Phosphoethanolamine And Omega-3 In Patients With Asthma

The effect of omega-3 (n-3) in asthma has been inconclusive. One explanation for it may be the low incorporation of these fatty acids in clinical studies. Phosphoethanolamine (PEtn) can increase the synthesis of phosphatidylethanolamine, which can, in turn, increase the incorporation of n-3 in cell membranes. The aim of this study is to evaluate the effect of synthetic PEtn in patients with asthma who are receiving n-3. This randomized, double-blind, placebo-controlled study was carried out over a two month period by using spirometry, the Asthma Control Test questionnaire (ACT) and medicine intake. Forty-one patients with asthma were studied. Twenty-one patients received n-3 daily (1.080 mg of EPA, 720 mg of DHA) and 800 mg of PEtn (PEtn group), and twenty patients received the same doses of n-3 and placebo (control group). All patients continued receiving their conventional treatment for asthma. The hospital ethics committee approved the study. Five patients of each group required systemic corticosteroids, being the total consumption, Smaller in the PEtn group (127.4 mg of prednisone/patient versus 416.0 mg of prednisone/patient in the control group, p-value = 0.0269). There were no significant differences in the changing of ATC and FEV1, as well as in the intake of formoterol or budesonide between the groups. In this study, patients who received phosphoethanolamine and omega-3 needed a Smaller dose of systemic corticosteroid for asthma control than patients who only received omega-3. However, as the trial was conducted on a Small scale, more studies are necessary.99185431854

Patch-augmented rotator cuff surgery (PARCS) study-protocol for a feasibility study

Background: A rotator cuff tear is a common disabling shoulder problem. Symptoms include pain, weakness, lack of shoulder mobility and sleep disturbance. Many patients require surgery to repair the tear; however, there is a high failure rate. There is a pressing need to improve the outcome of rotator cuff surgery and the use of patch augmentation to provide support to the healing process and improve patient outcomes holds new promise. Patches have been made using different materials (e.g. human/animal skin or intestine tissue, and completely synthetic materials) and processes (e.g. woven or a mesh). However, clinical evidence on their use is limited. The aim of the patch-augmented rotator cuff surgery (PARCS) feasibility study is to determine, using a mixed method approach, the design of a definitive randomised trial assessing the effectiveness and cost-effectiveness of a patch to augment surgical repair of the rotator cuff that is both acceptable to stakeholders and feasible. Methods: The objectives of this six-stage mixed methods feasibility study are to determine current practice, evidence and views about patch use; achieve consensus on the design of a randomised trial to evaluate patch-augmented rotator cuff surgery; and assess the acceptability and feasibility of the proposed design. The six stages will involve a systematic review of clinical evidence, two surveys of surgeons, focus groups and interviews with stakeholders, a Delphi study and a consensus meeting. The various stakeholders (including patients, surgeons, and representatives from industry, the NHS and regulatory bodies) will be involved across the six stages. Discussion: The PARCS feasibility study will inform the feasibility and acceptability of a randomised trial of the effectiveness and cost-effectiveness of a patch-augmented rotator cuff surgery. Consensus opinion on the basic design of a randomised trial will be sought. Trial registration: Not applicable

Considerations and methods for placebo controls in surgical trials (ASPIRE guidelines)

Placebo comparisons are increasingly being considered for randomised trials assessing the efficacy of surgical interventions. The aim of this Review is to provide a summary of knowledge on placebo controls in surgical trials. A placebo control is a complex type of comparison group in the surgical setting and, although powerful, presents many challenges. This Review outlines what a placebo control entails and present understanding of this tool in the context of surgery. We consider when placebo controls in surgery are acceptable (and when they are desirable) in terms of ethical arguments and regulatory requirements, how a placebo control should be designed, how to identify and mitigate risk for participants in these trials, and how such trials should be done and interpreted. Use of placebo controls is justified in randomised controlled trials of surgical interventions provided there is a strong scientific and ethical rationale. Surgical placebos might be most appropriate when there is poor evidence for the efficacy of the procedure and a justified concern that results of a trial would be associated with high risk of bias, particularly because of the placebo effect. Feasibility work is recommended to optimise the design and implementation of randomised controlled trials. This Review forms an outline for best practice and provides guidance, in the form of the Applying Surgical Placebo in Randomised Evaluations (known as ASPIRE) checklist, for those considering the use of a placebo control in a surgical randomised controlled trial

Swelling behavior of ordered miktoarm star block copolymer-homopolymer blends

We report the morphological characterization of asymmetric miktoarm star block copolymers of the (PS-b-PI)n, PS type where n = 2, 3 (denoted 2DB and 3DB miktoarm stars, respectively) and a symmetric super H-shaped block copolymer of the (PS-b- PI)3PS(PI-b-PS)3 type (denoted SH) which were synthesized by anionic polymerization. The initial volume fraction of PS (φPS) for each copolymer was 0.51-0.56, giving a lamellar morphology. Addition of homopolystyrene (hPS) with a molecular weight lower than the respective PS blocks in the neat materials lead to a transition from the lamellar structure to hexagonally packed cylinders. Addition of low molecular weight homopolyisoprene (hPI) on the other hand, only resulted in swollen lamellae even when the overall composition was highly asymmetric (80/20). Changes in the lamellar spacing as well as in the respective PS and PI layer thickness were measured by SAXS. The transition from lamellae to cylinders with increased PS content occurred without the observation of an intervening cubic morphology for the 2DB and 3DB miktoarm stars. However, blends with 30 and 35% hPS (φPS)total = 0.68-0.70) with the super H-shaped block copolymer lead to the observation of lamellar-catenoid structures. © 2002 Elsevier Science Ltd. All rights reserved

Tricontinuous double gyroid cubic phase in triblock copolymers of the ABA type

We report the synthesis and morphological characterization of two triblock copolymers of the ABA type, where A is polystyrene (PS) and B polyisoprene (PI). The volume fraction of the minority component, PS or PI, is approximately 1/3. Cubic microdomain morphologies, already found in diblock and star block copolymers with the same composition range, are observed for the first time in the case of linear triblock copolymers. The two ABA triblocks are on opposite sides of the phase diagram, which signifies that both the A end blocks and the B midblock are capable of forming the interconnected double network structure. Investigation of the morphology was done via birefringence, small-angle X-ray scattering (SAXS), and transmission electron microscopy (TEM). Birefringence measurements showed each triblock structure to have isotropic optical properties. The characteristic ratio of the observed Bragg peaks, q2/q1, was approximately √4/√3 for each sample, indicating a set of eight possible cubic space groups. TEM data showed an interconnected tricontinuous microdomain structure. Since the two triblocks have essentially complementary structures (PS = 0.32 in one and PI = 0.36 in the other), the TEM images of OsC4-stained thin sections are complementary and the diffraction patterns of the images are approximately equal according to Babinet's principle. Examination of high-symmetry projections demonstrated p6mm, p4mm, and c2mm symmetry present in the TEM images. Comparison with the 〈111〉, 〈100〉 and 〈110〉 projections of the eight cubic space groups satisfying the SAXS data eliminated all but the Fm3m and Ia3d groups as possible structures. Due to the observed connectivity of the structure, the Fm3m structure could be eliminated by inspection of possible network structures and the resultant symmetries. Computer simulations of a model structure (double gyroid) based on level surfaces with Ia3d symmetry and their Fourier transforms showed excellent agreement with the high-symmetry projections and their respective optical transforms

Oriented double gyroid films via roll casting

Films of an isoprene-rich poly (styrene-b-isoprene-b-styrene) (SIS) triblock copolymer thermoplastic elastomer having a highly textured double gyroid (DG) morphology were produced via roll casting and annealing. The symmetries of the extensional and shear flows involved in the roll casting process are not commensurate with those of the cubic Ia3̄d symmetry of the tricontinuous, triply periodic cubic DG phase. Upon roll casting the microdomain morphology produced is predominantly that of cylinders, oriented with the axes along the roll cast direction. Upon annealing, the DG phase nucleates and grows with the [111] direction oriented along the roll cast direction. The resultant textured films are suitable for investigating the directional dependence of physical properties. Films of an isoprene-rich poly (styrene-b-isoprene-b-styrene) (SIS) triblock copolymer thermoplastic elastomer having a highly textured double gyroid (DG) morphology were produced via roll casting and annealing. The symmetries of the extensional and shear flows involved in the roll casting process are not commensurate with those of the cubic Ia3d symmetry of the tricontinuous, triply periodic cubic DG phase. Upon roll casting the microdomain morphology produced is predominantly that of cylinders, oriented with the axes along the roll cast direction. Upon annealing, the DG phase nucleates and grows with the [111] direction oriented along the roll cast direction. The resultant textured films are suitable for investigating the directional dependence of physical properties. (C) 2000 Elsevier Science Ltd. All rights reserved

Mechanical properties and deformation behavior of the double gyroid phase in unoriented thermoplastic elastomers

The mechanical properties of the double gyroid (DG) cubic phase in glassy-rubbery block copolymer systems are examined. The stress-strain properties of an isoprene-rich polystyrene/polyisoprene/polystyrene (SIS) triblock and a polystyrene/polyisoprene (SI) starblock DG, both comprised of two separate interpenetrating glassy networks embedded in rubbery matrices, are compared to those of the sphere, cylinder, and lamellar morphologies. This 3-dimensionally interpenetrating periodic nanocomposite is found to have superior properties over those of its classical counterparts, attributable to the morphology rather than to the volume fraction of the glassy component, the architecture of the molecule, or the molecular weight. The DG is the only polygranular/isotropic thermoplastic elastomer morphology which exhibits necking and drawing and which requires considerably higher stresses for deformation up to 200% strain than any of the three classical microdomain morphologies. The deformation behavior of the DG is further investigated as a function of applied strain using in situ synchrotron small-angle X-ray scattering. Yielding and necking are observed at approx. 20% strain, accompanied by sudden changes in the SAXS patterns: the characteristic Bragg rings of the DG disappear and are replaced by a lobe pattern containing streaks and diffuse scattering. Analysis of the {211} reflection in the SAXS data indicates that PS networks play a large role in governing the deformation behavior. The necking behavior of the DG suggests a different deformation mechanism. The DG samples recover both microscopically and macroscopically upon unloading and annealing, indicating that the complex interconnected nano-composite structure was not permanently damaged, even after having been stretched to 600% strain