Buprenorphine in Neonatal Abstinence Syndrome.

Infants exposed in utero to opioids will demonstrate a withdrawal syndrome known as neonatal abstinence syndrome (NAS). Buprenorphine is a long-acting opioid with therapeutic use in medication-assisted treatment of opioid dependency in adults and adolescents. Emerging data from clinical trials and treatment cohorts demonstrate the efficacy and safety of sublingual buprenorphine for those infants with NAS who require pharmacologic treatment. Pharmacometric modeling will assist in defining the exposure-response relationships and facilitate dose optimization

License expenditures of incumbents and potential entrants : an empirical analysis of firm behavior.

This paper presents the results of an empirical test concerning the auction model of Gilbert and Newbery (1982). The study uses data on German companies in order to analyze expenditures for technology licenses. Aside of standard control variables the motives for innovation expenditures are also taken into account. We differentiate between firms which intend to secure their present position in the market (incumbents) and those intending to enter a new market (challengers). In line with the prediction of the auction model, it turns out that incumbents show higher expenditures for technology licenses than potential entrants.Behavior; Companies; Data; Firms; Incumbant versus entrant; Innovation;

Pharmacological and non-pharmacological treatments for the Neonatal Abstinence Syndrome (NAS).

Neonatal abstinence syndrome is defined by signs and symptoms of withdrawal that infants develop after intrauterine maternal drug exposure. All infants with documented in utero opioid exposure, or a high pre-test probability of exposure should have monitoring with a standard assessment instrument such as a Finnegan Score. A Finnegan score of \u3e8 is suggestive of opioid exposure, even in the absence of declared use during pregnancy. At least half of infants in most locales can be treated without the use of pharmacologic means. For this reason, symptom scores will drive the decision for pharmacologic therapy. Nevertheless, all infants, regardless of initial manifestations, should be first be managed with non-pharmacologic approaches which in turn, should not be considered as the sole alternative to drug therapy, but rather, as the base upon which all patients are treated. Those who continue to have symptoms despite supportive care should be pharmacologically treated, which in the most severe cases, is life-saving

Tumor necrosis factor inhibitors in psoriatic arthritis.

INTRODUCTION: Psoriatic arthritis (PsA) is a chronic inflammatory disease that can result in significant disability. With the emergence of tumor necrosis factor inhibitors (TNFi), therapeutic outcomes in PsA have improved substantially. The clinical efficacy and the inhibition of radiographic progression demonstrated by TNFi have transformed the management of PsA. However, there is still an unmet need for a subset of patients who do not respond adequately to TNFi. Areas covered: This review provides an overview of the pharmacokinetics of TNFi, the efficacy of TNFi in PsA, and the role of immunogenicity of TNFi in the treatment of PsA. In addition, we address the use of TNFi in the setting of other medications utilized in the treatment of PsA and the potential future role of biosimilars. Expert commentary: Monoclonal antibodies exhibit complex and widely variable pharmacokinetics. The study of factors that can affect the pharmacokinetics, such as immunogenicity, is valuable to further define and understand the use of TNFi in PsA, especially in the subset of patients who do not respond adequately to these agents or lose effectiveness over time

Preliminary Evaluation of a Turbine/Rotary Combustion Compound Engine for a Subsonic Transport

The fuel consumption of a modern compound engine with that of an advanced high pressure ratio turbofan was compared. The compound engine was derived from a turbofan engine by replacing the combustor with a rotary combustion (RC) engine. A number of boost pressure ratios and compression ratios were examined. Cooling of the RC engine was accomplished by heat exchanging to the fan duct. Performance was estimated with an Otto-cycle for two levels of energy lost to cooling. The effects of added complexity on cost and maintainability were not examined and the comparison was solely in terms of cruise performance and weight. Assuming a 25 percent Otto-cycle cooling loss (representative of current experience), the best compound engine gave a 1.2 percent improvement in cruise. Engine weight increased by 23 percent. For a 10 percent Otto-cycle cooling loss (representing advanced insulation/high temperature materials technology), a compound engine with a boost PR of 10 and a compression ratio of 10 gave an 8.1 percent lower cruise than the reference turbofan

Mental health and spiritual well-being in humanitarian crises: the role of faith communities providing spiritual and psychosocial support during the COVID-19 pandemic

Across the globe, people’s reactions to the COVID-19 pandemic and its accompanying lockdowns highlighted, and continued to stress, the relevance of mental health and psychosocial support (MHPSS) in responding to crises, including in low-income and emergency settings. They also demonstrated the importance of faith practices and communities of faith as core needs and important coping mechanisms for many affected people in times of crisis. Drawing on data collected by World Vision International, the world’s largest child-focused humanitarian and development organisation, in the course of its response to COVID-19 in 70 different countries, this article explores the ways in which faith groups and faith leaders responded to the perceived needs of their communities. While keen to offer psychosocial support to people suffering anxiety and fear in the context of the crisis, this has often been integrated with spiritual support. Analysing their work from the framework of a rights-based approach to mental health, we conclude that they did contribute to psychosocial support through their MHPSS, in part through their provision of spiritual care. However, spiritual well-being should not be conflated with psychosocial well-being. While faith groups play an important role in MHPSS, their primary role is to offer spiritual care