Knee Joint Movement Monitoring Device based on Optical Fiber Bending Sensor

This paper discusses the possible implementation of an optical fiber bending sensor for knee joint monitoring application. The studied technique is based on the use of an intensity modulated optical fiber via angular displacement between two separated fibers, which approach has been implemented previously in spine movement and respiration rate measurement. To estimate the suitability of this technique for knee monitoring application, the maximum range of detection of the sensor is estimated using the output intensity equation for plastic optical fiber. Based on the estimated output intensity graph with respect to bending angle, it is concluded that the aimed technique is not perfectly suitable for the knee monitoring due to limited sensor’s range of motion, which renders a limited the sensor detection range for knee joint movement. In addition to this, several other types of knee joint monitoring devices are also presented and summarized in a table form to highlight the contribution of other devices

Application of SeDeM Expert System in the development of novel directly compressible co-processed excipients via co-processing

Abstract Background Computer-aided formulation design is gaining fantastic attention in chemical engineering of high functionality pharmaceutical materials for dosage form manufacture. To accelerate development of novel formulations in a quality-by-design perspective, SeDeM Expert System preformulation algorithm was developed as a tool for the design of solid drug delivery systems and for prediction of direct compression manufacturability of solid formulations. This research aims to integrate SeDeM Expert System into particle engineering design space of co-processing of solid excipients to develop novel composites with optimum direct compression propensity, using corn starch and microcrystalline cellulose powders as model primary excipients. Result The data and information generated from the expert system have elucidated the bulk-level characteristics of the primary excipients, enabled computation of the optimum co-processing ratio of the ingredients, and validated the impact of co-processing on material functionality. The experimental flowability (7.78±0.17), compressibility functions (5.16±0.14), parameter profile (0.92), and parametric profile index (6.72±0.27) of the engineered composites, were within the acceptable thresholds. With a reliability constant of 0.961, the net direct compression propensity of the composites expressed as Good Compression Index (6.46±0.26) was superior to that of the primary excipients, but comparable to reference co-processed materials, StarLac® (6.44±0.14) and MicroceLac®100 (6.58±0.03). Conclusion Application of SeDeM Expert System in particle engineering via co-processing has provided an accelerated upstream proactive mechanism for designing directly compressible co-processed excipients in a quality-by-design fashion. A four-stage systematic methodology of co-processing of solid excipients was postulated. Stage I entails the characterization of CMAs of both defective and corrective excipients, and elucidation of their physicomechanical limitations using SeDeM diagrams. Stage II involves computation of loading capacity of the corrective excipient using dilution potential equation. Stage III entails the selection of co-processing technique based on desired Critical Material Attributes as revealed by the information obtained from Stage I. Stage IV evaluates the impact of co-processing by monitoring the critical behavior of the engineered composites with a decision on either to accept or reject the product

Differences in Characteristics and Outcome of Patients with Penetrating Injuries in the USA and the Netherlands: A Multi-institutional Comparison

Introduction: The incidence and nature of penetrating injuries differ between countries. The aim of this study was to analyze characteristics and clinical outcomes of patients with penetrating injuries treated at urban Level-1 trauma centers in the USA (USTC) and the Netherlands (NLTC). Methods: In this retrospective cohort study, 1331 adult patients (470 from five NLTC and 861 from three USTC) with truncal penetrating injuries admitted between July 2011 and December 2014 were included. In-hospital mortality was the primary outcome. Outcome comparisons were adjusted for differences in population characteristics in multivariable analyses. Results: In USTC, gunshot wound injuries (36.1 vs. 17.4%, p < 0.001) and assaults were more frequent (91.2 vs. 77.7%, p < 0.001). ISS was higher in USTC, but the Revised Trauma Score (RTS) was comparable. In-hospital mortality was similar (5.0 vs. 3.6% in NLTC, p = 0.25). The adjusted odds ratio for mortality in USTC compared to NLTC was 0.95 (95% confidence interval 0.35–2.54). Hospital stay length of stay was shorter in USTC (difference 0.17 days, 95% CI −0.29 to −0.05, p = 0.005), ICU admission rate was comparable (OR 0.96, 95% CI 0.71–1.31, p = 0.80), and ICU length of stay was longer in USTC (difference of 0.39 days, 95% CI 0.18–0.60, p < 0.0001). More USTC patients were discharged to home (86.9 vs. 80.6%, p < 0.001). Readmission rates were similar (5.6 vs. 3.8%, p = 0.17). Conclusion: Despite the higher incidence of penetrating trauma, particularly firearm-related injuries, and higher hospital volumes in the USTC compared to the NLTC, the in-hospital mortality was similar. In this study, outcome of care was not significantly influenced by differences in incidence of firearm-related injuries

Etiology, screening, and treatment of hepatocellular carcinoma

The prognosis with large hepatocellular carcinomas is poor, and only palliative treatment is available. Small tumors are amenable to several modes of treatment, including liver transplantation, resection, or alcohol injection, with acceptable 5-year survival rates. Although the value of screening for hepatocellular carcinoma has yet to be shown, these data, coupled with the recognition of at-risk groups and useful diagnostic techniques, might encourage the clinician to screen at-risk patients in the clinic. New imaging techniques such as ultrasonographic angiography enhanced with CO2 microbubbles, or color Doppler ultrasound, may clarify the intratumoral blood flow of small tumor

Concurrent use of orthodox and herbal antimalarials among science-based undergraduate students of Ahmadu Bello University, Nigeria

Many patients combine conventional and herbal drug for malaria treatment. The pattern and extent of such concurrent medication among medical and non-medical science based  undergraduate students of Ahmadu Bello University (ABU), Zaria was evaluated in this study. Three hundred and eighty (380) structured questionnaires were administered based on faculties of study to retrieve data. The study indicates that 60.1% of the students utilize hospitals for treatment, while self-medication and patronage of traditional medicine practitioners account for 30.4% and 9.5%, respectively. Majority (57.3%) use orthodox antimalarials alone, 7.6% utilize herbal antimalarials alone, while 35.1% use both concurrently. Non-medical science based students recorded highest incidence of concomitant orthodox–herbal drug usage (23.4%). Evaluation of perception on effectiveness revealed that 48.1% ranked concomitant medication as “relatively effective”, 28.7% regarded it as “considerably effective", and only 23.3% considered it as “not effective”. This study report that concurrent use of orthodox and herbal antimalarials among medical and non-medical science-based undergraduate students of ABU Zaria is not uncommon and that healthcare professionals are not always informed about concomitant drugs usage when visited by clients for treatment. Further studies should evaluate the clinical safety and efficacy of such concurrent use of the antimalarials and prescribers should always inquire and counsel potential parallel medications accordingly.Keywords: Conventional antimalarials; Herbal antimalarials; Concurrent medication; Malaria treatmen

Lymphocyte and macrophage phenotypes in chronic hepatitis C infection. Correlation with disease activity

The pathogenesis of chronic hepatitis C and the mechanisms underlying progressive liver disease in patients with chronic hepatitis C infection are poorly understood. To demonstrate which inflammatory cells might be responsible for the necroinflammatory damage in chronic hepatitis C infection, we have correlated the phenotype of the intrahepatic lymphocytes and macrophages with histological activity in liver biopsy and explant specimens from 19 patients with chronic hepatitis C infection. In all stages of disease, more CD8+ than CD4+ lymphocytes were found. However, histologically active versus histologically mild hepatitis was associated with a trend toward greater parenchymal concentrations of CD4+ lymphocytes (0.71 +/- 0.27 per 10(4) microns 2 versus 0.35 +/- 0.15; not significant), significantly less parenchymal CD8+ lymphocytes (0.90 +/- 0.1 versus 1.70 +/- 0.3; t = 2.32, P = 0.03) and a greater parenchymal CD4/CD8 ratio (4.1 +/- 2.8 versus 0.91 +/- 0.3; t = 1.65, P = 0.07). No difference was found in the number of cells containing cytotoxic granules between the two groups. Greater numbers of CD4+ lymphocytes were found in liver biopsy specimens with little or no staining for hepatitis C virus antigen (1.47 +/- 0.88 versus 0.27 +/- 0.27; t = 2.28, P &lt; 0.05). No significant differences were found in the macrophage subsets between the three stages of disease. Our data suggest that active histological disease in chronic hepatitis C infection may be associated with an increase in CD4+ lymphocytes and suggest that CD4+ T cells may play an important role in the hepatic injury in these patients