Compounded Apixaban Suspensions for Enteral Feeding Tubes

Objective: There is limited information on compounded apixaban formulations for administration via enteral feeding tubes. This study was designed to identify a suitable apixaban suspension formulation that is easy to prepare in a pharmacy setting, is compatible with commonly used feeding tubes, and has a beyond-use date of seven days. Methods: Apixaban suspensions were prepared from commercially available 5 mg Eliquis® tablets. Several vehicles and compounding methods were screened for ease of preparation, dosage accuracy, and tube compatibility. Two tubing types, polyurethane and polyvinyl chloride (PVC), with varying lengths and diameters, were included in the study. They were mounted on a peg board during evaluation to mimic the patient body position. A seven-day stability study of the selected formulation was also conducted. Results: Vehicles containing 40-60% Ora-Plus® in water all exhibited satisfactory flowability through the tubes. The mortar/pestle compounding method was found to produce more accurate and consistent apixaban suspensions than the pill crusher or crushing syringe method. The selected formulation, 0.25 mg/mL apixaban in 50:50 Ora-Plus®:water, was compatible with both tubing types, retaining \u3e 98% drug in post-tube samples. The stability study also confirmed that this formulation was stable physically and chemically over seven days of storage at room temperature. Conclusions: A suitable apixaban suspension formulation was identified for administration via enteral feeding tubes. The formulation consisted of 0.25 mg/mL apixaban in 50:50 Ora-Plus®:water. The stability study results supported a beyond-use date of seven days at room temperature

The three dimensional globally modified Navier-Stokes equations: Recent developments

The globally modified Navier-Stokes equations (GMNSE) were introduced by Caraballo, Kloeden & Real in 2006 and have been investigated in a number of papers since then, both for their own sake and as a means of obtaining results about the 3-dimensionalNavier-Stokes equations. These results were reviewed by Kloeden et al, which was published in 2009, but there have been some important developments since then, which will be reviewed here

Random attractors for stochastic 2D-Navier-Stokes equations in some unbounded domains

We show that the stochastic flow generated by the Stochastic Navier-Stokes equations in a 2-dimensional Poincar\'e domain has a unique random attractor. This result complements a recent result by Brze\'zniak and Li [10] who showed that the flow is asymptotically compact and generalizes a recent result by Caraballo et al. [12] who proved existence of a unique pullback attractor for the time-dependent deterministic Navier-Stokes equations in a 2-dimensional Poincar\'e domain

Improving health literacy about Tuberculosis among drug users. A pilot randomized controlled trial

Introduction: Despite effective treatment, tuberculosis remains among the top-10 causes of death causing ~1.3 million deaths in 2017. Furthermore, tuberculosis infection rates have increased amongst excluded populations such as people misusing substances. Objectives and design: We conducted a two London sites pilot randomized controlled trial to test interventions, recruitment, attrition rates and assessment procedures of a parallel, three-arms controlled trial to assess the effectiveness of tuberculosis health literacy interventions among drug dependent (heroin, crack cocaine or heroin and crack cocaine) population in treatment. Results: Forty-two subjects were recruited to the pilot trial (response rate = 26%) and randomized to three interventions (1st: Information booklet; 2nd: Interactive seminar; 3rd: Interactive seminar + contingency management targeting tuberculosis-health-related action). Baseline and post-intervention tuberculosis knowledge scores were obtained and re-assessed at 2-months follow up. The overall attrition rate was 43%. The knowledge scale had good internal reliability (Cronbach’s α = 0.7). Statistically significant increases in knowledge scores (baseline to post-intervention = 5.9 points, baseline to follow-up = 4.3) were recorded for the whole sample (CI = 99%; p < 0.001 for both analysis), but no statistically significant differences between-groups were observed (p = 0.7). Half of participants in the contingency management group achieved their health-action targets. Conclusion: Health literacy interventions to increase knowledge about tuberculosis among drug users are feasible and achieve promising increases in knowledge and health-related actions but measures to prevent a high attrition rate in a large-scale trial must be introduced. The absence of difference between trial-group outcomes suggests low-intensity interventions may achieve knowledge gain too. Further investigation of contingency management to promote tuberculosis-related health behaviours is needed

Study of the chemostat model with non-monotonic growth under random disturbances on the removal rate

We revisit the chemostat model with Haldane growth function, here subject to bounded random disturbances on the input flow rate, as often met in biotechnological or waste-water industry. We prove existence and uniqueness of global positive solution of the random dynamics and existence of absorbing and attracting sets that are independent of the realizations of the noise. We study the longtime behavior of the random dynamics in terms of attracting sets, and provide first conditions under which biomass extinction cannot be avoided. We prove conditions for weak and strong persistence of the microbial species and provide lower bounds for the biomass concentration, as a relevant information for practitioners. The theoretical results are illustrated with numerical simulations

L\'evy-areas of Ornstein-Uhlenbeck processes in Hilbert-spaces

In this paper we investigate the existence and some useful properties of the L\'evy areas of Ornstein-Uhlenbeck processes associated to Hilbert-space-valued fractional Brownian-motions with Hurst parameter $H\in (1/3,1/2]$. We prove that this stochastic area has a H\"older-continuous version with sufficiently large H\"older-exponent and that can be approximated by smooth areas. In addition, we prove the stationarity of this area.Comment: 18 page

Smooth stable and unstable manifolds for stochastic partial differential equations

Invariant manifolds are fundamental tools for describing and understanding nonlinear dynamics. In this paper, we present a theory of stable and unstable manifolds for infinite dimensional random dynamical systems generated by a class of stochastic partial differential equations. We first show the existence of Lipschitz continuous stable and unstable manifolds by the Lyapunov-Perron's method. Then, we prove the smoothness of these invariant manifolds

The random case of Conley's theorem: III. Random semiflow case and Morse decomposition

In the first part of this paper, we generalize the results of the author \cite{Liu,Liu2} from the random flow case to the random semiflow case, i.e. we obtain Conley decomposition theorem for infinite dimensional random dynamical systems. In the second part, by introducing the backward orbit for random semiflow, we are able to decompose invariant random compact set (e.g. global random attractor) into random Morse sets and connecting orbits between them, which generalizes the Morse decomposition of invariant sets originated from Conley \cite{Con} to the random semiflow setting and gives the positive answer to an open problem put forward by Caraballo and Langa \cite{CL}.Comment: 21 pages, no figur

Random attractors for degenerate stochastic partial differential equations

We prove the existence of random attractors for a large class of degenerate stochastic partial differential equations (SPDE) perturbed by joint additive Wiener noise and real, linear multiplicative Brownian noise, assuming only the standard assumptions of the variational approach to SPDE with compact embeddings in the associated Gelfand triple. This allows spatially much rougher noise than in known results. The approach is based on a construction of strictly stationary solutions to related strongly monotone SPDE. Applications include stochastic generalized porous media equations, stochastic generalized degenerate p-Laplace equations and stochastic reaction diffusion equations. For perturbed, degenerate p-Laplace equations we prove that the deterministic, infinite dimensional attractor collapses to a single random point if enough noise is added.Comment: 34 pages; The final publication is available at http://link.springer.com/article/10.1007%2Fs10884-013-9294-