Pharmaceutical Care in Kidney Transplant Recipients: Behavioral and Physiologic Outcomes at 12 Months.

BACKGROUND: A variety of complex drug regimens are offered to kidney transplant recipients after transplantation. This study aimed to evaluate the behavioral and physiological outcomes of pharmaceutical care in this population. METHODS: A cross-sectional prospective study was conducted, which collected and categorized kidney transplant recipients according to pharmaceutical care. In the IR group, patients had received irregular pharmaceutical care after transplantation, and in the RE group, patients had received regular intervention. Intervention included face-to-face interview, checkup for laboratory examinations, discovery of drug-related problems, and pharmaceutical consultation. Baseline knowledge for self-care was tested for patients in both groups. Correct concepts and medication guidance were consistently provided to enable patients to understand the importance of rejection prevention and knowledge for medication and renal care after transplantation. After 12 months, the same test was used to evaluate the outcomes for pharmaceutical care and a satisfaction questionnaire was used to assess for pharmacy service. RESULTS: The study results revealed that patients in the RE group possessed better knowledge for self-care (P < .001); however, the differences at 12 months became insignificant (P = .72) after patients in the IR group had also received routine pharmaceutical care. Besides, serum creatinine level of the RE patients was stable without significant variation (P = .93), but it demonstrated a rising trend in IR patients (P < .01). Patients were greatly satisfactory with the intervention. CONCLUSIONS: A consistent post-transplantation pharmaceutical care service is effective to substantially improve knowledge of post-transplantation self-care. Pharmaceutical care should be started as early as possible during the pre-transplant period and continue in a long-term follow-up.

Mechanical responses of a-axis GaN nanowires under axial loads.

Gallium nitride (GaN) nanowires (NWs) hold technological significance as functional components in emergent nano-piezotronics. However, the examination of their mechanical responses, especially the mechanistic understanding of behavior beyond elasticity (at failure) remains limited due to the constraints of in situ experimentation. We therefore performed simulations of the molecular dynamics (MD) of the mechanical behavior of [Formula: see text]-oriented GaN NWs subjected to tension or compression loading until failure. The mechanical properties and critical deformation processes are characterized in relation to NW sizes and loading conditions. Detailed examinations revealed that the failure mechanisms are size-dependent and controlled by the dislocation mobility on shuffle-set pyramidal planes. The size dependence of the elastic behavior is also examined in terms of the surface structure determined modification of Young's modulus. In addition, a comparison with c-axis NWs is made to show how size-effect trends vary with the growth orientation of NWs.

Optimal time window of myelotomy in rats with acute traumatic spinal cord injury: a preliminary study.

OBJECTIVES: Pathophysiological mechanisms underlying spinal cord injury (SCI) partially involve edema and formation of a hematoma. Myelotomy seems to be a promising intervention. However, the appropriate timing of myelotomy is still unknown in SCI. Here we aimed to determine the timing of microsurgical myelotomy in an animal model of SCI. METHODS: The SCI model was contusion-induced with a new york university impactor. Sixty-five adult female rats were randomly divided into the following groups: laminectomy alone (the 'sham group', SG), laminectomy plus contusion (the 'contusion group', CG) or laminectomy plus contusion followed by myelotomy at 8, 24 or 48 h (8 h-MTG [myelotomy-treated group], 24 h-MTG or 48 h-MTG). Functional recovery was evaluated via the open field test and the inclined plane test every week after SCI. The percentage of spared white matter area (SWMA) and ultrastructure characteristics of the injured dorsolateral spinal cord were determined on the 42nd day after SCI. RESULTS: Compared with the CG, myelotomy at 8 h-MTG or 24 h-MTG greatly improved the BASSO-BEATTIE- BRESNAHAN scores (P<0.008), whereas the 48 h-MTG showed less efficacy (P=0.023). All myelotomy groups showed higher mean angle values in an inclined plane test (P<0.005) and had greater percentages of SWMA than the CG. Rats in the 24 h-MTG showed a higher intra-axonal fraction and myelin fraction than those in 48 h-MTG (P<0.005). CONCLUSION: Myelotomy up to 48 h after SCI improves recovery in rats. The potential time window of myelotomy may be between 8 and 24 h after SCI.

Finite element analysis modelling of proximal femoral fractures, including post-fixation periprosthetic fractures.

Biomechanical testing has been a cornerstone for the development of surgical implants used in fracture stabilisation. In a multi-disciplinary collaboration complex at the University of Wales, Swansea, novel computerised clinically relevant models were developed using advanced computational engineering. In-house software (developed initially for commercial aerospace engineering), allowed accurate finite element analysis (FEA) models of the whole femur to be created, including the internal architecture of the bone, by means of linear interpolation of greyscale images from multiaxial CT scans. This allowed for modelling the changing trabecular structure and bone mineral density as seen in progressive osteoporosis. Falls from standing were modelled in a variety of directions (with and without muscle action) using analysis programmes which resulted in fractures consistent with those seen in clinical practice. By meshing implants into these models and repeating the mechanism of injury in simulation, periprosthetic fractures were also recreated. Further development with simulated physiological activities (e.g. walking and rising from sitting) along with attrition in the bone (in the boundary zones where stress concentration occurs) will allow further known modes of failure in implants to be reproduced. Robust simulation of macro and micro-scale events will allow the testing of novel new designs in simulations far more complex than conventional biomechanical testing will allow.

Effect of carbon nanotube structural parameters on field emission properties.

Experimental studies were devoted to the effect of structural parameters, i.e., tube diameter and density, on the field electron emission characteristics of carbon nanotubes. Thermal chemical vapor deposition system was employed to synthesize carbon nanotubes. Nanotubes with different diameters and densities were obtained by adjusting the thickness of the iron (Fe) catalyst film. The morphologies of the Fe and carbon nanotube film were characterized by scanning electron microscopy respectively. Further field emission measurement confirmed that the tube diameter and density could significantly affect the electron emission properties of the carbon nanotube. Possible physical reasons for the effect are discussed.

The necessity for a collection development policy statement.

The heart of the library lies in its collections, and collections have to be built continuously. Budgetary constraints perforce stress the need for better defined collection development policy, although the ultimate goal should be an improvement of library service rather than any reduction of library cost. A written collection development policy facilitates a consistent and balanced growth of library resources, and a dynamic policy is one that evolves as the institution grows. Such a policy is based on the understanding of the needs of the community it serves and seeks to define and delimit the goals and objectives of the institution. A collection development statement is not a substitute for book selection; it charts the forest but does not plant the trees. It should be used as a guidepost, not a crutch. Book selection requires judgment and the courage to choose. A sound collection development policy, on the other hand, provides the necessary rational without which a collection may grow amoebalike, by means of pseudopodia.