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Copyright of China Pulp & Paper is the property of China Pulp & Paper Magazines Publisher and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Photodetectors, which convert the light signal into other forms of signal, have been under the spotlight of research for many years because they are widely applied in monitoring, communication, and imaging. Most of the currently available photodetectors can output electrical signals to indicate the transient light intensity, while some display color change to reveal the absorbed light dosage. However, there is no device that can tell the transient light intensity and accumulated light dosage at the same time. Here, a paper‐based wearable photodetector that can simultaneously measure transient light intensity and accumulated light dosage is reported. The phosphomolybdic acid/citric acid system, whose color change can be observed by the naked eye, is designed as the photochromic material to combine with photodetective materials (using 2D Sr2Nb3O10 and ZnO nanoparticle as examples) on paper. Such paper‐based photodetector fully utilizes natural hygroscopicity and softness of paper, showing decent flexibility. Its optoelectronic signal remains stable even after 1000 cycles of bending. To the best of one's knowledge, this is the first photodetector that can tell light intensity and dosage simultaneously. This work introduces a new type of wearable photodetector by structure design and material selection, shedding light on more novel works for convenient and practical photodetection. [ABSTRACT FROM AUTHOR]

Hairy cellulose nanocrystalloids (HNC) are a brand new family of nanocellulose characterized by having functionalized amorphous poles joined by a crystalline shaft. In this paper we hypothesize that cationic HNC (CNCC) could be used as an effective retention agent in papermaking. To investigate this, we first flocculated a suspension of only fillers, namely kaolinite and CaCO3, and second, a suspension of recycled fibers, with CNCC. It was monitored by photometric dispersion analysis and laser focused beam reflectance. The flocculation mechanism was assessed by means of zeta potential, reflocculation efficiency, flocculation stability and optical microscopy. Finally, the effect of CNCC on drainage, retention and paper mechanical properties was studied. CNCC were found to heteroflocculate fillers at a wide range of dosages, finding a maximum floc size at a dosage of 30 mg/g. On the other hand, the maximum floc size when flocculating the pulp suspension, was found at a lower CNCC dosage (20 mg/g). In this case, fillers were being attached to the exterior surface of the fibers. In both systems, the maximum size increment was observed at the isoelectric point, so a charge neutralization mechanism was proposed. The addition of CNCC not only improved filler retention, but also pulp drainage by reducing these times. Moreover, although mechanical properties of the handsheets were affected by the presence of CNCC, this effect was much lighter than that caused by traditionally used retention systems. Hence, CNCC could replace many additives used in the wet-end of a paper machine, thus simplifying its operation. [ABSTRACT FROM AUTHOR]

Resin acids are mixtures of high molecular weight carboxylic acids found in tree resins. Due to higher hydrophobicity and low solubility, they tend to adsorb on the suspended solids in pulp and paper (P&P) mill wastewater and accumulate in primary sludge through settling. Anaerobic digestion (AD) is a common practice stabilizing sludge; however, high concentration of resin acids affects the AD process. The aim of this research was mainly to determine the impact of ferrate (Fe (VI)) oxidation on selected resin acids and anaerobic digestibility of ferrate-treated primary sludge (PS) spiked with the resin acids. First, batch control oxidation of model resin acids with Fe (VI) was conducted to identify an optimum dosage, pH and contact time using a Box–Behnken design approach. Thereafter, anaerobic treatability studies of primary sludge spiked with resin acids both under control condition and optimum ferrate pretreatment were conducted. Up to 97% oxidation of resin acids occurred in pure water, while only 44%—62% oxidation of resin acids occurred in PS with an increasing Fe (VI) dosage from 0.034 to 0.137 mg Fe (VI)/mg tCODfed. The pretreatment did not affect the anaerobic biodegradability of resin acids; however, it lowered their negative influences on the PS digestibility. About 0.076 mg Fe (VI) dosage/mg tCODfed solubilized the sludge increasing the methane production by 40% compared to the untreated digester. The potential benefits of ferrate pretreatment of P&P primary sludge include resin acids oxidation and subsequent toxicity reduction, higher sludge solubilization enhancing methane production and enabling anaerobic digestion at higher COD loading. [ABSTRACT FROM AUTHOR]

Spinal cord injury (SCI) represents an urgent unmet need for clinical reparative therapy due to its largely irreversible and devastating effects on patients, and the tremendous socioeconomic burden to the community. While different approaches are being explored, therapy to restore the lost function remains unavailable. Olfactory ensheathing cell (OEC) transplantation is a promising approach in terms of feasibility, safety, and limited efficacy; however, high variability in reported clinical outcomes prevent its translation despite several clinical trials. The aims of this position paper are to present an in-depth analysis of previous OEC transplantation-based clinical trials, identify existing challenges and gaps, and finally propose strategies to improve standardization of OEC therapies. We have reviewed the study design and protocols of clinical trials using OEC transplantation for SCI repair to investigate how and why the outcomes show variability. With this knowledge and our experience as a team of biologists and clinicians with active experience in the field of OEC research, we provide recommendations regarding cell source, cell purity and characterisation, transplantation dosage and format, and rehabilitation. Ultimately, this position paper is intended to serve as a roadmap to design an effective clinical trial with OEC transplantation-based therapy for SCI repair. [ABSTRACT FROM AUTHOR]

As a typical advanced oxidation process, Fe2+-persulfate (PDS) oxidation technology has been widely and efficiently reported for enhancing sludge dewaterability. However, higher dosage of Fe2+ must be added, which will restrain the oxidation efficiency of Fe2+-PDS process. In this work, the oxalic acid (OA)/Fe2+-PDS process was studied to improve paper sludge dewatering. With the OA dosage of 6 μmol (g total solid (TS))−1, Fe2+ dosage of 0.3 mmol (g TS)−1, and PDS dosage of 0.6 mmol (g TS)−1, sludge dewaterability was improved more efficiently. The specific resistance to filtration and water content of sludge cake were decreased by 70.7% and 8.0%, respectively. In comparison with Fe2+-PDS process, the viscosities of sludge suspension and supernatant were further reduced by 3.73% and 51.77%, respectively, and the contents of extracellular polymeric substances fractions were increased. The improved sludge dewaterability in OA/Fe2+-PDS process was mainly contributed by the synergistic effect of oxidative disintegration by free radicals and flocs re-flocculation, the contributions of which were the orders: metal cations > sulfate radical > hydroxyl radical. OA enhanced the efficient disintegration of sludge flocs, released more bound water, generated more Fe3+-oxalate complexes, and finally increased the sludge particle size significantly, forming a larger aggregation and obvious cracks. Additionally, the stabilization of several heavy metals was improved due to the chelating capacity of OA. These works will provide a novel approach for sludge dewatering in the PDS oxidation process. [Display omitted] • Oxalic acid (OA) chelated Fe2+ activated persulfate process was more efficient for enhancing sludge dewaterability. • Free radicals oxidation and flocculation effect were the proposed pathways on the improvement of sludge dewaterability. • OA promoted the recovery of Fe2+ and the production of Fe3+-oxalate complexes. • The release of water bound on extracellular polymeric substances improved sludge dewaterability. [ABSTRACT FROM AUTHOR]

The use of antibiotics to prevent post-weaning diarrhoea (PWD) in pigs has faced a setback owing to the associated antibiotic resistance in pigs and in the human populace that consumes the pork. In fact, antibiotic resistance that originates from the food chain is estimated to cause around 700,000 deaths globally each year. Consequently, scientists and researchers have suggested possible alternatives to antibiotics in pig diets. The chief of these has been the use of probiotics. The authors reviewed the literature on the use of probiotics as an alternative to antibiotics in treating PWD in pigs. It is clear that because of pathogenic Escherichia coli PWD continues to be a challenge to profitable swine production. The vast number of studies that was reviewed, point to the beneficial effects of probiotic supplementation on reducing the severity and incidence of PWD. However, some studies report inconsistencies to the general hypothesis. The majority of the microorganisms used as probiotics in the studies belong to the genera Lactobacilli, Bacillus, Bifidobacterium, Enterococcus, probiotic Escherichia coli, and Saccharomyces. The review also revealed that the bacterial strains that are used as probiotics are given individually or as combinations of multiple strains, and at various dosages, yielding varied results in each case. Interestingly, the authors observed wide disparities in the onset of probiotic supplementation and duration of the treatment to attain the results. Hence there is a need to standardize supplementation strategies, including dosage, onset and duration of treatment for probiotics. Furthermore, many of the in vivo studies that revealed positive effects of probiotics on diarrhoea and other production parameters were carried out in more controlled environments. The authors therefore suggest that more field studies in more natural and commercial farm settings should be conducted to augment the literature in relation to the use of probiotics as alternatives to antibiotics in treating PWD. [ABSTRACT FROM AUTHOR]

Objectives: The aims of the study were to investigate discrepancies between general practitioners' paper medication orders and pharmacy-prepared electronic medication administration charts, back-up paper charts and dose-administration aids, as well as delays between prescribing, charting and administration, at a 90-bed residential aged care facility that used a hybrid paper-electronic medication management system. Methods: A cross-sectional audit of medication orders, medication charts and dose-administration aids was performed to identify discrepancies. In addition, a retrospective audit was performed of delays between prescribing and availability of an updated electronic medication administration chart. Medication administration records were reviewed retrospectively to determine whether discrepancies and delays led to medication administration errors. Results: Medication records for 88 residents (mean age 86 years) were audited. Residents were prescribed a median of eight regular medicines (interquartile range 5-12). One hundred and twenty-five discrepancies were identified. Fortyseven discrepancies, affecting 21 (24%) residents, led to a medication administration error. The most common discrepancies were medicine omission (44.0%) and extra medicine (19.2%). Delays from when medicines were prescribed to when they appeared on the electronic medication administration chart ranged from 18 min to 98 h. On nine occasions (for 10% of residents) the delay contributed to missed doses, usually antibiotics. Conclusion: Medication discrepancies and delays were common. Improved systems for managing medication orders and charts are needed. [ABSTRACT FROM AUTHOR]

Emulsified asphalt is the primary material for preventive maintenance and cold-mix paving, but its low cohesive strength and poor mechanical properties limit its wide application, even with polymer modification. In this study, Styrene-Butadiene Rubber (SBR) emulsified asphalt was modified with nano-cellulose materials, namely nano paper-cellulose (NPC) and wood-derived nano-cellulose (WDC), to improve its properties. A novel preparation method of nano-cellulose solution was developed, including blending, ultrasonic stirring, and centrifugal treatment. Four types of nano-cellulose solution (0.5% NPC, 0.5%, 1.0%, and 1.5% WDC by weight of water) were selected. The microscopy analysis indicated that 0.5% WDC emulsion had a smaller particle size than 1.5% WDC emulsion. The rheology test indicated that WDC modified residue improved rutting resistance with the increased solution dosage due to the cross-linking effect, but its creep-and-recovery performance was worse than that of SBR emulsion residue. The NPC modified binder had a higher rutting factor than WDC modified binder at the same dosage after short-term aging. In addition, 1.0% WDC could be regarded as the optimal dosage in terms of fatigue and low-temperature performance. Furthermore, Fourier Transform Infrared Spectroscopy (FTIR) results showed that 0.5% NPC modified residue performed better in long-term aging resistance compared with 0.5%WDC modified asphalt. [ABSTRACT FROM AUTHOR]

Forty anaesthetists calculated maximum permissible doses of eight local anaesthetic formulations for simulated patients three times with three methods: an electronic calculator; nomogram; and pen and paper. Correct dose calculations with the nomogram (85/120) were more frequent than with the calculator (71/120) or pen and paper (57/120), Bayes Factor 4 and 287, p = 0.01 and p = 0.0003, respectively. The rates of calculations at least 120% the recommended dose with each method were different, Bayes Factor 7.9, p = 0.0007: 14/120 with the calculator; 5/120 with the nomogram; 13/120 with pen and paper. The median (IQR [range]) speed of calculation with pen and paper, 38.0 (25.0-56.3 [5-142]) s, was slower than with the calculator, 24.5 (17.8-37.5 [6-204]) s, p = 0.0001, or nomogram, 23.0 (18.0-29.0 [4-100]) s, p = 1 × 10-7 . Local anaesthetic dose calculations with the nomogram were more accurate than with an electronic calculator or pen and paper and were faster than with pen and paper. [ABSTRACT FROM AUTHOR]

The author reports on the discussion of the white paper on adaptive dose-ranging designs by the Phrma working Group in Great Britain. He states that the discussion is focusing on methodological issues and drug development. He stresses out that the white paper conducts simulations to compare a traditional approach with alternative design-focused and analysis-focused approaches. He also discusses the different level of phases on the pre-clinical trials.

Copyright of China Pulp & Paper is the property of China Pulp & Paper Magazines Publisher and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Identifying cell response to a chemotherapy drug treatment, in particular at the single cell level, is an important issue in patient management. This study aims at evaluating the effect of gemcitabine on single living cells using micro-Raman imaging. We used as a model the non-small lung cancer cell line, Calu-1, exposed to cytostatic doses (1 nM to 1 μM for 24 h and 48 h) of gemcitabine, an antitumor drug currently used in the treatment of lung cancer. Following drug treatment as a function of doses and incubation times, the Raman maps of single living cells were acquired. Cell biomolecules (DNA, RNA, and proteins) were chemically extracted and their spectral signatures used to evaluate their respective distribution in the cellular spectral information of control and treated cells. The quantification of these distributions reveals a significant effect of 100 nM gemcitabine at 48 h incubation (concomitant decrease of nucleic acids and increase of proteins). PCA analyses performed both on nuclear and extracted biomolecules spectra show a time-dependent effect of the drug. These promising results reveal that effects of subtoxic doses can be monitored at the single cell level highlighting the importance of such studies for clinical applications. [ABSTRACT FROM AUTHOR]

The article discusses the White Paper of adaptive dose-ranging study to address the early phase drug development issues through simulation methods. The author provides the evaluation metrics including the detection of dose-response (DR), identification of clinical outputs, selection of target dose and estimation of DR profile within the observed dose range.

Copyright of China Pulp & Paper is the property of China Pulp & Paper Magazines Publisher and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: Background: Measurement of time to first antibiotic dose (TFAD) in the emergency department (ED) in community-acquired pneumonia (CAP) has been controversial. Objective: To evaluate original articles reporting outcomes in CAP patients before and after TFAD measurement and assess whether it increases antibiotic overuse in non-CAP conditions. Methods: We performed searches using PubMed, addressing two questions: 1) Is the measurement of TFAD associated with improved outcomes in CAP? and 2) Is the measurement of TFAD associated with antibiotic overuse or interventions that could result in overuse in non-CAP conditions? Two independent reviewers assessed studies addressing these questions. Results: Eight studies were identified. All were Grade C or D and of “Adequate” quality: two studies supported TFAD by showing improved outcomes (improved survival in one study and no survival difference but shorter hospital length-of-stay in the second) in CAP patients after the implementation of TFAD; one neutral article reported no difference in survival with improved TFAD timing; five studies opposed TFAD either by showing increases in antibiotic overuse in non-CAP patients, or suggesting that TFAD measurement would promote antibiotic misuse. Conclusion: Given inconsistent evidence to demonstrate that improving TFAD in CAP improves outcomes or that TFAD is associated with antibiotic overuse, a Class C indication has been assigned (not acceptable/not appropriate) for ED TFAD measurement. The American Academy of Emergency Medicine recommends that measurement of TFAD in CAP be discontinued. [Copyright &y& Elsevier]

Although no randomized studies have demonstrated a positive impact of therapeutic drug monitoring (TDM) on clinical outcome in epilepsy, evidence from nonrandomized studies and everyday clinical experience does indicate that measuring serum concentrations of old and new generation antiepileptic drugs (AEDs) can have a valuable role in guiding patient management provided that concentrations are measured with a clear indication and are interpreted critically, taking into account the whole clinical context. Situations in which AED measurements are most likely to be of benefit include (1) when a person has attained the desired clinical outcome, to establish an individual therapeutic concentration which can be used at subsequent times to assess potential causes for a change in drug response; (2) as an aid in the diagnosis of clinical toxicity; (3) to assess compliance, particularly in patients with uncontrolled seizures or breakthrough seizures; (4) to guide dosage adjustment in situations associated with increased pharmacokinetic variability (e.g., children, the elderly, patients with associated diseases, drug formulation changes); (5) when a potentially important pharmacokinetic change is anticipated (e.g., in pregnancy, or when an interacting drug is added or removed); (6) to guide dose adjustments for AEDs with dose-dependent pharmacokinetics, particularly phenytoin. [ABSTRACT FROM AUTHOR]

This study assessed the effect on coagulation tests of fresh frozen plasma (FFP), given according to guidelines compared with higher doses in critically ill patients. Group 1 (10 patients) received 12·2 ml/kg and group 2 (12 patients) 33·5 ml/kg FFP. Prothrombin time, activated partial thromboplastin time and factors I–XII were measured before and after FFP infusion. Factor levels of 30 IU/dl (1 g/l for fibrinogen) were considered haemostatic. A retrospective review showed 10 of 22 (five in group 1 and five in group 2) patients had not required FFP. Of those that needed FFP, one of five in group 1 and seven of seven in group 2 had coagulation factor levels above the target post-FFP. Increments for group 1 versus 2 were: fibrinogen 0·4 vs. 1·0 g/l, FII 16 vs. 41*, FV 10 vs. 28*, FVII 11 vs. 38*, FVIII 10 vs. 17, FIX 8 vs. 28*, FX 15 vs. 37*, FXI 9 vs. 23 and FXII 30 vs. 44 IU/dl* (* P < 0·01). In vivo recovery of coagulation factors was the same for both groups and the observed increments correlated with the dose of FFP. In conclusion, coagulation screens were poor predictors of coagulation factor levels and current guidelines on the use of FFP result in predictably small increments in coagulation factors in critically ill patients and should be reviewed. [ABSTRACT FROM AUTHOR]

Objectives To investigate whether Galantamine significantly improves the core symptoms of Alzheimer's disease (AD). Background Galantamine is a reversible, competitive, selective inhibitor of acetylcholinesterase (AChE) that also allosterically modulates nicotinic acetylcholine receptors. This dual mechanism of action provided the rationale for a phase II trial of galantamine in AD. Method A multicentre, randomized, parallel, double-blind, placebo-controlled trial was carried out to evaluate the efficacy and tolerability of galantamine 18, 24 and 36 mg/day administered for 3 months in 285 patients with mild-to-moderate probable AD. The primary outcome measure was the Alzheimer's Disease Assessment Scale cognitive subscale (ADAS-cog); secondary outcome measures were the Clinical Global Impression of Change (CGIC) and the Progressive Deterioration Scale (PDS). Results Patients treated with galantamine 24 mg/day had a significantly better outcome than placebo on ADAS-cog; the treatment difference was 3 points on the intention-to-treat (ITT) analysis ( p = 0.01) and 4.2 points on per protocol analysis ( p = 0.001). Per protocol analysis showed that galantamine had a significantly better outcome than placebo on PDS ( 24-mg/day dose, p < 0.05) and CGIC (36-mg/day dose, p < 0.05). Galantamine was well tolerated at the lower doses of 18 and 24 mg/day where it produced mild, transient effects typical of cholinomimetic agents. Conclusion This study shows that, relative to placebo, galantamine significantly improves the core symptoms of Alzheimer's disease. Copyright © 2001 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Copyright of Zentralsterilisation is the property of mhp Verlag GmbH and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article discusses orofacial pain dentists' appropriate use of pharmacotherapeutic agents. A discussion of recommendations which have been offered by the American Academy of Orofacial Pain on the appropriate use of pharmacotherapeutics by orofacial pain dentists is presented. The role that having knowledge about pharmacotherapeutic agents can play in an orofacial pain dentist's ability to properly treat patients is discussed.

Copyright of China Pulp & Paper is the property of China Pulp & Paper Magazines Publisher and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: This article presents the WHO recommendations on the use of polio vaccines excerpted from the recently published Polio vaccines and polio immunization in the pre-eradication era: WHO position paper. This document replaces the WHO position paper entitled Introduction of inactivated poliovirus vaccine into oral poliovirus vaccine-using countries published in the Weekly Epidemiological Record in July 2003. Footnotes to this paper provide a limited number of core references; their abstracts as well as a more comprehensive list of references may be found at http://www.who.int/immunization/documents/positionpapers/en/index.html. Grading tables which assess the quality of scientific evidence for key conclusions are also available through this link and are referenced in the position paper. In accordance with its mandate to provide guidance to Member States on health policy matters, WHO issues a series of regularly updated position papers on vaccines and combinations of vaccines against diseases that have an international public health impact. These papers are concerned primarily with the use of vaccines in large-scale immunization programmes; they summarize essential background information on diseases and vaccines, and conclude with WHO''s current position on the use of vaccines in the global context. This updated paper reflects the recent recommendations of WHO''s Strategic Advisory Group of Experts on immunization, or SAGE. [Copyright &y& Elsevier]

The conventional approach to intensity-modulated radiation therapy treatment planning involves two distinct strategies: optimizing an evaluation function while accounting for dose constraints, and solving feasibility problems using feasibility-seeking projection methods that incorporate inequality constraints. This paper introduces a novel iterative scheme within the framework of continuous dynamical systems, wherein constraint conditions dynamically evolve to enhance the optimization process. The validity of dynamically varying dose constraints is theoretically established through the foundation of continuous-time dynamical systems theory. In particular, we formalize a system of differential equations, with both beam coefficients and dose constraints modeled as state variables. The asymptotic stability of the system's equilibrium is rigorously proven, ensuring convergence to a solution. In practical terms, we leverage a discretized iteration formula derived from the continuous-time system to achieve rapid computational speed. The mathematical structure of the proposed approach, which directly incorporates dose-volume constraints into the objective function, facilitates significant computational efficiency and solution refinement. The proposed method has an inherent dynamics that approaches more desirable solutions within the set of solutions when the solution to the optimization problem is not an isolated point. This property guarantees the identification of optimal solutions that respect the prescribed dose-volume constraints while enhancing accuracy when such constraints are feasible. By treating dose constraints as variables and concurrently solving the optimization problem with beam coefficients, we can achieve more accurate results when compared with using fixed values for prescribed dose conditions. [ABSTRACT FROM AUTHOR]

BACKGROUND CONTEXT The U.S. opioid epidemic has been declared a national public health emergency with the HHS, FDA, and CDC all taking steps to address the alarming rates of opioid addiction and abuse. Since 2000, the annual death toll from an opioid associated overdose has increased by over 300%. In an effort to reduce the amount of opioids, physicians have used alternative approaches, which have proven to not only be effective, but also reduce the side effects such as nausea, constipation, and addiction. IV acetaminophen has been shown to successfully accomplish the reduction in opioid use, however, it is an expensive alternative. Testing the efficacy of IV acetaminophen versus its oral formulation will likely modify future postoperative pain management regimens while also addressing its cost-effectiveness. PURPOSE The objective of the study is to prospectively evaluate clinical outcomes and determine the cost effectiveness of IV versus oral (PO) acetaminophen following lumbar circumferential spine surgery. STUDY DESIGN/SETTING A prospective, single center, randomized controlled trial. PATIENT SAMPLE Patients between the ages of 18-80 who underwent circumferential lumbar fusion surgery were included in the study. Patients had failed conservative management for more than 12 months. Patients were excluded if they had already undergone lumbar surgery at the index level(s), were diagnosed with osteoporosis, had dysphagia prohibiting oral administration, or had a history of substance abuse. OUTCOME MEASURES Outcome measures included opioid equivalence, length of hospital stay, VAS measurements, and Oswestry Disability Index (ODI) scores. METHODS Patients were randomized to either the IV or PO acetaminophen treatment groups. Preoperatively, patients completed a baseline analgesic regimen questionnaire, surveys including VAS, SF-12, and ODI, and were administered their first acetaminophen dose within three hours of first incision. Postoperatively, patients received seven subsequent doses of their assigned acetaminophen, with access to supplemental analgesics if needed. Analgesic usage and VAS scores were monitored until discharge. Surveys were completed at six weeks and six months follow up. RESULTS Postoperatively, the daily morphine equivalence taken by the IV acetaminophen group was 66% less than the oral acetaminophen group (p<.05), with both the one and two-level cohorts also seeing significant differences between groups. When looking at the average length of stay between groups, the average time is not statistically significant. However, in the one-level group, it is notable that the average length of stay for four patients is only 2.5 days, while the PO patients stay for an average of 4 days. CONCLUSIONS In conjunction with an overall reduction in opioid usage, patient reported surveys indicate better improvement of pain management with the use of IV acetaminophen following circumferential lumbar spine surgery. Despite the large discrepancy between the two formulations in cost to perceived benefit ratio, by significantly reducing the opioid usage and, therefore, its costs due to associated side effects, that discrepancy becomes far less dramatic. Our findings suggest that IV acetaminophen is a safe and effective alternative to current opioid-based postoperative analgesic regimens with a promising answer to the national public health emergency plaguing communities across the U.S. [ABSTRACT FROM AUTHOR]

Oritavancin (ORI) is a semisynthetic lipoglycopeptide approved as a single 1200 mg dose intravenous infusion for the treatment of acute bacterial skin and skin structure infections (ABSSSIs) caused by Gram-positive organisms in adults. The pharmacokinetic/pharmacodynamic (PK/PD) linear kinetic profile and long terminal half-life (~393 h) of ORI make it therapeutically attractive for the treatment of other Gram-positive infections for which prolonged therapy is needed. Multidose regimens are adopted in real-world clinical practice with promising results, but aggregated efficacy data are still lacking. A comprehensive search on PubMed/Medline, Scopus, Cochrane and Google Scholar databases was performed to include papers published up to the end of January 2023. All articles on ORI multiple doses usage, including case reports, with quantitative data and relevant clinical information were included. Two reviewers independently assessed papers against the inclusion/exclusion criteria and for methodological quality. Differences in opinion were adjudicated by a third party. From 1751 potentially relevant papers identified by this search, a total of 16 studies met the inclusion criteria and were processed further in the final data analysis. We extracted data concerning clinical response, bacteriologic response, mortality and adverse events (AEs). From the 16 included papers, 301 cases of treatment with multidose ORIs were identified. Multidose regimens comprised an initial ORI dose of 1200 mg followed by 1200 mg or 800 mg subsequent doses with a varying total number and frequency of reinfusions. The most often treated infections and isolates were osteomyelitis (148; 54.4%), ABSSSI (35; 12.9%) and cellulitis (14; 5.1%); and MRSA (121), MSSA (66), CoNS (17), E. faecalis (13) and E. faecium (12), respectively. Clinical cure and improvement by multidose ORI regimens were observed in 85% (231/272) and 8% (22/272) patients, respectively. Multidose ORI was safe and well tolerated; the most frequent AEs were infusion-related reactions and hypoglycemia. A multidose ORI regimen may be beneficial in treating other Gram-positive infections besides ABSSSIs, with a good safety profile. Further studies are warranted to ascertain the superiority of one multidose ORI scheme or posology over the other. [ABSTRACT FROM AUTHOR]

Background The effects of drugs on psychomotor performance have been investigated using a variety of techniques. But the various techniques used are often complex and sometimes inconvenient. Paper and pencil tests do not need complex equipment, they are easy to administer and replicate. That's why the present study was planned to assess the utility of paper pencil test for conducting psychomotor studies. Materials and methods Following each single dose of chlorpheniramine 4 mg or placebo, 24 subjects performed paper pencil tests- six digit cancellation test, digit symbol substitution test and arithmetic ability at 0, 2, and 4 hours interval. Subjective assessment was done by three different visual analogue scales in the double blind placebo controlled study. Results In all the paper pencil tests performance was impaired by chlorpheniramine significantly at 2 hours and 4 hours in comparison to placebo. These findings were also reflected in the subjective assessment of visual analogue scales. Conclusion It can be concluded from the study that paper and pencil tests are useful tools for the assessment of psychomotor performance. Paper pencil test should be the part of battery of psychometric tests. [ABSTRACT FROM AUTHOR]

Soil treated with silicone hydrophobic material for a long time can effectively improve the saturated permeability of the ground, which has been confirmed. However, the long time will increase the cost in engineering construction. Secondly, the mechanism of alteration of soil–water properties by silicone hydrophobic materials is not understood. This lack of understanding is not conducive to the engineering application of silicone hydrophobic materials. Therefore, variable-head permeability and matrix suction tests under 15 different test conditions were conducted with different hydrophobic material dosage and action time as variables in this paper. The soil–water characteristic curve (SWCC) was plotted according to the test results, the unsaturated permeability coefficient was calculated, and curve fitting was performed. It can be seen from the test data that, with the increase in the dosage of hydrophobic materials and the action time, the permeability coefficient and the air-entry value showed a downward trend. Nevertheless, as the reaction proceeded, a mutation occurred at 4 h. When the minimum dosage and action time were used, the soil's permeability coefficient and air-entry value decreased by 80.65% and 71.09%. The test results show that, even when the action time was 2 h, the hydrophobic material could maintain the permeability of the soil and reduce its air-entry value; thus, the hydrophobic material could effectively reduce the rise of capillary water in the soil and protect the roadbed. [ABSTRACT FROM AUTHOR]

Background: Peanut allergy is a common food allergy with potentially life-threatening implications. Early oral immunotherapy for peanut allergy (P-EOIT) has been shown to be effective and safe in research and specialty clinic settings. Provision of P-EOIT in primary care would make it available to more patients. We sought to assess the safety of P-EOIT in a primary care setting by documenting the rates of peanut-related allergic reactions leading to emergency department (ED) visits and use of epinephrine. We also examined adherence by assessing the percentage of patients reaching maintenance phase and continuing ingestion after one year of P-EOIT. Methods: This retrospective study included all patients aged less than 36 months who started P-EOIT at a primary care allergy clinic in New Brunswick, Canada, from 2016 to 2020. The population included patients who (1) had a history of an allergic reaction to peanuts with a positive skin prick test or positive peanut specific IgE level (ps-IgE) or (2) no history of ingestion and a baseline ps-IgE ≥5 kU/L. Patients had biweekly clinic visits with graded increases in peanut protein up to a maintenance dose of 300 mg of peanut protein daily. A blinded retrospective review of paper charts and electronic medical records was conducted along with phone interviews regarding ED visits and epinephrine use. Results: All 69 consented patients reached maintenance dose over a median of 29 weeks, and 66 patients (95.7%) were still regularly consuming peanut protein after 1 year of maintenance. One patient had a peanut ingestion-related ED visit requiring epinephrine during the escalation phase of peanut protein dosing (1.4%). During the first year of maintenance phase, no patients had peanut ingestion-related ED visits nor required epinephrine. Conclusion: Early oral immunotherapy for peanut allergy in a primary care setting appears to be safe and our findings suggest that it does not lead to an increased burden of emergency department visits. Our population had high adherence rates, with the majority achieving maintenance dose and staying on this dose for one year. [ABSTRACT FROM AUTHOR]

Clinical trials, the empirical discipline of medical experimentation conducted on human subjects, have engendered a paradigm shift in medical research. The need for new clinical studies is paramount in the Middle East and North Africa (MENA) region, with its rising cancer incidence and demand for efficient oncology treatments. This paper comprehensively reviews the challenges, opportunities, and future directions of phase I oncology clinical trials in the MENA region. Early-phase trials are vital in determining drug dosage and assessing toxicity, bridging the gap between preclinical research and clinical practice. Considering the unique landscape of MENA, this review explores regulatory aspects, specific hurdles faced, potential advantages, and areas for improvement in conducting these trials. Various future directions can be pursued to maximize the potential of phase I oncology trials in MENA. While regulatory bodies like the Ministry of Health adhere to the International Conference on Harmonization-Good Clinical Practice guidelines, a unified system meeting high standards would yield better results. Strengthening research infrastructure, establishing research centers, incorporating clinical trial education into the curriculum, and improving access to medical facilities are crucial. Enhancing consumer understanding of research would facilitate increased participation and promote sustainability in trial recruitment. Navigating various funding sources would open the door for more funding opportunities. Collaborations between academia, industry, and regulatory bodies, both international and local, should be fostered to promote knowledge sharing, resource pooling, and harmonization of standards. Such collaborations would contribute to the sustainability of clinical trial activities by leveraging collective expertise, sharing research infrastructure, and distributing the burden of regulatory compliance. By adopting these strategies, the MENA region can advance its capacity to conduct early phases of oncology trials and contribute significantly to the global medical research landscape. [ABSTRACT FROM AUTHOR]

Copyright of Veterinary Dermatology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Based on the reduction of environmental pollution, a biological enzyme assisted alkali-oxygen pulping method was explored to improve the delignification efficiency and fiber accessibility of wheat straw and improve the properties of wheat straw pulp. In this paper, lipase and xylanase were used to pretreat wheat straw and the effects of different enzyme types and enzyme dosage on the microstructure and pulp properties of wheat straw were investigated and experimented. The results showed that the lipase can remove fat and wax on the surface of wheat straw, while xylanase degraded the hemicellulose components, such as xylan, of wheat straw fiber, destroyed the structure of the lignin-carbohydrate complex, increasing lignin removal as a result and enhancing the impregnating, diffusion and penetration of alkali. Compared with wheat straw without enzyme pretreatment, the skeleton of wheat straw pretreated by enzyme became looser, the internal cavity appeared and the wall cavity became thin and transparent. The fines decreased obviously and the length of fibers increased. After combined pretreatment with lipase (15 U·g−1) and xylanase (15 U·g−1), the pulping performance of wheat straw was improved and the tensile index (97.37 N·m·g−1), brightness (40.9% ISO) and yield (58.10%) of the pulp increased by 12.9%, 19.9% and 9.9%, respectively. It can be seen that enzyme pretreatment is a green and effective approach to improving the alkali-oxygen pulping performance of wheat straw. [ABSTRACT FROM AUTHOR]

Infantile hemangiomas are one of the most common benign vascular tumors in infants and children. Because hemangiomas can resolve spontaneously, they usually do not require specific treatment unless the proliferation interferes with normal function or causes interference with the function of essential vital organs. There are several types of therapy, but in recent decades the use of propranolol has become more common due to its excellent effectiveness. The purpose of this paper is to analyze different pharmaceutical formulations of propranolol in the treatment of infantile hemangioma, including technological differences of the oral and topical pharmaceutical dosage forms of propranolol. The European Medicines Agency (EMA) has approved the commercially available oral propranolol therapy in the countries of the European Union, but this is not yet happened in our country. Recommendations to follow and use the protocols for the oral application of propranolol in the treatment of this disease are difficult due to the fact that this drug formulation is not registered in our country and patients are forced to obtain it from countries where it is registered. The use of syrup as an oral form of therapy has been clinically proven and has a high percentage of efficiency in infantile hemangioma, but side effects such as sleep disturbance, bronchospasm, hypoglycemia, hypotension. The goal of this publication is to propose the most appropriate topical formulation of propranolol for external use in infantile hemangioma through a review of relevant published data on the use of various pharmaceutical formulations of propranolol in clinical studies and documents from the European Medicines Agency, In this paper, we used compilation and comparison methods, as most useful for a high-quality critical evaluation of the literature regarding problematic topics, in our case the pharmaceutical formulation of propranolol, the effect of clinical treatment and the required legislation, and which have the potential to promote clearer, shared understandings and accelerate advances in the research. Our results were focused on obtained and published data related to pharmaceutical-technological aspects of production of topical formulations and the effect of clinical application, especially when it is necessary to define exactly the amount of the released active compound from the topical form (cream, ointment or gel) and its absorption through the skin. Topical form of propranolol avoids the side effects of oral administrated propranolol, can help maintain a high level of active ingredient in a local or focal region, and has an easy way of administration. The obtained research data showed that the topical application and penetration of propranolol through the skin is good and has a lower and controlled systemic absorption. To achieve this, the choice of the formulation and the excipients used are particularly important. Lipophilic formulations have limited release and penetration of propranolol. The best results are achieved by using a hydrophilic cream. After the research done, we can conclude that the production of topical formulations containing specific active components with a strong systemic effect, such as propranolol, can be carried out in galenic laboratories or hospital pharmacies. For this, already existing validated equipment and excipients that are readily available can be used. We believe that the use of topical pharmaceutical forms for local application, even in children such as the case of propranolol in infantile hemangioma, is justified, especially to the fact that so far no side effects have been registered even after long-term therapy. [ABSTRACT FROM AUTHOR]

Present paper deals with 20 selected potential ethnomedicinal wild plants and an insect taxon which may be used to cure a good number of human diseases based on oral interviews with ten different Gorkha-Nepalese community of Darjeeling hills. Diseases like piles, skin irritation, diarrhoea, jaundice, old wounds, gastric problems including chronic acidity and gas, arthritis, pyorrhea or toothache, snakebite polyherbal formulations, fevers, urinary problem including kidney disorder, energy tonic, earache, anaemia, bone fracture and ligament injury, abdominal pain, high blood pressure, diabetes melitus, body pain reliever, throat pain, cold and cough, labour pain reliever and vomiting etc. are either cured or relieved by using different parts of these plants documented during oral interviews since December 2011 till December 2022. The efficacy of these ethno medicinal plants needs to be subjected to pharmacological validation. Maximum number of ethnomedicinal first hand information was documented from Rhododendron arboreum Sm. Minimum number of information documented from Boehmeria clideminoides Miq. var. diffusa (Wedd.) Hand.-Mazz. Maximum number of informants belonged to Rai, Tamang and Thami communities followed by Chhetri, Sherpa and Gurung communities, respectively. Most of these validated authentic information are not recorded earlier, when reportedtheir dosimetry and plant parts are different. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article about the importance of effective dose in patient's health that was published in the previous issue.

Gas hydrate blockage is a major issue that the production and transportation processes in the oil/gas industry faces. The formation of gas hydrates in pipelines results in significant financial losses and serious safety risks. To tackle the flow assurance issues caused by gas hydrate formation in the pipelines, some physical methods and chemical inhibitors are applied by the oil/gas industry. The physical techniques involve subjecting the gas hydrates to thermal heating and depressurization. The alternative method, on the other hand, relies on injecting chemical inhibitors into the pipelines, which affects gas hydrate formation. Chemical inhibitors are classified into high dosage hydrate inhibitors (thermodynamic hydrate inhibitors (THI)) and low dosage hydrate inhibitors (kinetic hydrate inhibitors (KHI) and anti-agglomerates (AAs)). Each chemical inhibitor affects the gas hydrate from a different perspective. The use of physical techniques (thermal heating and depressurization) to inhibit hydrate formation is studied briefly in this review paper. Furthermore, the application of various THIs (alcohols and electrolytes), KHIs (polymeric compounds), and dual function hydrate inhibitors (amino acids, ionic liquids, and nanoparticles) are discussed thoroughly in this study. This review paper aims to provide a complete and comprehensive outlook on the fundamental principles of gas hydrates, and the recent mitigation techniques used by the oil/gas industry to tackle the gas hydrate formation issue. It hopes to provide the chemical engineering platform with ultimate and effective techniques for gas hydrate inhibition. [ABSTRACT FROM AUTHOR]

Chronic Myelogenous Leukaemia (CML) is a haematopoietic stem cells disease with complex dynamical behaviour. One of the effective factors in treating patients is to determine the appropriate drug dosage. A physician should test the different drug dosages through trial and error in order to find its optimal value. This procedure is normally a time‐consuming and error‐prone task that can even be harmful. The contribution of this paper is to design an intelligent control strategy, which can be used to help physicians, by finding a drug treatment regimen to minimize the number of cancer cells for a CML patient. In this paper, the eligibility traces algorithm and Q‐learning approach are adopted as sub‐optimal methods for progressively reducing the population of cancer cells. In addition, the injected dosage of the drug has improved, compared with previous methods. More importantly, the proposed method is followed by the reduction in side effects of the drug. The advantage of the backward view and the previous states investigation are applied in the Eligibility Traces algorithm. These effects increase the learning procedure and decrease the growth rate of cancer cells and total dosage of the injected drug during the treatment period of time. The proposed strategy mitigates the side effects of the drug on the normal cells. [ABSTRACT FROM AUTHOR]

Background: Therapeutic radiopharmaceuticals [177Lu]Lu-DOTA-TATE and [90Y]Y-DOTA-TATE are used in peptide receptor radionuclide therapy (PRRT) of neuroendocrine tumors. One of the factors determining the efficacy of such therapy is administering the radiopharmaceutical dose to the patients in a way consistent with treatment planning. This paper evaluates the loss of [177Lu]Lu-DOTA-TATE and [90Y]Y-DOTA-TATE and their mixed doses during the administration to the patient either by direct infusion or by gravity method. Material and methods: The loss of [177Lu]Lu-DOTA-TATE and [90Y]Y-DOTA-TATE, was assessed in tests simulating the administration procedures and during infusion to the patients performed at four clinical centres. One clinical centre used a direct infusion, and three others used a gravity method to administer radiopharmaceuticals to the patient. Results: In the direct infusion the highest radioactivity loss was 3.88% ± 0.49% (n = 3) and 3.76% ± 0.83% (n = 3) for [177Lu] Lu-DOTA-TATE infusion with radioactivity of 3.71 GBq ± 0.08 GBq (n = 3) and 1.06 GBq ± 0.08 GBq (n = 3), respectively, and 4.04% ± 0.40% (n = 5) for infusion of [90Y]Y-DOTA-TATE dose of 1.98 GBq ± 0.05 GBq (n = 5). In the gravity method administration of [177Lu]Lu-DOTA-TATE generated losses of up to 1.31% ± 0.46% (n = 16) for a dose of 7.45 GBq ± 0.06 GBq (n = 16) and 2.93% ± 1.64% (n = 8) for a dose of 3.78 GBq ± 0.05 GBq (n = 8). However, the infusion of the lowest doses of 0.95 GBq ± 0.01 GBq (n = 4) [177Lu]Lu-DOTA-TATE and 1.96 GBq ± 0.03 GBq (n = 8) [90Y]Y-DOTA-TATE resulted in higher loss of radiopharmaceuticals up to 6.00% ± 0.97% (n = 4) and 4.00% ± 1.57% (n = 8), respectively. Conclusions: Both investigated methods of radiopharmaceutical administration are associated with the loss of the radioactivity of radiopharmaceutical. [ABSTRACT FROM AUTHOR]

Copyright of Journal of South China University of Technology (Natural Science Edition) is the property of South China University of Technology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The author discusses a research study by Doug Goodin on a 21-year follow up of 372 patients with relapsing remitting multiple sclerosis (RRMS) enrolled in an original study on beta interferon-1b (IFNB-1b). He says that in the original study, the patients were randomized to take low dose or standard dose of IFNB-1b or placebo for a mean of 3.3 years. He states that 18% of patients who had active therapy were dead, as compared to the 31% in the placebo cohort group who had no active therapy.

Introduction: The risk of dose errors is high in paediatric inpatient settings. Computerized provider order entry (CPOE) systems with clinical decision support (CDS) may assist in reducing the risk of dosing errors. Although a frequent type of medication error, the prevalence of dose errors is not well described. Dosing error rates in hospitals with or without CPOE have not been compared.Objective: Our aim was to conduct a systematic review assessing the prevalence and impact of dose errors in paediatric wards with and without CPOE and/or CDS.Methods: We systematically searched five databases to identify studies published between January 2000 and December 2017 that assessed dose error rates by medication chart audit or direct observation.Results: We identified 39 studies, nine of which involved paediatric wards using CPOE with or without CDS. Studies of paediatric wards using paper medication charts reported approximately 8-25% of patients experiencing a dose error, and approximately 2-6% of medication orders and approximately 3-8% of dose administrations contained a dose error, with estimates varying by ward type. The nine studies of paediatric wards using CPOE reported approximately 22% of patients experiencing a dose error, and approximately 1-6% of medication orders and approximately 3-8% of dose administrations contained a dose error. Few studies provided data for individual wards. The severity and prevalence of harm associated with dose errors was rarely assessed and showed inconsistent results.Conclusions: Dose errors occur in approximately 1 in 20 medication orders. Hospitals using CPOE with or without CDS had a lower rate of dose errors compared with those using paper charts. However, few pre/post studies have been conducted and none reported a significant reduction in dose error rates associated with the introduction of CPOE. Future research employing controlled designs is needed to determine the true impact of CPOE on dosing errors among children, and any associated patient harm. [ABSTRACT FROM AUTHOR]