Practice of Perioperative Rational Use of Antibacterial Drugs Based on Drug Pathway

[Objectives]To establish a new management model for rational use of perioperative antibacterial drugs in surgical departments.[Methods]Based on evidence-based medicine,the department s drug pathway was formulated,and the new mode of rational drug use control was established by using fine pharmaceutical technology intervention,and the intervention effect was evaluated by the intensity of antibacterial drug use,per capita drug costs and the proportion of drugs.[Results]After adopting drug pathway in departments,the intensity of antibacterial drug use,per capita drug costs and the proportion of drugs decreased significantly,and the effect of rational drug use control was remarkable.[Conclusions]The drug pathway provides a new management and control mode for the rational use of perioperative antibacterial drugs in surgical departments of hospitals.Thus,it is worthy of popularization and application.

The Level of Knowledge, Behaviors, and Attitudes on Rational Use of Drugs of Patients Who Applied to the Family Health Center in Istanbul, Türkiye: A Cross-Sectional Study

Background: This study, it was aimed to determine the level of knowledge, attitudes, and behaviors of patients who applied to a family health center about the rational use of drugs. Irrational use of drugs is a major problem worldwide. WHO reports that half of the patients do not use their drugs correctly. Methods: This cross-sectional study was conducted between 1 October 2017 and 30 November 2018 at Istanbul Fatih Family Health Center No 7. The sample size was determined as 301 people selected by systematic sampling method from patients aged 18 and older. Results: The mean age of the participants was 53.8% ± 16.8%, 59.8% were female, 62.5% were married, and 52.5% were primary school graduates. 63.9% of the participants knew the names of the drugs they used, and 79.9% of them knew the indication for use. 89% of individuals check the expiry date of the drugs before using them, and 83.1% read the drug prospectus. 84% of the participants support the prohibition of using over-the-counter drugs. Conclusion: The level of knowledge of the participants about the rational use of drugs is above the societal average. However, some issues need more awareness. The high level of rational use of drugs awareness of physicians and pharmacists will also strengthen the rational use of drugs and indirectly increase the awareness of the public.

Restoration and Rational Use of Degraded Saline Reed Wetlands:A Case Study in Western Songnen Plain, China

The protection, restoration and sustainable use are key issues of all the wetlands worldwide. Ecological, agronomic, and engineering techniques have been integrated in the development of a structurally sound, ecologically beneficial engineering restoration method for restoring and utilizing a degraded saline wetland in the western Songnen Plain of China. Hydrological restoration was performed by developing a system of biannual irrigation and drainage using civil engineering measures to bring wetlands into contact with river water and improve the irrigation and drainage system in the wetlands. Agronomic measures such as plowing the reed fields, reed rhizome transplantation, and fertilization were used to restore the reed vegetation. Biological measures, including the release of crab and fish fry and natural proliferation, were used to restore the aquatic communities. The results of the restoration were clear and positive. By the year 2009, the reed yield had increased by 20.9 times. Remarkable ecological benefits occurred simultaneously. Vegetation primary-production capacity increased, local climate regulation and water purification enhanced, and biodiversity increased. This demonstration of engineering techniques illustrates the basic route for the restoration of degraded wetlands, that the biodiversity should be reconstructed by the comprehensive application of engineering, biological, and agronomic measures based on habitat restoration under the guidance of process-oriented strategies. The complex ecological system including reeds, fish and crabs is based on the biological principles of coexistence and material recycling and provides a reasonable ecological engineering model suitable for the sustainable utilization of degraded saline reed wetlands.

Vegetation Improvement and Rational Use of Winter Pastures of ＂CeyranchoI-Acinohur＂ Arrays

This article describes the development of human potential interaction between society and nature. The environment, sustainable use of natural resources, prevention of adverse effects of human activities on the environment, and disturbances of dynamical ecological balance of the existing natural systems have received increased attention. The heed is introduced both on the state scale and in broad circles of science and society in The Azerbaijan Republic.

Evaluation of Rational Use of Antiretrovirals before the Dolutegravir Transition in Kinshasa, Democratic Republic of Congo

Background: The ultimate goal of AntiRetroViral Treatments (ART) is to achieve complete immune restoration and lasting viral suppression in the infected patient. In order to ensure the efficacy, safety and accessibility of antiretroviral drugs (ARVs), it is recommended that they should be prescribed according to national guidelines;which are evolving with the various recommendations of the World Health Organization (WHO) and the arrival of newer, more effective and safer molecules. Objective: The objective of this study was to assess the rational use of Antiretrovirals in patients treated in Kinshasa before the use of Dolutegravir within the national program in order to assess the correct use of these molecules. Methods: This work is a descriptive cross-sectional study to assess the rational use of first-line ARVs among People Living with HIV (PLHIV) in different Centers of Treatment (ATCs) in Kinshasa before the introduction of Dolutegravir. The records of patients on ARVs were randomly and rationally selected in 12 different ATCs for HIV in Kinshasa according to three centers per district in the period from June to September 2018. Information on use and consumption of ARVs, compliance with guidelines, change of therapeutic combination as well as their reasons were consulted for the present study. Results: 507 files of PLHIV were collected in the various ATCs. 274 (54.1%) were from female patients. The most represented age group was 26 to 35 years with 192 patients (37.9%). The mean duration of first-line treatment for all patients included was 16.30 ± 5.85 months. The most widely used combination of ARVs overall was TDF + 3TC + EFV at 45.4%. 305 (60.2%) PLHIV kept the same first-line treatment molecule throughout the treatment period with an average treatment duration of 12.9 ± 2.77 months. The most common combination found in this population was TDF + 3TC + EFV (69.2%). 202 (39.8%) PLHIV changed treatment molecule yet respecting the first-line combinations. The average duration of treatment for those who changed molecules was 21.43 ± 7.25 months. Before the change, 112 (55.5%) of these patients were using the ZDV + 3TC + EFV combination. After switching, 105 (52%) of the patients used the TDF + 3TC + NVP combination. The first reason for changing molecules was its unavailability (53.3%) in the ATCs. Conclusion: Although some banned molecules are still available in some treatment centers, the guidelines on first-line treatments are respected in different centers in Kinshasa.

Cases analysis of rational use of medicine (31) Nongonococcal urethritis(NGU)

1.Patient's conditionsA 29-year-old man,was infected with nongonococcal urethritis(NGU).He complained that he had dysuria and discomfort in the urethra and mucopurulent discharge,which appeared one week after intercourse.

Evaluation of rational use of antimicrobial agents in a Brazilian intensive care unit

The present study sought to assess the rational use of antimicrobial agents in a Brazilian intensive care unit (ICU) and its association with antimicrobial resistance in elderly patients admitted to the unit. Results: Choice of empiric and sensitivity-guided therapy was inadequate in > 80% and 59% of cases respectively. Inadequate antimicrobial therapy, whether empiric or sensitivity-guided, was positively correlated with bacterial resistance (r = 0.316;p = 0.001). Sensitivity testing revealed a 46.5% resistance rate to eight out of the ten most commonly used antibiotics. Multiple drug-resistant organisms were found in 40.8% of patients. A significant increase was observed in the number of multidrug-resistant samples between 2006/2007 and 2008 (r = 0.41, p = 0.006), (r = 0.598, p = 0.001), (r = 0.688, p = 0.00). Conclusion: We found a high rate of antibiotic misuse in the study sample. Inadequate therapy was correlated with resistance to antimicrobial agents.

How to Make Highly Rational Use of Modern Educational Technologies

Modern educational technology is playing a very important role in information engineering discipline in ordinary universities and colleges. The using of modern educational technology can be classified into instinctive stage and rational stage. In the instinctive stage, users have been aware of the importance of those modern assisted teaching methods and make full application already. In rational stage, the user should not only establish a best teaching environment by using all teaching methods, but also optimize the usage of these methods to get the most powerful effects in class based on specific educational goal. In this paper, how to make highly rational use of modern educational technologies in ordinary universities and colleges is the main topic we discussed. Authors investigate relative educational environment and consequences in their teaching experiences of many years, and conclude from those data by comparing, evaluating and analyzing relative situation.

Clinical rational use of traditional Chinese medicine

Since the outbreak of COVID-19,more than 4,900 medical members of the national Chinese medicine teams stationed in Wuhan Jinyintan Hospital,Mobile Cabin Hosipital and Leishen Shan Hospital.The utilization rate of Traditional Chinese Medicine(TCM)in Hubei is 88.93%and it is 97.71%in the Chinese medicine hospital.The patients'fever,fatigue,coughing and other symptom were significantly improved.Along with the significant effects,slight adverse reaction and health concept,people pay more and more attention to the diagnostic and therapeutic approaches of TCM[1].

Rational Usage of Disease Modifying Anti-Rheumatic Drugs with the Guidance of EULAR and ACR Suggestions

Disease modifying anti-rheumatic agents are the cornerstone in management of Rheumatoid Arthritis and when used correctly they are life-saving. As the number of the agents increases, detailed guidelines become more and more important for clinicians to set safe and effective regimens. Herein, we combined the EULAR and ACR recommendations for clinicians and also pointed some important facts peculiar to our country.

Rational Engineering of Secondary Metabolic Pathways in a Heterologous Host to Enable the Biosynthesis of Hibarimicin Derivatives with Enhanced Anti-Melanomic Activity

A 61-kb biosynthetic gene cluster(BGC),which is accountable for the biosynthesis of hibarimicin(HBM)B from Microbispora rosea subsp.hibaria TP-A0121,was heterologously expressed in Streptomyces coelicolor M1154,which generated a trace of the target products but accumulated a large amount of shunt products.Based on rational analysis of the relevant secondary metabolism,directed engineering of the biosynthetic pathways resulted in the high production of HBM B,as well as new HBM derivates with improved antitumor activity.These results not only establish a biosynthetic system to effectively synthesize HBMs-a class of the largest and most complex Type-Ⅱpolyketides,with a unique pseudo-dimeric structure-but also set the stage for further engineering and deep investigation of this complex biosynthetic pathway toward potent anticancer drugs.

Approximate solution of Volterra-Fredholm integral equations using generalized barycentric rational interpolant

It is well-known that interpolation by rational functions results in a more accurate approximation than the polynomials interpolation.However,classical rational interpolation has some deficiencies such as uncontrollable poles and low convergence order.In contrast with the classical rational interpolants,the generalized barycentric rational interpolants which depend linearly on the interpolated values,yield infinite smooth approximation with no poles in real numbers.In this paper,a numerical collocation approach,based on the generalized barycentric rational interpolation and Gaussian quadrature formula,was introduced to approximate the solution of Volterra-Fredholm integral equations.Three types of points in the solution domain are used as interpolation nodes.The obtained numerical results confirm that the barycentric rational interpolants are efficient tools for solving Volterra-Fredholm integral equations.Moreover,integral equations with Runge’s function as an exact solution,no oscillation occurrs in the obtained approximate solutions so that the Runge’s phenomenon is avoided.

Blockchain-Based Key Management Scheme Using Rational Secret Sharing

Traditional blockchain key management schemes store private keys in the same location,which can easily lead to security issues such as a single point of failure.Therefore,decentralized threshold key management schemes have become a research focus for blockchain private key protection.The security of private keys for blockchain user wallet is highly related to user identity authentication and digital asset security.The threshold blockchain private key management schemes based on verifiable secret sharing have made some progress,but these schemes do not consider participants’self-interested behavior,and require trusted nodes to keep private key fragments,resulting in a narrow application scope and low deployment efficiency,which cannot meet the needs of personal wallet private key escrow and recovery in public blockchains.We design a private key management scheme based on rational secret sharing that considers the self-interest of participants in secret sharing protocols,and constrains the behavior of rational participants through reasonable mechanism design,making it more suitable in distributed scenarios such as the public blockchain.The proposed scheme achieves the escrow and recovery of personal wallet private keys without the participation of trusted nodes,and simulate its implementation on smart contracts.Compared to other existing threshold wallet solutions and keymanagement schemes based on password-protected secret sharing(PPSS),the proposed scheme has a wide range of applications,verifiable private key recovery,low communication overhead,higher computational efficiency when users perform one-time multi-key escrow,no need for trusted nodes,and personal rational constraints and anti-collusion attack capabilities.

Rationale and Pathway for New Industrialization in the Context of Chinese Modernization

The concepts of modernization and industrialization have different connotations that are specific to their historical backgrounds,and their theoretical innovation and development may benefit from China’s experiences.Industrialization is the cornerstone of modernization,and holds the key to its success.China’s experiences in blazing a new trail of industrialization are challenging the traditional Western theory of industrialization and deepening the connotations of Chinese modernization.New industrialization is a key entry point for steering China’s modernization drive and theoretical innovations.This paper offers an overview of the theory of Chinese modernization and its evolving trend along China’s socialist industrialization path,as well as the rationale and pathway for new industrialization in the context of Chinese modernization.As our findings suggest,the new industrialization concept has taken hold in every key aspect of Chinese modernization.When combined with the theory of Chinese modernization,the theoretical implications of new industrialization play a crucial role in propelling Chinese modernization forward along a new journey in the new era.

Evaluation of the Effectiveness of Community Pharmacy Services on Rational Medication Use in Elderly Patients with Hypertension and Diabetes

Objective:To explore the effect of community pharmacy services on rational medication use in elderly patients with hypertension and diabetes.Methods:Between November 2022 and December 2023,80 elderly patients with hypertension and diabetes were selected and randomly divided into a control group(routine medication guidance)and an observation group(community pharmacy services),with 40 subjects each.The medication effect scores,blood pressure,blood sugar levels,and quality of life scores before and after intervention were compared between the two groups.Results:Comparison of pharmaceutical knowledge,medication compliance,and safe medication behavior scores showed that the observation group had higher scores as compared to the control group(P<0.05);blood pressure(systolic blood pressure,diastolic blood pressure,heart rate)and blood sugar(fasting blood glucose,2 h postprandial blood glucose,glycated hemoglobin)index levels were compared,and the observation group’s index levels were lower than those of the control group(P<0.05);the scores of physical health,mental health,social relationships,and environment in the observation group were higher than those in the control group(P<0.05).Conclusion:Community pharmacy services improved the rational medication effect of elderly patients with hypertension and diabetes,and improved their blood pressure,blood sugar control levels,and quality of life.

Present situation of rational drug use in plateau area

Plateau is characterized by low oxygen,low pressure,strong radiation,cold and dryness,among which low oxygen is the main factor that affects the normal life activities of human body.Altitude hypoxia leads to significant changes in the metabolic characteristics of drugs in vivo,which in turn affects the efficacy and adverse actions of drugs.This paper summarizes the present situation of rational drug use in plateau area and pinpoints the existing problems.Meanwhile,we posit the strategies and measures for realizing rational and precise pharmacotherapy of plateau residents.First,we need to acquire a panoramic view of differential and relative pharmacokinetics and pharmacodynamics in between plateau area and plain area by carrying out comparative studies on drug metabolisms and on comprehensive drug efficacies and mechanisms.Second,we must apply the findings from basic research to clinical practice and formulate guidelines and recommendations of drug use for plateau habitants.Finally,we should eventually achieve precise and individualized drug use for plateau habitants based on their characteristic etiology and pathogenesis.

Experimental study of core MHD behavior and a novel algorithm for rational surface detection based on profile reflectometry in EAST

Microwave reflectometry is a powerful diagnostic that can measure the density profile and localized turbulence with high spatial and temporal resolution and will be used in ITER,so understanding the influence of plasma perturbations on the reflect signal is important.The characteristics of the reflect signal from profile reflectometry,the time-of-flight(TOF)signal associated with the MHD instabilities,are investigated in EAST.Using a 1D full-wave simulation code by the Finite-DifferenceTime-Domain(FDTD)method,it is well validated that the local density flattening could induce the discontinuity of the simulated TOF signal and an obvious change of reflect amplitude.Experimental TOF signals under different types of MHD instabilities(sawtooth,sawtooth precursors and tearing mode)are studied in detail and show agreement with the simulation.Two new improved algorithms for detecting and localizing the radial positions of the low-order rational surface,the cross-correlation and gradient threshold(CGT)method and the 2D convolutional neural network approach(CNN)are presented for the first time.It is concluded that TOF signal analysis from profile reflectometry can provide a straightforward and localized measurement of the plasma perturbation from the edge to the core simultaneously and may be a complement or correction to the q-profile control,which will be beneficial for the advanced tokamak operation.

Smoking of Carica papaya in Nigeria:The rationale,the public health effects and policies for intervention

Psychoactive substance use is characterized by the habitual use of substances that have significant effects in altering the activities of neurotransmitters in certain regions of the brain.Consequently,these alterations manifest as cognitive,emotional,perceptual and behavioural changes in affected individuals[1].

Scientific principles for accelerating the Sustainable Development Goals

The Sustainable Development Goals(SDGs)are significantly off-course as we reach the midpoint of their 2030 deadline.From a scientific perspective,the critical challenge in achieving the SDGs lies in the need for more scientific principles to understand the complex socio-ecological systems(SES)and their interactions influencing the 17 SDGs.Here,we propose a scientific framework to clarify the common scientific principles and the rational treatment of diversity under these principles.The framework’s core is revealing the complex mechanisms underlying the achievement of each Sustainable Development Goal(SDG)and SDG interactions.Building upon the identified mechanisms,complex SES models can be established,and the implementation of SDGs can be formulated as a multi-objective optimization problem,seeking a compromise in competition between essential costs and desired benefits.Our framework can assist countries,and even the world in accelerating progress towards the SDGs.

Erratum regarding Declaration of Competing Interest statements in previously published articles

Declaration of Competing Interest statements were incorrectly included in the published version of the following articles that appeared in previous issues of Materials Reports:Energy.The appropriate Declaration of Competing Interest statements,provided by the authors,are included below.