Validity of particle size analysis techniques for measurement of the attrition that occurs during vacuum agitated powder drying of needle-shaped particles

Analysis of needle-shaped particles of cellobiose octaacetate (COA) obtained from vacuum agitated drying experiments was performed using three particle size analysis techniques: laser diffraction (LD), focused beam reflectance measurements (FBRM) and dynamic image analysis. Comparative measurements were also made for various size fractions of granular particles of microcrystalline cellulose. The study demonstrated that the light scattering particle size methods (LD and FBRM) can be used qualitatively to study the attrition that occurs during drying of needle-shaped particles, however, for full quantitative analysis, image analysis is required. The algorithm used in analysis of LD data assumes the scattering particles are spherical regardless of the actual shape of the particles under evaluation. FBRM measures a chord length distribution (CLD) rather than the particle size distribution (PSD), which in the case of needles is weighted towards the needle width rather than their length. Dynamic image analysis allowed evaluation of the particles based on attributes of the needles such as length (e.g. the maximum Feret diameter) or width (e.g. the minimum Feret diameter) and as such, was the most informative of the techniques for the analysis of attrition that occurred during drying

A Microfluidic Platform for Precision Small-volume Sample Processing and Its Use to Size Separate Biological Particles with an Acoustic Microdevice.

A major advantage of microfluidic devices is the ability to manipulate small sample volumes, thus reducing reagent waste and preserving precious sample. However, to achieve robust sample manipulation it is necessary to address device integration with the macroscale environment. To realize repeatable, sensitive particle separation with microfluidic devices, this protocol presents a complete automated and integrated microfluidic platform that enables precise processing of 0.15-1.5 ml samples using microfluidic devices. Important aspects of this system include modular device layout and robust fixtures resulting in reliable and flexible world to chip connections, and fully-automated fluid handling which accomplishes closed-loop sample collection, system cleaning and priming steps to ensure repeatable operation. Different microfluidic devices can be used interchangeably with this architecture. Here we incorporate an acoustofluidic device, detail its characterization, performance optimization, and demonstrate its use for size-separation of biological samples. By using real-time feedback during separation experiments, sample collection is optimized to conserve and concentrate sample. Although requiring the integration of multiple pieces of equipment, advantages of this architecture include the ability to process unknown samples with no additional system optimization, ease of device replacement, and precise, robust sample processing

Challenges with Delivering Gender-Specific and Comprehensive Primary Care to Women Veterans

Background The growing presence of women veterans in Veterans Administration (VA) settings has prompted the need for greater attention to clinical proficiency related to women's health (WH) primary care needs. Instead of making appointments for multiple visits or referring patients to a WH clinic or alternate site for gender-specific care, a comprehensive primary care model now allows for women veteran patients be seen by primary care providers (PCPs) who have WH training/experience and can see patients for both primary and WH care in the context of a single visit. However, little is currently known about the barriers and facilitators WH-PCPs face in using this approach to incorporate gender-specific services into women veterans' primary care services. Methods We conducted qualitative in-depth interviews with 22 WH-PCPs at one Midwestern VA Medical Center. All participants were members of one of four outpatient primary care clinics within the main medical center, one off-site satellite clinic, or two off-site community-based outpatient clinics. Results Inductive thematic analysis identified six themes: 1) Time constraints, 2) importance of staff support, 3) necessity of sufficient space and equipment/supplies, 4) perceptions of discomfort among patients with trauma histories, 5) lack of education/training, and 6) challenges with scheduling/logistics. Conclusion Although adequate staff was a key facilitator, the findings suggest that there may be barriers that undermine the ability of VA WH-PCPs to provide high-quality, comprehensive primary and gender-specific care. The nature of these barriers is multifactorial and multilevel in nature, and may therefore require special policy and practice action

Activation of GATA4 gene expression at the early stage of cardiac specification

The exclusionary protected area-based approach to biodiversity conservation has succeeded at several places,but at a significant social cost and conflict, especially in the developing country tropics.More inclusive approaches, including community-based conservation (CBC), its subset enterprise-based conservation(EBC), and payments-based conservation (PES) programs, have been tried in the past 15 years. A brief summary of the literature on socio-economic impacts of the exclusionary approach suggests that, although detailed studies and documentation is missing,impacts are significant, and the ethical argument against forced displacement quite strong. We then examine the potential of non exclusionary approaches from a broader perspective that values biodiversity gains as well as socio-economic ones. Our review suggests that (a) comprehensive socio–ecological and comparative studies of such initiatives are surprisingly scarce, (b) enterprise-based conservation offers some potential if design flaws, poor implementation, assumptions about homogeneous communities, and inattention to tenurial change and security are addressed, (c) payments-based programs require caution because of their focus on economic efficiency, and simplified assumptions regarding the nature of rights, biological information,monitoring costs, and state interventions, and (d) the alternatives to exclusion have often not been given adequate state support and space to function, nor is the ongoing neoliberalization of the political-economic system conducive to giving them that space, except when they fit the direction of this larger process

IL-4Rα Blockade by Dupilumab Decreases Staphylococcus aureus Colonization and Increases Microbial Diversity in Atopic Dermatitis.

Dupilumab is a fully human antibody to interleukin-4 receptor α that improves the signs and symptoms of moderate to severe atopic dermatitis (AD). To determine the effects of dupilumab on Staphylococcus aureus colonization and microbial diversity on the skin, bacterial DNA was analyzed from swabs collected from lesional and nonlesional skin in a double-blind, placebo-controlled study of 54 patients with moderate to severe AD randomized (1:1) and treated with either dupilumab (200 mg weekly) or placebo for 16 weeks. Microbial diversity and relative abundance of Staphylococcus were assessed by DNA sequencing of 16S ribosomal RNA, and absolute S. aureus abundance was measured by quantitative PCR. Before treatment, lesional skin had lower microbial diversity and higher overall abundance of S. aureus than nonlesional skin. During dupilumab treatment, microbial diversity increased and the abundance of S. aureus decreased. Pronounced changes were seen in nonlesional and lesional skin. Decreased S. aureus abundance during dupilumab treatment correlated with clinical improvement of AD and biomarkers of type 2 immunity. We conclude that clinical improvement of AD that is mediated by interleukin-4 receptor α inhibition and the subsequent suppression of type 2 inflammation is correlated with increased microbial diversity and reduced abundance of S. aureus

Patterns of bruising in preschool children with inherited bleeding disorders: a longitudinal study

Objective The extent that inherited bleeding disorders affect; number, size and location of bruises in young children <6 years. Design Prospective, longitudinal, observational study. Setting Community. Patients 105 children with bleeding disorders, were compared with 328 without a bleeding disorder and classified by mobility: premobile (non-rolling/rolling over/ sitting), early mobile (crawling/cruising) and walking and by disease severity: severe bleeding disorder factor VIII/IX/XI <1 IU/dL or type 3 von Willebrand disease. Interventions Number, size and location of bruises recorded in each child weekly for up to 12 weeks. Outcomes The interventions were compared between children with severe and mild/moderate bleeding disorders and those without bleeding disorders. Multiple collections for individual children were analysed by multilevel modelling. Results Children with bleeding disorders had more and larger bruises, especially when premobile. Compared with premobile children without a bleeding disorder; the modelled ratio of means (95% CI) for number of bruises/ collection was 31.82 (8.39 to 65.42) for severe bleeding disorders and 5.15 (1.23 to 11.17) for mild/moderate, and was 1.81 (1.13 to 2.23) for size of bruises. Children with bleeding disorders rarely had bruises on the ears, neck, cheeks, eyes or genitalia. Conclusions Children with bleeding disorder have more and larger bruises at all developmental stages. The differences were greatest in premobile children. In this age group for children with unexplained bruising, it is essential that coagulation studies are done early to avoid the erroneous diagnosis of physical abuse when the child actually has a serious bleeding disorder, however a blood test compatible with a mild/moderate bleeding disorder cannot be assumed to be the cause of bruising

ارائه یک الگو برای سیستم ملی طبقه بندی اقدامات پزشکی ایران

مقدمه:مدیران اطلاعات بهداشتی، اطلاعات مربوط به مراقبت و درمان را بر اساس سیستم های طبقه بندی اقدامات پزشکی طبقه بندی نموده و براساس اطلاعات طبقه بندی شده گزارشات آماری را تهیه و تحلیل می نمایند . امروزه مراقبت بهداشتی با کیفیت مطلوب بدون وجود یک سیستم طبقه بندی اقدامات پزشکی کامل و کارآمد امکانپذیر نخواهد بود . با استفادهد از این سیستم نتایج عملیات مراقبت در پرونده بیمار به صورت کدهای استاندارد ثبت می شود . این کدها اساس تحلیل اطلاعات برای پرسنل درمانی ، پژوهشگران ، سیاستگذاران و برنامه ریزان بهداشتی است. با توجه به اینکه در حال حاضر در کشور ما یک سیتم طبقه بندی اقدامات که بتواند نیازهای کدگذاران را برآورده کند وجود ندارد، ضرورت ارائه یک الگو مناسب احساس گردیده است. روش بررسی : این تحقیق به صورت یک مطالعه مقطعی ـ مقایسه ای در سال های 82-1381 به منظور ارائه یک الگوی مناسب برای سیستم ملی طبقه بندی اقداماتی پزشکی کشورمان انجام شده است . ابزار گردآوری داده های این پژوهش کتاب ها ، نشریات ، پایان نامه های موجود در کتابخانه ، اینترنت و پست الکترونیکی بوده است . در این پژوهش با مطالعه سیر پیدایش و تکامل ، ساختار ، سازمان ایجادکننده ، مزایا و محدودیت ها و استانداردهای به کار رفته در طراحی سیستم های طبقه بندی اقدامات به زبان انگلیسی و یک الگو برای سیستم ملی طبقه بندی اقدامات پزشکی کشورمان پیشنهاد شد. الگوی پیشنهادی طی دو مرحله به روش دلفی آزمون شده است . سرانجام پس از تحلیل نتایج آزمون ، الگویی مناسب برای سیستم ملی طبقه بندی اقدامات کشورمان ارائه گردیده است . یافته ها : نتایج مطالعه سیستم های ملی طبقه بندی اقدامات نگاشته شده به زبان انگلیسی همراه سیستم های موجود در کشورمان به طور مقایسه ای آورده شده است . همچنین الگوی نهایی در پنج محور اصلی به طور مبسوط تشریح گردیده است. به طور خلاصه می توان چند محوری بودن ، امکان گسترش سیستم بدون تغییر در ساختار آن ، وسعت بیشتر ، در نظر گرفتن راهنمای فارسی کدگذاری اقدامات ، وجود توصیف گرهای مورد نیاز ، استاندارد بودن و تنظیم فصول بر اساس نوع اقدام یا مداخله از مزیت های الگوی ارائه شده در مقایسه با سیستم های اقدامات موجود کشور دانست : نتیجه گیری : الگوی ارائه شده برای سیتسم ملی طبقه بندی اقدامات کشورمان در مقایسه با سیستم ملی طبقه بندی کشورهای انگلیسی زبان بیانگر آن است که این الگو بیشتر منطبق بر سیستم ملی طبقه بندی اقدامات کشورهای اروپای شمالی است. به دلیل نوپا بودن سیستم ملی طبقه بندی اقدامات پزشکی کشورمان و امکان نادیده گرفتن برخی اقدامات ، کدهایی برای موارد طبقه بندی نشده پیش بینی گردید