Background
Drug-drug interactions are frequently observed in kidney transplant recipients due to polypharmacy and use of immunosuppressants. However, there is only one study evaluating clinically ...relevant potential drug-drug interactions of immunosuppressants specially in kidney transplant recipients by means of online databases and Stockleys Drug Interactions, as a gold standard.
Aim
This study aimed to compare four online databases used frequently to determined clinically relevant potential drug-drug interactions of immunosuppressants in kidney transplant recipients according to the Renal Drug Handbook.
Method
This was a descriptive cross-sectional study conducted between October 1, 2019, and March 18, 2020, in the nephrology ward of Ankara University School of the Medicine, Ibn-i Sina Hospital. In total, 52 adult patients’ discharge prescriptions were retrieved from their medical records and analyzed retrospectively. Micromedex®, Lexicomp®, Medscape, and Drugs.com databases were used to evaluate drug interactions. The Renal Drug Handbook was used as a gold standard to do specificity and sensitivity analysis.
Results
A total of 127 potential drug-drug interactions between the immunosuppressants and co-medications were detected by at least one online database. 32 (25.2%) of these were approved as clinically relevant potential drug-drug interactions by the Renal Drug Handbook. Lexicomp® and Drugs.com have exhibited the highest sensitivity (0.72 and 0.75) while Micromedex® has shown the highest specifity (0.83). Furthermore, the highest positive predictive value has been observed in Micromedex® (0.53). Micromedex® and Medscape had the highest negative predictive value (0.83 and 0.82). However, the kappa value of all was low. The values of inter-rater agreement (Kappa index) between online databases and the Renal Drug Handbook were weak (range 0.05–0.36). In addition, only 11 (8.7%) of potential drug-drug interactions were identified by all online databases.
Conclusion
This study showed that there was a weak compatibility between each database examined and the Renal Drug Handbook to detect clinically relevant potential drug-drug interactions for immunosuppressants in kidney transplant recipients. Therefore, we suggest that although databases might be practical to take a quick glance in detection of potential drug-drug interactions between immunosuppressants and co-medications, the data should be evaluated in detail and interpreted with caution in combination with a reference book like Renal Drug Handbook.
This article explores the needs of Chinese beginner learners regarding a pocket guide to using Chinese social deixis. The method used is descriptive qualitative with data collection techniques in the ...form of questionnaires. The questionnaire was distributed through Google Forms to 40 first and second-semester students or the equivalent of CEFR A1 and A2 standards or HSK levels 1 and 2 in the Chinese Language Education Study Program at the State University of Jakarta. The results of this study are 73.1% of students have a non-Chinese background, and 92.9% of students' parents do not speak Chinese, so students can only learn Chinese in the campus environment. 53.8% of students have difficulty translating and interpreting social deixis that appears in texts and dialogues. In Chinese communication, 65.4% of students feel insecure about the accuracy of the greetings they use. 96.6% of students stated that they needed a guidebook for using social deixis by compiling a list of greeting words based on the textbook's chapter order.
The battle for Europe in 1943-45 was one of the greatest military challenges in the history of the U.S. Army. Fighting against often veteran German forces from the mountains of Italy to the beaches ...of Normandy and the frozen forests of the Ardennes, hundreds of thousands of US infantrymen had to move quickly beyond their training and acquire real-world combat skills with extraordinary pace if they were to raise their chances of survival beyond a few days. They fought in an age of total war, in which the enemy deployed heavy armor, artillery, air power, and their own infantry firepower in a battle of true equals. Without the drive and blood of the U.S. Army infantry, the Allies could not have defeated the Wehrmacht in Western Europe.Extensive documentation was provided for the in-theater US Army infantryman, from booklets rather misguidedly advising on how to behave in foreign countries through to field manuals explaining core combat tactics across squad, platoon, company, and battalion levels. This pocket manual presents critical insights from many of these sources, but also draws on a broad spectrum of intelligence reports, after-action reports, and other rare publications. Together they give an inside view on what it was like to live and fight in the U.S. Army infantry during arguably the most consequential conflict in human history.
What is cultural about vision--or visual about culture? In this ambitious book, Whitney Davis provides new answers to these difficult and important questions by presenting an original framework for ...understanding visual culture. Grounded in the theoretical traditions of art history, A General Theory of Visual Culture argues that, in a fully consolidated visual culture, artifacts and pictures have been made to be seen in a certain way; what Davis calls "visuality" is the visual perspective from which certain culturally constituted aspects of artifacts and pictures are visible to informed viewers. In this book, Davis provides a systematic analysis of visuality and describes how it comes into being as a historical form of vision. Expansive in scope, A General Theory of Visual Culture draws on art history, aesthetics, the psychology of perception, the philosophy of reference, and vision science, as well as visual-cultural studies in history, sociology, and anthropology. It provides penetrating new definitions of form, style, and iconography, and draws important and sometimes surprising conclusions (for example, that vision does not always attain to visual culture, and that visual culture is not always wholly visible). The book uses examples from a variety of cultural traditions, from prehistory to the twentieth century, to support a theory designed to apply to all human traditions of making artifacts and pictures--that is, to visual culture as a worldwide phenomenon.
Updated in this third edition for Photoshop CC 2021, this full-color book provides users of Photoshop: CC with comprehensive hands-on learning projects using a building block teaching style. Whether ...you are new to Photoshop or an experienced user, this book is packed with inventive, easy to apply photograph restoration and tonal correction techniques. Learn to repair all types of photograph damage, various ways to improve discolored photographs, colorize black and white photographs, multiple ways to digitize photographs too large to scan, and how to add and remove content from your photographs so that every photograph will be "the perfect shot." With many new tips, notes, figures, and projects to guide you from start to finish, learn to create professionalrestorations and enhancements you will be proud to call your own.Features:Updated for Photoshop CC 2021Includes seven demonstration videos on how to perform key restoration and enhancement techniquesFeatures hands on projects provided with each chapter specifically tailored to reinforce the tools and techniques introduced in the chapterWith enhanced full-color figures and more trade secrets, this new edition makes learning photograph restoration and enhancement easier yet more comprehensive than ever.Companion Files (includedwith this text and also available for downloading by writing to the publisherat info@merclearning.com):Photographs to complete all projects covered in the textExtra Try It Yourself Projects for each chapterCopies of all figures used in the text7 Demonstration videos
The goal of the paper is to highlight the management of the complexities and risks for light non-aqueous phase liquid (LNAPL) sites, and how the Illustrated Handbook of LNAPL Transport and Fate in ...the Subsurface (CL:AIRE, London. ISBN 978-1-905046-24-9. http://www.claire.co.uk/LNAPL; “LNAPL illustrated handbook”) is useful guidance and a tool for professionals to understand these complexities and risks. The LNAPL illustrated handbook provides a clear and concise best-practice guidance document, which is a valuable decision support tool for use in discussions and negotiations regarding LNAPL impacted sites with respect to the risks of LNAPL. The LNAPL illustrated handbook is a user-friendly overview of the nature of LNAPL contamination in various geological settings including unconsolidated, consolidated, and fractured rock environments to best understand its fate and behavior leading to the appropriate management and/or remedial approach of the two major risks associated with a LNAPL source. As a source term, LNAPL has chemicals that form dissolved- and vapor-phase plumes, which are referred to as composition-based risks; and being a liquid there is the risk that the source may expand impacting a greater volume of the aquifer, which are referred to as saturation-based risks. There have been significant developments in recent years on the understanding of the complex behavior of LNAPL and associated groundwater and vapor plumes; however, the state of practice has often lagged these improvements in knowledge. The LNAPL illustrated handbook aids the site investigator, site owners, and regulators to understand these risks, and understand how these risks behave through better conceptual understanding of LNAPL transport and fate in the subsurface.
Display omitted
•Management of the complexities and risks, both composition- and saturation-based, of LNAPL sites.•Better conceptual understanding of LNAPL transport and fate in the subsurface.•More effective site-characterization and robust risk prediction.•Risk-based management of LNAPL releases that is more sustainable.
The calculation of neutron physics in nuclear reactors is the most basic research content in the design and safety analysis of nuclear reactor systems, and the accuracy and confidence of the ...calculation results directly affect the evaluation of the safety and economy of nuclear reactors. The core physics multi-group constant library provides cross-section data and burn-up data for the calculation of neutron physics of nuclear reactors, which is the basis and guarantee of reactor physical calculation, and the accuracy of multi-group constant data in the core physics library directly affects the accuracy of reactor physical calculation and reactor design. At present, the international verification of multi-group constant library is usually carried out by simulating the critical experiments of the multi-group constant library coupling lattices calculation codes to be verified. The critical experiments in the International Handbook on Nuclear Criticality Safety (ICSBEP) are an important means to verify the accuracy and reliability of the nuclear library and neutron transport calculation codes, and the uranium and plutonium solution experiments with pure nuclide content and sensitive 1H/235U ratio under different spectral indexes in the ICSBEP are very suitable for verifying the data of the scattering cross section, the capture cross section of 1H, and the fission spectrum and absorption cross section of the 235U, 238U, 239Pu, 240Pu and other nuclide thermal energy points in the multi-group constant library. The critical experiments in ICSBEP are all three-dimensional experiments, and the two-dimensional modeling of the three-dimensional experimental setup is one of the keys to the verification of the multi-group constant library of core physics, and the accuracy of the model directly affects the accuracy of the verification results. Due to the limitations of the geometric processing method, the calculation code of each component cannot model the spherical device, so there is no benchmark method for the multi-group constant library based on the spherical critical benchmark experiments. In this paper, a modeling method for spherical experimental devices was proposed, which greatly increased the selection range of benchmark experiments used in critical benchmarking. At the same time, based on the international criticality safety benchmark evaluation project (ICSBEP2006), 49 uranium and plutonium solution experiments under different energy spectrum indicators were selected to conduct criticality benchmarking on the core physical multi-group constant library developed by China Nuclear Data Center (CNDC), and the reference results range of benchmark experiments under different energy spectrum indicators were given. The results of this paper can expand the scale and coverage of the benchmark of the core physical multi-group constant library, and help to further improve the accuracy of the high-fidelity core physical calculation codes.
The Routledge Handbook of Chinese Culture and Society is an interdisciplinary resource that offers a comprehensive overview of contemporary Chinese social and cultural issues in the twenty-first ...century.
Bringing together experts in their respective fields, this cutting-edge survey of the significant phenomena and directions in China today covers a range of issues including the following:
State, privatisation and civil society
Family and education
Urban and rural life
Gender, and sexuality and reproduction
Popular culture and the media
Religion and ethnicity
Forming an accessible and fascinating insight into Chinese culture and society, this handbook will be invaluable to students and scholars across a range of disciplines, including anthropology, sociology, area studies, history, politics and cultural and media studies.
Paediatric cardiology fellows, tasked with studying a large and dynamic field, may benefit from a quick-access digital resource that reflects contemporary practice. The objective of this study was to ...evaluate the effectiveness of a paediatric cardiology handbook smartphone app in enhancing the accessibility of information such as guidelines and recommendations for paediatric cardiology fellows.
The Peds Cardiology Handbook app (iOS) was designed using XCode and Swift programming. A pre-app survey and download instructions were sent to the US paediatric cardiology fellows, followed by a post-app survey. Fellows were asked to rate the ease of rapid access to various types of information. Responses were compared pre- and post-app using McNemar's test and Wilcoxon signed-rank test.
Two-hundred and thirty paediatric cardiology fellows were contacted; 23% (n = 53) completed both the pre- and post-app surveys and were included for analysis. After using the app, fellows found it easier to quickly access information in eight out of nine domains evaluated (p < 0.05). All fellows found the app easy to use (100%), most felt that the app was well-organised (98%), contained reliable information (92%), and was useful for finding quick answers to clinical questions (87%).
The Peds Cardiology Handbook iPhone app is a useful, reliable tool that provides quick access to high-yield information, including guidelines and references. Overall, paediatric cardiology fellows found it easier to rapidly access clinically relevant information after using the app. Future studies may be necessary to evaluate long-term use and impact on evidence-based practice.
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