Modeling the biomechanics of cells on microcarriers in a stirred-tank bioreactor: an ABM-CFD coupling approach

Highly productive and efficient biomass growth in bioreactors is an essential bioprocess outcome in many industrial applications. Large-scale biomass creation in the cultivated meat industry will be critical given the demand size in the conventional meat and seafood sectors. However, many challenges must be overcome before cultivated meat and seafood become commercially viable, including cost reductions of cell culture media, bioprocess design innovation and optimization, and scaling up in the longer term. Computational modeling and simulation can help to address many of these challenges and can be a far cheaper and faster alternative to performing physical experiments. Computer modeling can also help researchers pinpoint system interactions that matter and guide researchers to identify those parameters that should be changed in later designs for eventual optimization. This work developed a computational model that combines agent-based modeling and computational fluid dynamics to study biomass growth as a function of the operative conditions of stirred-tank bioreactors. The focus was to analyze how the mechanical stress induced by rotor speed can influence the growth of cells attached to spherical microcarriers. The computer simulation results reproduced observations from physical experiments that high rotor speeds reduce cell growth rates and induce cell death under the high mechanical stresses induced at these stir speeds. Moreover, the results suggest that modeling cell death and cell quiescence is required to recapitulate these observations from physical experiments. These simulation outcomes are the first step towards more comprehensive models that, combined with experimental observations, will improve our knowledge of biomass production in bioreactors for cultivated meat and other industries

An error tolerant memory aid for reduced cognitive load in number copying tasks

Number copying tasks are still common despite increased digitalization of services. Number copying tasks are cognitively and visually demanding, errors are easily introduced and the process is often perceived as laborious. This study proposes an alternative scheme based on dictionary coding that reduces the cognitive load on the user by a factor of five. The strategy has several levels of error detection and error correction characteristics and is easy to implemen

The effects of using the PReDicT Test to guide the antidepressant treatment of depressed patients: study protocol for a randomised controlled trial

Background Antidepressant medication is commonly used to treat depression. However, many patients do not respond to the first medication prescribed and improvements in symptoms are generally only detectable by clinicians 4–6 weeks after the medication has been initiated. As a result, there is often a long delay between the decision to initiate an antidepressant medication and the identification of an effective treatment regimen. Previous work has demonstrated that antidepressant medications alter subtle measures of affective cognition in depressed patients, such as the appraisal of facial expression. Furthermore, these cognitive effects of antidepressants are apparent early in the course of treatment and can also predict later clinical response. This trial will assess whether an electronic test of affective cognition and symptoms (the Predicting Response to Depression Treatment Test; PReDicT Test) can be used to guide antidepressant treatment in depressed patients and, therefore, hasten treatment response compared to a control group of patients treated as usual. Methods/design The study is a randomised, two-arm, multi-centre, open-label, clinical investigation of a medical device, the PReDicT Test. It will be conducted in five European countries (UK, France, Spain, Germany and the Netherlands) in depressed patients who are commencing antidepressant medication. Patients will be randomised to treatment guided by the PReDicT Test (PReDicT arm) or to Treatment as Usual (TaU arm). Patients in the TaU arm will be treated as per current standard guidelines in their particular country. Patients in the PReDicT arm will complete the PReDicT Test after 1 (and if necessary, 2) weeks of treatment. If the test indicates non-response to the treatment, physicians will be advised to immediately alter the patient’s antidepressant therapy by dose escalation or switching to another compound. The primary outcome of the study is the proportion of patients showing a clinical response (defined as 50% or greater decrease in baseline scores of depression measured using the Quick Inventory of Depressive Symptoms – Self-Rated questionnaire) at week 8. Health economic and acceptability data will also be collected and analysed. Discussion This trial will test the clinical efficacy, cost-effectiveness and acceptability of using the novel PReDicT Test to guide antidepressant treatment selection in depressed patients

Mind the gap: Investigating the role of collective action in the evolution of Indian medical device regulation

Using the Indian medical device sector as a case study, this research examines the evolution of regulatory frameworks by analysing the conditions and processes through which regulatory environments for a technology-based industry come about. It also attempts to unpack the complex relationships between industrial capabilities in healthcare technology and human health, and the role of regulation in facilitating more inclusive healthcare and development in emerging countries. In doing so, the paper explains the ways in which an absence of collective action can severely inhibit the development of appropriate technological regulation and industry growth, particularly in the context of developing countries. It shows that contestation, conflict and coalitions as a key mechanism through which different stakeholders influence, enable and/or disable institutional change. These findings have significant implications for other developing countries which are struggling with the development of healthcare technology regulatory policy that is appropriate to local societal context and needs

Impact of opioid rescue medication for breakthrough pain on the efficacy and tolerability of long-acting opioids in patients with chronic non-malignant pain

There is little evidence that short-acting opioids as rescue medication for breakthrough pain is an optimal long-term treatment strategy in chronic non-malignant pain. We compared clinical studies of long-acting opioids that allowed short-acting opioid rescue medication with those that did not, to determine the impact of opioid rescue medication use on the analgesic efficacy and tolerability of chronic opioid therapy in patients with chronic non-malignant pain. We searched MEDLINE (1950 to July 2006) and EMBASE (1974 to July 2006) using terms for chronic non-malignant pain and long-acting opioids. Independent review of the search results identified 48 studies that met the study selection criteria. The effect of opioid rescue medication on analgesic efficacy and the incidence of common opioid-related side-effects were analysed using meta-regression. After adjusting for potentially confounding variables (study design and type of opioid), the difference in analgesic efficacy between the 'rescue' and the 'no rescue' studies was not significant, with regression coefficients close to 0 and 95% confidence intervals that excluded an effect of more than 18 points on a 0-100 scale in each case. There was also no significant difference between the 'rescue' and the 'no rescue' studies for the incidence of nausea, constipation, or somnolence in both the unadjusted and the adjusted analyses. We found no evidence that rescue medication with short-acting opioids for breakthrough pain affects analgesic efficacy of long-acting opioids or the incidence of common opioid-related side-effects among chronic non-malignant pain patients

Regulating E-Cigarettes: Why Policies Diverge

This paper, part of a festschrift in honor of Professor Malcolm Feeley, explores the landscape of e-cigarette policy globally by looking at three jurisdictions that have taken starkly different approaches to regulating e-cigarettes—the US, Japan, and China. Each of those countries has a robust tobacco industry, government agencies entrusted with protecting public health, an active and sophisticated scientific and medical community, and a regulatory structure for managing new pharmaceutical, tobacco, and consumer products. All three are signatories of the World Health Organization’s Framework Convention on Tobacco Control, all are signatories of the Agreement on Trade-Related Aspects of Intellectual Property Rights, and all are members of the World Trade Organization. Which legal, economic, social and political differences between the three countries explain their diverse approaches to regulating e-cigarettes? Why have they embraced such dramatically different postures toward e-cigarettes? In seeking to answer those questions, the paper builds on Feeley\u27s legacy of comparative scholarship, policy analysis, and focus on law in action

Law, Environment, and the “Nondismal” Social Sciences

Over the past 30 years, the influence of economics over the study of environmental law and policy has expanded considerably, becoming in the process the predominant framework for analyzing regulations that address pollution, natural resource use, and other environmental issues. This review seeks to complement the expansion of economic reasoning and methodology within the field of environmental law and policy by identifying insights to be gleaned from various “nondismal” social sciences. In particular, three areas of inquiry are highlighted as illustrative of interdisciplinary work that might help to complement law and economics and, in some cases, compensate for it: the study of how human individuals perceive, judge, and decide; the observation and interpretation of how knowledge schemes are created, used, and regulated; and the analysis of how states and other actors coordinate through international and global regulatory regimes. The hope is to provide some examples of how environmental law and policy research can be improved by deeper and more diverse engagement with social science