With the rapid development of clinical pharmacy in China, therapeutic drug monitoring (TDM) has become an essential tool for guiding rational clinical drug use and is widely concerned. TDM is a tool that combines pharmacokinetic and pharmacodynamic knowledge to optimize personalized drug therapy, which can improve treatment outcomes, reduce drug-drug toxicity, and avoid the risk of developing drug resistance. To effectively implement TDM, accurate and sophisticated analytical methods are required. By researching the literature published in recent years, we summarize the types of commonly monitored drugs, therapeutic windows, and clinical assays and track the trends and hot spots of therapeutic drug monitoring. The purpose is to provide guidelines for clinical blood drug concentration monitoring, to implement individualized drug delivery programs better, to ensure the rational use of drugs for patients, and to provide a reference for the group to carry out related topics in the future.

Despite the strong decrease in antimicrobial use in the French poultry and pig sectors over the last decade, room for improvement remains. A participatory approach was set up in France, involving representatives of veterinarians, the pig and poultry industries, technical institutes, the French Ministry of Agriculture, and researchers, to further improve how antimicrobials are used on farms. By successively defining a shared, long-term vision of future antimicrobial use on farms, identifying lock-in mechanisms impeding this future vision from being realized, and articulating practical questions on how to move in the desired direction, the group rapidly reached a consensus. The results highlight the need for consensual standardized monitoring tools that would allow farmers and veterinarians to jointly monitor the health, welfare, antimicrobial resistance, and antimicrobial use on farms. Other results relate to better communication and training for citizens regarding animal health, animal welfare, and proper antimicrobial use; some benefits but also counterproductive effects of antibiotic-free labels that imperil animal health and welfare; the economic competitiveness of farms on international markets; and the economic sustainability of farm animal veterinary practices. These results call for a concerted way to produce tools for farmers and veterinarians and the broader involvement of other food sector actors.

Adherence to proper environmental cleaning practices is critical in food establishments. To validate cleanliness, cleaning practices should be routinely monitored, preferably by a rapid, reliable, and cost-effective method. The aim of this study was to determine whether a correlation exists between ATP bioluminescence measurements and selected microbial assessments in studies conducted in food establishments. A systematic literature review and meta-analysis was conducted using the principles of preferred reporting items for systematic reviews and meta-analyses. Twelve online databases and search engines were selected for the review. Peer-reviewed articles published in English between January 2000 and July 2020 were included in the search. From a total of 19 eligible studies, 3 that included Pearson correlation coefficients (r) between ATP bioluminescence measurements and microbial assessments were used for the meta-analysis calculations. Only the fixed-effect model produced a strong correlation because one value dominated the estimates: r = 0.9339 (0.9278, 0.9399). In contrast, both the random effects model, 0.2978 (0.24, 0.3471), and the mixed effects model, r = 0.3162 (-0.0387, 0.6711), indicated a weak relationship between ATP bioluminescence and microbial assessments, with no evidence of a strong correlation. The meta-analysis results indicated no sufficient evidence of a strong correlation between ATP bioluminescence measurements and microbial assessments when applied within food establishments. This lack of evidence for a strong correlation between the results of these two monitoring tools suggests that food establishments cannot depend on only one method. Yet, with immediate feedback and quantification of organic soiling, ATP bioluminescence could be an effective monitoring tool to use in food establishments.

The ability to identify, target, and treat critical pollution source areas on a landscape is an ongoing challenge for water quality programs that seek to address nonpoint source (NPS) pollution. In this article, we develop a conceptual framework for targeting program design, and review recent experience with the implementation of targeting programs that corresponds with a wide range of program characteristics. Through this review, we emphasize that the complex and locally dependent nature of NPS generation and transport makes it impossible to define a narrow set of rules to guide targeting programs everywhere. Instead, we evaluate key features of NPS targeting in several different contexts, highlighting lessons learned from recent experience. This synthesis of targeting program design and implementation points toward several areas of opportunity for improved NPS policy, however more research is needed to systematically document changes in behavior and pollutant loads. The lack of monitoring data at refined scales presents a major obstacle to targeting program success. This paper synthesizes new opportunities and ongoing challenges for the implementation of targeting in NPS water quality programs.

Brown marmorated stink bug, Halyomorpha halys, is native to Asia and has invaded North America and Europe inflicting serious agricultural damage to specialty and row crops. Tools to monitor the spread of H. halys include traps baited with the two-component aggregation pheromone (PHER), (3S,6S,7R,10S)-10,11-epoxy-1-bisabolen-3-ol and (3R,6S,7R,10S)-10,11-epoxy-1-bisabolen-3-ol, and pheromone synergist, methyl (2E,4E,6Z)-decatrienoate (MDT). Here, an international team of researchers conducted trials aimed at evaluating prototype commercial lures for H. halys to establish relative attractiveness of: 1) low and high loading rates of PHER and MDT for monitoring tools and attract and kill tactics; 2) polyethylene lure delivery substrates; and 3) the inclusion of ethyl (2E,4E,6Z)-decatrieonate (EDT), a compound that enhances captures when combined with PHER in lures. In general, PHER loading rate had a greater impact on overall trap captures compared with loading of MDT, but reductions in PHER loading and accompanying lower trap captures could be offset by increasing loading of MDT. As MDT is less expensive to produce, these findings enable reduced production costs. Traps baited with lures containing PHER and EDT resulted in numerically increased captures when EDT was loaded at a high rate, but captures were not significantly greater than those traps baited with lures containing standard PHER and MDT. Experimental polyethylene vial dispensers did not outperform standard lure dispensers; trap captures were significantly lower in most cases. Ultimately, these results will enable refinement of commercially available lures for H. halys to balance attraction and sensitivity with production cost.

Transthyretin amyloid cardiomyopathy (ATTR-CM) is a life-threatening condition with a heterogeneous clinical presentation. The recent availability of treatment for ATTR-CM has stimulated increased awareness of the disease and patient identification. Stratification of patients with ATTR-CM is critical for optimal management and treatment; however, monitoring disease progression is challenging and currently lacks best-practice guidance. In this report, experts with experience in treating amyloidosis and ATTR-CM developed consensus recommendations for monitoring the course of patients with ATTR-CM and proposed meaningful thresholds and frequency for specific parameters. A set of 11 measurable features across three separate domains were evaluated: (i) clinical and functional endpoints, (ii) biomarkers and laboratory markers, and (iii) imaging and electrocardiographic parameters. Experts recommended that one marker from each of the three domains provides the minimum requirements for assessing disease progression. Assessment of cardiac disease status should be part of a multiparametric evaluation in which progression, stability or improvement of other involved systems in transthyretin amyloidosis should also be considered. Additional data from placebo arms of clinical trials and future studies assessing ATTR-CM will help to elucidate, refine and define these and other measurements.

UNASSIGNED: Inflammatory bowel disease (IBD) is a lifelong disease requiring frequent assessment to guide treatment and prevent flares or progression. Multiple tools are available for clinicians to monitor disease activity; however, there are a paucity of data to inform which monitoring tools are most acceptable to patients. The review aims to describe the available evidence for patient preference, satisfaction, tolerance and/or acceptability of the available monitoring tools in adults with IBD.
UNASSIGNED: Embase, Medline, Cochrane Central and Clinical Trials.gov were searched from January 1980 to April 2019 for all study types reporting on the perspectives of adults with confirmed IBD on monitoring tools, where two or more tools were compared. Outcome measures with summary and descriptive data were presented.
UNASSIGNED: In 10 studies evaluating 1846 participants, monitoring tools included venipuncture, stool collection, gastrointestinal ultrasound, computed tomography, magnetic resonance imaging, wireless capsule endoscopy, barium follow-through and endoscopy. Outcome domains were patient satisfaction, acceptability of monitoring tool and patient preference. Noninvasive investigations were preferable to endoscopy in nine studies. When assessed, gastrointestinal ultrasound was consistently associated with greater acceptability and satisfaction compared with endoscopy or other imaging modalities.
UNASSIGNED: Adults with IBD preferred noninvasive investigations, in particular gastrointestinal ultrasound, as compared to endoscopy for monitoring disease activity. When assessing disease activity, patient perceptions should be considered in the selection of monitoring tools. Further research should address whether adpoting monitoring approaches considered more acceptable to patients results in greater satisfaction, adherence and ultimately more beneficial clinical outcomes.

Over the last decade, activated carbon amendments have successfully been applied to retain chlorinated ethene subsurface contamination. The concept of this remediation technology is that activated carbon and bioamendments are injected into aquifer systems to enhance biodegradation. While the scientific basis of the technology is established, there is a need for methods to characterise and quantify the biodegradation at field scale. In this study, an integrated approach was applied to assess in situ biodegradation after the establishment of a cross sectional treatment zone in a TCE plume. The amendments were liquid activated carbon, hydrogen release donors and a Dehalococcoides containing culture. The integrated approach included spatial and temporal evaluations on flow and transport, redox conditions, contaminant concentrations, biomarker abundance and compound-specific stable isotopes. This is the first study applying isotopic and microbial techniques to assess field scale biodegradation enhanced by liquid activated carbon and bioamendments. The injection enhanced biodegradation from TCE to primarily cis-DCE. The Dehalococcoides abundances facilitated characterisation of critical zones with insufficient degradation and possible explanations. A conceptual model of isotopic data together with distribution and transport information improved process understanding; the degradation of TCE was insufficient to counteract the contaminant input by inflow into the treatment zone and desorption from the sediment. The integrated approach could be used to document and characterise the in situ degradation, and the isotopic and microbial data provided process understanding that could not have been gathered from conventional monitoring tools. However, quantification of degradation through isotope data was restricted for TCE due to isotope masking effects. The combination of various monitoring tools, applied frequently at high-resolution, with system understanding, was essential for the assessment of biodegradation in the complex, non-stationary system. Furthermore, the investigations revealed prospects for future research, which should focus on monitoring contaminant fate and microbial distribution on the sediment and the activated carbon.

A simplified magnetic resonance enterography (MRe) index (sMARIA) for Crohn\'s disease (CD) was recently developed and validated.
Our aims were (a) to assess sMARIA\'s accuracy in a sample other than the validation cohort; (b) to evaluate its correlation with a simpler endoscopy index (SES-CD) and fecal calprotectin (FC); and (c) to assess the need of an expert radiologist to reliably use sMARIA.
Patients with CD who underwent MRe, ileocolonoscopy and FC within 2-4 weeks had their MRe retrospectively reviewed by two blinded raters. Disease activity was evaluated through sMARIA, SES-CD and FC. sMARIA\'s accuracy, indices correlation, and interrater reliability were assessed.
In total, 84 patients were included, comprising 420 intestinal segments evaluations. sMARIA ≥1 accurately identified segments with active disease (90% sensitivity, 98% specificity; area under the curve 0.94, 95% confidence interval (CI) 0.91-0.97; p < 0.01). sMARIA correlated with endoscopy, both for ileal and colonic segments (R = 0.94 and R = 0.82; p < 0.01). Per patient, there was a strong correlation between sMARIA, endoscopy (R = 0.95; p < 0.01) and FC (R = 0.91; p < 0.01). Interrater agreement was excellent (intraclass correlation coefficient 0.95; 95% CI 0.94-0.96; p < 0.01).
sMARIA accurately measured CD activity using SES-CD as standard of reference, and exhibited high correlation with a simple endoscopic index and a biomarker. The interrater reliability between a radiology resident and an expert was excellent.