Cytotoxics compounded sterile preparation control by HPLC during a 16-month assessment in a French university hospital: importance of the mixing bags step

The Centralized Chemotherapy Reconstitution Unit (CCRU) of Paul Brousse Hospital Pharmacy Department assessed the reliability of its Cytotoxics Compounded Sterile Products (CCSP) preparation method in order to improve its CCSP quality assurance system. Five cytotoxic drugs — gemcitabine, 5-fluorouracil, docetaxel, paclitaxel, and oxaliplatin — were assayed by high performance liquid chromatography (HPLC) to determine CCSP concentration. During the observation period, 23,892 CCSP were prepared. Overall, 12,964 preparations contained one of the five analyzed drugs; 7382 (56.9%) out of 12,964 CCSP were analyzed by HPLC; 646 (8.8%) out of 7382 concentrations were outside ± 20% of the prescribed dose; 544 (84.2%) out of 646 were post-administration results and could not be verified. Out of 102 (15.8%) pre-administration results that were re-tested after re-shaking, 94 (92.2%) were found to be acceptable upon re-testing, and 8 (7.8%) were confirmed to be unacceptable and needed to be re-compounded. The 8.8% of tested CCSP were outside ± 20% of the prescribed dose, but extrapolating the results on re-tested CCSP, we can say that our CCSP preparation is reliable with an estimation of only 0.7% of 7382 CCSP analyzed, confirmed as being ± 20% outside the prescribed dose. Nevertheless, this ± 20% magnitude of error should be reduced. Based on pre-administration results, the primary cause of concentration errors appeared to be insufficient mixing of the finished product. Most CCSP dosages occurred after it had been administered, the organization should, therefore, be improved to include testing all CCSP prior to administration. Pharmaceutical companies should endeavor to manufacture compounded injectible drugs in a ‘ready to use’ form and provide vehicles in accurate volumes in order to improve compounding precision

Consequences of the ion beam irradiation on the chemical durability of thorium phosphate diphosphate – kinetics study

RADIOCHIn the field of the long-term specific immobilization of actinides, thorium phosphate diphosphate (β-TPD), as potential candidate, must respond to several criteria. Among them, the material must present a good resistance to irradiation and keep its initial good properties such as resistance to aqueous alteration. In order to check this later point, sintered samples of β-TUPD solid solutions were pre-irradiated with ion beams with various conditions (fluence, stopping power) then submitted to leaching tests in different media (pH, temperature, complexing reagents, flow rate, ...). The normalized dissolution rates depend significantly on the amorphous fraction (increase by a factor of 10–100 between unirradiated and fully amorphized materials). On the contrary, the pre-irradiation of the samples does not affect the kinetic parameters of the dissolution such as the partial order relative to the proton concentration (n = 0.37 ± 0.01 and n = 0.34 ± 0.01 for unirradiated and fully amorphized samples, respectively) and the activation energy of the reaction of dissolution (Eapp = 49 ± 4 kJ mol−1 and Eapp = 42 ± 4 kJ mol−1 for unirradiated and partly amorphized samples (fA < 1), respectively)

The political economy of the Jospin government

This article explores the political economy of the French Socialist Party (PS), beginning with the neo-liberal U-turn of 1983. It then charts the re-evaluation of the PS's political economic foundations after the 1993 defeat, the rejection of the neo-liberal 'pensée unique', and the rehabilitation of a broadly Keynesian frame of reference. The article goes on to explore how this shift has fed through into the Jospin government's policy and positions at both the national and international level. It explores aspirations to reinvent the EU as a Keynesian social democratic 'policy space', and at the national level, employment, macroeconomic, and structural policies

LR characterization of chirotopes of finite planar families of pairwise disjoint convex bodies

We extend the classical LR characterization of chirotopes of finite planar families of points to chirotopes of finite planar families of pairwise disjoint convex bodies: a map \c{hi} on the set of 3-subsets of a finite set I is a chirotope of finite planar families of pairwise disjoint convex bodies if and only if for every 3-, 4-, and 5-subset J of I the restriction of \c{hi} to the set of 3-subsets of J is a chirotope of finite planar families of pairwise disjoint convex bodies. Our main tool is the polarity map, i.e., the map that assigns to a convex body the set of lines missing its interior, from which we derive the key notion of arrangements of double pseudolines, introduced for the first time in this paper.Comment: 100 pages, 73 figures; accepted manuscript versio

Un bilan du systeme reparti a objets SOS

Projet SORNous presentons ici un systeme a objets reparti appele SOS. SOS a pour but de faciliter la programmation d'applications reparties, grace au mecanisme des objets fragmentes. SOS offre de plus des mecanismes generiques pour la gestion des objets composant les applications : invocation, identification, migration, stockage. Nous presentons le modele d'objets de SOS, compose d'objets elementaires et fragmentes. Ce modele garantit l'integrite de type des objets a travers la migration et le stockage, et des communications entre espaces d'objets disjoints, bien qu'aucune forme de typage ne soit imposee. Nous presentons les mecanismes de migration, communication, persistence et nommage. Nous tirons aussi les lecons de cette experience

Computing pseudotriangulations via branched coverings

We describe an efficient algorithm to compute a pseudotriangulation of a finite planar family of pairwise disjoint convex bodies presented by its chirotope. The design of the algorithm relies on a deepening of the theory of visibility complexes and on the extension of that theory to the setting of branched coverings. The problem of computing a pseudotriangulation that contains a given set of bitangent line segments is also examined.Comment: 66 pages, 39 figure

Awareness of cognitive decline trajectories in asymptomatic individuals at risk for AD

Background: Lack of awareness of cognitive decline (ACD) is common in late-stage Alzheimer’s disease (AD). Recent studies showed that ACD can also be reduced in the early stages. Methods: We described different trends of evolution of ACD over 3 years in a cohort of memory-complainers and their association to amyloid burden and brain metabolism. We studied the impact of ACD at baseline on cognitive scores’ evolution and the association between longitudinal changes in ACD and in cognitive score. Results: 76.8% of subjects constantly had an accurate ACD (reference class). 18.95% showed a steadily heightened ACD and were comparable to those with accurate ACD in terms of demographic characteristics and AD biomarkers. 4.25% constantly showed low ACD, had significantly higher amyloid burden than the reference class, and were mostly men. We found no overall effect of baseline ACD on cognitive scores’ evolution and no association between longitudinal changes in ACD and in cognitive scores. Conclusions: ACD begins to decrease during the preclinical phase in a group of individuals, who are of great interest and need to be further characterized. Trial registration: The present study was conducted as part of the INSIGHT-PreAD study. The identification number of INSIGHT-PreAD study (ID-RCB) is 2012-A01731-42

Low Cognitive Awareness, but Not Complaint, is a Good Marker of Preclinical Alzheimer's Disease

Subjective cognitive decline (SCD) may result from many conditions, including Alzheimer's disease (AD)