (90%) was the most common barrier from patients' outlook. Professional satisfaction (88%) and better business proposition (82%) were observed as main motivators while availability of the trials (84%) and correct patient selection (82%) were the major enablers. Graduate Optometrists felt dispensing MFCL did not offer a good business proposition (p=0.02). Experienced practitioners were observed to be least motivated (p=0.01) and believed that their patients found these lenses expensive (p=0.02). To enhance the MFCL practice, barriers like lack of awareness and limitations in power range must be addressed. Trial lens availability may motivate practitioners to prescribe MFCL. Further probing is required to understand lack of motivation among experienced practitioners. Copyright © 2014 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.

  18. Unlocking the Potential of High-Throughput Drug Combination Assays Using Acoustic Dispensing.

    Science.gov (United States)

    Chan, Grace Ka Yan; Wilson, Stacy; Schmidt, Stephen; Moffat, John G

    2016-02-01

    Assessment of synergistic effects of drug combinations in vitro is a critical part of anticancer drug research. However, the complexities of dosing and analyzing two drugs over the appropriate range of doses have generally led to compromises in experimental design that restrict the quality and robustness of the data. In particular, the use of a single dose response of combined drugs, rather than a full two-way matrix of varying doses, has predominated in higher-throughput studies. Acoustic dispensing unlocks the potential of high-throughput dose matrix analysis. We have developed acoustic dispensing protocols that enable compound synergy assays in a 384-well format. This experimental design is considerably more efficient and flexible with respect to time, reagent usage, and labware than is achievable using traditional serial-dilution approaches. Data analysis tools integrated in Genedata Screener were used to efficiently deconvolute the combination compound mapping scheme and calculate compound potency and synergy metrics. We have applied this workflow to evaluate interactions among drugs targeting different nodes of the mitogen-activated protein kinase pathway in a panel of cancer cell lines. © 2015 Society for Laboratory Automation and Screening.

  19. Use of Six Sigma to improve pharmacist dispensing errors at an outpatient clinic.

    Science.gov (United States)

    Chan, Agnes L F

    2004-01-01

    Hospital pharmacists have been challenged to face the paradigm shift in their model of services in the 21st century in Taiwan. Patients are increasingly concerned about drug safety and medication errors. Because of the financial crisis of our national insurance bureau, pharmacists are required to care for more patients, use fewer resources, and work faster, better, and more efficiently than ever before while striving to enhance customer satisfaction and quality of care. Under these circumstances, patient safety needs to be a priority of pharmacists. According to a preliminary report on medication error announced by the nonofficial medication error reporting system, pharmacist dispensing error ranked second in the list of errors in Taiwan. In our drive to improve quality, reduce costs, and enhance financial performance, our department has tried the traditional quality-improvement strategy with varying degrees of success. We wanted to achieve a breakthrough result, hence we implemented Six-Sigma methodology. This program is the catalyst needed to combine quality, cost, and patient safety. This article describes our experience using Six-Sigma methodology to reduce dispensing error in our pharmacy department.

  20. Enhanced performance of dispenser printed MA n-type Bi₂Te₃ composite thermoelectric generators.

    Science.gov (United States)

    Madan, Deepa; Wang, Zuoqian; Chen, Alic; Juang, Rei-Cheng; Keist, Jay; Wright, Paul K; Evans, Jim W

    2012-11-01

    This work presents performance advancements of dispenser printed composite thermoelectric materials and devices. Dispenser printed thick films allow for low-cost and scalable manufacturing of microscale energy harvesting devices. A maximum ZT value of 0.31 has been achieved for mechanically alloyed (MA) n-type Bi₂Te₃-epoxy composite films with 1 wt % Se cured at 350 °C. The enhancement of ZT is a result of increase in the electrical conductivity through the addition of Se, which ultimately lowers the sintering temperature (350 °C). A 62 single-leg thermoelectric generator (TEG) prototype with 5 mm ×700 μm × 120 μm printed element dimensions was fabricated on a custom designed polyimide substrate with thick metal contacts. The prototype device produced a power output of 25 μW at 0.23 mA current and 109 mV voltage for a temperature difference of 20 °C, which is sufficient for low power generation for autonomous microsystem applications.

  1. Molecular epidemiology of a Pseudomonas aeruginosa hospital outbreak driven by a contaminated disinfectant-soap dispenser.

    Science.gov (United States)

    Lanini, Simone; D'Arezzo, Silvia; Puro, Vincenzo; Martini, Lorena; Imperi, Francesco; Piselli, Pierluca; Montanaro, Marco; Paoletti, Simonetta; Visca, Paolo; Ippolito, Giuseppe

    2011-02-16

    Pseudomonas aeruginosa infection represents a main cause of morbidity and mortality among immunocompromised patients. This study describes a fatal epidemic of P. aeruginosa that occurred in a hematology unit in Italy. Retrospective cohort study, prospective surveillance, auditing, extensive testing on healthcare workers and environmental investigation were performed to define the dynamics and potential causes of transmission. RAPD, macrorestriction analyses and sequence typing were used to define relationships between P. aeruginosa isolates. Eighteen cases of infection were identified in the different phases of the investigation. Of these, five constitute a significant molecular cluster of infection. A P. aeruginosa strain with the same genetic fingerprint and sequence type (ST175) as clinical isolates strain was also isolated from a heavily contaminated triclosan soap dispenser. Our results are consistent with the hypothesis that patients became indirectly infected, e.g., during central venous catheter handling through contaminated items, and that the triclosan soap dispenser acted as a common continuous source of P. aeruginosa infection. Since P. aeruginosa is intrinsically unsusceptible to triclosan, the use of triclosan-based disinfectant formulations should be avoided in those healthcare settings hosting patients at high risk of P. aeruginosa infection.

  2. Prototype of a Questionnaire and Quiz System for Supporting Increase of Health Awareness During Wait Time in Dispensing Pharmacy

    Science.gov (United States)

    Toda, Takeshi; Chen, Poa-Min; Ozaki, Shinya; Ideguchi, Naoko; Miyaki, Tomoko; Nanbu, Keiko; Ikeda, Keiko

    For quit-smoking clinic and its campaign, there was a need for pharmacists to investigate pediatric patient's parent consciousness to tobacco harm utilizing wait time in a pediatric dispensing pharmacy. In this research, we developed the questionnaire and quiz total system using the tablet for user interface, in which people can easily answer the questionnaire/quiz and quickly see the total results on the spot in order to enhance their consciousness to the tobacco harm. The system also provides their tobacco dependence level based on the questionnaire results and some advice for their health and dietary habits due to the tobacco dependence level. From a field trial with one hundred four examinees in the pediatric dispensing pharmacy, the user interface was useful compared to conventional questionnaire form. The system could enhance their consciousness to tobacco harm and make their beneficial use of waiting time in dispensing pharmacy. Some interesting suggestions for improvement and new services were also obtained.

  3. Closing the hand hygiene gap in the postanesthesia care unit: a body-worn alcohol-based dispenser.

    Science.gov (United States)

    Petty, William Clayton

    2013-04-01

    Clinicians who work in the postanesthesia care unit (PACU), operating room (OR), and intensive care unit (ICU) have a greater opportunity to cross-contaminate patients because of high workloads and frequent patient contact events. Much progress has been made to increase hand hygiene compliance with the introduction of alcohol-based wall, bedside, and pocket dispensers. The introduction of body-worn alcohol-based dispensers to anesthesia and ICU providers has been shown to decrease ICU hospital-acquired infections and ventilator-associated pneumonias, and decrease contamination of the anesthesia workplace. Body-worn alcohol-based dispensers are an improvement in ergonomics, especially for those working in high intensity areas. The unit worn on the belt or scrubs waist is readily accessible, can be activated with one hand, and can be a vital tool to close the gap for hand hygiene. Copyright © 2013 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.

  4. Economic benefits of using a dose dispensing system at hospital units of the Mexican Institute of Social Security.

    Directory of Open Access Journals (Sweden)

    Rocío Ofelia-Uc Coyoc

    2014-05-01

    Full Text Available Objective. To estimate the potential economic benefits at The Mexican Institute of Social Security (IMSS per its abbreviation in spanish according to the drug expenditure of using drug dispensing system, based on literature information. Materials and methods. A systematic review was performed to identify savings from drugs and reduction of medication errors. The total and mean health expenditure by level of medical attention was calculated using the dispensed collective prescriptions at IMSS during 2009. Three savings scenarios were applied. Results. The total drug savings were in a range of 870.49 Mexican million pesos to 4050.05 Mexican million pesos. Reductions of medication errors can contribute with additional savings up to 3455.56 Mexican million pesos. Conclusion. The drug dispensing system unit generates savings opportunities at the second and third level of attention. The maximum economic benefit was observed in the last level.

  5. Randomization tests

    CERN Document Server

    Edgington, Eugene

    2007-01-01

    Statistical Tests That Do Not Require Random Sampling Randomization Tests Numerical Examples Randomization Tests and Nonrandom Samples The Prevalence of Nonrandom Samples in Experiments The Irrelevance of Random Samples for the Typical Experiment Generalizing from Nonrandom Samples Intelligibility Respect for the Validity of Randomization Tests Versatility Practicality Precursors of Randomization Tests Other Applications of Permutation Tests Questions and Exercises Notes References Randomized Experiments Unique Benefits of Experiments Experimentation without Mani

  6. The changing patterns of dispensing branded and generic drugs for the treatment of gastroesophageal reflux disease between 2006 and 2011 in Japan: a retrospective cohort study.

    Science.gov (United States)

    Murata, Kyoko; Hinotsu, Shiro; Hamada, Shota; Ezoe, Yasumasa; Muto, Manabu; Kawakami, Koji

    2015-02-27

    Despite rising healthcare costs, generic drugs are less frequently dispensed in Japan compared with other developed countries. This study aimed to describe changes in dispensing of branded and generic drugs and to explore possible factors that promote the use of generic drugs. We conducted a retrospective cohort study using a Japanese medical and pharmacy claims database. All proton pump inhibitors (PPIs) and histamine H2-receptor antagonists (H2RAs) with indications for gastroesophageal reflux disease (GERD) described on Japanese labels were included. Patterns of dispensing branded and generic drugs for the treatment of GERD between 2006 and 2011 were analyzed. Multivariate logistic regression was applied to investigate factors associated with receiving generic drugs. The study cohort included 14,590 patients (male: 50.2%, mean age: 43.1 years). Branded drugs for GERD were still frequently dispensed despite an increase in the share of generic drugs. Only 4.3% of patients who initially received branded drugs switched to generic drugs. The percentage of patients who received only generic drugs increased over time (6.5% to 22.1%). The frequency of generic drug dispensing was the highest in the setting where both prescription and dispensing were implemented in clinics (43.3%), while the lowest in the setting where both prescription and dispensing were implemented in hospitals (11.5%). Factors associated with receiving generic drugs included year of dispensing (adjusted OR 2.22, 95% CI 1.94 to 2.55 for 2009-11 v 2006-8), prescription and dispensing setting (OR 1.81, 95% CI 1.44 to 2.26 for prescription in hospitals and dispensing in community pharmacies; OR 2.21, 95% CI 1.80 to 2.72 for prescription in clinics and dispensing in community pharmacies; and OR 4.55, 95% CI 3.68 to 5.62 for prescription and dispensing in clinics v prescription and dispensing in hospitals) and H2RAs (OR 1.64, 95% CI 1.49 to 1.81 compared to PPIs). The share of generic drugs for the

  7. Success of immediate loading implants compared to conventionally-loaded implants: a literature review.

    Science.gov (United States)

    Al-Sawai, Abdul-Aziz; Labib, Hussein

    2016-08-01

    The purpose of this systematic literature review was to compare the clinical performance between conventionally- (delayed) and immediately-loaded implants. A literature search of studies published between 1995 and 2012 was performed using several electronic databases and the following key words: "immediate loading", "dental implants", "immediate function", "early loading", "oral implants", "immediate restoration", and "systematic review" was performed. The electronic search was supplemented with hand-searching in dental journals and cross-referencing within the selected articles. Studies were considered for inclusion if they analyzed the success of the immediate loading protocol for implants, with emphasis given to randomized, controlled clinical trials. Among the clinical studies extracted from the literature, 120 studies met the inclusion criteria and were included in this systematic review. These studies included trials that involved yielded consistent results of success rates of immediately-loaded implants comparable to those known from conventionally-loaded implants, which were subjected to the immediate loading protocol or other loading protocols. According to the findings, there is evidence to suggest that immediate loading protocols demonstrate high implant survival rates and could be cautiously recommended for certain clinical situations. However, studies with a high level of evidence, especially randomized, controlled trials, performed over a longer timeframe are required to show a clear benefit over conventional and other loading types. © 2015 Wiley Publishing Asia Pty Ltd.

  8. Scaling and root planning, and locally delivered minocycline reduces the load of Prevotella intermedia in an interdependent pattern, correlating with symptomatic improvements of chronic periodontitis: a short-term randomized clinical trial

    NARCIS (Netherlands)

    Deng, S.; Wang, Y.; Sun, W.; Chen, H.; Wu, G.

    2015-01-01

    Background: To evaluate the respective or combinatory efficacy of locally delivered 2% minocycline (MO) and scaling and root planning (SRP) by assessing both clinical parameters and the loads of four main periodontal pathogens in treating chronic periodontitis (CP). Methods: Seventy adults with CP

  9. Prescription of potentially inappropriate medication in older persons in Switzerland: does the dispensing channel make a difference?

    Directory of Open Access Journals (Sweden)

    Blozik E

    2015-04-01

    Full Text Available Eva Blozik,1,2 Roland Rapold,1 Oliver Reich1 1Department of Health Sciences, Helsana Group, Zürich, Switzerland; 2Department of Medicine, Division of General Practice, University Medical Centre Freiburg, Freiburg, Germany Background: Drugs can be supplied either directly from the prescribing physician (physician dispensing [PD] or via a pharmacy. It is unclear whether the dispensing channel is associated with quality problems. Potentially inappropriate medication (PIM is associated with adverse outcomes in older persons and can be considered a marker for quality deficits in prescribing. We investigated whether prevalence of PIM differs across dispensing channels. Patients and methods: We analyzed basic health insurance claims of 50,747 person quarter years with PIM use of residents of the Swiss cantons Aargau and Lucerne of the years 2012 and 2013. PIM was identified using the Beers 2012 criteria and the PRISCUS list. We calculated PIM prevalence stratified by supply channel. Adjusted mixed effects logistic regression analysis was done to estimate the effect of obtaining medications through the dispensing physician as compared to the pharmacy channel on receipt of PIM. The most frequent PIMs were identified. Results: There is a small but detectable difference in total PIM prevalence: 30.7% of the population supplied by a dispensing physician as opposed to 29.3% individuals who received medication in a pharmacy. According to adjusted logistic regression individuals who obtained the majority of their medications from their prescribing physician had a 15% higher chance to receive a PIM (odds ratio 1.15, 95% confidence interval 1.08–1.22; P<0.001. Conclusion: Physician dispensing seems to affect quality and safety of drug prescriptions. Quality issues should not be neglected in the political discussion about the regulations on PD. Future studies should explore whether PD is related to other indicators of inefficiency or quality flaws. The present

  10. Immediate loading of Brånemark system TiUnite and machined-surface implants in the posterior mandible, part II: a randomized open-ended 9-year follow-up clinical trial.

    Science.gov (United States)

    Rocci, Antonio; Rocci, Marta; Rocci, Cecilia; Scoccia, Andrea; Gargari, Marco; Martignoni, Massimiliano; Gottlow, Jan; Sennerby, Lars

    2013-01-01

    To present clinical results with 9 years of follow-up of a protocol of immediately loaded implants with two different surfaces. A total of 44 patients received 66 Brånemark System TiUnite and 55 Brånemark machined implants, all immediately loaded. Control examinations were performed on the day of surgery and at 1-, 3-, and 9-year follow-up visits. All implant sites had intact buccal and lingual bone walls. The prefabricated provisional restorations showed an excellent fit. Three TiUnite and 8 machined implants failed within 7 weeks of loading, resulting in a cumulative survival rate of 95.5% and 85.5% respectively after 9 years of load. The survival rate for implants in a partial prosthesis was 98.8% and 92.2% for single restorations in the TiUnite group, and 87.8% and 83.2%, respectively, for partial and single resorations in the control group. The marginal bone resorption in the first year was on average 0.9 mm in the TiUnite group and 1.0 mm in the machined group; at the third year it was 0.4 and 0.5 mm, respectively. On examination at 9 years, there was a general settlement of the bone, with a negligible further loss in height. The unchanged survival rate and the low bone loss after 9 years confirm the feasibility of an immediate loading protocol in the mandible, which included flapless surgery. TiUnite implants obtained a 10% higher success rate compared with machined fixtures .

  11. Suppression of mediterranean fruit fly(Diptera: Tephritidae) with trimedlure(TML) dispensers and biolure in coffee(Coffea arabica L)

    Science.gov (United States)

    Solid Trimedlure[TML] dispensers and novel solid triple lure dispensers[TMR] without insecticides were tested as “attract and kill” devices alone and in combination with Biolure mass trapping to evaluate suppression of Mediterranean fruit fly, Ceratitis capitata(Wiedemann) in a large coffee plantati...

  12. Control of Cydia pomonella L. and Cydia molesta (Busck) (Lepidoptera Tortricidae) in pome-fruit orchards with Ecodian sex pheromone dispensers.

    Science.gov (United States)

    Anfora, G; Baldessari, M; Maines, R; Trona, F; Reggiori, F; Angeli, G

    2007-01-01

    A mating disruption approach using high densities of pheromone dispensers, has been recently proposed for codling moth, Cydia pomonella (L.), and oriental fruit moth, Cydia molesta (Busck.), (Lepidoptera Tortricidae), control. Ecodian Star dispensers, made of low-cost biodegradable material and easy to apply, were formulated with 10 mg of codlemone (E8,E10-12OH) and 10 mg of grapamone (Z8-12OH) and placed at a rate of 1,400-2,000 dispensers/ha. The pheromone release rates from new and field aged dispensers were evaluated by hexane extraction of the residual attractant (indirectly) and gas-chromatographic analysis. The release rate of field-aged dispensers decreased over time with a good linearity; they released a significant amount of synthetic sex pheromones over the entire season. Dispensers elicited close-range approaches of codling moth males in wind tunnel irrespective of their age. Field trials carried out from 2003 to 2004 confirmed the efficacy of Ecodian Star dispensers for codling moth and oriental fruit moth control, regardless the size of the treated area. Our results demonstrate that Ecodian dispensers achieved a good level of activity and longevity over the season. The potential of this strategy for the control of the moths is discussed.

  13. Assessing opioid shopping behaviour: a large cohort study from a medication dispensing database in the US.

    Science.gov (United States)

    Cepeda, M Soledad; Fife, Daniel; Chow, Wing; Mastrogiovanni, Gregory; Henderson, Scott C

    2012-04-01

    : Risks of abuse, misuse and diversion of opioids are of concern. Obtaining opioid prescriptions from multiple prescribers, known as opioid shopping, is a way in which opioids may be abused and diverted. Previous studies relied on counting the number of prescribers or number of pharmacies a subject goes to in a year to define shopping behaviour, but did not distinguish successive prescribers from concomitant prescribers. : The aim of the study was to assess the frequency of opioid overlapping prescriptions from different prescribers, compare it with diuretics and benzodiazepines, and provide a definition of shopping behaviour that differentiates opioids from diuretics, avoiding the inappropriate flagging of individuals with legitimate use of opioids. : Population-based cohort study using the IMS LRx database. This database covers 65% of all retail prescriptions in the US and includes mail service and specialty pharmacy provider prescriptions independent of the method of payment. : Ambulatory. : Subjects with at least one dispensing for any type of opioid in 2008. Similar cohorts were created for subjects exposed to benzodiazepines or diuretics. Analyses were performed separately for naïve subjects and those with prior use. : Frequency of overlapping prescriptions defined as at least 1 day of overlapping dispensing of prescriptions written by two or more different prescribers at any time during an 18-month period. : A total of 25 161 024 subjects exposed to opioids were included, of whom 13.1% exhibited at least one episode of overlapping prescriptions during 18 months of follow-up. Almost 10% of subjects exposed to benzodiazepines and 13.8% of subjects exposed to diuretics exhibited a similar behaviour. Having overlapping prescriptions dispensed by three or more pharmacies differentiates opioids from the other medication classes. Using that criterion, the overall risk of shopping behaviour was 0.18% in subjects exposed to opioids, 0.10% in subjects exposed to

  14. Comparison of Deterministic and Probabilistic Radial Distribution Systems Load Flow

    Science.gov (United States)

    Gupta, Atma Ram; Kumar, Ashwani

    2017-08-01

    Distribution system network today is facing the challenge of meeting increased load demands from the industrial, commercial and residential sectors. The pattern of load is highly dependent on consumer behavior and temporal factors such as season of the year, day of the week or time of the day. For deterministic radial distribution load flow studies load is taken as constant. But, load varies continually with a high degree of uncertainty. So, there is a need to model probable realistic load. Monte-Carlo Simulation is used to model the probable realistic load by generating random values of active and reactive power load from the mean and standard deviation of the load and for solving a Deterministic Radial Load Flow with these values. The probabilistic solution is reconstructed from deterministic data obtained for each simulation. The main contribution of the work is: Finding impact of probable realistic ZIP load modeling on balanced radial distribution load flow. Finding impact of probable realistic ZIP load modeling on unbalanced radial distribution load flow. Compare the voltage profile and losses with probable realistic ZIP load modeling for balanced and unbalanced radial distribution load flow.

  15. Comparison of Deterministic and Probabilistic Radial Distribution Systems Load Flow

    Science.gov (United States)

    Gupta, Atma Ram; Kumar, Ashwani

    2017-12-01

    Distribution system network today is facing the challenge of meeting increased load demands from the industrial, commercial and residential sectors. The pattern of load is highly dependent on consumer behavior and temporal factors such as season of the year, day of the week or time of the day. For deterministic radial distribution load flow studies load is taken as constant. But, load varies continually with a high degree of uncertainty. So, there is a need to model probable realistic load. Monte-Carlo Simulation is used to model the probable realistic load by generating random values of active and reactive power load from the mean and standard deviation of the load and for solving a Deterministic Radial Load Flow with these values. The probabilistic solution is reconstructed from deterministic data obtained for each simulation. The main contribution of the work is: Finding impact of probable realistic ZIP load modeling on balanced radial distribution load flow. Finding impact of probable realistic ZIP load modeling on unbalanced radial distribution load flow. Compare the voltage profile and losses with probable realistic ZIP load modeling for balanced and unbalanced radial distribution load flow.

  16. Contribution of static and dynamic load balancing in a real-time distributed air defence simulation

    CSIR Research Space (South Africa)

    Duvenhage, B

    2008-05-01

    Full Text Available the analysis and the available literature the appropriate metrics and a static load balancing heuristic is chosen and its performance compared to that of the statistical static load balancing. The dynamic suitability of the static load balancing schemes... metrics are applied to these distributions to find a subset of metrics applicable to static load balancing and a static load balancing heuristic. 3.1 The Static Optimisation Problem A simple way to perform static load balancing is to randomly assign...

  17. Acetyl CoA Carboxylase 2 Is Dispensable for CD8+ T Cell Responses.

    Directory of Open Access Journals (Sweden)

    Jang Eun Lee

    Full Text Available Differentiation of T cells is closely associated with dynamic changes in nutrient and energy metabolism. However, the extent to which specific metabolic pathways and molecular components are determinative of CD8+ T cell fate remains unclear. It has been previously established in various tissues that acetyl CoA carboxylase 2 (ACC2 regulates fatty acid oxidation (FAO by inhibiting carnitine palmitoyltransferase 1 (CPT1, a rate-limiting enzyme of FAO in mitochondria. Here, we explore the cell-intrinsic role of ACC2 in T cell immunity in response to infections. We report here that ACC2 deficiency results in a marginal increase of cellular FAO in CD8+ T cells, but does not appear to influence antigen-specific effector and memory CD8+ T cell responses during infection with listeria or lymphocytic choriomeningitis virus. These results suggest that ACC2 is dispensable for CD8+ T cell responses.

  18. Hydrogen Station Compression, Storage, and Dispensing Technical Status and Costs: Systems Integration

    Energy Technology Data Exchange (ETDEWEB)

    Parks, G.; Boyd, R.; Cornish, J.; Remick, R.

    2014-05-01

    At the request of the U.S. Department of Energy Fuel Cell Technologies Office (FCTO), the National Renewable Energy Laboratory commissioned an independent review of hydrogen compression, storage, and dispensing (CSD) for pipeline delivery of hydrogen and forecourt hydrogen production. The panel was asked to address the (1) cost calculation methodology, (2) current cost/technical status, (3) feasibility of achieving the FCTO's 2020 CSD levelized cost targets, and to (4) suggest research areas that will help the FCTO reach its targets. As the panel neared the completion of these tasks, it was also asked to evaluate CSD costs for the delivery of hydrogen by high-pressure tube trailer. This report details these findings.

  19. Fast turn-on characteristics of tungsten-based dispenser cathodes following gas exposures

    Science.gov (United States)

    Marrian, C. R. K.; Haas, G. A.; Shih, A.

    The problems associated with the reactivation following shelf storage of different types of tungsten-based dispenser cathodes have been investigated. Reactivation times were found to be severely limited by repoisoning processes, which have been isolated and identified. Data are presented, indicating the finite times (in the absence of repoisoning), which are required to reactivate the cathodes following exposure to various gases. Of the gases studied, exposure to oxygen and water vapour caused the slowest reactivations. Water vapour was the component of the vacuum system ambient responsible for the poisoning caused by exposure to the ambient. Following exposure to each of the gases studied, the "M" type cathode reactivated slower than the "B" type cathode. The results have shown that both the choice of cathode and the design of the microwave tube are important if a fast turn-on following shelf storage is to be achieved.

  20. Centrioles initiate cilia assembly but are dispensable for maturation and maintenance in C. elegans.

    Science.gov (United States)

    Serwas, Daniel; Su, Tiffany Y; Roessler, Max; Wang, Shaohe; Dammermann, Alexander

    2017-06-05

    Cilia are cellular projections that assemble on centriole-derived basal bodies. While cilia assembly is absolutely dependent on centrioles, it is not known to what extent they contribute to downstream events. The nematode C. elegans provides a unique opportunity to address this question, as centrioles do not persist at the base of mature cilia. Using fluorescence microscopy and electron tomography, we find that centrioles degenerate early during ciliogenesis. The transition zone and axoneme are not completely formed at this time, indicating that cilia maturation does not depend on intact centrioles. The hydrolethalus syndrome protein HYLS-1 is the only centriolar protein known to remain at the base of mature cilia and is required for intraflagellar transport trafficking. Surprisingly, targeted degradation of HYLS-1 after initiation of ciliogenesis does not affect ciliary structures. Taken together, our results indicate that while centrioles are essential to initiate cilia formation, they are dispensable for cilia maturation and maintenance. © 2017 Serwas et al.

  1. Estimated antimicrobial dispensing frequency and preferences for lactating cow therapy by Ontario dairy veterinarians.

    Science.gov (United States)

    Léger, David F; Newby, Nathalie C; Reid-Smith, Richard; Anderson, Neil; Pearl, David L; Lissemore, Kerry D; Kelton, David F

    2017-01-01

    In this cross-sectional study, data were collected from responses to a questionnaire on dispensing frequencies of antimicrobials used by dairy practitioners in Ontario in dairy cattle in 2001. Data were validated through clinical case scenarios. Respondents reported using antimicrobials across all categories of importance to human medicine (medically important, Categories I to III) with a diversity of treatment combinations and routes of administration. Respondents anticipated that a request for direct veterinary supervision by producers was dependent on case severity, highlighting the importance of on-farm diagnostic and treatment protocols. Knowledge of the antimicrobials used in lactating cow therapy, and their frequency and reasons for use, will provide baseline information and contribute to antimicrobial stewardship in this food-animal production sector.

  2. A single-step lithography system based on an enhanced robotic adhesive dispenser

    Science.gov (United States)

    Xing, Jiyao; Rong, Weibin; Sun, Ding; Wang, Lefeng; Sun, Lining

    2016-09-01

    In the paper, we present a single-step lithography system whereby the robotically controlled micro-extrusion of resist adhesive onto a substrate surface to directly create resist adhesive patterns of interest. This system is modified from a robotic adhesive dispenser by shrinking the aperture of the nozzle to a few micrometers aiming to realize patterns at microscale. From experimental investigation, it is found that working factors including writing speed, working time, and applied pressure can be adopted to conveniently regulate the feature size (the width of the line features and the diameter of the dot features). To test its functionality, the system was used to pattern line features on silicon dioxide (SiO2) and generate an array of square-like silicon microstructure by combining with wet etching. It provides a simple and flexible alternative tool to facilitate the development of microfabrication.

  3. Printed droplet microfluidics for on demand dispensing of picoliter droplets and cells

    Science.gov (United States)

    Cole, Russell H.; Tang, Shi-Yang; Siltanen, Christian A.; Shahi, Payam; Zhang, Jesse Q.; Poust, Sean; Gartner, Zev J.; Abate, Adam R.

    2017-08-01

    Although the elementary unit of biology is the cell, high-throughput methods for the microscale manipulation of cells and reagents are limited. The existing options either are slow, lack single-cell specificity, or use fluid volumes out of scale with those of cells. Here we present printed droplet microfluidics, a technology to dispense picoliter droplets and cells with deterministic control. The core technology is a fluorescence-activated droplet sorter coupled to a specialized substrate that together act as a picoliter droplet and single-cell printer, enabling high-throughput generation of intricate arrays of droplets, cells, and microparticles. Printed droplet microfluidics provides a programmable and robust technology to construct arrays of defined cell and reagent combinations and to integrate multiple measurement modalities together in a single assay.

  4. [Food protective property of new liquid food container PID (Pouch in Dispenser) for microbes].

    Science.gov (United States)

    Tominari, Keita; Tanaka, Asato; Shinoda, Yuma; Futase, Katsunori; Nei, Daisuke; Isshiki, Kenji

    2011-01-01

    We examined the content protection characteristics of the PID (Pouch in Dispenser) when it was used in the usual manner and when it was polluted artificially. When the PID was used in the usual manner, the nozzle was opened, and experiments were carried out with and without air-blowing. The invasion of bacteria into the PID was not detected. Also, no bacteria were detected in the material poured from the nozzle of the PID. When 3 strains of bacteria suspensions were intentionally smeared on the nozzle of the PID, invasion of bacteria was observed. When the PID was wiped with a dirty cloth, no invasion of bacteria into the PID was detected. It may be necessary to label the PID with the instruction that the nozzle should not be touched. The effected of changes in the water activity and pH, and the preservatives used, may also need to be considered, depending on the contents in the PID.

  5. A simple microfluidic dispenser for single-microparticle and cell samples.

    Science.gov (United States)

    Kasukurti, A; Eggleton, C D; Desai, S A; Disharoon, D I; Marr, D W M

    2014-12-21

    Non-destructive isolation of single-cells has become an important need for many biology research laboratories; however, there is a lack of easily employed and inexpensive tools. Here, we present a single-particle sample delivery approach fabricated from simple, economical components that may address this need. In this, we employ unique flow and timing strategies to bridge the significant force and length scale differences inherent in transitioning from single particle isolation to delivery. Demonstrating this approach, we use an optical trap to isolate individual microparticles and red blood cells that are dispensed within separate 50 μl droplets off a microfluidic chip for collection into microscope slides or microtiter plates.

  6. Performance Evaluation of Strain Gauge Printed Using Automatic Fluid Dispensing System on Conformal Substrates

    Science.gov (United States)

    Khairilhijra Khirotdin, Rd.; Faridzuan Ngadiron, Mohamad; Adzeem Mahadzir, Muhammad; Hassan, Nurhafizzah

    2017-08-01

    Smart textiles require flexible electronics that can withstand daily stresses like bends and stretches. Printing using conductive inks provides the flexibility required but the current printing techniques suffered from ink incompatibility, limited of substrates to be printed with and incompatible with conformal substrates due to its rigidity and low flexibility. An alternate printing technique via automatic fluid dispensing system is proposed and its performances on printing strain gauge on conformal substrates were evaluated to determine its feasibility. Process parameters studied including printing speed, deposition height, curing time and curing temperature. It was found that the strain gauge is proven functional as expected since different strains were induced when bent on variation of bending angles and curvature radiuses from designated bending fixtures. The average change of resistances were doubled before the strain gauge starts to break. Printed strain gauges also exhibited some excellence elasticity as they were able to resist bending up to 70° angle and 3 mm of curvature radius.

  7. ASCIZ/ATMIN is dispensable for ATM signaling in response to replication stress.

    Science.gov (United States)

    Liu, Rui; King, Ashleigh; Hoch, Nicolas C; Chang, Catherine; Kelly, Gemma L; Deans, Andrew J; Heierhorst, Jörg

    2017-09-01

    The ATM kinase plays critical roles in the response to DNA double-strand breaks, and can also be activated by prolonged DNA replication blocks. It has recently been proposed that replication stress-dependent ATM activation is mediated by ASCIZ (also known as ATMIN, ZNF822), an essential developmental transcription factor. In contrast, we show here that ATM activation, and phosphorylation of its substrates KAP1, p53 and H2AX in response to the replication blocking agent aphidicolin was unaffected in both immortalized and primary ASCIZ/ATMIN-deficient murine embryonic fibroblasts compared to control cells. Similar results were also obtained in human ASCIZ/ATMIN-deleted lymphoma cells. The results demonstrate that ASCIZ/ATMIN is dispensable for ATM activation, and contradict the previously reported dependence of ATM on ASCIZ/ATMIN. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  8. N-cadherin is dispensable for pancreas development but required for β-cell granule turnover

    Science.gov (United States)

    Johansson, Jenny K; Voss, Ulrikke; Kesavan, Gokul; Kostetskii, Igor; Wierup, Nils; Radice, Glenn L.; Semb, Henrik

    2010-01-01

    Summary The cadherin family of cell adhesion molecules mediates adhesive interactions that are required for the formation and maintenance of tissues. Previously, we demonstrated that N-cadherin, which is required for numerous morphogenetic processes, is expressed in the pancreatic epithelium at E9.5, but later becomes restricted to endocrine aggregates in mice. To study the role of N-cadherin during pancreas formation and function we generated a tissue specific knockout of N-cadherin in the early pancreatic epithelium by inter-crossing N-cadherin-floxed mice with Pdx1Cre mice. Analysis of pancreas-specific ablation of N-cadherin demonstrates that N-cadherin is dispensable for pancreatic development, but required for β-cell granule turnover. The number of insulin secretory granules is significantly reduced in N-cadherin-deficient β-cells, and as a consequence insulin secretion is decreased. PMID:20533404

  9. Printed droplet microfluidics for on demand dispensing of picoliter droplets and cells.

    Science.gov (United States)

    Cole, Russell H; Tang, Shi-Yang; Siltanen, Christian A; Shahi, Payam; Zhang, Jesse Q; Poust, Sean; Gartner, Zev J; Abate, Adam R

    2017-08-15

    Although the elementary unit of biology is the cell, high-throughput methods for the microscale manipulation of cells and reagents are limited. The existing options either are slow, lack single-cell specificity, or use fluid volumes out of scale with those of cells. Here we present printed droplet microfluidics, a technology to dispense picoliter droplets and cells with deterministic control. The core technology is a fluorescence-activated droplet sorter coupled to a specialized substrate that together act as a picoliter droplet and single-cell printer, enabling high-throughput generation of intricate arrays of droplets, cells, and microparticles. Printed droplet microfluidics provides a programmable and robust technology to construct arrays of defined cell and reagent combinations and to integrate multiple measurement modalities together in a single assay.

  10. 76 FR 53154 - In the Matter of Certain Electronic Paper Towel Dispensing Devices and Components Thereof; Notice...

    Science.gov (United States)

    2011-08-25

    ... From the Federal Register Online via the Government Publishing Office INTERNATIONAL TRADE COMMISSION In the Matter of Certain Electronic Paper Towel Dispensing Devices and Components Thereof; Notice... Trade Commission. ACTION: Notice. SUMMARY: Notice is hereby given that the U.S. International Trade...

  11. 21 CFR 1300.04 - Definitions relating to the dispensing of controlled substances by means of the Internet.

    Science.gov (United States)

    2010-04-01

    ... controlled substances by means of the Internet. 1300.04 Section 1300.04 Food and Drugs DRUG ENFORCEMENT... substances by means of the Internet. (a) Any term not defined in this part or elsewhere in this chapter shall... evaluation of the patient. (c) The term deliver, distribute, or dispense by means of the Internet refers...

  12. SOCS5 is expressed in primary B and T lymphoid cells but is dispensable for lymphocyte production and function

    DEFF Research Database (Denmark)

    Brender, Christine; Columbus, Ruth; Metcalf, Donald

    2004-01-01

    Suppressors of cytokine signaling (SOCSs) are key regulators of cytokine-induced responses in hematopoietic as well as nonhematopoietic cells. SOCS1 and SOCS3 have been shown to modulate T-cell responses, whereas the roles of other SOCS family members in the regulation of lymphocyte function are ...... to be dispensable for the regulation of lymphocyte function....

  13. Efficacy Evaluation of a non-contact automatic articulating paper dispenser in controlling articulating paper microbial contamination.

    Science.gov (United States)

    Li, Yajin; Chen, Litong; Yuan, Fusong; Li, Yugui; Zhou, Yongsheng; Sun, Yuchun

    2017-05-03

    This study is to quantitatively evaluate the efficacy of using a non-contact automatic articulating paper dispenser for reducing microbial articulating paper contamination. Articulating papers in four-handed mode, non-four-handed mode, and via an automatic articulating paper dispenser were evaluated. An adenosine triphosphate bioluminescence assay was used to quantitatively measure the relative light unit (RLU) values of the rest unused articulating papers in the same package to detect contamination at 4 time points, and triplicate examinations were performed for all three methods. The RLUs were recorded, compared, and evaluated. For four-handed mode (n = 36), the RLUs at the four time points were 2.44, 32.89, 37.89, and 27.22, with a satisfactory rate of 94%. The RLUs for non-four-handed mode (n = 36) were 2.22, 286.44, 299.44, and 493.56, with a satisfactory rate of 36%. The RLUs for using the automatic dispenser (n = 36) were all 0 with a satisfactory rate of 100%. The satisfactory rates were significantly different among three methods. No significant differences were observed in the satisfactory rates for the four time points samples. Contact by gloved hands can cause severe biological contamination of articulating paper. However, by using standard four-handed mode or a non-contact automatic articulating paper dispenser, contamination can be controlled.

  14. 40 CFR 80.522 - May used motor oil be dispensed into diesel motor vehicles or nonroad diesel engines?

    Science.gov (United States)

    2010-07-01

    ... diesel motor vehicles or nonroad diesel engines? 80.522 Section 80.522 Protection of Environment... Motor Vehicle Diesel Fuel; Nonroad, Locomotive, and Marine Diesel Fuel; and ECA Marine Fuel Motor Vehicle Diesel Fuel Standards and Requirements § 80.522 May used motor oil be dispensed into diesel motor...

  15. Clinical use and control of the dispensing of thalidomide in Brasilia-Federal District, Brazil, from 2001 to 2012

    Directory of Open Access Journals (Sweden)

    Francisco José Roma Paumgartten

    2013-11-01

    Full Text Available The use of thalidomide was never discontinued in Brazil where it is prescribed for leprosy type 2 reaction. Babies with birth defects compatible with the thalidomide embryopathy phenotype were born after 1965, an indication that control on drug dispensing and use failed in the country. The article reports data on thalidomide dispensing and clinical uses in the Federal District in 2011/12, when new rules were put into effect, and data on drug dispensing and use obtained ten years earlier. It was found that the number of patients making use of thalidomide declined from 819 in 2001 to 369 in 2011/12. Leprosy accounted for over 70% of prescriptions in both time periods analyzed in this study. In the same time interval, however, use for lupus erythematosus decreased from 13.7 to 4.9%, while that for multiple myeloma increased from 2.9 to 20.3% of all prescriptions. Thalidomide prescription for the remaining approved indications was far less frequent, and so was the use for off label indications that accounted for <1% of prescriptions in 2001 and 2011/12. Registration of prescribing doctors, patients and dispensing units at the state department of health, apparently rendered this control more effective and reliable.

  16. "Doi moi" and private pharmacies: a case study on dispensing and financial issues in Hanoi, Vietnam.

    Science.gov (United States)

    Chuc, N T; Tomson, G

    1999-06-01

    Vietnam, a developing country, has had comparatively good health and human survival at low cost. The economic reform changed the health care system, and private pharmacies during the last 5 years have taken over a majority of the drug distribution. Problems include weaknesses in drug regulation and reported increases in antibiotic resistance. This case study, a purposive sample of two private pharmacies in Hanoi, explored management, including dispensing, inventory and financing, using the concept of triangulation. Observations and interviews of customers were complemented by stock inventory and interviews of the pharmacy staff. Drugs were classified according to the ATC code and the essential drug list of Vietnam. Pretested protocols were used. In all 1833 encounters were studied during the 2 weeks, out of which 286 were children. Less than 1% of customers came with prescriptions and 94.9% decided by themselves which drugs to buy. Antibiotics represented 17%, of which 90% were broad spectrum. Ampicillin dominated, both in children and adults. Some 50% of the antibiotics were given for 2.5 days or less. Less than 50% of the drugs were essential drugs (ED) on dispensing and even less on inventory. Antibiotics and vitamins were the most commonly sold drugs and, overall, brand names dominated. Little if any drug information was observed. Antibiotics were said to represent the most profitable drugs, according to the pharmacy staff. More than 20% of all products were combination drugs, including irrational and popular products with antibiotics and corticosteroids and combinations of aspirin, phenacetin and caffeine. This study shows an unexpectedly high proportion of customers, being "Tu Lam Bac Sy" (their own doctors), deciding themselves which drugs to buy. Although the "Doi moi" renovation has led to much improved drug availability, at least in urban setting, our case study highlights major problems in need of urgent actions. In particular the prevailing practices

  17. BAZ1B is dispensable for H2AX phosphorylation on Tyrosine 142 during spermatogenesis

    Directory of Open Access Journals (Sweden)

    Tyler J. Broering

    2015-07-01

    Full Text Available Meiosis is precisely regulated by the factors involved in DNA damage response in somatic cells. Among them, phosphorylation of H2AX on Serine 139 (γH2AX is an essential signal for the silencing of unsynapsed sex chromosomes during male meiosis. However, it remains unknown how adjacent H2AX phosphorylation on Tyrosine 142 (pTyr142 is regulated in meiosis. Here we investigate the meiotic functions of BAZ1B (WSTF, the only known Tyr142 kinase in somatic cells, using mice possessing a conditional deletion of BAZ1B. Although BAZ1B deletion causes ectopic γH2AX signals on synapsed autosomes during the early pachytene stage, BAZ1B is dispensable for fertility and critical events during spermatogenesis. BAZ1B deletion does not alter events on unsynapsed axes and pericentric heterochromatin formation. Furthermore, BAZ1B is dispensable for localization of the ATP-dependent chromatin remodeling protein SMARCA5 (SNF2h during spermatogenesis despite the complex formation between BAZ1B and SMARCA5, known as the WICH complex, in somatic cells. Notably, pTyr142 is regulated independently of BAZ1B and is dephosphorylated on the sex chromosomes during meiosis in contrast with the presence of adjacent γH2AX. Dephosphorylation of pTyr142 is regulated by MDC1, a binding partner of γH2AX. These results reveal the distinct regulation of two adjacent phosphorylation sites of H2AX during meiosis, and suggest that another kinase mediates Tyr142 phosphorylation.

  18. Level of job satisfaction amongst nurses in the North-West Province, South Africa: Post occupational specific dispensation

    Directory of Open Access Journals (Sweden)

    Sisinyana H. Khunou

    2016-02-01

    Full Text Available Background: Job satisfaction and burnout have been recurring problems amongst nurses in the Republic of South Africa (RSA. As a result, nurses are still leaving the rural public sector in search of lucrative work at the urban and private sectors and in developed countries. Accordingly, Occupational Specific Dispensation (OSD was introduced as a strategy to ircumvent the problem. However, since the implementation of OSD in 2007, there have been no studies conducted regarding the level of job satisfaction amongst nurses after the implementation of OSD in the North-West Province, especially because each province has its own challenges that are unique to the area.Objectives: The study had two objectives: to describe the level of job satisfaction amongstprofessional and other category nurses (OCNs at a public hospital in the North-West Provinceand describe the perceptions of nurses about OSD and their intention to continue working inthe hospital.Method: A quantitative descriptive cross-sectional design was used. Stratified random sampling was used to select a sample of 92 professional nurses (PNs, 90 enrolled nurses and enrolled nursing assistants (Nursing Act 2005, which made a total of 182 participants. For the purpose of the study, the enrolled nurses and enrolled nursing assistants were referred to as OCNs. Data were collected using the Minnesota Satisfaction Questionnaire–short form and OSD statements and analysed with Statistical Package for Social Science (SPSS, version 18.Results: The majority of PNs (79.3%, n = 73 and OCNs (86.7%, n = 77 were dissatisfied with the working conditions and salary: PNs (80.4%, n = 74 and OCNs (87.8%, n = 79. The nurses mostly discredited the current state of the OSD implementation. Majority of the PNs (84%, n = 77 and OCNs (91%, n = 82 disagreed with the statement that ‘level of job satisfaction has improved after the implementation of OSD’.Conclusions: The National Department of Health should consider a

  19. Dispensing of benzodiazepines and benzodiazepine-related drugs to pregnant women: a populati