Intervention for a correct medication list and medication use in older adults: a non-randomised feasibility study among inpatients and residents during care transitions.

BACKGROUND: Medication discrepancies in care transitions and medication non-adherence are problematic. Few interventions consider the entire process, from the hospital to the patient's medication use at home. AIM: In preparation for randomised controlled trials (RCTs), this study aimed (1) to investigate the feasibility of recruitment and retention of patients, and data collection to reduce medication discrepancies at discharge and improve medication adherence, and (2) to explore the outcomes of the interventions. METHOD: Participants were recruited from a hospital and a residential area. Hospital patients participated in a pharmacist-led intervention to establish a correct medication list upon discharge and a follow-up interview two weeks post-discharge. All participants received a person-centred adherence intervention for three to six months. Discrepancies in the medication lists, the Beliefs about Medicines Questionnaire (BMQ-S), and the Medication Adherence Report Scale (MARS-5) were assessed. RESULTS: Of 87 asked to participate, 35 were included, and 12 completed the study. Identifying discrepancies, discussing discrepancies with physicians, and performing follow-up interviews were possible. Conducting the adherence intervention was also possible using individual health plans for medication use. Among the seven hospital patients, 24 discrepancies were found. Discharging physicians agreed that all discrepancies were errors, but only ten were corrected in the discharge information. Ten participants decreased their total BMQ-S concern scores, and seven increased their total MARS-5 scores. CONCLUSION: Based on this study, conducting the two RCTs separately may increase the inclusion rate. Data collection was feasible. Both interventions were feasible in many aspects but need to be optimised in upcoming RCTs.

Toward reliable low-density lipoprotein ultrastructure prediction in clinical conditions: A small-angle X-ray scattering study on individuals with normal and high triglyceride serum levels.

Atherosclerosis is the main killer in the west and therefore a major health challenge today. Total serum cholesterol and lipoprotein concentrations, used as clinical markers, fail to predict the majority of cases, especially between the risk scale extremes, due to the high complexity in lipoprotein structure and composition. In particular, low-density lipoprotein (LDL) plays a key role in atherosclerosis development, with LDL size being a parameter considered for determining the risk for cardiovascular diseases. Determining LDL size and structural parameters is challenging to address experimentally under physiological-like conditions. This article describes the biochemistry and ultrastructure of normolipidemic and hypertriglyceridemic LDL fractions and subfractions using small-angle X-ray scattering. Our results conclude that LDL particles of hypertriglyceridemic compared to healthy individuals 1) have lower LDL core melting temperature, 2) have lower cholesteryl ester ordering in their core, 3) are smaller, rounder and more spherical below melting temperature, and 4) their protein-containing shell is thinner above melting temperature.

A Rosenzweig-MacArthur (1963) Criterion for the Chemostat.

The Rosenzweig-MacArthur (1963) criterion is a graphical criterion that has been widely used for elucidating the local stability properties of the Gause (1934) type predator-prey systems. It has not been stated whether a similar criterion holds for models with explicit resource dynamics (Kooi et al. (1998)), like the chemostat model. In this paper we use the implicit function theorem and implicit derivatives for proving that a similar graphical criterion holds under chemostat conditions, too.

Segmentation of B-mode cardiac ultrasound data by Bayesian Probability Maps.

In this paper we present a model for describing the position distribution of the endocardium in the two-chamber apical long-axis view of the heart in clinical B-mode ultrasound cycles. We propose a novel Bayesian formulation, including priors for spatial and temporal smoothness, and preferred shapes and position. The shape model takes into account both endocardium, atrial region and apex. The likelihood is built using a statistical signal model, which attempts to closely model a censored signal. In addition, the use of a censored Gamma mixture model with unknown censoring point, to handle artefacts resulting from left-censoring of the in US clinical B-mode, is to our knowledge novel. The posterior density is sampled by the Gibbs method to estimate the expected latent variable representation of the endocardium, which we call the Bayesian Probability Map; the map describes the probability of pixels being classified as being within the endocardium. The regularization parameters of the model are estimated by cross-validation, and the results are compared against the two-chamber apical model of Chen et al.

On the global stability of a generalized cholera epidemiological model.

In this paper, we conduct a careful global stability analysis for a generalized cholera epidemiological model originally proposed in [J. Wang and S. Liao, A generalized cholera model and epidemic/endemic analysis, J. Biol. Dyn. 6 (2012), pp. 568-589]. Cholera is a water- and food-borne infectious disease whose dynamics are complicated by the multiple interactions between the human host, the pathogen, and the environment. Using the geometric approach, we rigorously prove the endemic global stability for the cholera model in three-dimensional (when the pathogen component is a scalar) and four-dimensional (when the pathogen component is a vector) systems. This work unifies the study of global dynamics for several existing deterministic cholera models. The analytical predictions are verified by numerical simulation results.