Crystal structure of aqua-(2-{[2-({2-[bis-(carboxyl-ato-κ O -meth-yl)amino-κ N ]eth-yl}(carboxyl-ato-κ O -meth-yl)amino-κ N)eth-yl](carb-oxy-meth-yl)aza-niumyl}acetato)-gallium(III) trihydrate

In the title GaIII complex compound with pentetic acid, [Ga(C14H20N3O10)(H2O)]·3H2O, the GaIII centre is bound in a slightly distorted octa­hedral coordination sphere by two amine N atoms, three carboxyl­ate O atoms and one water O atom. The complex mol­ecule exists as a zwitterion. In the crystal, the complexes are linked to each other via O—H⋯O and C—H⋯O hydrogen bonds, forming layers parallel to (001). Three uncoordinating water mol­ecules link the complex layers via O—H⋯O, N—H⋯O and C—H⋯O hydrogen bonds, forming a three-dimensional network

Convergence ― Divergence in Capitalism Revisited

Recently, there has been a surge of interest in analyzing the market as a social structure. One of the major issues is whether the industrialization paths in various countries have become divergent or convergent. In this paper, we attempt to compare South Korea and the United States. Research questions raised are: first, what are the main characteristics of the structural change in the market; and second, whether the evolving Korean industrial structure is converging toward the structure exhibited by advanced economies such as the United States? Because of active interventions of the Korean government in industrial development, we originally expected that the Korean Industrial Input/Output structures would differ from those of the United States. However, we found that Korean I/O structures are moving towards the U.S. structure as the Korean economy develops. We interpreted that the convergent path may have resulted from technological imperatives of inter-industry relations. During the market's evolutionary process, however, we found that the government participated in the evolution of such a market structure by selectively supporting key industries with its policy loans

Fundamentals of aerosol therapy in critical care

Drug dosing in critically ill patients is challenging due to the altered drug pharmacokinetics-pharmacodynamics associated with systemic therapies. For many drug therapies, there is potential to use the respiratory system as an alternative route for drug delivery. Aerosol drug delivery can provide many advantages over conventional therapy. Given that respiratory diseases are the commonest causes of critical illness, use of aerosol therapy to provide high local drug concentrations with minimal systemic side effects makes this route an attractive option. To date, limited evidence has restricted its wider application. The efficacy of aerosol drug therapy depends on drug-related factors (particle size, molecular weight), device factors, patient-related factors (airway anatomy, inhalation patterns) and mechanical ventilation-related factors (humidification, airway). This review identifies the relevant factors which require attention for optimization of aerosol drug delivery that can achieve better drug concentrations at the target sites and potentially improve clinical outcome

Earlier versus later start of antiretroviral therapy in HIV-infected adults with tuberculosis.

Tuberculosis remains an important cause of death among patients infected with the human immunodeficiency virus (HIV). Robust data are lacking with regard to the timing for the initiation of antiretroviral therapy (ART) in relation to the start of antituberculosis therapy

The effect of active pharmaceutical ingredients on aerosol electrostatic charges from pressurized metered dose inhalers

Purpose. This study investigated the effect of different active pharmaceutical ingredients (API) on aerosol electrostatic charges and aerosol performances for pressurized metered dose inhalers (pMDIs), using both insulating and conducting actuators. Methods. Five solution-based pMDIs containing different API ingredients including: beclomethasone dipropionate (BDP), budesonide (BUD), flunisolide (FS), salbutamol base (SB) and ipratropium bromide (IPBr) were prepared using pressure filling technique. Actuator blocks made from nylon, polytetrafluoroethylene (PTFE) and aluminium were manufactured with 0.3 mm nominal orifice diameter and cone nozzle shape. Aerosol electrostatics for each pMDI formulation and actuator were evaluated using the electrical low-pressure impactor (ELPI) and drug depositions were analysed using high performance liquid chromatography (HPLC). Results. All three actuator materials showed the same net charge trend across the five active drug ingredients, with BDP, BUD and FS showing positive net charges for both nylon and PTFE actuators, respectively. While SB and IPBr had significantly negative net charges across the three different actuators, which correlates to the ionic functional groups present on the drug molecule structures. Conclusions. The API present in a pMDI has a dominant effect on the electrostatic properties of the formulation, overcoming the charge effect arising from the actuator materials. Results have shown that the electrostatic charges for a solution-based pMDI could be related to the interactions of the chemical ingredients and change in the work function for the overall formulation

Permanent Pacemaker for Syncope after Heart Transplantation with Bicaval Technique

Sinus node dysfunction occurs occasionally after heart transplantation and may be caused by surgical trauma, ischemia to the sinus node, rejection, drug therapy, and increasing donor age. However, the timing and indication of permanent pacemaker insertion due to sinus node dysfunction following heart transplantation is contentious. Here, we report a case of a permanent pacemaker insertion for syncope due to sinus arrest after heart transplantation, even with a bicaval technique, which has been known to associate with few incidences of sinus node dysfunction

The effect of actuator nozzle designs on the electrostatic charge generated in pressurised metered dose inhaler aerosols

Purpose To investigate the influence of different actuator nozzle designs on aerosol electrostatic charges and aerosol performances for pressurised metered dose inhalers (pMDIs). Methods Four actuator nozzle designs (flat, curved flat, cone and curved cone) were manufactured using insulating thermoplastics (PET and PTFE) and conducting metal (aluminium) materials. Aerosol electrostatic profiles of solution pMDI formulations containing propellant HFA 134a with different ethanol concentration and/or model drug beclomethasone dipropionate (BDP) were studied using a modified electrical low-pressure impactor (ELPI) for all actuator designs and materials. The mass of the deposited drug was analysed using high performance liquid chromatography (HPLC). Results Both curved nozzle designs for insulating PET and PTFE actuators significantly influenced aerosol electrostatics and aerosol performance compared with conducting aluminium actuator, where reversed charge polarity and higher throat deposition were observed with pMDI formulation containing BDP. Results are likely due to the changes in plume geometry caused by the curved edge nozzle designs and the bipolar charging nature of insulating materials. Conclusions This study demonstrated that actuator nozzle designs could significantly influence the electrostatic charges profiles and aerosol drug deposition pattern of pMDI aerosols, especially when using insulating thermoplastic materials where bipolar charging is more dominant