Effect of Air Injection on Nucleation Rates: An Approach from Induction Time Statistics

From disruption of the supersaturated solution to improved mass transfer in the crystallizing suspension, the introduction of a moving gas phase in a crystallizer could lead to improved rates of nucleation and crystal growth. In this work, saturated air has been injected to batch crystallizers to study the effects on formation of the first crystal and subsequent turbidity buildup. To account for the typically large sample-to-sample variation, nucleation rates were evaluated for a large number of replicates using probability distributions of induction times. The slope and the intercept of the distributions were studied independently, allowing the simultaneous determination of the mean induction time and a certain detection delay related to the rate of crystal growth after formation of the first nucleus. When saturated air was injected in aqueous glycine solutions, the average detection delay was reduced from 69 to 13 min, and the mean induction time decreased from 128 to 36 min. The effect on aqueous solutions of l-arginine was less apparent, with a detection delay reduction from 15 to 3 min, and no significant changes on the rate of primary nucleation. These results demonstrate the potential of this technique for reduction in nucleation induction time and improved mass deposition rates in crystallization operations

Optimization of Grignard Addition to Esters: Kinetic and Mechanistic Study of Model Phthalide using Flow Chemistry

© 2018 American Chemical Society. The kinetics of sequential addition of a distinct Grignard species onto a lactone is studied by flow chemistry. The experimental data are shown to be consistent with a kinetic model based on four reaction steps, reaction of ester to magnesium hemiacetal, rearrangement to ketone (forward and backward), and reaction of ketone to tertiary alcohol upon quenching. The experimental derived reaction mechanism is supported by ab initio molecular computations, and the predicted activation energy is in good agreement with the experimental observations. The Grignard reaction follows a substrate-independent, reductive [2 + 2] cycloaddition of the Meisenheimer/Casper type. Moreover, the rearrangement equilibrium between magnesium hemiacetal and ketone is characterized and found to be feasible. Monoaddition of the ester carbonyl group is demonstrated for fluorophenylmagnesium bromide but at reaction conditions at -40 °C with several hours of residence time. Working under cryogenic temperature conditions is essential to realizing monoaddition of the ester carbonyl group with Grignard reagents

Characterization of a Multistage Continuous MSMPR Crystallization Process assisted by Image Analysis of Elongated Crystals

This work demonstrates how quantitative image analysis can assist in the characterization of continuous crystallization processes and in the proper selection of mathematical models for the early assessment of crystal quality. An active pharmaceutical ingredient presenting an elongated crystal habit was crystallized using two stirred tank crystallizers in series. With image analysis of the crystallization magma, the sources of crystal breakage in the crystallization cascade were identified, and the impact on crystal habit was evaluated quantitatively. As it is expected for particles presenting high aspect ratios, crystal breakage preferentially occurs in the smallest plane, perpendicular to the largest dimension. This phenomenon is hardly avoidable in downstream production, but it can be accounted for with a design approach based on the real crystal dimensions. The kinetic rate equations for nucleation and crystal growth were determined based on crystal width, from which a model for the accurate prediction of this dimension was applied. The predicted crystal size distribution is consistent through a moderate degree of crystal breakage during downstream processing

Female hormonal exposures and neuromyelitis optica symptom onset in a multicenter study

Objective: To study the association between hormonal exposures and disease onset in a cohort of women with neuromyelitis optica spectrum disorder (NMOSD). Methods: Reproductive history and hormone use were assessed using a standardized reproductive survey administered to women with NMOSD (82% aquaporin-4 antibody positive) at 8 clinical centers. Using multivariable regression, we examined the association between reproductive exposures and age at first symptom onset (FS). Results: Among 217 respondents, the mean age at menarche was 12.8 years (SD 1.7). The mean number of pregnancies was 2.1 (SD 1.6), including 0.3 (SD 0.7) occurring after onset of NMOSD symptoms. In the 117 participants who were postmenopausal at the time of the questionnaire, 70% reported natural menopause (mean age: 48.9 years [SD 3.9]); fewer than 30% reported systemic hormone therapy (HT) use. Mean FS age was 40.1 years (SD 14.2). Ever-use of systemic hormonal contraceptives (HC) was marginally associated with earlier FS (39 vs 43 years, p = 0.05). Because HC use may decrease parity, when we included both variables in the model, the association between HC use and FS age became more significant (estimate = 2.7, p = 0.007). Among postmenopausal participants, 24% reported NMOSD onset within 2 years of (before or after) menopause. Among these participants, there was no association between age at menopause or HT use and age at NMOSD onset. Conclusions: Overall, age at NMOSD onset did not show a strong relationship with endogenous hormonal exposures. An earlier onset age did appear to be marginally associated with systemic HC exposure, an association that requires confirmation in future studies

Collaborative International Research in Clinical and Longitudinal Experience Study in NMOSD.

Objective: To develop a resource of systematically collected, longitudinal clinical data and biospecimens for assisting in the investigation into neuromyelitis optica spectrum disorder (NMOSD) epidemiology, pathogenesis, and treatment. Methods: To illustrate its research-enabling purpose, epidemiologic patterns and disease phenotypes were assessed among enrolled subjects, including age at disease onset, annualized relapse rate (ARR), and time between the first and second attacks. Results: As of December 2017, the Collaborative International Research in Clinical and Longitudinal Experience Study (CIRCLES) had enrolled more than 1,000 participants, of whom 77.5% of the NMOSD cases and 71.7% of the controls continue in active follow-up. Consanguineous relatives of patients with NMOSD represented 43.6% of the control cohort. Of the 599 active cases with complete data, 84% were female, and 76% were anti-AQP4 seropositive. The majority were white/Caucasian (52.6%), whereas blacks/African Americans accounted for 23.5%, Hispanics/Latinos 12.4%, and Asians accounted for 9.0%. The median age at disease onset was 38.4 years, with a median ARR of 0.5. Seropositive cases were older at disease onset, more likely to be black/African American or Hispanic/Latino, and more likely to be female. Conclusions: Collectively, the CIRCLES experience to date demonstrates this study to be a useful and readily accessible resource to facilitate accelerating solutions for patients with NMOSD

Lady and the Trump: Status and Wealth in the Marriage Market

We examine a relatively neglected aspect of intergenerational transmission of economic standing, namely culturally determined status markers and their valuation in the marriage market. We take nobility to be such a status marker. Using data on Swedish marriages, we test the hypothesis that nobility have a greater probability of marrying up in terms of wealth. We find a large and statistically significant positive effect for nobility. This finding has important implications for the intergenerational transmission of inequality, and for the longevity of the institution of nobility itself

The development and validation of a scoring tool to predict the operative duration of elective laparoscopic cholecystectomy

Background: The ability to accurately predict operative duration has the potential to optimise theatre efficiency and utilisation, thus reducing costs and increasing staff and patient satisfaction. With laparoscopic cholecystectomy being one of the most commonly performed procedures worldwide, a tool to predict operative duration could be extremely beneficial to healthcare organisations. Methods: Data collected from the CholeS study on patients undergoing cholecystectomy in UK and Irish hospitals between 04/2014 and 05/2014 were used to study operative duration. A multivariable binary logistic regression model was produced in order to identify significant independent predictors of long (> 90 min) operations. The resulting model was converted to a risk score, which was subsequently validated on second cohort of patients using ROC curves. Results: After exclusions, data were available for 7227 patients in the derivation (CholeS) cohort. The median operative duration was 60 min (interquartile range 45–85), with 17.7% of operations lasting longer than 90 min. Ten factors were found to be significant independent predictors of operative durations > 90 min, including ASA, age, previous surgical admissions, BMI, gallbladder wall thickness and CBD diameter. A risk score was then produced from these factors, and applied to a cohort of 2405 patients from a tertiary centre for external validation. This returned an area under the ROC curve of 0.708 (SE = 0.013, p  90 min increasing more than eightfold from 5.1 to 41.8% in the extremes of the score. Conclusion: The scoring tool produced in this study was found to be significantly predictive of long operative durations on validation in an external cohort. As such, the tool may have the potential to enable organisations to better organise theatre lists and deliver greater efficiencies in care