Product standardisation as a tool to control prescribing costs a case study of alginate liquid preparations

Introduction Product standardisation involves promoting the prescribing of pre-selected products within a particular category across a healthcare region and is designed to improve patient safety by promoting continuity of medicine use across the primary/secondary care interface, in addition to cost containment without compromising clinical care (i.e. maintaining safety and efficacy). Objectives To examine the impact of product standardisation on the prescribing of compound alginate preparations within primary care in Northern Ireland. Methods Data were obtained on alginate prescribing from the Northern Ireland Central Services Agency (Prescription Pricing Branch), covering a period of 43 months. Two standardisation promotion interventions were carried out at months 18 and 33. In addition to conventional statistical analyses, a simple interrupted time series analysis approach, using graphical interpretation, was used to facilitate interpretation of the data. Results There was a significant increase in the prescribed share of the preferred alginate product in each of the four health boards in Northern Ireland and a decrease in the cost per Defined Daily Dose for alginate liquid preparations overall. Compliance with the standardisation policy was, however, incomplete and was influenced to a marked degree by the activities of the pharmaceutical industry. The overall economic impact of the prescribing changes during the study was small (3.1%). Conclusion The findings suggested that product standardisation significantly influenced the prescribing pattern for compound alginate liquid preparations within primary care across Northern Ireland. © 2012 The Authors. IJPP © 2012 Royal Pharmaceutical Society.

In Vitro UDP-Sugar:Undecaprenyl-Phosphate Sugar-1-Phosphate Transferase Assay and Product Detection by Thin Layer Chromatography

In vitro assays are invaluable for the biochemical characterization of UDP-sugar:undecaprenyl-phosphate sugar-1-phosphate transferases. These assays typically involve the use of a radiolabeled substrate and subsequent extraction of the product, which resides in a lipid environment. Here, we describe the preparation of bacterial membranes containing these enzymes, a standard in vitro transferase assay with solvents containing chloroform and methanol, and two methods to measure product formation: scintillation counting and thin layer chromatography.

EFFECT OF IMPELLER DESIGN ON PRODUCT HOMOGENIETY IN HIGH SHEAR WET GRANULATION

Design of small mixer impellers is not tailored for granulation as they are designed for a wide range of processes. The Kenwood KM070 was employed as a standard apparatus to undertake this investigation. Five different impeller designs were used, possessing different shapes and surface areas. The aim of this research was to evaluate the performances of these impellers to provide
guidance on the selection and design for the purposes of granulation. Lactose granules were produced using wet granulation with water as the binder.
The efficacy of respective granulates was measured by adding an optically
sensitive tracer.This was used to determine powder concentrations
within various regions of the granulator. It was found that impeller design influenced the homogeneity of the granules; and therefore can affect final product performance.

The advanced glycation end product, Nepsilon-(carboxymethyl)lysine, is a product of both lipid peroxidation and glycoxidation reactions

Nepsilon-(Carboxymethyl)lysine (CML) is an advanced glycation end product formed on protein by combined nonenzymatic glycation and oxidation (glycoxidation) reactions. We now report that CML is also formed during metal-catalyzed oxidation of polyunsaturated fatty acids in the presence of protein. During copper-catalyzed oxidation in vitro, the CML content of low density lipoprotein increased in concert with conjugated dienes but was independent of the presence of the Amadori compound, fructoselysine, on the protein. CML was also formed in a time-dependent manner in RNase incubated under aerobic conditions in phosphate buffer containing arachidonate or linoleate; only trace amounts of CML were formed from oleate. After 6 days of incubation the yield of CML in RNase from arachidonate was approximately 0.7 mmol/mol lysine compared with only 0.03 mmol/mol lysine for protein incubated under the same conditions with glucose. Glyoxal, a known precursor of CML, was also formed during incubation of RNase with arachidonate. These results suggest that lipid peroxidation, as well as glycoxidation, may be an important source of CML in tissue proteins in vivo and that CML may be a general marker of oxidative stress and long term damage to protein in aging, atherosclerosis, and diabetes.

The efficacy of a CDIO based integrated curriculum as preparation for professional practice in product design and development

The School of Mechanical and Aerospace Engineering at Queen’s University Belfast started BEng and MEng degree programmes in Product Design and Development (PDD) in 2004. Intended from the outset to be significantly different from the existing programmes within the School the PDD degrees used the syllabus and standards defined by the CDIO Initiative as the basis for an integrated curriculum. Students are taught in the context of conceiving, designing, implementing and operating a product. Fundamental to this approach is a core sequence of Design-Build-Test (DBT) experiences which facilitates the development of a range of professional skills as well as the immediate application of technical knowledge gained in strategically aligned supporting modules.
The key objective of the degree programmes is to better prepare students for professional practice. PDD graduates were surveyed using a questionnaire developed by the CDIO founders and interviewed to examine the efficacy of these degree programmes, particularly in this key objective. Graduate employment rates, self assessment of graduate attributes and examples of work produced by MEng graduates provided positive evidence that their capabilities met the requirements of the profession. The 24% questionnaire response rate from the 96 graduates to date did not however facilitate statistically significant conclusions to be drawn and particularly not for BEng graduates who were under represented in the response group. While not providing proof of efficacy the investigation did provide a good amount of useful data for consideration as part of a continuous improvement process.

Phosphorus Adsorption onto an Industrial Acidified Laterite By‒Product: Equilibrium and Thermodynamic Investigation

The present research investigates the uptake of phosphate ions from aqueous solutions using acidified laterite (ALS), a by-product from the production of ferric aluminium sulfate using laterite. Phosphate adsorption experiments were performed in batch systems to determine the amount of phosphate adsorbed as a function of solution pH, adsorbent dosage and thermodynamic parameters per fixed P concentration. Kinetic studies were also carried out to study the effect of adsorbent particle sizes. The maximum removal capacity of ALS observed at pH 5 was 3.68 mg P g^-1. It was found that as the adsorbent dosage increases, the equilibrium pH decreases, so an adsorbent dosage of 1.0 g L^-1 of ALS was selected. Adsorption capacity (q_m) calculated from the Langmuir isotherm was found to be 2.73 mg g^-1. Kinetic experimental data were mathematically well described using the pseudo first-order model over the full range of the adsorbent particle size. The adsorption reactions were endothermic, and the process of adsorption was favoured at high temperature; the ΔG and ΔH values implied that the main adsorption mechanism of P onto ALS is physisorption. The desorption studies indicated the need to consider a NaOH 0.1M solution as an optimal solution for practical regeneration applications.

Rapid and efficient production of L-lactate from xylose using electrodialysis culture-associated product separation

L-Lactate was produced from xylose using electrodialysis culture (ED-C)-associated product separation. In a medium containing 50 g xylose/l, the ED-C was completed in only 32 h (i.e. less than half the time taken by the control culture, without electrodialysis). At 80 g xylose/l, the control culture was unable to consume more than 50 g xylose/1, whereas the ED-C showed increased xylose consumption and was completed by 45 h. The maximum rate of lactate production in the ED-C was higher than that in the control culture. ED-C was also carried out (at 80 g initial xylose/ l) with a supply of fresh xylose-free medium. This ED-C was completed within 30 h, which represents a reduction in fermentation time of 15 h when compared to ED-C without addition of xylose-free medium. Thus, rapid production of L-lactate was achieved by using ED-C which supplied fresh xylose-free medium.

Chaotropicity: a key factor in product tolerance of biofuel-producing microorganisms

Fermentation products can chaotropically disorder macromolecular systems and induce oxidative stress, thus inhibiting biofuel production. Recently, the chaotropic activities of ethanol, butanol and vanillin have been quantified (5.93, 37.4, 174kJkg(-1)m(-1) respectively). Use of low temperatures and/or stabilizing (kosmotropic) substances, and other approaches, can reduce, neutralize or circumvent product-chaotropicity. However, there may be limits to the alcohol concentrations that cells can tolerate; e.g. for ethanol tolerance in the most robust Saccharomyces cerevisiae strains, these are close to both the solubility limit (<25%, w/v ethanol) and the water-activity limit of the most xerotolerant strains (0.880). Nevertheless, knowledge-based strategies to mitigate or neutralize chaotropicity could lead to major improvements in rates of product formation and yields, and also therefore in the economics of biofuel production.

Hierarchical energy management system for multi-source multi-product microgrids

This paper proposes a hierarchical energy management system for multi-source multi-product (MSMP) microgrids. Traditional energy hub based scheduling method is combined with a hierarchical control structure to incorporate transient characteristics of natural gas flow and dynamics of energy converters in microgrids. The hierarchical EMS includes a supervisory control layer, an optimizing control layer, and an execution control layer. In order to efficiently accommodate the systems multi time-scale characteristics, the optimizing control layer is decomposed into three sub-layers: slow, medium and fast. Thermal, gas and electrical management systems are integrated into the slow, medium, and fast control layer, respectively. Compared with wind energy, solar energy is easier to integrate and more suitable for the microgrid environment, therefore, potential impacts of the hierarchical EMS on MSMP microgrids is investigated based on a building energy system integrating photovoltaic and microturbines. Numerical studies indicate that by using a hierarchical EMS, MSMP microgrids can be economically operated. Also, interactions among thermal, gas, and electrical system can be effectively managed.