Warfarin is a drug used for anticoagulation management, with a narrow therapeutic range and multiple drug-drug interactions. Adherence and proper use of concomitant medication are thus fundamental to the efficacy and safety of warfarin therapy. In 2012, we retrospectively analyzed data from three large-scale pharmacy chains in Japan. We included all adults (≥ 20 years old) with at least one record of warfarin dispensation. We examined patient demographic data, adherence as measured by medication possession ratio (MPR), and co-dispensation focusing on the number of concomitant dispensations and concurrent use of medications that increase bleeding risk. Thresholds of underadherence and overadherence were set at <0.9 and >1.1, considering the narrow therapeutic window. We reviewed 443007 warfarin dispensation records of 71340 individuals (median age, 73 years; 62% male). The MPR was 1.0 (interquartile range: 0.96-1.0), and underadherence and overadherence was found in 16.3 and 1.9% of individuals, respectively. The median number of co-dispensed drugs was eight at each pharmacy encounter, which did not differ by age group. Drugs associated with a high bleeding risk were dispensed in 40.0% of encounters and accounted for 16.4% of all co-dispensed drugs. In summary, we found optimal overall adherence, as assessed by MPR, among our Japanese study population, even when defining a strict cutoff value. However, polypharmacy was common in all age groups and medications with a high bleeding risk profile were often co-dispensed with warfarin. Future research addressing how these dispensation patterns affect patient outcome is warranted.

No abstract

Hydroinertia gas journal bearings have been applied to solid state nuclear magnetic resonance spectroscopy.These bearings, which require a larger radial clearance than conventional externally pressurized bearings, achieve stable operation for ultra high-speed rotation of spinner shaft at several million rpm. However, their small diameters, which range within 1-6 mm, have limited experimental verifications of their static characteristics. A computational fluid dynamics analysis was therefore performed to fill this gap. The effects of radial clearance and gas supply hole number on bearing characteristics, such as pressure distribution and load capacity, were investigated. This analysis showed that negative and positive pressures generated some clearance. Pressure distribution also changes in the gas supply hole number. A large load capacity was obtained at this clearance. To verify the phenomenon, measurement of pressure distribution was performed using experimental setup. Negative pressure could be confirmed actually in the large radial clearance condition.

No abstract

No abstract