Continuity of medication information transfer and continuous medication supply during hospital-to-home transitions - nationwide surveys in hospital and community pharmacies after implementing new legal requirements in Germany.

Background: While successful information transfer and seamless medication supply are fundamental to medication safety during hospital-to-home transitions, disruptions are frequently reported. In Germany, new legal requirements came into force in 2017, strengthening medication lists and discharge summaries as preferred means of information transfer. In addition to previous regulations - such as dispensing medication at discharge by hospital pharmacies - hospital physicians were now allowed to issue discharge prescriptions to be supplied by community pharmacies.

A long-acting LEAP2 analog reduces hepatic steatosis and inflammation and causes marked weight loss in mice.

Objective: The number of individuals affected by metabolic dysfunction associated fatty liver disease [1] is on the rise, yet hormonal contributors to the condition remain incompletely described and only a single FDA-approved treatment is available. Some studies suggest that the hormones ghrelin and LEAP2, which act as agonist and antagonist/inverse agonist, respectively, for the G protein coupled receptor GHSR, may influence the development of MAFLD. For instance, ghrelin increases hepatic fat whereas synthetic GHSR antagonists do the opposite.

Ghrelin deletion and conditional ghrelin cell ablation increase pancreatic islet size in mice.

Ghrelin exerts key effects on islet hormone secretion to regulate blood glucose levels. Here, we sought to determine whether ghrelin's effects on islets extend to the alteration of islet size and β cell mass. We demonstrate that reducing ghrelin - by ghrelin gene knockout (GKO), conditional ghrelin cell ablation, or high-fat diet (HFD) feeding - was associated with increased mean islet size (up to 62%), percentage of large islets (up to 854%), and β cell cross-sectional area (up to 51%).

Ghrelin-responsive mediobasal hypothalamic neurons mediate exercise-associated food intake and exercise endurance.

Previous studies have implicated the orexigenic hormone ghrelin as a mediator of exercise endurance and the feeding response postexercise. Specifically, plasma ghrelin levels nearly double in mice when they are subjected to an hour-long bout of high-intensity interval exercise (HIIE) using treadmills. Also, growth hormone secretagogue receptor-null (GHSR-null) mice exhibit decreased food intake following HIIE and diminished running distance (time until exhaustion) during a longer, stepwise exercise endurance protocol.

Ghrelin does not impact the blunted counterregulatory response to recurrent hypoglycemia in mice.

Introduction: Recurrent episodes of insulin-induced hypoglycemia in patients with diabetes mellitus can result in hypoglycemia-associated autonomic failure (HAAF), which is characterized by a compromised response to hypoglycemia by counterregulatory hormones (counterregulatory response; CRR) and hypoglycemia unawareness. HAAF is a leading cause of morbidity in diabetes and often hinders optimal regulation of blood glucose levels. Yet, the molecular pathways underlying HAAF remain incompletely described.

Effects of thermoneutrality on food intake, body weight, and body composition in a Prader-Willi syndrome mouse model.

Objective: Prader-Willi syndrome (PWS) is a multisystem genetic disorder. Unfortunately, none of several mouse models carrying PWS mutations emulates the entirety of the human PWS phenotype, including hyperphagia plus obesity.

Methods: To determine whether housing at thermoneutrality (TN, 30 °C) permits the development of hyperphagia and obesity in the Snord116del PWS mouse model, the effects of housing three different ages of Snord116del and wild-type (WT) littermates at TN versus room temperature (RT, 22-24 °C) for 8 weeks were compared.

Multiple-wavelength range-gated active imaging applied to the evaluation of simultaneous movement of millimeter-size objects moving in a given volume.

The combined multiple-wavelength range-gated active imaging (WRAI) principle is able to determine the position of a moving object in a four-dimensional space and to deduce its trajectory and its speed independently of the video frequency. However, when the scene size is reduced and the objects have a millimeter size, the temporal values intervening on the depth of the visualized zone in the scene cannot be reduced further because of technological limitations. To improve the depth resolution, the illumination type of the juxtaposed style of this principle has been modified.

A mad yearning for solitude: Timon the Misanthrope and his relevance to the study of ancient psychopathology.

Ancient Greek and Latin medical authors considered a flight into solitude a compelling sign of mental disturbance, frequently described as misanthropia, a word fraught with meaning beyond the medical discourse. The fictionalised character Timon of Athens, the quintessential misanthrope, can shed light on ancient cultural concepts of self-imposed isolation from human contact. To cope with the sense of unease this deviant behaviour induced, misanthropia was explained as 'madness', ridiculed in various genres of humour, morally condemned in philosophy, and ultimately demonized in Christian cosmology.

Achieving greater value for veterans through full cost transparency in primary care.

The COVID-19 pandemic has led to increased use of telephone and video encounters in the Veterans Health Administration and many other healthcare systems. One important difference between these virtual modalities and traditional face-to-face encounters is the different cost-sharing, travel costs, and time costs that patients face. Making the full costs of different visit modalities transparent to patients and their clinicians can help patients obtain greater value from their primary care encounters.

Fine-grained population mapping from coarse census counts and open geodata.

Fine-grained population maps are needed in several domains, like urban planning, environmental monitoring, public health, and humanitarian operations. Unfortunately, in many countries only aggregate census counts over large spatial units are collected, moreover, these are not always up-to-date. We present POMELO, a deep learning model that employs coarse census counts and open geodata to estimate fine-grained population maps with [Formula: see text]m ground sampling distance.

Live synthesis.

Synthesis automatically constructs an implementation that satisfies a given logical specification. In this paper, we study the problem, where the synthesized implementation replaces an already running system. In addition to satisfying its own specification, the synthesized implementation must guarantee a sound transition from the previous implementation.

Technical and Economic Analysis of Fuel Cells for Forklift Applications.

This study compared the life cycle cost (LCC) of LiFePO battery, proton exchange membrane fuel cell (PEMFC), and direct methanol fuel cell (DMFC) as the main power source of electric forklifts. The battery showed the lowest LCC over 10 years ($14,935) among the three power sources, thanks to the significant price reduction in recent years. The fuel cost accounted for more than 70% of the total LCC of PEMFC ($36,682) when the hydrogen price was $8/kg.

Visual Analysis of Hyperproperties for Understanding Model Checking Results.

Model checkers provide algorithms for proving that a mathematical model of a system satisfies a given specification. In case of a violation, a counterexample that shows the erroneous behavior is returned. Understanding these counterexamples is challenging, especially for hyperproperty specifications, i.

Ghrelin cell-expressed insulin receptors mediate meal- and obesity-induced declines in plasma ghrelin.

Mechanisms underlying postprandial and obesity-associated plasma ghrelin reductions are incompletely understood. Here, using ghrelin cell-selective insulin receptor-KO (GhIRKO) mice, we tested the impact of insulin, acting via ghrelin cell-expressed insulin receptors (IRs), to suppress ghrelin secretion. Insulin reduced ghrelin secretion from cultured gastric mucosal cells of control mice but not from those of GhIRKO mice.

LEAP2 deletion in mice enhances ghrelin's actions as an orexigen and growth hormone secretagogue.

Objective: The hormone liver-expressed antimicrobial peptide-2 (LEAP2) is a recently identified antagonist and an inverse agonist of the growth hormone secretagogue receptor (GHSR). GHSR's other well-known endogenous ligand, acyl-ghrelin, increases food intake, body weight, and GH secretion and is lowered in obesity but elevated upon fasting. In contrast, LEAP2 reduces acyl-ghrelin-induced food intake and GH secretion and is found elevated in obesity but lowered upon fasting.

High Coexpression of the Ghrelin and LEAP2 Receptor GHSR With Pancreatic Polypeptide in Mouse and Human Islets.

Islets represent an important site of direct action of the hormone ghrelin, with expression of the ghrelin receptor (growth hormone secretagogue receptor; GHSR) having been localized variably to alpha cells, beta cells, and/or somatostatin (SST)-secreting delta cells. To our knowledge, GHSR expression by pancreatic polypeptide (PP)-expressing gamma cells has not been specifically investigated. Here, histochemical analyses of Ghsr-IRES-Cre × Cre-dependent ROSA26-yellow fluorescent protein (YFP) reporter mice showed 85% of GHSR-expressing islet cells coexpress PP, 50% coexpress SST, and 47% coexpress PP + SST.

Disrupting the ghrelin-growth hormone axis limits ghrelin's orexigenic but not glucoregulatory actions.

Objective: Acyl-ghrelin regulates eating, body weight, blood glucose, and GH secretion upon binding to its receptor GHSR (growth hormone secretagogue receptor; ghrelin receptor). GHSR is distributed in several brain regions and some peripheral cell-types including pituitary somatotrophs. The objective of the current study was to determine the functional significance of acyl-ghrelin's action on GHSR-expressing somatotrophs in mediating GH secretion and several of acyl-ghrelin's metabolic actions.

Evaluation of a risk assessment model to predict infection with healthcare facility-onset Clostridioides difficile.

Purpose: We evaluated a previously published risk model (Novant model) to identify patients at risk for healthcare facility-onset Clostridioides difficile infection (HCFO-CDI) at 2 hospitals within a large health system and compared its predictive value to that of a new model developed based on local findings.

Methods: We conducted a retrospective case-control study including adult patients admitted from July 1, 2016, to July 1, 2018. Patients with HCFO-CDI who received systemic antibiotics were included as cases and were matched 1 to 1 with controls (who received systemic antibiotics without developing HCFO-CDI).

Ghrelin Protects Against Insulin-Induced Hypoglycemia in a Mouse Model of Type 1 Diabetes Mellitus.

Insulin-induced hypoglycemia is a major limiting factor in maintaining optimal blood glucose in patients with type 1 diabetes and advanced type 2 diabetes. Luckily, a counterregulatory response (1) system exists to help minimize and reverse hypoglycemia, although more studies are needed to better characterize its components. Recently, we showed that the hormone ghrelin is permissive for the normal CRR to insulin-induced hypoglycemia when assessed in mice without diabetes.