Closed-loop control of continuous piperacillin delivery: an in silico study

Background and objective: Sub-therapeutic dosing of piperacillin-tazobactam in critically-ill patients is associated with poor clinical outcomes and may promote the emergence of drug-resistant infections. In this paper, an in silico investigation of whether closed-loop control can improve pharmacokinetic-pharmacodynamic (PK-PD) target attainment is described. Method: An in silico platform was developed using PK data from 20 critically-ill patients receiving piperacillin-tazobactam where serum and tissue interstitial fluid (ISF) PK were defined. Intra-day variability on renal clearance, ISF sensor error, and infusion constraints were taken into account. Proportional-integral-derivative (PID) control was selected for drug delivery modulation. Dose adjustment was made based on ISF sensor data with a 30-minute sampling period, targeting a serum piperacillin concentration between 32-64 mg/L. A single tuning parameter set was employed across the virtual population. The PID controller was compared to standard therapy, including bolus and continuous infusion of piperacillin-tazobactam. Results: Despite significant inter-subject and simulated intra-day PK variability and sensor error, PID demonstrated a significant improvement in target attainment compared to traditional bolus and continuous infusion approaches. Conclusion: A PID controller driven by ISF drug concentration measurements has the potential to precisely deliver piperacillin-tazobactam in critically-ill patients undergoing treatment for sepsis

An effective Nuclear Model: from Nuclear Matter to Finite Nuclei

The momentum and density dependence of mean fields in symmetric and asymmetric nuclear matter are analysed using the simple density dependent finite range effective interaction containing a single Gaussian term alongwith the zero-range terms. Within the formalism developed, it is possible to reproduce the various diverging predictions on the momentum and density dependence of isovector part of the mean field in asymmetric matter. The finite nucleus calculation is formulated for the simple Gaussian interaction in the framework of quasilocal density functional theory. The prediction of energies and charge radii of the interaction for the spherical nuclei compares well with the results of other effective theories.Comment: 10 pages, 3 figures, 2 tables, To appear in the Proceedings of the 11th International Conference on Nucleus-Nucleus Collisions (NN2012), May 27-June 1, 2012, San Antonio, Texas, US

Cooper pair sizes in 11Li and in superfluid nuclei: a puzzle?

We point out a strong influence of the pairing force on the size of the two neutron Cooper pair in $^{11}$Li, and to a lesser extent also in $^6$He. It seems that these are quite unique situations, since Cooper pair sizes of stable superfluid nuclei are very little influenced by the intensity of pairing, as recently reported. We explore the difference between $^{11}$Li and heavier superfulid nuclei, and discuss reasons for the exceptional situation in $^{11}$Li.Comment: 9 pages. To be published in J. of Phys. G special issue on Open Problems in Nuclear Structure (OPeNST

Acceleration of Solar Wind Ions by Nearby Interplanetary Shocks: Comparison of Monte Carlo Simulations with Ulysses Observations

The most stringent test of theoretical models of the first-order Fermi mechanism at collisionless astrophysical shocks is a comparison of the theoretical predictions with observational data on particle populations. Such comparisons have yielded good agreement between observations at the quasi-parallel portion of the Earth's bow shock and three theoretical approaches, including Monte Carlo kinetic simulations. This paper extends such model testing to the realm of oblique interplanetary shocks: here observations of proton and alpha particle distributions made by the SWICS ion mass spectrometer on Ulysses at nearby interplanetary shocks are compared with test particle Monte Carlo simulation predictions of accelerated populations. The plasma parameters used in the simulation are obtained from measurements of solar wind particles and the magnetic field upstream of individual shocks. Good agreement between downstream spectral measurements and the simulation predictions are obtained for two shocks by allowing the the ratio of the mean-free scattering length to the ionic gyroradius, to vary in an optimization of the fit to the data. Generally small values of this ratio are obtained, corresponding to the case of strong scattering. The acceleration process appears to be roughly independent of the mass or charge of the species.Comment: 26 pages, 6 figures, AASTeX format, to appear in the Astrophysical Journal, February 20, 199

Simultaneous quantification of 12 different nucleotides and nucleosides released from renal epithelium and in human urine samples using ion-pair reversed-phase HPLC

Nucleotides and nucleosides are not only involved in cellular metabolism but also act extracellularly via P1 and P2 receptors, to elicit a wide variety of physiological and pathophysiological responses through paracrine and autocrine signalling pathways. For the first time, we have used an ion-pair reversed-phase high-performance liquid chromatography ultraviolet (UV)-coupled method to rapidly and simultaneously quantify 12 different nucleotides and nucleosides (adenosine triphosphate, adenosine diphosphate, adenosine monophosphate, adenosine, uridine triphosphate, uridine diphosphate, uridine monophosphate, uridine, guanosine triphosphate, guanosine diphosphate, guanosine monophosphate, guanosine): (1) released from a mouse renal cell line (M1 cortical collecting duct) and (2) in human biological samples (i.e., urine). To facilitate analysis of urine samples, a solid-phase extraction step was incorporated (overall recovery rate ? 98 %). All samples were analyzed following injection (100 ?l) into a Synergi Polar-RP 80 Å (250 × 4.6 mm) reversed-phase column with a particle size of 10 ?m, protected with a guard column. A gradient elution profile was run with a mobile phase (phosphate buffer plus ion-pairing agent tetrabutylammonium hydrogen sulfate; pH 6) in 2-30 % acetonitrile (v/v) for 35 min (including equilibration time) at 1 ml min(-1) flow rate. Eluted compounds were detected by UV absorbance at 254 nm and quantified using standard curves for nucleotide and nucleoside mixtures of known concentration. Following validation (specificity, linearity, limits of detection and quantitation, system precision, accuracy, and intermediate precision parameters), this protocol was successfully and reproducibly used to quantify picomolar to nanomolar concentrations of nucleosides and nucleotides in isotonic and hypotonic cell buffers that transiently bathed M1 cells, and urine samples from normal subjects and overactive bladder patients

Congenital Chagas Disease: Recommendations for Diagnosis, Treatment and Control of Newborns, Siblings and Pregnant Women

SCOPUS: ar.jinfo:eu-repo/semantics/publishe

MMS Measurements of the Vlasov Equation: Probing the Electron Pressure Divergence Within Thin Current Sheets

We investigate the kinetic structure of electron‐scale current sheets found in the vicinity of the magnetopause and embedded in the magnetosheath within the reconnection exhaust. A new technique for computing terms of the Vlasov equation using Magnetospheric Multiscale (MMS) measurements is presented and applied to study phase space density gradients and the kinetic origins of the electron pressure divergence found within these current sheets. Crescent‐shaped structures in ∇⊥2fe give rise to bipolar and quadrupolar signatures in v·∇fe measured near the maximum ∇·Pe inside the current layers. The current density perpendicular to the magnetic field is strong (J⊥∼2 μA/m2), and the thickness of the current layers ranges from 3 to 5 electron inertial lengths. The electron flows supporting the current layers mainly result from the combination of E×B and diamagnetic drifts. We find nonzero J·E′ within the current sheets even though they are observed apart from typical diffusion region signatures.publishedVersio

Effects of isopropanol on collagen fibrils in new parchment

Background: Isopropanol is widely used by conservators to relax the creases and folds of parchment artefacts. At present, little is known of the possible side effects of the chemical on parchments main structural component- collagen. This study uses X-ray Diffraction to investigate the effects of a range of isopropanol concentrations on the dimensions of the nanostructure of the collagen component of new parchment. Results: It is found in this study that the packing features of the collagen molecules within the collagen fibril are altered by exposure to isopropanol. The results suggest that this chemical treatment can induce a loss of structural water from the collagen within parchment and thus a rearrangement of intermolecular bonding. This study also finds that the effects of isopropanol treatment are permanent to parchment artefacts and cannot be reversed with rehydration using deionised water. Conclusions: This study has shown that isopropanol induces permanent changes to the packing features of collagen within parchment artefacts and has provided scientific evidence that its use to remove creases and folds on parchment artefacts will cause structural change that may contribute to long-term deterioration of parchment artefacts. This work provides valuable information that informs conservation practitioners regarding the use of isopropanol on parchment artefacts