Management of combined oral antithrombotic therapy by an antithrombotic stewardship program: a prospective study

Aims: Given the complexity of antithrombotic therapy guidelines especially in patients with combined antithrombotic therapy, there is a risk of inappropriate prescribing and medication errors. In order to prevent this, a multidisciplinary antithrombotic stewardship (ASP) is implemented in our hospital. The primary aim of this study is to determine the efficacy of this ASP by assessing the number of patients on combined antithrombotic therapy for whom one or more interventions are needed. Methods: A prospective cohort study in a large teaching hospital is conducted. Hospitalized patients who received combined antithrombotic therapy in which an oral anticoagulant was combined with one (double therapy) or two (triple therapy) platelet aggregation inhibitors were included. The ASP proactively evaluated the appropriateness of this combined antithrombotic therapy. If needed, ASP improved the concerned therapy. Each improvement measurement by ASP was counted as one intervention. Results: A total of 460 patients were included over a period of 12 months. 251 (54.6%) patients required at least one intervention from the ASP. The most common intervention was to define and document a maximum duration of the combined antithrombotic therapy (65.5%) instead of lifetime use of the combination, to discontinue antithrombotic therapy (19.4%) as the proper indication was lacking and to adjust the dosage (8.1%). Conclusion: As intervention was needed in more than half of the patients on combined antithrombotic therapy, it seems essential to implement an ASP that dedicated evaluates antithrombotic therapy to improve and ensure optimal use and medication safety.

Mechanical properties changes in fir wood (abies sp.), linden wood (tilia sp.), and beech wood (fagus sp.) subjected to various thermal modification process conditions

Wood is one of the most important construction materials in Europe and its use in building applications has increased in the recent decades. To enable even more extensive and reliable use of wood, this article aimed to determine the effect of thermal modification on mechanical properties of fir wood (lat. Abies sp.), linden wood (lat. Tilia sp.), and beech wood (lat. Fagus sp.). The thermal modification was conducted in a laboratory oven at five different temperatures of 170, 180, 195, 210, 220 °C and processed with a different maximum duration of the process of 78, 120, 180, 240, 276 minutes. Mechanical properties of treated wood have shown statistically insignificant fluctuations at lower temperatures compared to control samples. On the other hand, raising the temperature to 210 °C significantly affected the strength of all the species. The results revealed that thermal modification at high temperatures and longer exposure causes a decrease in the maximum force of the three wood species.

Short- and Medium-Term Impact of a Structured Medical Intervention in Adolescents with Overweight, Obesity, or Increased Waist Circumference

Introduction and Objectives: This study aimed to assess the impact of a structured medical intervention in adolescents with overweight or obesity at medical discharge and after 5 years and identify the factors responsible for the reappearance of anthropometric alterations. Methods: A total of 42 adolescents with overweight, obesity, and/or increased waist circumference (WC) participated in a survey on eating habits, physical exercise, and sedentary habits. Body mass index (BMI), fat mass (FM), and WC were evaluated quarterly during a structured medical intervention, with a maximum duration of 3 years (2007–2010) and 5 years after its conclusion (2015–2016). SPSS 19.0®was used for statistical analysis. Results: Initially, 23.8% adolescents were overweight, 28.6% were obese, 83.3% had increased FM, and 95.2% had high WC. A significant improvement was noted until medical discharge with respect to BMI, FM, and WC (p < 0.001) owing to an increased number of meals; reduction in the consumption of hypercaloric foods/drinks (p < 0.001); increase in the consumption of fruits, vegetables, and soup (p < 0.001); increase in physical exercise and daily walks (p < 0.001); and reduction in sedentary habits (p < 0.001). At reassessment, after 5 years, the majority had normal BMI, FM, and WC (p < 0.001), although 45.2% had abandoned sports (p < 0.001). Conclusions: A relation exists between the improvement or normalization of BMI, FM, and WC and the number of meals, healthy eating habits, physical exercise, and less sedentary habits. The intervention was associated with an improvement in the parameters during the short and medium terms.

Sea water flood resilience of five plant species with conservation status over the Bulgarian Black Sea Coast

The Bulgarian Black Sea coastal zone is relatively protected from sea floods. Only extreme meteorological events such as unusual storms can cause flooding of coastal areas. Crucial for the application of rapid methods for vulnerability assessment of coastal plant communities from flooding caused by unusual storms over the Bulgarian Black Sea Coast is to obtain experimental data for sea water flood resilience. This study aims to determine the plant species survival in simulated flooding experiments in order to identify sea water flood resilience of five plant species with conservation status: Centaurea arenaria M. Bieb. ex Willd., Crambe tataria Sebeok, Aurinia uechtritziana (Bornm.) Cullen & Dudley, Silene thymifolia Sm., and Stachys maritima Gouan. As a result of a simulated flooding experiment, Critical Decomposition Time (CDT) was obtained. The five species were within the most vulnerable group (CDT < 48 h). The CDT was significantly shorter than floods with a maximum duration for the Bulgarian Black Sea Coast. Only the values of the parameter beginning of decomposition of the leaves were accelerated by higher water temperatures. Other parameters were unrelated to different water temperatures. The investigated species have low survival rates and low degree of sea water flood resilience and their communities will not be able to recover after flooding with maximum duration within one vegetation season.

Resurgence initiation and subsolidus eruption of cold carapace of warm magma at Toba Caldera, Sumatra

Supervolcanoes like Toba Caldera, Sumatra, produce the largest eruptions on Earth. However, the magmatic conditions and processes during the period of recovery after catastrophic supereruptions, known as resurgence, are poorly understood. Here we use Bayesian statistical analysis and inverse thermal history modelling of feldspar argon-argon and zircon uranium-thorium/helium ages to investigate resurgence after the 74-thousand-year-old Youngest Toba Tuff eruption. We identify a discordance of up to around 13.6 thousand years between older feldspar and younger zircon ages. Our modelling suggests cold storage of feldspar antecrysts prior to eruption for a maximum duration of around 5 and 13 thousand years at between 280 °C and 500 °C. We propose that the solidified carapace of remnant magma after the Youngest Toba Tuff eruption erupted in a subsolidus state, without being thermally remobilized or rejuvenated. Our study indicates that resurgent uplift and volcanism initiated approximately 5 thousand years after the climactic caldera forming supereruption.

Local Spread of Influenza A (H1N1) Viruses Without A Mutation For The Maximum Duration of An Epidemic Season In Japan

Close observation of the local transmission of influenza A(H1N1) viruses enabled an estimation of the transmission period of the virus without a mutation. Of 4,448 isolates from 11 consecutive years, 237 isolates could be categorized into 57 strain groups with identical hemagglutinin genes. Transmission of these 57 strains was chased for the maximum duration of an epidemic season. In addition, 35 identical strains were recognized at the study site and other countries within 147 days. Consequently, it can be postulated that once an influenza virus enters a temperate country, the strain rarely mutates until the end of the season.

Assessment of the Effects of NPK on Flowering Characters of Gladiolus (Gladiolus grandiflorus L.) cv. Big Time Supreme

Aim: Gladiolus the most important cut flower crop and as it has great demand in national and international flower market it is worthwhile to apply the experimental trial on it, in respect to estimate the flowering characters of Gladiolus. Place and duration of Study: The field experiment was conducted at Horticultural Research Farm-I, Babasaheb Bhimrao Ambedkar University (A Central University), Lucknow, (U.P), India. During the 2018-2019 and 2019-2020 rabi seasons. Results: Replicated thrice having twenty three treatments in each replication. The minimum days taken to emergence of spike (102.21 and 101.04 days), The maximum number of spikes per plant (1.29 and 1.30), The minimum days to first floret opening (109.25 and 110.25 days), The maximum duration of flowering (15.55 and 15.85 days), The highest length of spike (87.35 and 88.05 cm), The highest number of florets per spike (15.12 and 16.13), The maximum diameter of floret (9.25 and 9.42 cm) and The maximum length of floret (9.85 and 9.92 cm) with the application of N 20g + P 15g + K 15g (T16). Moreover, the treatment T16 showed the best results on flowering characters of gladiolus. Appeared as the best practice for better flowering and therefore it may be recommended to boost up flower production and quality of gladiolus.