Proliposome formulations for delivery via medical nebulisers

This study aims to investigate the ability of proliposomes to generate liposomes for delivery using air-jet, ultrasonic and vibrating-mesh nebulisers. Particulate-based proliposomes successfully generated liposomes under static conditions. Manually dispersed proliposomes generated multilamellar vesicles, with formulation having a small effect on the liposome size. Using sucrose as a carrier, liposomes were generated or dispersed in situ from proliposomes within the medical nebulisers investigated. The Pari (air-jet) and the Omron (vibrating-mesh) nebulisers produced large mass and lipid outputs with a large lipid fraction deposited in the lower stage of a two stage impinger. The Liberty (Ultrasonic) nebuliser failed to deliver more than 6% of the lipid employed. Multilamellar liposomes were generated from ethanol-based proliposomes. The resultant vesicles entrapped 62% of the available salbutamol sulphate compared to only 1.23% entrapped by liposomes made by the thin film method. Aeroneb Pro or Aeroneb Go vibrating-mesh nebulisers generated aerosol droplets of larger volume median diameter and narrower size distribution than the Pari (air-jet) nebuliser. Unlike the vibrating-mesh nebulisers, the performance of the jet nebuliser was largely independent of formulation. A nebuliser-dependent significant loss of the originally entrapped drug was demonstrated. A customised large mesh Aeroneb Pro reduced the drug losses during nebulisation. High sensitivity differential scanning calorimetry showed that the phospholipid phase transitions and liposomal bilayer interaction with beclometasone dipropionate were dependent on the method of liposome manufacture. Ethanol-based proliposomes produced liposomes having no pretransition, with a very low incorporation of the steroid (max. 1 mole%). This was attributed to an alcohol-induced interdigitation of the bilayers. 1 to 2.5 mole% steroid seemed to be optimal for incorporation in liposomes manufactured by the thin film or particulate-based proliposome method. Jet-nebulisation of particulate-based proliposomes delivered vesicles with enhanced steroid incorporation compared to liposomes generated by manual dispersion of these proliposomes

Retrofitting multi-span dairy buildings to improve indoor environment

Several dairy farms still have old multi-span barns which are encountering several problems in summer and they are: low ventilation rates, non-uniformed air distribution, heat stress and high indoor concentrations of harmful gases. A solution has been suggested, in this study, which is refurbishing the roofs of old multi-span dairy barns by modifying the roof design, increasing the cowshed height and the roof slope angle. In order to implement this new roof design, rigorous experimental measurements and theoretical calculations were carried out to evaluate the indoor environment before and after refurbishment which was determined by measuring and estimating the following parameters: air exchange rate, indoor temperature, gaseous concentrations (NH3, CH4, N2O, CO2, CO and H2S) and difference between indoor and outdoor temperatures. The results of the field measurements showed that the air exchange rates were 9.6 h-1 and 53.7 h-1 before and after refurbishment, respectively. The measured temperature differences (outdoor to indoor) were 1.1oC and 7.2oC before and after refurbishment, respectively. The indoor gaseous concentrations were 5.6, 19.9, 0.89, 1487, 8.95 and 0.52 mg m-3 before retrofitting; and were 2.8, 13.6, 0.59, 998, 3.3, 0.17 mg m-3 after retrofitting for NH3, CH4, N2O, CO2, CO and H2S, respectively

Early left ventricular dyssynchrony in acute ST elevation myocardial infarction: A gated single photon emission computed tomography study

AbstractIntroductionThe resulting left ventricular (LV) dysfunction in acute STEMI is definitely secondary to loss of myocardial muscle mass (Krumholz et al., 2009; Guerchicoff et al., 2014) but may have an additional component of LV dyssynchrony.AimDetection of LV dyssynchrony in acute STEMI patients and its relation to LV dysfunction in these patients.Patients and methods60 patients presenting with acute STEMI were injected with 25mCi of Tc99m SestaMIBI prior to primary PCI. Acquisition was deferred after the procedure within 6h of injection. Images were analyzed using QGS Cedars Sinai software to measure the histogram bandwidth, standard deviation and entropy using GSPECT phase analysis. The results were compared to 60 patients with negative perfusion scans upon maximal exercise imaged using the same protocol during rest.ResultsOur study included a total number of 60 acute STEMI patients, 54 males, mean age 54.8±10.38years, Compared to 60 controls mean age 50.7+20.3years. Risk factors for CAD were smoking in 41 patients, hypertension in 17, dyslipidemia in 7, diabetes in 15, and positive family history of CAD in 21. 30 patients had acute anterior STEMI and 30 had inferior. LVEDV and LVESV were larger compared to controls; 133.0±88.7 vs. 62.0±19.2ml and 89.7±82.1 vs. 19.9±12.3ml respectively, p<0.001, and lower LVEF 39.0±16.8 vs. 71.1±10.4%, p<0.001. Histogram bandwidth (BW), standard deviation (SD) and entropy (E) values were significantly higher in patients when compared to controls; 76.2±54.7 vs. 17.8±5.3, 20.7±15.2 vs. 4.1±2.0 and 51.1±18.6 vs. 21.8±7.1 degrees respectively, p<0.001. BW, SD and E significantly negatively correlated with LVEF in acute STEMI cases; r=−.733, p<0.001, r=−.75, p<0.001, and r=−.858, p<0.001 respectively.ConclusionLV dyssynchrony may be acquired acutely very early in STEMI and may have a negative impact on LV ejection fraction

What Makes Arab Economies Fail? An Assessment of the Complementary Relationship between Socioeconomic Reforms and Institutions

Following the Arab spring, Arabs today are passing through a dangerous time of tough and difficult choices that bear far-reaching consequences. This paper argues that there was a significant economic element to the Arab Spring, which relies mainly on the Arab economies’ failure to achieve sustained inclusive growth. The purpose of the study is to understand whether the economic growth of the region has been unsatisfactory due to Arab economies lagging in terms of reforms, or because of the reform programs themselves. In this paper, the empirical model analyses the linkages between economic reforms, human capital, physical infrastructure, and governance and growth for a panel of 87 countries, including 20 from the Arab region over the period 1995 to 2014. The analysis finds that macroeconomic and external stability are primary variables for the reform development and the growth prospects of the developing countries. The efficiency of structural reforms depends on success in stabilising the economy. The most striking result from the baseline model is that the coefficient of governance is significant and positively determines growth in the whole sample, while it is harmful in Arab sample. Additionally, the result tends to show that the resource curse in the Arab region is largely an “institutional curse”, even though it has several macroeconomic manifestations. The conclusion of the study confirms that reform is simultaneously political, social and economic. Economic reform should not be seen in a vacuum, in isolation from the political and social choices that society makes

Factors Influencing Adoption of Biometrics by Employees in Egyptian Five Star Hotels

Safety and security of employees and assets are important to hotels. Biometric technology provides a solution to this issue. Our study examined factors that influence adoption of biometrics by employees of Egyptian five star hotels. Using Technology Acceptance Model (TAM) as the theoretical model to test adoption behavior, a survey was designed to explore factors including biometric devices, source of knowledge, ease of use, value added, and concerns about technology application. The Data supported a positive attitude towards biometrics application and some concerns about personal safety. A revised theoretical model was supported by the data. Limitations and recommendations are discussed

Role of Computerized Physician Order Entry Usability in the Reduction of Prescribing Errors

Some hospitals have implemented computerized physician order entry (CPOE) systems to reduce the medical error rates. However, research in this area has been very limited, especially regarding the impact of CPOE use on the reduction of prescribing errors. Moreover, the past studies have dealt with the overall impact of CPOE on the reduction of broadly termed "medical errors", and they have not specified which medical errors have been reduced by CPOE. Furthermore, the majority of the past research in this field has been either qualitative or has not used robust empirical techniques. This research examined the impacts of usability of CPOE systems on the reduction of doctors' prescribing errors. Methods: One hundred and sixty-six questionnaires were used for quantitative data analyses. Since the data was not normally distributed, partial least square path modelling-as the second generation of multivariate data analyses-was applied to analyze data. Results: It was found that the ease of use of the system and information quality can significantly reduce prescribing errors. Moreover, the user interface consistency and system error prevention have a significant positive impact on the perceived ease of use. More than 50% of the respondents believed that CPOE reduces the likelihood of drug allergy, drug interaction, and drug dosing errors thus improving patient safety. Conclusions: Prescribing errors in terms of drug allergy, drug interaction, and drug dosing errors are reduced if the CPOE is not error-prone and easy to use, if the user interface is consistent, and if it provides quality information to doctors

The Role of Nutrient Supplementation to Prevent Perinatal Depression. A Narrative Review

Background: Micronutrient supplements are widely available and can play a crucial role in the prevention of perinatal depression; however, their benefits are still not well studied.Objectives: The authors performed this literature review to assess the effectiveness of micronutrients to prevent perinatal depression.Method: The authors searched electronic databases (PubMed, Scopus, and USW Library) until May 1, 2023. The studies were included if they were evaluating the preventive effect of micronutrients on perinatal depression.Results: The authors identified 3218 articles, of which 14 were eligible to be included in the review (8 RCTs, 3 Cohort studies, and 3 cross-sectional studies). Results of the review illustrate some degree of effectiveness of vitamin D supplementation, calcium, selenium, manganese, and probiotics to provide preventive effects against perinatal depression, while there is no evidence of a significant preventive effect for PUFAS (fish oil) supplementation.Conclusion: Despite the popular information. PUFA supplements had no role in preventing perinatal depression. Other nutrients such as vitamin D, calcium, selenium, manganese, and probiotics showed some protective effects, which warranted more research in this area and preferably in women with a history of perinatal depression for a better understanding of their preventive effects