BACKGROUND Upper respiratory tract infections(URTIs)are one of the most frequent causes of childhood school leave and morbidity.AIM To study the present trend of medications’prescribing pattern utilized in URTIs amon...BACKGROUND Upper respiratory tract infections(URTIs)are one of the most frequent causes of childhood school leave and morbidity.AIM To study the present trend of medications’prescribing pattern utilized in URTIs among the pediatric population attending outpatient clinics in pediatric hospitals.METHODS This analytical observational cross-sectional research was conducted in 200 children aged 1–10 years with URTIs attending the pediatric outpatient clinics in pediatric hospitals,one of which is an educational hospital,from July 2018 to August 2020.RESULTS Most of the prescriptions in our study included antibiotics(116/58%).The most commonly prescribed antibiotic family was ampicillin/sulbactam or amoxici-llin/clavulanic acid(53/26.5%),followed by first-generation cephalosporin(25/12.5%)and third-generation cephalosporin(20/10%).Macrolides and second-generation cephalosporins were prescribed less frequently,in 16(8%)and 2(1%)patients,respectively.Most of our study population(155/77.5%)was satisfied with their prescriptions,whereas the rest of the study population(45/22.5%)was unsatisfied.CONCLUSION Overprescription of antibiotics is a significant issue among clinicians in pediatric outpatient clinics.Stewardship of drugs,particularly antibiotics,is a must to prevent the development of drug resistance.Most cases of URTIs were treated in accordance with the existing national treatment guidelines.展开更多
Xishui National Forest Park in Heilongjiang Province hosts China's most pristine temperate forests and serves as a key site for ecotourism and forest therapy.However,the emission patterns of phytoncides(key bio ac...Xishui National Forest Park in Heilongjiang Province hosts China's most pristine temperate forests and serves as a key site for ecotourism and forest therapy.However,the emission patterns of phytoncides(key bio active compounds) remain poorly understood,limiting their therapeutic application.This study provides the first comprehensive characterization of spatiotemporal dynamics in airborne phytoncides and their synergistic interactions with environmental factors throughout the autumn-early spring seasonal transition in a temperate forest ecosystem.We analyzed the compositional dynamics of phytoncides and terpenoid content variations using thermal desorption-gas chromatography-mass spectrometry(TD-GC-MS) from September 2024 to March 2025.This period encompassed seasonal transitions from autumn to early spring,including diurnal variations in September and snowfall events in November.The method demonstrated detection limits(LODs) ranging from 1.35 to 5.33 ng m-3 and quantification limits(LOQs) from 4.09 to 16.15 ng m-3.Our results revealed pronounced seasonal fluctuations in phytoncide composition.In September,terpenoids,esters,alcohols,and alkanes displayed a diurnal "decrease-increase" trend,whereas aldehydes and ketones peaked at midday.Notably,esters and alcohols were undetectable in November and January.By January,terpenoids reached their lowest proportion(0.17±0.02%) at noon.Five terpenoids(α-pinene,myrcene,D-limonene,camphene,p-cymene) were detected in September,four(α-pinene,D-limonene,camphene,p-cymene) in November,two(D-limonene,p-cymene) in January,and only p-cymene in March.The total concentration and emission rate of the five terpenoids peaked in September afternoons at 1961.58±106.67 ng m^(-3) and653.86±35.56 ng m^(-3) h^(-1),respectively.Nocturnal emissions(32131.95±2522.21 ng m^(-3)) significantly surpassed daytime levels(14473.04±958.49 ng m^(-3)),with emission rates escalating from 1447.30±95.85 ng m^(-3) h^(-1)(day) to 5355.33±420.37 ng m^(-3) h^(-1)(night),marking a3.7-fold increase.Snowfall dramatically elevated terpenoid concentrations(pre-snowfall:158.58±14.12 ng m^(-3);post-snowfall:1080.57±57.76 ng m^(-3)) and emission rates(pre-snowfall:52.86±4.71 ng m^(-3) h^(-1);post-snowfall:360.19±19.25 ng m^(-3) h^(-1)),reflecting a 6.8-fold surge.This study underscores the profound influence of light intensity,seasonal shifts,and climatic conditions on airborne phytoncide levels,offering a scientific foundation for optimizing forest therapy and ecotourism strategies.展开更多
Urban forests are essential components of green infrastructure,however,rapid urbanization-induced changes in landscape patterns may affect their ecosystem services through complex ecological processes.A total of 184 s...Urban forests are essential components of green infrastructure,however,rapid urbanization-induced changes in landscape patterns may affect their ecosystem services through complex ecological processes.A total of 184 sample plots in the built-up areas of Nanchang,China,were used as research sites.Urbanization intensities were categorized by the rate of impervious surface area,and forest types were classified into landscape and relaxation forest,attached forest(AF),road forest(RF),and ecological public welfare forest.This study aimed to explore the spatial variations in vegetation characteristics and landscape pattern indices of different forest types under rapid urbanization.The results indicated that the largest patch index(LPI),aggregation index(AI),and percentage of landscape(PLAND)in RF and AF were lower than those in the other forest types(p<0.05).With increasing urbanization intensity,the mean perimeter-area ratio increased by 130.84%,whereas the PLAND,LPI,and AI decreased by 22−86%(p<0.05).Redundancy analysis and variation partitioning suggested that the interpretation rate of landscape pattern indices for variations in vegetation characteristics increased from low to heavy urbanization areas.Especially,the landscape shape index,patch connection index,PLAND,and mean patch size were significantly correlated with vegetation characteristics(e.g.,tree richness,herb coverage,and tree height).In the future,appropriate landscape layout superiority cases should be considered in different urbanization areas and forest types;for instance,increasing the patch connection index will beneficially improve the diversity of trees and herbs in heavy urbanization areas and the RF.This study serves as a reference for maximizing the ecosystem services of urban forests.展开更多
The performance of data restore is one of the key indicators of user experience for backup storage systems.Compared to the traditional offline restore process,online restore reduces downtime during backup restoration,...The performance of data restore is one of the key indicators of user experience for backup storage systems.Compared to the traditional offline restore process,online restore reduces downtime during backup restoration,allowing users to operate on already restored files while other files are still being restored.This approach improves availability during restoration tasks but suffers from a critical limitation:inconsistencies between the access sequence and the restore sequence.In many cases,the file a user needs to access at a given moment may not yet be restored,resulting in significant delays and poor user experience.To this end,we present Histore,which builds on the user’s historical access sequence to schedule the restore sequence,in order to reduce users’access delayed time.Histore includes three restore approaches:(i)the frequency-based approach,which restores files based on historical file access frequencies and prioritizes ensuring the availability of frequently accessed files;(ii)the graph-based approach,which preferentially restores the frequently accessed files as well as their correlated files based on historical access patterns,and(iii)the trie-based approach,which restores particular files based on both users’real-time and historical access patterns to deduce and restore the files to be accessed in the near future.We implement a prototype of Histore and evaluate its performance from multiple perspectives.Trace-driven experiments on two datasets show that Histore significantly reduces users’delay time by 4-700×with only 1.0%-14.5%additional performance overhead.展开更多
Tajikistan represents a core region of the biodiversity hotspot in Central Asian mountains and has exceptional vascular plant diversity.However,the species diversity of the country faces urgent conservation challenges...Tajikistan represents a core region of the biodiversity hotspot in Central Asian mountains and has exceptional vascular plant diversity.However,the species diversity of the country faces urgent conservation challenges.There has been a lack of a comprehensive and multidimensional assessment to inform strategic conservation planning.Therefore,this study integrated 4 key biodiversity indices including species richness(SR),phylogenetic diversity(PD),threatened species richness(TSR),and endemic species richness(ESR)to map species diversity distribution patterns,identify conservation gaps,and elucidate their effects of climatic factors.This study revealed that species diversity shows a clear trend of decreasing from the western region to the eastern region of Tajikistan.The central–western mountains(specifically the Gissar-Darvasian and Zeravshanian regions)emerge as irreplaceable biodiversity hotspots.However,we found a severe spatial mismatch between these priority areas and the existing protected areas(PAs).Protection coverage for all hotspots was alarmingly low,ranging from 31.00%to 38.00%.Consequently,a critical 64.80%of integrated priority areas fall outside of the current PAs,representing a major conservation gap.This study identified precipitation seasonality and isothermality as the principal drivers,collectively explaining over 50.00%of the diversity variation and suggesting high vulnerability to hydrological shifts.Furthermore,we detected significant geographic sampling bias in the public biodiversity databases,with the most critical hotspot being systematically under-sampled.This study provides a robust scientific basis for conservation action,highlighting the urgent need to strategically expand PAs in the under-protected southwestern region and to mitigate critical sampling gaps through targeted data digitization and field surveys.These measures are indispensable for securing Tajikistan’s unique biodiversity and achieving the Kunming-Montreal Global Biodiversity Framework Target 3(“30×30 Protection”).展开更多
Wide-field mesoscopy provides the capabilities of cortex-wide field of view(FOV),cellular resolution and high frame rate for neuronal imaging in the mouse brain.However,inherent background fluorescence degrades the im...Wide-field mesoscopy provides the capabilities of cortex-wide field of view(FOV),cellular resolution and high frame rate for neuronal imaging in the mouse brain.However,inherent background fluorescence degrades the image quality and hinders neuronal signal extraction.To address this problem,we first introduce a cortex-wide,high-resolution lineillumination mesoscope with a moving slit designed for in vivo mouse brain imaging.This system achieves a 6.6×6.6 mm FOV,microscale cellular resolution,a high frame rate of 10 Hz,as well as the background rejection ability.Furthermore,we integrated patterned illumination into the system to enhance the background suppression.Experimental results show that the proposed system successfully captures neurodynamics in the living mouse brain.Compared with conventional wide-field mesoscopes,the cortex-wide patterned line-illumination mesoscope(PLIM)achieves a threefold increase in the signal-to-background ratio(SBR).With patterned illumination integrated,the SBR enhancement further reaches four-anda-half-fold.展开更多
BACKGROUND Drug utilization research has an important role in assisting the healthcare administration to know,compute,and refine the prescription whose principal objective is to enable the rational use of drugs.Resear...BACKGROUND Drug utilization research has an important role in assisting the healthcare administration to know,compute,and refine the prescription whose principal objective is to enable the rational use of drugs.Research in developing nations relating to the cost of treatment is scarce when compared with developed countries.Thus,the drug utilization research studies from developing nations are most needed,and their number has been growing.AIM To evaluate patterns of utilization of antipsychotic drugs and direct medical cost analysis in patients newly diagnosed with schizophrenia.METHODS The present study was observational in type and based on a retrospective cohort to evaluate patterns of utilization of antipsychotic drugs using World Health Organization(WHO)core prescribing indicators and anatomical therapeutic chemical/defined daily dose indicators.We also calculated direct medical costs for a period of 6 months.RESULTS This study has found that atypical antipsychotics are the mainstay of treatment for schizophrenia in every age group and subcategories of schizophrenia.The evaluation based on WHO prescribing indicators showed a low average number of drugs per prescription and low prescribing frequency of antipsychotics from the National List of Essential Medicines 2015 and the WHO Essential Medicines List 2019.The total mean drug cost of our study was 1396 Indian rupees.The total mean cost due to the investigation in our study was 1017.34 Indian rupees.Therefore,the total mean direct medical cost incurred on patients in our study was 4337.28 Indian rupees.CONCLUSION The information from the present study can be used for reviewing and updating treatment policy at the institutional level.展开更多
Understanding spatial patterns of plant species diversity and the factors(e.g.,climate and human)that drive these patterns is essential for biodiversity conservation.We used data from 1700.1-ha forest plots in the She...Understanding spatial patterns of plant species diversity and the factors(e.g.,climate and human)that drive these patterns is essential for biodiversity conservation.We used data from 1700.1-ha forest plots in the Shettihalli tropical forest landscape of the Western Ghats biodiversity hotspot,India,to analyse tree community composition and the drivers ofα-diversity(Shannon)andβ-diversity(LCBD).Compositional patterns were visualized using Non-Metric Multidimensional Scaling(NMDS),and hybrid feature selection with structural equation modeling(SEM)was employed to evaluate the direct and indirect effects of environmental variables on diversity.NMDS identified four distinct forest types in the Shettihalli landscape:semi-evergreen,dry deciduous,moist deciduous,and plantation forests,each with distinct plant composition.Shannon diversity and ecological uniqueness was significantly higher in semi-evergreen forest than in deciduous forest plots.The SEMs explained about 79%and 39–45%of the variation inα-diversity andβ-diversity.Our analysis indicated that current diversity patterns result from multiple processes,with structure,disturbance,and edaphic parameters exerting the strongest direct and indirect effects onα-diversity.β-diversity,in contrast,was largely influenced by climate,topography,stand structure,and edaphic factors.Overall,our findings indicate that various factors(e.g.,climate,topography,and human disturbance)interact to shape tree diversity patterns in tropical forests.These findings will help develop unique conservation and management strategies for distinct forest types in tropical forest ecosystems.展开更多
Mineral resources in Asia continent and its mining industry play a significant role in the economic growth and industrialization of both Asia and the world.Asia continent boasts the most comprehensive kinds of mineral...Mineral resources in Asia continent and its mining industry play a significant role in the economic growth and industrialization of both Asia and the world.Asia continent boasts the most comprehensive kinds of minerals,with reserves of at least 38 of over 80 widely used minerals worldwide accounting for more than30%of the global total reserves.Asia continent experienced three main tectonic evolution and mineralization stages:The Precambrian,the Paleozoic,and the Mesozoic to Cenozoic.The abundant mineral resources in this continent can be divided into seven first-order metallogenic belts(metallogenic domains),18 second-order metallogenic belts(metallogenic provinces),61 third-order metallogenic belts(metallogenic zones),and nine main minerogenetic series.Asia continent exhibits the most significant metallogenic specialization among all continents.Specifically,granite belts of Asia continent manifest pronounced metallogenic specialization of tin,rare metals,and porphyry Cu-Au-Mo deposits.Its maficultramafic rock belts and ophiolite belts display notable metallogenic specialization of lateritic nickel deposits and magmatic type chromite deposits,while its Mesozoic to Cenozoic basalt belts show remarkable metallogenic specialization of lateritic bauxite deposits.Consequently,many giant metallogenic belts were formed,including the Southeast Asian tin belt,the Qinghai-Xizang Plateau rare metal metallogenic belt,the Tethyan porphyry Cu-Au-Mo metallogenic belt,the circum-Pacific porphyry Cu-Au-Mo metallogenic belt,the Southeast Asian lateritic bauxite metallogenic belt,the Deccan Plateau lateritic bauxite metallogenic belt in India,the Southeast Asian lateritic nickel metallogenic belt,and the Tethyan magmatic type chromite metallogenic belt—all of which are significant metallogenic belts in Asia continent.Future mineral exploration in Asia should focus primarily on the Precambrian mineralization of ancient cratons,the Paleozoic mineralization of the Central Asian-Mongolian orogenic belt,and the Mesozoic to Cenozoic mineralization of the Tethyan and circum-Pacific mobile belts.Asia's mining industry not only underpins its own economic growth but also propels global economic development and industrialization,contributing significantly to the world economy.Asia boasts the highest production value of minerals,the largest annual production of minerals,and the greatest trade value of mineral products among all the continents,having emerged as the trade center of global mineral products and the center of the mining industry economy.China is identified as one of the few countries that possess the most comprehensive kinds of minerals,and its mining industry has supported and driven the economic development and industrialization of Asia and even the world.Standing as the largest mineral producer worldwide,China ranked first in the production of 28 mineral commodities in the world in 2022.Besides,China exhibits the highest annual production value of minerals and the largest trade value of mineral products among all countries.Therefore,China's demand for global mineral products influences the global supply and demand patterns of minerals and the world economic situation.展开更多
The aim of this study is to determine the antipsychotic prescribing pattern and the prevalence of concurrent anticholinergic prescribing in a psychiatric referral hospital. A retrospective audit of prescriptions issue...The aim of this study is to determine the antipsychotic prescribing pattern and the prevalence of concurrent anticholinergic prescribing in a psychiatric referral hospital. A retrospective audit of prescriptions issued for outpatients was carried out at the Psychiatric Hospital, the only facility that provides psychiatric services for both inpatients and outpatients in the Kingdom of Bahrain. Antipsychotic monotherapy was prescribed for 89.2% patients, whereas polytherapy with two- and three-drugs in 10.4 and 0.4%, respectively. Atypical antipsychotics were prescribed more often (67.7%) than typical antipsychotics. Risperidone and haloperidol were the most frequently prescribed antipsychotics. Long-acting risperidone injection was the only depot preparation prescribed. The mean antipsychotic dose expressed as chlorpromazine equivalent (CPZeq;mg/day) was 242 (220 for monotherapy and 414 for polytherapy). The prevalence of high dose antipsychotic (mean CPZeq > 1000 mg/day) was 1.8%, prescribed at a mean CPZeq dose of 1531 (1925 for monotherapy and 1137 for polytherapy), mainly attributed to haloperidol. Anticholinergics were co-prescribed for almost two third of patients receiving antipsychotics, particularly for those on polytherapy (monotherapy 57.3%;poly-therapy 87.5%). Antipsychotic polytherapy, high dose and co-prescription of an oral with a depot antipsychotic preparation were strongly associated with concurrent prescription of anticholinergics. Procyclidine and orphenadrine were the most often prescribed anticholinergics. In Bahrain, antipsychotic monotherapy is a common practice for outpatients with psychotic disorders. Some of the antipsychotic polytherapies, dosage strategies, and high prevalence of anticholinergic use are therapeutic issues that need to be addressed to foster evidence-based prescribing practice.展开更多
Introduction: Indiscriminate prescribing and using of antibiotics have led to the development of antimicrobial resistance (AMR). To reduce this problem, the World Health Organization (WHO) developed the “Access”, “...Introduction: Indiscriminate prescribing and using of antibiotics have led to the development of antimicrobial resistance (AMR). To reduce this problem, the World Health Organization (WHO) developed the “Access”, “Watch”, and “Reserve” (AWaRe) classification of antibiotics that promotes antimicrobial stewardship (AMS). In Zambia, there are gaps in practice regarding prescribing of antibiotics based on the AWaRe protocol. This study assessed antibiotic prescribing patterns in adult in-patients in selected primary healthcare hospitals in Lusaka, Zambia. Materials and Methods: This retrospective cross-sectional study was conducted using 388 patient medical files from September 2021 to November 2021, five primary healthcare hospitals namely;Chawama, Matero, Chilenje, Kanyama, and Chipata. Data analysis was performed using the Statistical Package for Social Sciences version 23. Results: Of the selected medical files, 52.3% (n = 203) were for male patients. Overall, the prevalence of antibiotic use was 82.5% (n = 320) which was higher than the WHO recommendation of a less than 30% threshold. The most prescribed antibiotic was ceftriaxone (20.3%), a Watch group antibiotic, followed by metronidazole (17.8%) and sulfamethoxazole/trimethoprim (16.3%), both belonging to the Access group. Furthermore, of the total antibiotics prescribed, 41.9% were prescribed without adhering to the standard treatment guidelines. Conclusion: This study found a high prescription of antibiotics (82.5%) that can be linked to non-adherence to the standard treatment guidelines in primary healthcare hospitals. The most prescribed antibiotic was ceftriaxone which belongs to the Watch group, raising a lot of concerns. There is a need for rational prescribing of antibiotics and implementation of AMS programs in healthcare facilities in Zambia, and this may promote surveillance of irrational prescribing and help reduce AMR in the future.展开更多
Introduction: A caesarean section (CS) is one of the most frequently performed obstetric surgeries in the world and its use has increased dramatically in recent years. The number of caesarean section cases worldwide h...Introduction: A caesarean section (CS) is one of the most frequently performed obstetric surgeries in the world and its use has increased dramatically in recent years. The number of caesarean section cases worldwide has been increasing each year, and the World Health Organization (WHO) reported an excess of 10% - 15% of CS procedures for all births. However, some women experience surgical site infections (SSIs) after undergoing CS delivery. This study investigated the prescribing patterns of antibiotics in CS deliveries and the prevalence of SSIs at two tertiary hospitals in Lusaka, Zambia. Materials and Methods: A retrospective cross-sectional study was conducted from January 2020 to December 2020 at the Women and Newborn University Teaching Hospital (UTH) and the Levy Mwanawasa University Teaching Hospital, in Lusaka, Zambia. Results: Of a total of 838 women who delivered via CS, more than half were aged between 21 and 25 years (n = 461, 55.0%), 56.3% were from low-cost residential areas, and 57% had emergency CS delivery. The prevalence of SSIs was 6.0%, with the level of education (OR 0.377, 95% CI 0.150 - 0.946), type of caesarean section (OR 6.253, 95% CI 2.833 - 13.803), and oral antibiotics post-caesarean (OR 0.218, 95% CI 0.049 - 0.963). The duration of IV antibiotic treatment significantly predicted SSI (p Conclusion: This study found that the third-generation cephalosporin (cefotaxime) and triple combination therapy (benzylpenicillin, gentamicin, and metronidazole) were the most frequently prescribed antibiotics before and after CS. The level of education, type of CS, oral antibiotics post-CS, facility, and duration of administering IV antibiotics were all predictors of SSIs.展开更多
BACKGROUND Hypertension is commonly observed in patients living with chronic kidney disease(CKD).Finding an optimal treatment regime remains challenging due to the complex bidirectional cause-and-effect relationship b...BACKGROUND Hypertension is commonly observed in patients living with chronic kidney disease(CKD).Finding an optimal treatment regime remains challenging due to the complex bidirectional cause-and-effect relationship between hypertension and CKD.There remains variability in antihypertensive treatment practices.AIM To analyze data from the Salford Kidney Study database in relation to antihypertensive prescribing patterns amongst CKD patients.METHODS The Salford Kidney Study is an ongoing prospective study that has been recruiting CKD patients since 2002.All patients are followed up annually,and their medical records including the list of medications are updated until they reach study endpoints[starting on renal replacement therapy or reaching estimated glomerular filtration rate(eGFR)expressed as mL/min/1.73 m2≤10 mL/min/1.73 m2,or the last follow-up date,or data lock on December 31,2021,or death].Data on antihypertensive prescription practices in correspondence to baseline eGFR,urine albumin-creatinine ratio,primary CKD aetiology,and cardiovascular disease were evaluated.Associations between patients who were prescribed three or more antihypertensive agents and their clinical outcomes were studied by Cox regression analysis.Kaplan-Meier analysis demonstrated differences in survival probabilities.RESULTS Three thousand two hundred and thirty non-dialysis-dependent CKD patients with data collected between October 2002 and December 2019 were included.The median age was 65 years.A greater proportion of patients were taking three or more antihypertensive agents with advancing CKD stages(53%of eGFR≤15 mL/min/1.73 m2 vs 26%of eGFR≥60 mL/min/1.73 m2,P<0.001).An increased number of patients receiving more classes of antihypertensive agents was observed as the urine albumin-creatinine ratio category increased(category A3:62%vs category A1:40%,P<0.001),with the upward trends particularly noticeable in the number of individuals prescribed renin angiotensin system blockers.The prescription of three or more antihypertensive agents was associated with all-cause mortality,independent of blood pressure control(hazard ratio:1.15;95%confidence interval:1.04-1.27,P=0.006).Kaplan-Meier analysis illustrated significant differences in survival outcomes between patients with three or more and those with less than three antihypertensive agents prescribed(log-rank,P<0.001).CONCLUSION Antihypertensive prescribing patterns in the Salford Kidney Study based on CKD stage were consistent with expectations from the current United Kingdom National Institute of Health and Care Excellence guideline algorithm.Outcomes were poorer in patients with poor blood pressure control despite being on multiple antihypertensive agents.Continued research is required to bridge remaining variations in hypertension treatment practices worldwide.展开更多
Prescribing patterns amongst practising Australasian neurosurgeons regarding the use of prophylactic antiepileptic drugs (AEDs) in patients with newly diagnosed intrinsic brain tumours are not well established. This s...Prescribing patterns amongst practising Australasian neurosurgeons regarding the use of prophylactic antiepileptic drugs (AEDs) in patients with newly diagnosed intrinsic brain tumours are not well established. This study aimed to determine the rate of prophylactic AED prescribing in this clinical context and to determine if there were some particular factors that influenced prescribers in their decision. A survey was conducted, and of the 91 respondents, 23 (25.3%) prescribed prophylactic AEDs. No neurosurgeons practising in New Zealand prescribed, whereas within Australian states/territories, prescribing was most common in Western Australia (3/4, 75.0%) and Queensland (8/18, 44.4%) and less common in the Australian Capital Territory (0/2, 0.0%) and South Australia (1/7, 14.3%). The most commonly prescribed first-line AED was phenytoin (n = 15, 68.2%) followed by levetiracetam (n = 5, 22.7%). The duration of prescription varied from 1 week to 6 months, with 6 weeks chosen by most prescribers (n = 7, 35%). Important factors that influence the decision to prescribe include tumour location and a history of previous seizure/s, whereas the presence of oedema or haemorrhage and patients’ age do not seem to be major influences amongst prescribers.展开更多
To analyze the herbal medicine prescribing patterns of contemporary famous old traditional Chinese medicine doctors in treating coronary heart disease,based on data mining technology,so as to provide useful insights i...To analyze the herbal medicine prescribing patterns of contemporary famous old traditional Chinese medicine doctors in treating coronary heart disease,based on data mining technology,so as to provide useful insights into the clinical practice.Methods:Databases,including Medline(January 1966 to December 2019),Wanfang(January 1982 to December 2019),VIP Database(January 1989 to December 2019),CNKI(January 1979 to December 2019),CBMdisc(January 1978 to December 2019),and Classic Case Collection from Contemporary Famous Old Traditional Chinese Medicine Doctors were searched,and 224 eligible studies involving 416 patients were entered into the case study database after data processing.Frequency analysis and association rule analysis were used to investigate the prescribing patterns of contemporary famous old traditional Chinese medicine doctors in treating coronary heart disease.Results:In total 290 kinds of Chinese herbal drugs and 19 core drugs were used in the cases studied.The most commonly used categories were“Qi-Tonifying Drugs”,“Blood-Activating Drugs”,and“Phlegm-Eliminating Drugs”.The association rule analysis identified 14 commonly used herbal pairs,19 three-drug combinations,and 1 four-drug combination.Conclusion:Contemporary famous old traditional Chinese medicine doctors considered warming heart yang as an extremely important approach to treat coronary heart disease based on Zhang Zhongjing’s treatment for chest painful obstruction caused by“Inactivity of Chest Yang”(blockade of phlegm turbidity).Both symptoms and root causes were addressed in the formulas prescribed by these doctors.“Tonifying Qi,Nourishing Yin,Activating Blood,and Eliminating Phlegm”were the most commonly used therapeutic methods for patients with coronary heart disease.展开更多
Introduction: Skin diseases are the major contributors of disease burden in society. Dermatological therapy ultimate goal is achieved by administering the safest and least number of drugs. The problem gets compounded ...Introduction: Skin diseases are the major contributors of disease burden in society. Dermatological therapy ultimate goal is achieved by administering the safest and least number of drugs. The problem gets compounded with the inappropriate and irrational use of medicines. Therefore, periodic prescription audit in the form of prescribing patterns is away to improve irrational prescription. The objective of this study to assess the prescription patterns of dermatological agents in Borumeda hospital. Method: Hospital based retrospective cross sectional study in which prescribing patterns of dermatological agents are assessed. A total of 385 samples of patient record prescription from November/1/2016 to December/30/2016, and the sample were selected by systematic random sampling technique. Sample prescriptions were reviewed using structural data collection format. The Collected data was analyzed by using SPSS version 20. Result: Regarding rout of administration, the maximum number of drugs was prescribed topically (66.2%). Topical steroids were the most commonly prescribed drugs (25.3%). Use of generic prescribing in single drug prescribing was 81.7%. The prevalence of atopic dermatitis was higher (26.3%, 20.8%) in both male and female respectively followed by scabies in male with 12.2% and Acne vulgaris (12.9%) in female. Number of drugs per prescription was higher (2.46) than WHO standard (Conclusion: The current study reveals that topical corticosteroids were commonly prescribed drugs in the dermatology unit and the prescribing practice imitates incidence of polypharmacy.展开更多
The preparation of red,green,and blue quantum dot(QD)pixelated arrays with high precision,resolution,and brightness poses a significant challenge on the development of advanced micro-displays for virtual,augmented,and...The preparation of red,green,and blue quantum dot(QD)pixelated arrays with high precision,resolution,and brightness poses a significant challenge on the development of advanced micro-displays for virtual,augmented,and mixed reality applications.Alongside the controlled synthesis of high-performance QDs,a reliable QD patterning technology is crucial in overcoming this challenge.Among the various methods available,photolithography-based patterning technologies show great potentials in producing ultra-fine QD patterns at micron scale.This review article presents the recent advancements in the field of QD patterning using photolithography techniques and explores their applications in micro-display technology.Firstly,we discuss QD patterning through photolithography techniques employing photoresist(PR),which falls into two categories:PRassisted photolithography and photolithography of QDPR.Subsequently,direct photolithography techniques based on photo-induced crosslinking of photosensitive groups and photo-induced ligand cleavage mechanisms are thoroughly reviewed.Meanwhile,we assess the performance of QD arrays fabricated using these photolithography techniques and their integration into QD light emitting diode display devices as well as color conversionbased micro light emitting diode display devices.Lastly,we summarize the most recent developments in this field and outline future prospects.展开更多
Ecological security provides the basis of maintaining both a sustainable regional ecosystem and economic development.However,few studies have focused on how the features such as topography and geomorphology,lithologic...Ecological security provides the basis of maintaining both a sustainable regional ecosystem and economic development.However,few studies have focused on how the features such as topography and geomorphology,lithologic stratigraphic assemblages,and geohazard distribution affect the construction of ecological security patterns and the layout of optimization measures.In order to comprehensively reveal the key areas and key objects of ecological restoration in karst basins,this study takes the Beipan River Basin(BRB)as an example,constructs an ecological security pattern(ESP)based on the methods of morphological spatial pattern analysis(MSPA),landscape connectivity analysis and circuit theory,and lays out the optimization measures in combination with the spatial distribution characteristics of topographic and geomorphological differences and lithological stratigraphic combinations.The results show that 151 ecological sources,343 ecological corridors,121 pinch points and 178 barriers constitute the ESP of the BRB.Lithology is closely related to the spatial distribution characteristics of ecological source sites.Level 1 and 2 ecological sources(The ecological sources were categorized into level 1,level 2,and level 3 source from high to low importance.)are concentrated in the Emeishan basalt region of the upstream and the clastic and impure carbonate rock region of the downstream part of the BRB;level 3ecological sources are concentrated in the carbonate rock region of the midstream.Taking into account the outstanding ecological problems in the basin,and based on the characteristics of lithology and geohazard distribution,we propose the optimization scheme of“three axes,three zones and multiple points”for the ESP and the layout of specific measures of the BRB.The results can provide scientific references for maintaining ecological security maintenance in karst ecologically fragile areas.展开更多
AIM:To report the demographic and systemic characteristics of patients,clinical progression of endophthalmitis,and the efficacy of various treatment strategies,with a focus on identifying key factors for preserving vi...AIM:To report the demographic and systemic characteristics of patients,clinical progression of endophthalmitis,and the efficacy of various treatment strategies,with a focus on identifying key factors for preserving vision in eyes with endogenous endophthalmitis due to Klebsiella pneumoniae(K.pneumoniae)liver abscess.METHODS:In this single-center,retrospective case series of 18 patients with endogenous endophthalmitis due to K.pneumoniae liver abscess were analyzed.Ophthalmologic features of endophthalmitis at early,intermediate and advanced stages were obtained from eyes with endophthalmitis of different severities.Prompt vitrectomy was considered primarily for all eyes except for very early endophthalmitis.Intravitreal injections of antibiotics were performed in eyes with endophthalmitis in the very early stages and in eyes where vitrectomy was not available,and additional control of infection was needed after vitrectomy.Evisceration was performed in eyes with corneoscleral perforation,advanced endophthalmitis,perforation with preseptal or orbital cellulitis,uncontrolled infection,or severe pain with no vision.RESULTS:Mean(±standard deviation)age of the 18 patients with endophthalmitis was 64.5±12.2(range:32-84)y,and 14 patients(77.8%)were males.Endophthalmitis tended to involve the retinal parenchyma first and then progressed into the vitreous cavity and anterior segments.However,it presented a tendency to cause massive subretinal abscesses even after vitrectomy with silicone oil tamponade.Very high intraocular pressure with new vessels on the iris(41.7%)were also commonly observed.Although all but three patients had systemic disease such as diabetes or hypertension,visual prognosis after treatment did not appear to depend significantly on underlying comorbidities.A final best-corrected visual acuity better than 20/60 was achieved only when lesions were detected very early,with relatively good initial visual acuity,likely reflecting lower bacterial inoculation in the eye.CONCLUSION:Detection of early endophthalmitis lesions appears to be the only way to preserve good vision in patients with K.pneumoniae liver abscesses.Therefore,proper guidelines for ophthalmologic screening remain to be established for subjects at a high risk of endophthalmitis.展开更多
文摘BACKGROUND Upper respiratory tract infections(URTIs)are one of the most frequent causes of childhood school leave and morbidity.AIM To study the present trend of medications’prescribing pattern utilized in URTIs among the pediatric population attending outpatient clinics in pediatric hospitals.METHODS This analytical observational cross-sectional research was conducted in 200 children aged 1–10 years with URTIs attending the pediatric outpatient clinics in pediatric hospitals,one of which is an educational hospital,from July 2018 to August 2020.RESULTS Most of the prescriptions in our study included antibiotics(116/58%).The most commonly prescribed antibiotic family was ampicillin/sulbactam or amoxici-llin/clavulanic acid(53/26.5%),followed by first-generation cephalosporin(25/12.5%)and third-generation cephalosporin(20/10%).Macrolides and second-generation cephalosporins were prescribed less frequently,in 16(8%)and 2(1%)patients,respectively.Most of our study population(155/77.5%)was satisfied with their prescriptions,whereas the rest of the study population(45/22.5%)was unsatisfied.CONCLUSION Overprescription of antibiotics is a significant issue among clinicians in pediatric outpatient clinics.Stewardship of drugs,particularly antibiotics,is a must to prevent the development of drug resistance.Most cases of URTIs were treated in accordance with the existing national treatment guidelines.
基金supported by the Key Research and Development Plan Project of Heilongjiang Province (2022ZX02C13)。
文摘Xishui National Forest Park in Heilongjiang Province hosts China's most pristine temperate forests and serves as a key site for ecotourism and forest therapy.However,the emission patterns of phytoncides(key bio active compounds) remain poorly understood,limiting their therapeutic application.This study provides the first comprehensive characterization of spatiotemporal dynamics in airborne phytoncides and their synergistic interactions with environmental factors throughout the autumn-early spring seasonal transition in a temperate forest ecosystem.We analyzed the compositional dynamics of phytoncides and terpenoid content variations using thermal desorption-gas chromatography-mass spectrometry(TD-GC-MS) from September 2024 to March 2025.This period encompassed seasonal transitions from autumn to early spring,including diurnal variations in September and snowfall events in November.The method demonstrated detection limits(LODs) ranging from 1.35 to 5.33 ng m-3 and quantification limits(LOQs) from 4.09 to 16.15 ng m-3.Our results revealed pronounced seasonal fluctuations in phytoncide composition.In September,terpenoids,esters,alcohols,and alkanes displayed a diurnal "decrease-increase" trend,whereas aldehydes and ketones peaked at midday.Notably,esters and alcohols were undetectable in November and January.By January,terpenoids reached their lowest proportion(0.17±0.02%) at noon.Five terpenoids(α-pinene,myrcene,D-limonene,camphene,p-cymene) were detected in September,four(α-pinene,D-limonene,camphene,p-cymene) in November,two(D-limonene,p-cymene) in January,and only p-cymene in March.The total concentration and emission rate of the five terpenoids peaked in September afternoons at 1961.58±106.67 ng m^(-3) and653.86±35.56 ng m^(-3) h^(-1),respectively.Nocturnal emissions(32131.95±2522.21 ng m^(-3)) significantly surpassed daytime levels(14473.04±958.49 ng m^(-3)),with emission rates escalating from 1447.30±95.85 ng m^(-3) h^(-1)(day) to 5355.33±420.37 ng m^(-3) h^(-1)(night),marking a3.7-fold increase.Snowfall dramatically elevated terpenoid concentrations(pre-snowfall:158.58±14.12 ng m^(-3);post-snowfall:1080.57±57.76 ng m^(-3)) and emission rates(pre-snowfall:52.86±4.71 ng m^(-3) h^(-1);post-snowfall:360.19±19.25 ng m^(-3) h^(-1)),reflecting a 6.8-fold surge.This study underscores the profound influence of light intensity,seasonal shifts,and climatic conditions on airborne phytoncide levels,offering a scientific foundation for optimizing forest therapy and ecotourism strategies.
基金supported by the National Natural Science Foundation of China(32460380,42007042)State Key Laboratory of Subtropical Silviculture(SKLSSKF2023-06)+2 种基金Natural Science Foundation of Jiangxi Province(20242BAB25389)National Undergraduate Innovation and Entrepreneurship Training Program(202410410029X)Jiangxi Province Graduate Student Innovation Special Fund Project(YC2024-S330).
文摘Urban forests are essential components of green infrastructure,however,rapid urbanization-induced changes in landscape patterns may affect their ecosystem services through complex ecological processes.A total of 184 sample plots in the built-up areas of Nanchang,China,were used as research sites.Urbanization intensities were categorized by the rate of impervious surface area,and forest types were classified into landscape and relaxation forest,attached forest(AF),road forest(RF),and ecological public welfare forest.This study aimed to explore the spatial variations in vegetation characteristics and landscape pattern indices of different forest types under rapid urbanization.The results indicated that the largest patch index(LPI),aggregation index(AI),and percentage of landscape(PLAND)in RF and AF were lower than those in the other forest types(p<0.05).With increasing urbanization intensity,the mean perimeter-area ratio increased by 130.84%,whereas the PLAND,LPI,and AI decreased by 22−86%(p<0.05).Redundancy analysis and variation partitioning suggested that the interpretation rate of landscape pattern indices for variations in vegetation characteristics increased from low to heavy urbanization areas.Especially,the landscape shape index,patch connection index,PLAND,and mean patch size were significantly correlated with vegetation characteristics(e.g.,tree richness,herb coverage,and tree height).In the future,appropriate landscape layout superiority cases should be considered in different urbanization areas and forest types;for instance,increasing the patch connection index will beneficially improve the diversity of trees and herbs in heavy urbanization areas and the RF.This study serves as a reference for maximizing the ecosystem services of urban forests.
基金supported in part by National Key R&D Program of China(2022YFB4501200),National Natural Science Foundation of China(62332018)Science and Technology Program(2024NSFTD0031,2024YFHZ0339 and 2025ZNSFSC0497).
文摘The performance of data restore is one of the key indicators of user experience for backup storage systems.Compared to the traditional offline restore process,online restore reduces downtime during backup restoration,allowing users to operate on already restored files while other files are still being restored.This approach improves availability during restoration tasks but suffers from a critical limitation:inconsistencies between the access sequence and the restore sequence.In many cases,the file a user needs to access at a given moment may not yet be restored,resulting in significant delays and poor user experience.To this end,we present Histore,which builds on the user’s historical access sequence to schedule the restore sequence,in order to reduce users’access delayed time.Histore includes three restore approaches:(i)the frequency-based approach,which restores files based on historical file access frequencies and prioritizes ensuring the availability of frequently accessed files;(ii)the graph-based approach,which preferentially restores the frequently accessed files as well as their correlated files based on historical access patterns,and(iii)the trie-based approach,which restores particular files based on both users’real-time and historical access patterns to deduce and restore the files to be accessed in the near future.We implement a prototype of Histore and evaluate its performance from multiple perspectives.Trace-driven experiments on two datasets show that Histore significantly reduces users’delay time by 4-700×with only 1.0%-14.5%additional performance overhead.
基金the Chinese Academy of Sciences Research Center for Ecology and Environment of Central Asia(RCEECA),the construction and joint research for the China-Tajikistan“Belt and Road”Joint Laboratory on Biodiversity Conservation and Sustainable Use(2024YFE0214200)the Shanghai Cooperation Organization Partnership and International Technology Cooperation Plan of Science and Technology Projects(2023E01018,2025E01056)the Chinese Academy of Sciences President’s International Fellowship Initiative(PIFI)(2024VBC0006).
文摘Tajikistan represents a core region of the biodiversity hotspot in Central Asian mountains and has exceptional vascular plant diversity.However,the species diversity of the country faces urgent conservation challenges.There has been a lack of a comprehensive and multidimensional assessment to inform strategic conservation planning.Therefore,this study integrated 4 key biodiversity indices including species richness(SR),phylogenetic diversity(PD),threatened species richness(TSR),and endemic species richness(ESR)to map species diversity distribution patterns,identify conservation gaps,and elucidate their effects of climatic factors.This study revealed that species diversity shows a clear trend of decreasing from the western region to the eastern region of Tajikistan.The central–western mountains(specifically the Gissar-Darvasian and Zeravshanian regions)emerge as irreplaceable biodiversity hotspots.However,we found a severe spatial mismatch between these priority areas and the existing protected areas(PAs).Protection coverage for all hotspots was alarmingly low,ranging from 31.00%to 38.00%.Consequently,a critical 64.80%of integrated priority areas fall outside of the current PAs,representing a major conservation gap.This study identified precipitation seasonality and isothermality as the principal drivers,collectively explaining over 50.00%of the diversity variation and suggesting high vulnerability to hydrological shifts.Furthermore,we detected significant geographic sampling bias in the public biodiversity databases,with the most critical hotspot being systematically under-sampled.This study provides a robust scientific basis for conservation action,highlighting the urgent need to strategically expand PAs in the under-protected southwestern region and to mitigate critical sampling gaps through targeted data digitization and field surveys.These measures are indispensable for securing Tajikistan’s unique biodiversity and achieving the Kunming-Montreal Global Biodiversity Framework Target 3(“30×30 Protection”).
基金support from the National Natural Science Foundation of China(Grant No.61971256)。
文摘Wide-field mesoscopy provides the capabilities of cortex-wide field of view(FOV),cellular resolution and high frame rate for neuronal imaging in the mouse brain.However,inherent background fluorescence degrades the image quality and hinders neuronal signal extraction.To address this problem,we first introduce a cortex-wide,high-resolution lineillumination mesoscope with a moving slit designed for in vivo mouse brain imaging.This system achieves a 6.6×6.6 mm FOV,microscale cellular resolution,a high frame rate of 10 Hz,as well as the background rejection ability.Furthermore,we integrated patterned illumination into the system to enhance the background suppression.Experimental results show that the proposed system successfully captures neurodynamics in the living mouse brain.Compared with conventional wide-field mesoscopes,the cortex-wide patterned line-illumination mesoscope(PLIM)achieves a threefold increase in the signal-to-background ratio(SBR).With patterned illumination integrated,the SBR enhancement further reaches four-anda-half-fold.
文摘BACKGROUND Drug utilization research has an important role in assisting the healthcare administration to know,compute,and refine the prescription whose principal objective is to enable the rational use of drugs.Research in developing nations relating to the cost of treatment is scarce when compared with developed countries.Thus,the drug utilization research studies from developing nations are most needed,and their number has been growing.AIM To evaluate patterns of utilization of antipsychotic drugs and direct medical cost analysis in patients newly diagnosed with schizophrenia.METHODS The present study was observational in type and based on a retrospective cohort to evaluate patterns of utilization of antipsychotic drugs using World Health Organization(WHO)core prescribing indicators and anatomical therapeutic chemical/defined daily dose indicators.We also calculated direct medical costs for a period of 6 months.RESULTS This study has found that atypical antipsychotics are the mainstay of treatment for schizophrenia in every age group and subcategories of schizophrenia.The evaluation based on WHO prescribing indicators showed a low average number of drugs per prescription and low prescribing frequency of antipsychotics from the National List of Essential Medicines 2015 and the WHO Essential Medicines List 2019.The total mean drug cost of our study was 1396 Indian rupees.The total mean cost due to the investigation in our study was 1017.34 Indian rupees.Therefore,the total mean direct medical cost incurred on patients in our study was 4337.28 Indian rupees.CONCLUSION The information from the present study can be used for reviewing and updating treatment policy at the institutional level.
基金supported by the Department of Biotechnology,Ministry of Science and Technology,Govt.India,under grant No.BT/Coord.II/10/02/2016/22.03.2018the Indian Council of Social Science Research,New Delhi,India,for providing a short-term doctoral fellowship(RFD/Short-Term/2022-23/ENV/ST/66).
文摘Understanding spatial patterns of plant species diversity and the factors(e.g.,climate and human)that drive these patterns is essential for biodiversity conservation.We used data from 1700.1-ha forest plots in the Shettihalli tropical forest landscape of the Western Ghats biodiversity hotspot,India,to analyse tree community composition and the drivers ofα-diversity(Shannon)andβ-diversity(LCBD).Compositional patterns were visualized using Non-Metric Multidimensional Scaling(NMDS),and hybrid feature selection with structural equation modeling(SEM)was employed to evaluate the direct and indirect effects of environmental variables on diversity.NMDS identified four distinct forest types in the Shettihalli landscape:semi-evergreen,dry deciduous,moist deciduous,and plantation forests,each with distinct plant composition.Shannon diversity and ecological uniqueness was significantly higher in semi-evergreen forest than in deciduous forest plots.The SEMs explained about 79%and 39–45%of the variation inα-diversity andβ-diversity.Our analysis indicated that current diversity patterns result from multiple processes,with structure,disturbance,and edaphic parameters exerting the strongest direct and indirect effects onα-diversity.β-diversity,in contrast,was largely influenced by climate,topography,stand structure,and edaphic factors.Overall,our findings indicate that various factors(e.g.,climate,topography,and human disturbance)interact to shape tree diversity patterns in tropical forests.These findings will help develop unique conservation and management strategies for distinct forest types in tropical forest ecosystems.
基金funded by geological survey project of China Geological Survey(DD20211404)。
文摘Mineral resources in Asia continent and its mining industry play a significant role in the economic growth and industrialization of both Asia and the world.Asia continent boasts the most comprehensive kinds of minerals,with reserves of at least 38 of over 80 widely used minerals worldwide accounting for more than30%of the global total reserves.Asia continent experienced three main tectonic evolution and mineralization stages:The Precambrian,the Paleozoic,and the Mesozoic to Cenozoic.The abundant mineral resources in this continent can be divided into seven first-order metallogenic belts(metallogenic domains),18 second-order metallogenic belts(metallogenic provinces),61 third-order metallogenic belts(metallogenic zones),and nine main minerogenetic series.Asia continent exhibits the most significant metallogenic specialization among all continents.Specifically,granite belts of Asia continent manifest pronounced metallogenic specialization of tin,rare metals,and porphyry Cu-Au-Mo deposits.Its maficultramafic rock belts and ophiolite belts display notable metallogenic specialization of lateritic nickel deposits and magmatic type chromite deposits,while its Mesozoic to Cenozoic basalt belts show remarkable metallogenic specialization of lateritic bauxite deposits.Consequently,many giant metallogenic belts were formed,including the Southeast Asian tin belt,the Qinghai-Xizang Plateau rare metal metallogenic belt,the Tethyan porphyry Cu-Au-Mo metallogenic belt,the circum-Pacific porphyry Cu-Au-Mo metallogenic belt,the Southeast Asian lateritic bauxite metallogenic belt,the Deccan Plateau lateritic bauxite metallogenic belt in India,the Southeast Asian lateritic nickel metallogenic belt,and the Tethyan magmatic type chromite metallogenic belt—all of which are significant metallogenic belts in Asia continent.Future mineral exploration in Asia should focus primarily on the Precambrian mineralization of ancient cratons,the Paleozoic mineralization of the Central Asian-Mongolian orogenic belt,and the Mesozoic to Cenozoic mineralization of the Tethyan and circum-Pacific mobile belts.Asia's mining industry not only underpins its own economic growth but also propels global economic development and industrialization,contributing significantly to the world economy.Asia boasts the highest production value of minerals,the largest annual production of minerals,and the greatest trade value of mineral products among all the continents,having emerged as the trade center of global mineral products and the center of the mining industry economy.China is identified as one of the few countries that possess the most comprehensive kinds of minerals,and its mining industry has supported and driven the economic development and industrialization of Asia and even the world.Standing as the largest mineral producer worldwide,China ranked first in the production of 28 mineral commodities in the world in 2022.Besides,China exhibits the highest annual production value of minerals and the largest trade value of mineral products among all countries.Therefore,China's demand for global mineral products influences the global supply and demand patterns of minerals and the world economic situation.
文摘The aim of this study is to determine the antipsychotic prescribing pattern and the prevalence of concurrent anticholinergic prescribing in a psychiatric referral hospital. A retrospective audit of prescriptions issued for outpatients was carried out at the Psychiatric Hospital, the only facility that provides psychiatric services for both inpatients and outpatients in the Kingdom of Bahrain. Antipsychotic monotherapy was prescribed for 89.2% patients, whereas polytherapy with two- and three-drugs in 10.4 and 0.4%, respectively. Atypical antipsychotics were prescribed more often (67.7%) than typical antipsychotics. Risperidone and haloperidol were the most frequently prescribed antipsychotics. Long-acting risperidone injection was the only depot preparation prescribed. The mean antipsychotic dose expressed as chlorpromazine equivalent (CPZeq;mg/day) was 242 (220 for monotherapy and 414 for polytherapy). The prevalence of high dose antipsychotic (mean CPZeq > 1000 mg/day) was 1.8%, prescribed at a mean CPZeq dose of 1531 (1925 for monotherapy and 1137 for polytherapy), mainly attributed to haloperidol. Anticholinergics were co-prescribed for almost two third of patients receiving antipsychotics, particularly for those on polytherapy (monotherapy 57.3%;poly-therapy 87.5%). Antipsychotic polytherapy, high dose and co-prescription of an oral with a depot antipsychotic preparation were strongly associated with concurrent prescription of anticholinergics. Procyclidine and orphenadrine were the most often prescribed anticholinergics. In Bahrain, antipsychotic monotherapy is a common practice for outpatients with psychotic disorders. Some of the antipsychotic polytherapies, dosage strategies, and high prevalence of anticholinergic use are therapeutic issues that need to be addressed to foster evidence-based prescribing practice.
文摘Introduction: Indiscriminate prescribing and using of antibiotics have led to the development of antimicrobial resistance (AMR). To reduce this problem, the World Health Organization (WHO) developed the “Access”, “Watch”, and “Reserve” (AWaRe) classification of antibiotics that promotes antimicrobial stewardship (AMS). In Zambia, there are gaps in practice regarding prescribing of antibiotics based on the AWaRe protocol. This study assessed antibiotic prescribing patterns in adult in-patients in selected primary healthcare hospitals in Lusaka, Zambia. Materials and Methods: This retrospective cross-sectional study was conducted using 388 patient medical files from September 2021 to November 2021, five primary healthcare hospitals namely;Chawama, Matero, Chilenje, Kanyama, and Chipata. Data analysis was performed using the Statistical Package for Social Sciences version 23. Results: Of the selected medical files, 52.3% (n = 203) were for male patients. Overall, the prevalence of antibiotic use was 82.5% (n = 320) which was higher than the WHO recommendation of a less than 30% threshold. The most prescribed antibiotic was ceftriaxone (20.3%), a Watch group antibiotic, followed by metronidazole (17.8%) and sulfamethoxazole/trimethoprim (16.3%), both belonging to the Access group. Furthermore, of the total antibiotics prescribed, 41.9% were prescribed without adhering to the standard treatment guidelines. Conclusion: This study found a high prescription of antibiotics (82.5%) that can be linked to non-adherence to the standard treatment guidelines in primary healthcare hospitals. The most prescribed antibiotic was ceftriaxone which belongs to the Watch group, raising a lot of concerns. There is a need for rational prescribing of antibiotics and implementation of AMS programs in healthcare facilities in Zambia, and this may promote surveillance of irrational prescribing and help reduce AMR in the future.
文摘Introduction: A caesarean section (CS) is one of the most frequently performed obstetric surgeries in the world and its use has increased dramatically in recent years. The number of caesarean section cases worldwide has been increasing each year, and the World Health Organization (WHO) reported an excess of 10% - 15% of CS procedures for all births. However, some women experience surgical site infections (SSIs) after undergoing CS delivery. This study investigated the prescribing patterns of antibiotics in CS deliveries and the prevalence of SSIs at two tertiary hospitals in Lusaka, Zambia. Materials and Methods: A retrospective cross-sectional study was conducted from January 2020 to December 2020 at the Women and Newborn University Teaching Hospital (UTH) and the Levy Mwanawasa University Teaching Hospital, in Lusaka, Zambia. Results: Of a total of 838 women who delivered via CS, more than half were aged between 21 and 25 years (n = 461, 55.0%), 56.3% were from low-cost residential areas, and 57% had emergency CS delivery. The prevalence of SSIs was 6.0%, with the level of education (OR 0.377, 95% CI 0.150 - 0.946), type of caesarean section (OR 6.253, 95% CI 2.833 - 13.803), and oral antibiotics post-caesarean (OR 0.218, 95% CI 0.049 - 0.963). The duration of IV antibiotic treatment significantly predicted SSI (p Conclusion: This study found that the third-generation cephalosporin (cefotaxime) and triple combination therapy (benzylpenicillin, gentamicin, and metronidazole) were the most frequently prescribed antibiotics before and after CS. The level of education, type of CS, oral antibiotics post-CS, facility, and duration of administering IV antibiotics were all predictors of SSIs.
基金the National Institute of Health Research Manchester Biomedical Research Centre for their funding support in the SKS(NIHR203308).
文摘BACKGROUND Hypertension is commonly observed in patients living with chronic kidney disease(CKD).Finding an optimal treatment regime remains challenging due to the complex bidirectional cause-and-effect relationship between hypertension and CKD.There remains variability in antihypertensive treatment practices.AIM To analyze data from the Salford Kidney Study database in relation to antihypertensive prescribing patterns amongst CKD patients.METHODS The Salford Kidney Study is an ongoing prospective study that has been recruiting CKD patients since 2002.All patients are followed up annually,and their medical records including the list of medications are updated until they reach study endpoints[starting on renal replacement therapy or reaching estimated glomerular filtration rate(eGFR)expressed as mL/min/1.73 m2≤10 mL/min/1.73 m2,or the last follow-up date,or data lock on December 31,2021,or death].Data on antihypertensive prescription practices in correspondence to baseline eGFR,urine albumin-creatinine ratio,primary CKD aetiology,and cardiovascular disease were evaluated.Associations between patients who were prescribed three or more antihypertensive agents and their clinical outcomes were studied by Cox regression analysis.Kaplan-Meier analysis demonstrated differences in survival probabilities.RESULTS Three thousand two hundred and thirty non-dialysis-dependent CKD patients with data collected between October 2002 and December 2019 were included.The median age was 65 years.A greater proportion of patients were taking three or more antihypertensive agents with advancing CKD stages(53%of eGFR≤15 mL/min/1.73 m2 vs 26%of eGFR≥60 mL/min/1.73 m2,P<0.001).An increased number of patients receiving more classes of antihypertensive agents was observed as the urine albumin-creatinine ratio category increased(category A3:62%vs category A1:40%,P<0.001),with the upward trends particularly noticeable in the number of individuals prescribed renin angiotensin system blockers.The prescription of three or more antihypertensive agents was associated with all-cause mortality,independent of blood pressure control(hazard ratio:1.15;95%confidence interval:1.04-1.27,P=0.006).Kaplan-Meier analysis illustrated significant differences in survival outcomes between patients with three or more and those with less than three antihypertensive agents prescribed(log-rank,P<0.001).CONCLUSION Antihypertensive prescribing patterns in the Salford Kidney Study based on CKD stage were consistent with expectations from the current United Kingdom National Institute of Health and Care Excellence guideline algorithm.Outcomes were poorer in patients with poor blood pressure control despite being on multiple antihypertensive agents.Continued research is required to bridge remaining variations in hypertension treatment practices worldwide.
文摘Prescribing patterns amongst practising Australasian neurosurgeons regarding the use of prophylactic antiepileptic drugs (AEDs) in patients with newly diagnosed intrinsic brain tumours are not well established. This study aimed to determine the rate of prophylactic AED prescribing in this clinical context and to determine if there were some particular factors that influenced prescribers in their decision. A survey was conducted, and of the 91 respondents, 23 (25.3%) prescribed prophylactic AEDs. No neurosurgeons practising in New Zealand prescribed, whereas within Australian states/territories, prescribing was most common in Western Australia (3/4, 75.0%) and Queensland (8/18, 44.4%) and less common in the Australian Capital Territory (0/2, 0.0%) and South Australia (1/7, 14.3%). The most commonly prescribed first-line AED was phenytoin (n = 15, 68.2%) followed by levetiracetam (n = 5, 22.7%). The duration of prescription varied from 1 week to 6 months, with 6 weeks chosen by most prescribers (n = 7, 35%). Important factors that influence the decision to prescribe include tumour location and a history of previous seizure/s, whereas the presence of oedema or haemorrhage and patients’ age do not seem to be major influences amongst prescribers.
基金This study was supported by Chongqing Young and Middle-aged Medical Senior Personnel Training Program[Grant no.1055]Inheritance Studio Construction Project of Famous Old Traditional Chinese Medicine Expert He Deying in Chongqing(YAY2020-20)+1 种基金Technology Innovation and Application Development Project of Chongqing Kewei Joint Traditional Chinese Medicine(No.:2020ZY023938)Special Project CSTC2020JXJL0052 of Chongqing Science and Technology Bureau for Performance Incentive and Guidance of Research Institutions.
文摘To analyze the herbal medicine prescribing patterns of contemporary famous old traditional Chinese medicine doctors in treating coronary heart disease,based on data mining technology,so as to provide useful insights into the clinical practice.Methods:Databases,including Medline(January 1966 to December 2019),Wanfang(January 1982 to December 2019),VIP Database(January 1989 to December 2019),CNKI(January 1979 to December 2019),CBMdisc(January 1978 to December 2019),and Classic Case Collection from Contemporary Famous Old Traditional Chinese Medicine Doctors were searched,and 224 eligible studies involving 416 patients were entered into the case study database after data processing.Frequency analysis and association rule analysis were used to investigate the prescribing patterns of contemporary famous old traditional Chinese medicine doctors in treating coronary heart disease.Results:In total 290 kinds of Chinese herbal drugs and 19 core drugs were used in the cases studied.The most commonly used categories were“Qi-Tonifying Drugs”,“Blood-Activating Drugs”,and“Phlegm-Eliminating Drugs”.The association rule analysis identified 14 commonly used herbal pairs,19 three-drug combinations,and 1 four-drug combination.Conclusion:Contemporary famous old traditional Chinese medicine doctors considered warming heart yang as an extremely important approach to treat coronary heart disease based on Zhang Zhongjing’s treatment for chest painful obstruction caused by“Inactivity of Chest Yang”(blockade of phlegm turbidity).Both symptoms and root causes were addressed in the formulas prescribed by these doctors.“Tonifying Qi,Nourishing Yin,Activating Blood,and Eliminating Phlegm”were the most commonly used therapeutic methods for patients with coronary heart disease.
文摘Introduction: Skin diseases are the major contributors of disease burden in society. Dermatological therapy ultimate goal is achieved by administering the safest and least number of drugs. The problem gets compounded with the inappropriate and irrational use of medicines. Therefore, periodic prescription audit in the form of prescribing patterns is away to improve irrational prescription. The objective of this study to assess the prescription patterns of dermatological agents in Borumeda hospital. Method: Hospital based retrospective cross sectional study in which prescribing patterns of dermatological agents are assessed. A total of 385 samples of patient record prescription from November/1/2016 to December/30/2016, and the sample were selected by systematic random sampling technique. Sample prescriptions were reviewed using structural data collection format. The Collected data was analyzed by using SPSS version 20. Result: Regarding rout of administration, the maximum number of drugs was prescribed topically (66.2%). Topical steroids were the most commonly prescribed drugs (25.3%). Use of generic prescribing in single drug prescribing was 81.7%. The prevalence of atopic dermatitis was higher (26.3%, 20.8%) in both male and female respectively followed by scabies in male with 12.2% and Acne vulgaris (12.9%) in female. Number of drugs per prescription was higher (2.46) than WHO standard (Conclusion: The current study reveals that topical corticosteroids were commonly prescribed drugs in the dermatology unit and the prescribing practice imitates incidence of polypharmacy.
基金supported by the National Natural Science Foundation of China(62374142,12175189 and 11904302)External Cooperation Program of Fujian(2022I0004)+1 种基金Fundamental Research Funds for the Central Universities(20720190005 and 20720220085)Major Science and Technology Project of Xiamen in China(3502Z20191015).
文摘The preparation of red,green,and blue quantum dot(QD)pixelated arrays with high precision,resolution,and brightness poses a significant challenge on the development of advanced micro-displays for virtual,augmented,and mixed reality applications.Alongside the controlled synthesis of high-performance QDs,a reliable QD patterning technology is crucial in overcoming this challenge.Among the various methods available,photolithography-based patterning technologies show great potentials in producing ultra-fine QD patterns at micron scale.This review article presents the recent advancements in the field of QD patterning using photolithography techniques and explores their applications in micro-display technology.Firstly,we discuss QD patterning through photolithography techniques employing photoresist(PR),which falls into two categories:PRassisted photolithography and photolithography of QDPR.Subsequently,direct photolithography techniques based on photo-induced crosslinking of photosensitive groups and photo-induced ligand cleavage mechanisms are thoroughly reviewed.Meanwhile,we assess the performance of QD arrays fabricated using these photolithography techniques and their integration into QD light emitting diode display devices as well as color conversionbased micro light emitting diode display devices.Lastly,we summarize the most recent developments in this field and outline future prospects.
基金jointly supported by the Key Project of the Natural Science Foundation of Guizhou Province(No.Qiankehe Jichu-ZK[2023]Zhongdian027)the Project of the Science and Technology Innovation Base Construction of Guizhou Province(No.Qiankehe Zhongyindi[2023]005)Philosophy and Social Science Planning Subjects in Guizhou Province in 2022(No.22GZYB53)。
文摘Ecological security provides the basis of maintaining both a sustainable regional ecosystem and economic development.However,few studies have focused on how the features such as topography and geomorphology,lithologic stratigraphic assemblages,and geohazard distribution affect the construction of ecological security patterns and the layout of optimization measures.In order to comprehensively reveal the key areas and key objects of ecological restoration in karst basins,this study takes the Beipan River Basin(BRB)as an example,constructs an ecological security pattern(ESP)based on the methods of morphological spatial pattern analysis(MSPA),landscape connectivity analysis and circuit theory,and lays out the optimization measures in combination with the spatial distribution characteristics of topographic and geomorphological differences and lithological stratigraphic combinations.The results show that 151 ecological sources,343 ecological corridors,121 pinch points and 178 barriers constitute the ESP of the BRB.Lithology is closely related to the spatial distribution characteristics of ecological source sites.Level 1 and 2 ecological sources(The ecological sources were categorized into level 1,level 2,and level 3 source from high to low importance.)are concentrated in the Emeishan basalt region of the upstream and the clastic and impure carbonate rock region of the downstream part of the BRB;level 3ecological sources are concentrated in the carbonate rock region of the midstream.Taking into account the outstanding ecological problems in the basin,and based on the characteristics of lithology and geohazard distribution,we propose the optimization scheme of“three axes,three zones and multiple points”for the ESP and the layout of specific measures of the BRB.The results can provide scientific references for maintaining ecological security maintenance in karst ecologically fragile areas.
文摘AIM:To report the demographic and systemic characteristics of patients,clinical progression of endophthalmitis,and the efficacy of various treatment strategies,with a focus on identifying key factors for preserving vision in eyes with endogenous endophthalmitis due to Klebsiella pneumoniae(K.pneumoniae)liver abscess.METHODS:In this single-center,retrospective case series of 18 patients with endogenous endophthalmitis due to K.pneumoniae liver abscess were analyzed.Ophthalmologic features of endophthalmitis at early,intermediate and advanced stages were obtained from eyes with endophthalmitis of different severities.Prompt vitrectomy was considered primarily for all eyes except for very early endophthalmitis.Intravitreal injections of antibiotics were performed in eyes with endophthalmitis in the very early stages and in eyes where vitrectomy was not available,and additional control of infection was needed after vitrectomy.Evisceration was performed in eyes with corneoscleral perforation,advanced endophthalmitis,perforation with preseptal or orbital cellulitis,uncontrolled infection,or severe pain with no vision.RESULTS:Mean(±standard deviation)age of the 18 patients with endophthalmitis was 64.5±12.2(range:32-84)y,and 14 patients(77.8%)were males.Endophthalmitis tended to involve the retinal parenchyma first and then progressed into the vitreous cavity and anterior segments.However,it presented a tendency to cause massive subretinal abscesses even after vitrectomy with silicone oil tamponade.Very high intraocular pressure with new vessels on the iris(41.7%)were also commonly observed.Although all but three patients had systemic disease such as diabetes or hypertension,visual prognosis after treatment did not appear to depend significantly on underlying comorbidities.A final best-corrected visual acuity better than 20/60 was achieved only when lesions were detected very early,with relatively good initial visual acuity,likely reflecting lower bacterial inoculation in the eye.CONCLUSION:Detection of early endophthalmitis lesions appears to be the only way to preserve good vision in patients with K.pneumoniae liver abscesses.Therefore,proper guidelines for ophthalmologic screening remain to be established for subjects at a high risk of endophthalmitis.
