Safe to crush? A pilot study into solid dosage form modification in aged care

Aims To observe medication solid dosage form modification in aged care facilities (ACFs), and assess staff levels of self-perceived knowledge of medication modification and the types of resources available to them. Method Observation of medication rounds in a convenience sample of Australian Capital Territory ACFs and assessment of staff knowledge of dosage form modification and available resources. Results From 160 observations across six medication rounds, 29 residents had a total of 75 medications modified by the nursing staff prior to administration, with 32% of these instances identified as inappropriate. The methods used for crushing and administration resulted in drug mixing, spillage and incomplete dosing. The staff reported adequate resources; however, a lack of knowledge on how to locate and use these resources was evident. Conclusions Improved staff training on how to use available resources is needed to reduce the observed high incidence of inappropriate medication crushing.

A comparison of DNA pools constructed following whole genome amplification for two-stage SNP genotyping designs

Genotyping in DNA pools reduces the cost and the time required to complete large genotyping projects. The aim of the present study was to evaluate pooling as part of a strategy for fine mapping in regions of significant linkage. Thirty-nine single nucleotide polymorphisms (SNPs) were analyzed in two genomic DNA pools of 384 individuals each and results compared with data after typing all individuals used in the pools. There were no significant differences using data from either 2 or 8 heterozygous individuals to correct frequency estimates for unequal allelic amplification. After correction, the mean difference between estimates from the genomic pool and individual allele frequencies was .033. A major limitation of the use of DNA pools is the time and effort required to carefully adjust the concentration of each individual DNA sample before mixing aliquots. Pools were also constructed by combining DNA after Multiple Displacement Amplification (MDA). The MDA pools gave similar results to pools constructed after careful DNA quantitation (mean difference from individual genotyping .040) and MDA provides a rapid method to generate pools suitable for some applications. Pools provide a rapid and cost-effective screen to eliminate SNPs that are not polymorphic in a test population and can detect minor allele frequencies as low as 1% in the pooled samples. With current levels of accuracy, pooling is best suited to an initial screen in the SNP validation process that can provide high-throughput comparisons between cases and controls to prioritize SNPs for subsequent individual genotyping.

Oral medication delivery in impaired swallowing: Thickening liquid medications for safe swallowing alters dissolution characteristics

Acetaminophen (paracetamol) is available in a wide range of oral formulations designed to meet the needs of the population across the age-spectrum, but for people with impaired swallowing, i.e. dysphagia, both solid and liquid medications can be difficult to swallow without modification. The effect of a commercial polysaccharide thickener, designed to be added to fluids to promote safe swallowing by dysphagic patients, on rheology and acetaminophen dissolution was tested using crushed immediate-release tablets in water, effervescent tablets in water, elixir and suspension. The inclusion of the thickener, comprised of xanthan gum and maltodextrin, had a considerable impact on dissolution; acetaminophen release from modified medications reached 12-50% in 30 minutes, which did not reflect the pharmacopeia specification for immediate release preparations. Flow curves reflect the high zero-shear viscosity and the apparent yield stress of the thickened products. The weak gel nature, in combination with high G’ values compared to G” (viscoelasticity) and high apparent yield stress, impact drug release. The restriction on drug release from these formulations is not influenced by the theoretical state of the drug (dissolved or dispersed), and the approach typically used in clinical practice (mixing crushed tablets into pre-prepared thickened fluid) cannot be improved by altering the order of incorporation or mixing method.

Status on pre-surgical deformation apparatus for fracture fixation plates

Purpose: This paper reviews the apparatus used for deformation of bone fracture fixation plates during orthopaedic surgeries including surgical irons, pliers and bending press tools. This paper extends the review to various machineries in non-medical industries and adopts their suitability to clinics-related applications and also covers the evolution of orthopaedic bone plates. This review confirms that none of the studied machineries can be implemented for the deformation of bone fracture fixation plates during orthopaedic surgeries. In addition, this paper also presents the novel apparatus that are designed from scratch for this specific purpose. Several conceptual designs have been proposed and evaluated recently. It has been found that Computer Numerical Control (CNC) systems are not the golden solution to this problem and one needs to attempt to design the robotic arm system. A new design of robotic arm that can be used for facilitating orthopaedic surgeries is being completed.

Sinteractive anodic powders improve densification and electrochemical properties of BaZr0.8Y0.2O3-δ electrolyte films for anode-supported solid oxide fuel cells

The difficult sintering of BaZr0.8Y0.2O 3-δ (BZY20) powders makes the fabrication of anode-supported BZY20 electrolyte films complex. Dense BZY20 membranes were successfully fabricated on anode substrates made of sinteractive NiO-BZY20 powders, prepared by a combustion method. With respect to traditional anode substrates made of powders prepared by mechanical mixing, the anode substrates made of the wet-chemically synthesized composite NiO-BZY20 powders significantly promoted the densification of BZY20 membranes: dense BZY20 films were obtained after co-pressing and co-firing at 1300 °C, a much lower temperature than those usually needed for densifying BZY20 membranes. Improved electrochemical performance was also observed: the supported BZY20 films maintained a high proton conductivity, up to 5.4 × 10-3 S cm-1 at 700 °C. Moreover, an anode-supported fuel cell with a 30 m thick BZY20 electrolyte film fabricated at 1400 °C on the anode made of the wet-chemically synthesized NiO-BZY20 powder showed a peak power density of 172 mW cm-2 at 700 °C, using La0.6Sr0.4Co 0.2Fe0.8O3-δ-BaZr0.7Y 0.2Pr0.1O3-δ as the cathode material, with a remarkable performance for proton-conducting solid oxide fuel cell (SOFC) applications.

BaZr0.8Y0.2O3--NiO composite anodic powders for proton-conducting SOFCs prepared by a combustion method

BaZr0.8Y0.2O3- (BZY)-NiO composite powders with different BZY-NiO weight ratios were prepared by a combustion method as anodes for proton-conducting solid oxide fuel cells (SOFCs). After heating to 1100C for 6 h, the composite powders were made of a well-dispersed mixture of two phases, BZY and NiO. Chemical stability tests showed that the BZY-NiO anodic powders had good stability against CO2, whereas comparative tests under the same conditions showed degradation for BaCe0.7Zr 0.1Y0.2O3--NiO, which is at present the most used anode material for proton-conducting SOFCs. Area specific resistance (ASR) measurements for BZY-NiO anodes showed that their electrochemical performance depended on the BZY-NiO weight ratio. The best performance was obtained for the anode containing 50 wt BZY and 50 wt NiO, which showed the smallest ASR values in the whole testing temperature range (0.37 cm2 at 600C). The 50 wt BZY and 50 wt NiO anode prepared by combustion also showed superior performance than that of the BZY-NiO anode conventionally made by a mechanical mixing route, as well as that of Pt.

Dimethyl sulfide and other biogenic volatile organic compound emissions from branching coral and reef seawater: Potential sources of secondary aerosol over the Great Barrier Reef

Volatile organic compounds (VOCs) in the headspace of bubble chambers containing branches of live coral in filtered reef seawater were analysed using gas chromatography with mass spectrometry (GC-MS). When the coral released mucus it was a source of dimethyl sulfide (DMS) and isoprene; however, these VOCs were not emitted to the chamber headspace from mucus-free coral. This finding, which suggests that coral is an intermittent source of DMS and isoprene, was supported by the observation of occasional large pulses of atmospheric DMS (DMSa) over Heron Island reef on the southern Great Barrier Reef (GBR), Australia, in the austral winter. The highest DMSa pulse (320 ppt) was three orders of magnitude less than the DMS mixing ratio (460 ppb) measured in the headspace of a dynamically purged bubble chamber containing a mucus-coated branch of Acropora aspera indicating that coral reefs can be strong point sources of DMSa. Static headspace GC-MS analysis of coral fragments identified mainly DMS and seven other minor reduced sulfur compounds including dimethyl disulfide, methyl mercaptan, and carbon disulfide, while coral reef seawater was an indicated source of methylene chloride, acetone, and methyl ethyl ketone. The VOCs emitted by coral and reef seawater are capable of producing new atmospheric particles < 15 nm diameter as observed at Heron Island reef. DMS and isoprene are known to play a role in low-level cloud formation, so aerosol precursors such as these could influence regional climate through a sea surface temperature regulation mechanism hypothesized to operate over the GBR.

Eddy diffusivity: A single dispersion analysis of high resolution drifters in a tidal shallow estuary

In an estuary, mixing and dispersion resulting from turbulence and small scale fluctuation has strong spatio-temporal variability which cannot be resolved in conventional hydrodynamic models while some models employs parameterizations large water bodies. This paper presents small scale diffusivity estimates from high resolution drifters sampled at 10 Hz for periods of about 4 hours to resolve turbulence and shear diffusivity within a tidal shallow estuary (depth < 3 m). Taylor's diffusion theorem forms the basis of a first order estimate for the diffusivity scale. Diffusivity varied between 0.001 – 0.02 m2/s during the flood tide experiment. The diffusivity showed strong dependence (R2 > 0.9) on the horizontal mean velocity within the channel. Enhanced diffusivity caused by shear dispersion resulting from the interaction of large scale flow with the boundary geometries was observed. Turbulence within the shallow channel showed some similarities with the boundary layer flow which include consistency with slope of 5/3 predicted by Kolmogorov's similarity hypothesis within the inertial subrange. The diffusivities scale locally by 4/3 power law following Okubo's scaling and the length scale scales as 3/2 power law of the time scale. The diffusivity scaling herein suggests that the modelling of small scale mixing within tidal shallow estuaries can be approached from classical turbulence scaling upon identifying pertinent parameters.

Investigating the interactions of road users and pedestrians in a dynamic rail level crossing environment

There are 23,500 level crossings in Australia. In these types of environments it is important to understand what human factor issues are present and how road users and pedestrians engage with crossings. A series of on-site observations were performed over a 2-day period at a 3-track active crossing. This was followed by 52 interviews with local business owners and members of the public. Data were captured using a manual-coding scheme for recording and categorising violations. Over 700 separate road user and pedestrian violations were recorded, with representations in multiple categories. Time stamping revealed that the crossing was active for 59% of the time in some morning periods. Further, trains could take up to 4-min to arrive following its first activation. Many pedestrians jaywalked under side rails and around active boom gates. In numerous cases pedestrians put themselves at risk in order to beat or catch the approaching train, ignored signs to stop walking when the lights were flashing. Analysis of interview data identified themes associated with congestion, safety, and violations. This work offers insight into context specific issues associated with active level crossing protection.