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Piotr Merks,1 Regis Vaillancourt,2 Irene Dulai,2 Gloria Lamontagne,3 Jarosław Pinkas,4 Urszula Religioni,4 Dariusz Świetlik,5 Justyna Kaźmierczak,6 Eliza Blicharska,7 Mike Zender,8 Jameason Cameron2 1Department of Pharmacology and Clinical Pharmacology, Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszyński University in Warsaw, Warsaw, Poland; 2Pharmacy Department, Children’s Hospital of Eastern Ontario, Ottawa, Ontario, Canada; 3Biomedical Sciences Faculty, University of Ottawa, Ottawa, Ontario, Canada; 4School of Public Health, Centre of Postgraduate Medical Education of Warsaw, Warsaw, Poland; 5Department of Biostatistics and Neural Networks, Medical University of Gdansk, Gdansk, Poland; 6Zdrowit Sp. Z O.o, Pharmacy Chain, Piekary Śląskie, Poland; 7Department of Pathobiochemistry and Interdisciplinary Applications of Ion Chromatography, Medical University of Lublin, Lublin, Poland; 8School of Design, University of Cincinnati, Cincinnati, OH, USACorrespondence: Urszula Religioni, School of Public Health, Centre of Postgraduate Medical Education of Warsaw, Kleczewska 61/63, Warsaw, 01-826, Poland, Tel +48225693700, Email urszula.religioni@gmail.comIntroduction: Pain is both difficult to see and to articulate and this is challenging for both patients and clinicians. The aim of this study was to develop and test pictograms to describe different pain qualities.Methods: 22 pictograms were developed for evaluation based on pain qualities of the short form McGill Pain Questionnaire, version 2 (SF-MPQ-2). An online matching survey was conducted and disseminated via social media in 2021.Results: An overall matching of 66% or higher between pictogram and pain qualities descriptors was considered a proper matching. This study was carried out internationally (males = 57, age=41y.o. ± 16; females = 155, age=41y.o.± 17) and in Poland (males=49, age =35y.o.± 17; females = 164, age=35y.o.± 16). There were 14 pictograms that did not achieve 66% matching in any country. 8 pictograms mutually in all subgroups achieved a matching score of ≥ 66% regardless of geographic location, sex, income, or education level.Discussion and Conclusions: These 8 pictograms can be used clinically once they have been redrawn to improve consistency, and future research in the design of pictograms representing pain qualities of the SF-MPQ-2 should focus on design improvements for the remaining 14 pain qualities with poor comprehensibility.Keywords: pain, pictograms, health literacy, SF-MPQ-2, pain comprehension

Piotr Merks,1,2,* Damian Świeczkowski,3,* Marcin Balcerzak,4 Ewelina Drelich,4 Katarzyna Białoszewska,5 Natalia Cwalina,3 Jerzy Krysinski,1 Miłosz Jaguszewski,3 Annie Pouliot,6 Regis Vaillancourt6 1Department of Pharmaceutical Technology, Collegium Medicum in Bydgoszcz, Nicolaus University in Torun, Bydgoszcz-Torun, Poland; 2Piktorex Sp. z.o.o., Warsaw, Poland; 3First Department of Cardiology, Medical University of Gdansk, Gdansk, Poland; 4Farenta Polska, Warsaw, Poland; 5Department of Medical Psychology, Medical University of Warsaw, Warsaw, Poland; 6Children’s Hospital of Eastern Ontario, Ottawa, ON, Canada *These authors contributed equally to this work Introduction: The search for new ways to optimize the use of medications by patients has led the pharmaceutical community to promote the idea of introducing pictograms into routine practice. The main intention of pictograms is to ease patient adherence and to reduce potential risks or errors associated with the use of medications. Purpose: To evaluate a series of pharmaceutical pictograms for patient comprehension. Patients and methods: The study was conducted in community pharmacies within a European Union country that belongs to the professional research network. Structured interviews were used to evaluate the pictograms for patient comprehension. This consisted of an assessment of the following: the transparency and translucency of the pictograms, health literacy, and pictogram recall. Participants were also given the opportunity to provide feedback on how to improve the pictograms. The primary endpoint was pictogram comprehension. Secondary outcomes included recall of the pictograms and pictogram translucency. Results: The study included 68 patients with whom face-to-face interviews were performed. Low transparency results (≤25%) and extensive patient feedback in initial interviews led to the withdrawal of certain pictograms (n=15) from the evaluation. Among the pictograms included in the final stage of our research, 22 pictograms (62.8%) obtained an acceptable transparency level ≥66%. All pictograms passed the short-term recall test with positive results. Conclusion: A majority of the designed and modified pictograms reached satisfactory guessability scores. Feedback from patients enabled modification of the pictograms and proved that patients have an important voice in the discussion regarding the design of additional pictograms. Keywords: pharmaceutical pictograms, elderly population, health literacy, community pharmacy, Poland

Background: Vancomycin is used primarily for Gram-positive infections. Recommended dosage regimens and targeted therapeutic levels vary between institutions. Objectives: This study aims to describe therapeutic levels according to initial vancomycin doses and patient’s age. A secondary objective was to evaluate appropriateness of vancomycin use in our hospital. Methods: A retrospective chart review was conducted at the Children’s Hospital of Eastern Ontario. Patients included in this study were classified by age (neonates, infants, children and adolescents) and categorized into those who received vancomycin ≤5 and >5 days. Initial vancomycin dosing regimens and corresponding initial trough levels obtained were evaluated. Initial trough levels drawn in relation to the third, fourth, or fifth doses corresponding to the first course of therapy were analyzed. Acceptable trough levels ranged from 5-20 mg/L. Results: One-hundred-and-sixty-four patients who received intravenous vancomycin in 2013 were included. Of the 229 courses of vancomycin, 190 (83%) were used 5 days or less (mean 4.9 days). Sixteen infants (88.9%) and 21 adolescents (100%), who received vancomycin empiric dosing of 60 mg/kg/day, had initial trough levels >5mg/L. However, in the children’s group 20 (37.7%) did not reach levels >5 mg/L. None of vancomycin minimum inhibitory concentration (MIC) values were >1mg/L for the four patients who had infections due to methicillin-resistant Staphylococcus aureus strains. Conclusions: In our institution, initial empiric vancomycin dosing of 60 mg/kg/day resulted in levels ≥5mg/L in most infants and adolescents. It remains unclear why some children aged 1-12 years did not achieve these levels.

The propagation of a dispersive shock wave is studied in a quintic-derivative nonlinear Schrodinger (Q-DNLS) equation, which may describe, Por example, the wave propagation on a discrete electrical transmission line. II is shown that a physical system described by a Q-DNLS equation without a dissipative term may support the propagation of shock waves. The influence of the derivative nonlinearity terms on the shock is analyzed. Using the round exact shock solutions of the Q-DNLS equation as the initial input signal, we investigate numerically the spatiotemporal stability of the shock signal in the network. PACS Nos: 42.65.Tg, 42.25.Bs, 84.40.Az, 02.60.Cb Nous etudions la propagation d'une onde de choc dispersive a l'aide d'une equation differentielle quintique non lineaire de Schrodinger (equation Q-DNLS), qui peut decrire, par exemple. la propagation d'onde sur une ligne de transmission electrique discrete. Nous montrons qu'un systeme physique decrit par une equation Q-DNLS sans terme dissipatif peut permettre la propagation d'onde de choc. Nous etudions l'influence des termes non lineaires en derivee sur l'onde de choc. Utilisant comme signal de depart, la solution exacte pour l'onde de choc obtenue de l'equation Q-DNLS, nous etudions la stabilite spatiotemporelle du signal de choc dans la ligne. [Traduit par la Redaction], 1. Introduction Since the pioneering works by Hirota and Suzuky [l] on electrical transmission lines simulating the Toda lattice, a growing interest has been devoted to the use of the [...]

The modified Ginzburg-Landau equation that describes the pulse propagation in a lossy electrical transmission line is used to derive an eigenvalue problem that allows a detailed investigation of the modulational stability of the solitary states in the line. It is found that the growth rates of the perturbation are complex functions of the spatial variable and that, in general, the solitary states in the network can be either modulationally stable, unstable, or destabilized under a given perturbation function. PACS Nos: 42.65.Wi,84.40.Az, 02.30.Jr,05.45.Yv Nous utilisons l'equation modifieee de Ginzburg-Landau qui decrit la propagation d'une impulsion dans une ligne de transmission avec pertes ohmiques, afin d'obtenir le probleme aux valeurs propres qui permet une etude detaillee de la stabilite en modulation de l'onde solitaire dans la ligne. Nous trouvons que les taux de croissance de la perturbation sont des fonctions complexes de la variable d'espace et que, en general, les etats solitaires dans le reseau peuvent etre stables en modulation, instables ou deestabilisees selon la fonction de perturbation. [Traduit par la Redaction], 1. Introduction Distributed electrical transmission lines consisting of a large number of identical sections have been used for theoretical and experimental study of nonlinear propagation of signals. About a decade [...]

Background and Aims Hybridization is increasingly recognized as an integral part of the dynamics of species range expansion and contraction. Thus, it is important to understand the reproductive barriers between co-occurring species. Extending previous studies that argued that the rare Eucalyptus risdonii was expanding into the range of the surrounding E. amygdalina by both seed and pollen dispersal, we here investigate the long-term fitness of both species and their hybrids and whether expansion is continuing. Methods We assessed the survival of phenotypes representing a continuum between the two pure species in a natural hybrid swarm after 29 years, along with seedling recruitment. The performance of pure species as well as of artificial and natural hybrids was also assessed over 28 years in a common garden trial. Key Results In the hybrid zone, E. amygdalina adults showed greater mortality than E. risdonii , and the current seedling cohort is still dominated by E. risdonii phenotypes. Morphologically intermediate individuals appeared to be the least fit. Similar results were observed after growing artificial first-generation and natural hybrids alongside pure species families in a common garden trial. Here, the survival, reproduction, health and growth of the intermediate hybrids were significantly less than those of either pure species, consistent with hybrid inferiority, although this did not manifest until later reproductive ages. Among the variable progeny of natural intermediate hybrids, the most E. risdonii -like phenotypes were the most fit. Conclusions This study contributes to the increasing number of reports of hybrid inferiority in Eucalyptus , suggesting that post-zygotic barriers contribute to the maintenance of species integrity even between closely related species. However, with fitness rapidly recovered following backcrossing, it is argued that hybridization can still be an important evolutionary process, in the present case appearing to contribute to the range expansion of the rare E. risdonii in response to climate change. [ABSTRACT FROM AUTHOR]

The database on ocean primary productivity comprises over two decades (1985–2008) of data that the authors have participated in collecting, using the assimilation of inorganic 14C through photosynthesis, in incubations carried out in situ. The dataset is perhaps unique in that it uses, overwhelmingly, consistent methodology while covering a wide geographic range. Ancillary data are included. Using the database, it is hoped that investigators can test for the relationships among the environmental drivers for ocean productivity, the meaning of the 14C method in terms of phytoplankton physiology and the dynamics in the water column, and as a resource for further development of productivity algorithms using satellite ocean color imagery. [ABSTRACT FROM AUTHOR]