Improving antimicrobial release kinetics from hydrophobic polymer implants via ion pairing to combat biomedical-device related infection

Purpose The aim of this study is to improve the drug release properties of antimicrobial agents from hydrophobic biomaterials using using an ion pairing strategy. In so doing antimicrobial agents may be eluted and maintained over a sufficient time period thereby preventing bacterial colonisation and subsequent biofilm formation on medical devices. Methods The model antimicrobial agent was chlorhexidine and the selected fatty acid counter ions were capric acid, myristic acid and stearic acid. The polymethyl methacrylate films were loaded with 2% of fatty acid:antimicrobial agent at the following molar ratios; 0.5:1M, 1:1M and 2:1M and thermally polymerized using azobisisobutyronitrile initiator. Drug release experiments were subsequently performed over a 3-month period and the mass of drug released under sink conditions (pH 7.0, 37oC) quantified using a validated HPLC-UV method. Results In all platforms, a burst of chlorhexidine release was observed over the initial 24-hour period. Similar release kinetics were observed between the formulations during the initial 28 days. However, as time progressed, the chlorhexidine baseline plateaued after 56 days whereas formulations containing the counterions appeared to continuously elute linearly with time. As can be observed in figure 1, the rank order of total chlorhexidine release in the presence of 0.5M fatty acid was myristic acid (40%) > capric acid (35%) > stearic acid (30%)> chlorhexidine baseline (15%). Conclusion The incorporation of fatty acids within the formulation significantly improved chlorhexidine solubility within both the monomer and the polymer and enhanced the drug release kinetics over the period of study. This is attributed to the greater diffusivity of chlorhexidine through PMMA in the presence of fatty acids. In th absence of fatty acids, chlorhexidine release was facilitated by dissolution of surface associated drug particles. This study has illustrated the ability of fatty acids to modulate chlorhexidine release from a model biomaterial through enhanced diffusivity. This strategy may prove advantageous for improved medical devices with enhanced resistance to infection.

New pairing scheme to overhaul BCS theory

In a superconductor pair occupancy probabilities are doubly defined with conflicting values when normal and umklapp scattering coexist with the same destination momentum. To resolve this issue a new pairing scheme is introduced to assert normal–umklapp frustration under such circumstances. Superconductivity then arises solely from residual umklapp scattering to destination momenta not reached by normal scattering. Consequent Tc calculations from first principles for niobium, tantalum, lead and aluminum turn out to be accurate within a few percent. A new perspective is revealed to support Matthias׳ rule. New light is also shed relevant to the future study of metallic hydrogen.

Protocolised weaning from mechanical ventilation: pairing a qualitative review with an effectiveness review

In our systematic review of protocolised weaning from mechanical ventilation (Blackwood 2014) we found significant heterogeneity that could not be explained by subgroup analysis (type of protocol, ICU). We suspected that factors unreported in the trials relating to context and mechanisms of using the weaning protocols contributed to the heterogeneity. Therefore we set out to conduct a Cochrane qualitative evidence-synthesis of ‘sibling studies’ (qualitative studies undertaken alongside the included trials that may have examined these factors) and ‘stand-alone’ qualitative studies reporting barriers and facilitators to successful implementation of weaning protocols. The qualitative review was novel, there were few templates or guidelines which challenged us to consider how best to synthesise and report this evidence. However, the benefits of conducting this review are that not only do we have a template for future qualitative syntheses for the ACE group, but specifically for trials of weaning protocols, we found context-specific evidence concerning if, how and why specific protocols have been effective in the settings in which they were delivered and received.

An investigation into the subambient behavior of aqueous mannitol solutions using differential scanning calorimetry, cold stage microscopy, and X-ray diffractometry

The subambient behavior of aqueous mannitol solutions is of considerable relevance to the preparation of freeze dried formulations. In this investigation the properties of 3% w/v mannitol solutions were investigated using differential scanning calorimetry (DSC), cold stage microscopy (CSM), and X-ray diffraction (XRD) to identify the thermal transitions and structural transformations undergone by this system. It was found that on cooling from ambient the system formed ice at circa -20°C while a further exotherm was seen at approximately -30°C. Upon reheating an endotherm was seen at circa -30°C followed immediately by an exotherm at circa -25°C. Temperature cycling indicated that the thermal transitions observed upon reheating were not reversible. Modulated temperature DSC (MTDSC) indicated that the transitions observed upon reheating corresponded to a glass transition immediately followed by recrystallization, XRD data showed that recrystallization was into the ß form. Annealing at -35°C for 40 min prior to cooling and reheating resulted in a maximum enthalpy being observed for the reheating exotherm. It is concluded that on cooling 3% w/v aqueous mannitol solutions an amorphous phase is formed that subsequently recrystallises into the ß form. The study has also shown that DSC, CSM, and XRD are useful complementary techniques for the study of frozen systems

A note on the prediction of liquid hold-up with the stratified roll wave regime for gas/liquidco-current flow in horizontal pipes.

This note presents a simple model for prediction of liquid hold-up in two-phase horizontal pipe flow for the stratified roll wave (St+RW) flow regime. Liquid hold-up data for horizontal two-phase pipe flow [1, 2, 3, 4, 5 and 6] exhibit a steady increase with liquid velocity and a more dramatic fall with increasing gas rate as shown by Hand et al. [7 and 8] for example. In addition the liquid hold-up is reported to show an additional variation with pipe diameter. Generally, if the initial liquid rate for the no-gas flow condition gives a liquid height below the pipe centre line, the flow patterns pass successively through the stratified (St), stratified ripple (St+R), stratified roll wave, film plus droplet (F+D) and finally the annular (A+D, A+RW, A+BTS) regimes as the gas rate is increased. Hand et al. [7 and 8] have given a detailed description of this progression in flow regime development and definitions of the patterns involved. Despite the fact that there are over one hundred models which have been developed to predict liquid hold-up, none have been shown to be universally useful, while only a handful have proven to be applicable to specific flow regimes [9, 10, 11 and 12]. One of the most intractable regimes to predict has been the stratified roll wave pattern where the liquid hold-up shows the most dramatic change with gas flow rate. It has been suggested that the momentum balance-type models, which give both hold-up and pressure drop prediction, can predict universally for all flow regimes but particularly in the case of the difficult stratified roll wave pattern. Donnelly [1] recently demonstrated that the momentum balance models experienced some difficulties in the prediction of this regime. Without going into lengthy details, these models differ in the assumed friction factor or shear stress on the surfaces within the pipe particularly at the liquid–gas interface. The Baker–Jardine model [13] when tested against the 0.0454 m i.d. data of Nguyen [2] exhibited a wide scatter for both liquid hold-up and pressure drop as shown in Fig. 1. The Andritsos–Hanratty model [14] gave better prediction of pressure drop but a wide scatter for liquid hold-up estimation (cf. Fig. 2) when tested against the 0.0935 m i.d. data of Hand [5]. The Spedding–Hand model [15], shown in Fig. 3 against the data of Hand [5], gave improved performance but was still unsatisfactory with the prediction of hold-up for stratified-type flows. The MARS model of Grolman [6] gave better prediction of hold-up (cf. Fig. 4) but deterioration in the estimation of pressure drop when tested against the data of Nguyen [2]. Thus no method is available that will accurately predict liquid hold-up across the whole range of flow patterns but particularly for the stratified plus roll wavy regime. The position is particularly unfortunate since the stratified-type regimes are perhaps the most predominant pattern found in multiphase lines.