Avandamet:Combined metformin-rosiglitazone treatment for insulin resistance in type 2 diabetes

Insulin resistance is a major endocrinopathy underlying the development of hyperglycaemia and cardiovascular disease in type 2 diabetes. Metformin (a biguanide) and rosiglitazone (a thiazolidinedione) counter insulin resistance, acting by different cellular mechanisms. The two agents can be used in combination to achieve additive glucose-lowering efficacy in the treatment of type 2 diabetes, without stimulating insulin secretion and without causing hypoglycaemia. Both agents also reduce a range of atherothrombotic factors and markers, indicating a lower cardiovascular risk. Early intervention with metformin is already known to reduce myocardial infarction and increase survival in overweight type 2 patients. Recently, a single-tablet combination of metformin and rosiglitazone, Avandamet, has become available. Avandamet is suitable for type 2-diabetic patients who are inadequately controlled by monotherapy with metformin or rosiglitazone. Patients already receiving separate tablets of metformin and rosiglitazone may switch to the single-tablet combination for convenience. Also, early introduction of the combination before maximal titration of one agent can reduce side effects. Use of Avandamet requires attention to the precautions for both metformin and rosiglitazone, especially renal, cardiac and hepatic competence. In summary, Avandamet is a single-tablet metformin-rosiglitazone combination that doubly targets insulin resistance as therapy for hyperglycaemia and vascular risk in type 2 diabetes. © 2004 Blackwell Publishing Ltd.

A pragmatic approach for engineering porous mannitol and mechanistic evaluation of particle performance

The importance of mannitol has increased recently as an emerging diluent for orodispersible dosage forms. The study aims to prepare spray dried mannitol retaining high porosity and mechanical strength for the development of orally disintegrating tablets (ODTs). Aqueous feed of d-mannitol (10% w/v) comprising ammonium bicarbonate, NH4HCO3 (5% w/v) as pore former was spray dried at inlet temperature of 110-170°C. Compacts were prepared at 151MPa and characterized for porosity, hardness and disintegration time. Particle morphology and drying mechanisms were studied using thermal (HSM, DSC and TGA) and polymorphic (XRD) methods. Tablet porosity increased from 0.20±0.002 for pure mannitol to 0.53±0.03 using fabricated porous mannitol. Disintegration time dropped by 50-77% from 135±5.29s for pure mannitol to 75.33±2.52-31.67±1.53s for mannitol 110-170°C. Hardness increased by 150% at 110°C (258.67±28.89N) and 30% at 150°C (152.70±10.58N) compared to pure mannitol tablets (104.17±1.70N). Increasing inlet temperature resulted in reducing tablet hardness due to generation of 'micro-sponge'-like particles exhibiting significant elastic recovery. Impact of mannitol polymorphism on plasticity/elasticity cannot be ruled out as a mixture of α and β polymorphs formed upon spray drying.

Solid oral forms availability in children:a cost saving investigation

AIM: To assess the suitability and potential cost savings, from both the hospital and community perspective, of prescribed oral liquid medicine substitution with acceptable solid forms for children over 2 years. METHOD: Oral liquid medicines dispensed from a paediatric hospital (UK) in 1 week were assessed by screening for existence of the solid form alternative and evaluating the acceptability of the available solid form, firstly related to the prescribed dose and secondly to acceptable size depending on the child's age. Costs were calculated based on providing treatment for 28 days or prescribed duration for short term treatments. RESULTS: Over 90% (440/476) of liquid formulations were available as a marketed solid form. Considering dosage acceptability (maximum of 10% deviation from prescribed dosage or 0% for narrow therapeutic range drugs, maximum tablet divisions into quarters) 80% of liquids could be substituted with a solid form. The main limitation for liquid substitution would be solid form size. However, two-thirds of prescribed liquids could have been substituted with a suitable solid form for dosage and size, with estimated savings being of 5K and 8K in 1 week, respectively based on hospital and community costs, corresponding to a projected annual saving of 238K and 410K (single institution). CONCLUSION: Whilst not all children over 2 years will be able to swallow tablets, drug cost savings if oral liquid formulations were substituted with suitable solid dosage forms would be considerable. Given the numerous advantages of solid forms compared with liquids, this study may provide a theoretical basis for investing in supporting children to swallow tablets/capsules.

A holistic multi evidence approach to study the fragmentation behaviour of crystalline mannitol

Mannitol is an essential excipient employed in orally disintegrating tablets due to its high palatability. However its fundamental disadvantage is its fragmentation during direct compression, producing mechanically weak tablets. The primary aim of this study was to assess the fracture behaviour of crystalline mannitol in relation to the energy input during direct compression, utilising ball milling as the method of energy input, whilst assessing tablet characteristics of post-milled powders. Results indicated that crystalline mannitol fractured at the hydrophilic (011) plane, as observed through SEM, alongside a reduction in dispersive surface energy. Disintegration times of post-milled tablets were reduced due to the exposure of the hydrophilic plane, whilst more robust tablets were produced. This was shown through higher tablet hardness and increased plastic deformation profiles of the post-milled powders, as observed with a lower yield pressure through an out-of-die Heckel analysis. Evaluation of crystal state using x-ray diffraction/differential scanning calorimetry showed that mannitol predominantly retained the β-polymorph; however x-ray diffraction provided a novel method to calculate energy input into the powders during ball milling. It can be concluded that particle size reduction is a pragmatic strategy to overcome the current limitation of mannitol fragmentation and provide improvements in tablet properties.

Supporting families with a fussy eater

The article offers the authors insights on how to manage children who eat a limited diet. Topics discussed include the role of parents and caregivers in helping children to develop healthy eating habits, the Child Feeding Guide consists of ways how to increase fruit and vegetable intake of children, and the Child Feeding Guide app for tablets and smartphones provides evidence-based information for people who are concerned about the eating behavior of children.

Emerging perspectives on the design, use, and evaluation of mobile and handheld devices

Human-computer interaction is a growing field of study in which researchers and professionals aim to understand and evaluate the impact of new technologies on human behavior. With the integration of smart phones, tablets, and other portable devices into everyday life, there is a greater need to understand the influence of such technology on the human experience. Emerging Perspectives on the Design, Use, and Evaluation of Mobile and Handheld Devices is an authoritative reference source consisting of the latest scholarly research and theories from international experts and professionals on the topic of human-computer interaction with mobile devices. Featuring a comprehensive collection of chapters on critical topics in this dynamic field, this publication is an essential reference source for researchers, educators, students, and practitioners interested in the use of mobile and handheld devices and their impact on individuals and society as a whole. This publication features timely, research-based chapters pertaining to topics in the design and evaluation of smart devices including, but not limited to, app stores, category-based interfaces, gamified mobility applications, mobile interaction, mobile learning, pervasive multimodal applications, smartphone interaction, and social media use.

Characterization of Grewia gum, a potential pharmaceutical excipient

Grewia gum was extracted from the inner stem bark of Grewia mollis and characterized by several techniques such as gas chromatography (GC), gel permeation chromatography (GPC), scanning electron microscopy (SEM), differential scanning calorimetry (DSC) and thermogravimetric analysis of the extracted sample. Spectroscopic techniques such as x-ray photoelectron spectroscopy (XPS), fourier-transformed infrared (FT-IR), solid-state nuclear magnetic resonance (NMR), and 1H and 13C NMR techniques were also used to characterize the gum. The results showed that grewia gum is a typically amorphous polysaccharide gum containing glucose, rhamnose, galactose, arabinose and xylose as neutral sugars. It has an average molecular weight of 5925 kDa expressed as the pullulan equivalent. The gum slowly hydrated in water, dispersing and swelling to form a highly viscous dispersion exhibiting pseudoplastic flow behaviour. The polysaccharide gum is thermally stable and may have application as stabilizer or suspending agent in foods, cosmetics and in pharmaceuticals. It may have application as a binder or sustained-release polymer matrix in tablets or granulations. © IPEC-Americas Inc.

Improved sampling, pre-concentration, and detection of hidden explosives and illicit drugs by a novel solid phase microextraction geometry coupled to ion mobility spectrometry

The 9/11 Act mandates the inspection of 100% of cargo shipments entering the U.S. by 2012 and 100% inspection of air cargo by March 2010. So far, only 5% of inbound shipping containers are inspected thoroughly while air cargo inspections have fared better at 50%. Government officials have admitted that these milestones cannot be met since the appropriate technology does not exist. This research presents a novel planar solid phase microextraction (PSPME) device with enhanced surface area and capacity for collection of the volatile chemical signatures in air that are emitted from illicit compounds for direct introduction into ion mobility spectrometers (IMS) for detection. These IMS detectors are widely used to detect particles of illicit substances and do not have to be adapted specifically to this technology. For static extractions, PDMS and sol-gel PDMS PSPME devices provide significant increases in sensitivity over conventional fiber SPME. Results show a 50–400 times increase in mass detected of piperonal and a 2–4 times increase for TNT. In a blind study of 6 cases suspected to contain varying amounts of MDMA, PSPME-IMS correctly detected 5 positive cases with no false positives or negatives. One of these cases had minimal amounts of MDMA resulting in a false negative response for fiber SPME-IMS. A La (dihed) phase chemistry has shown an increase in the extraction efficiency of TNT and 2,4-DNT and enhanced retention over time. An alternative PSPME device was also developed for the rapid (seconds) dynamic sampling and preconcentration of large volumes of air for direct thermal desorption into an IMS. This device affords high extraction efficiencies due to strong retention properties under ambient conditions resulting in ppt detection limits when 3.5 L of air are sampled over the course of 10 seconds. Dynamic PSPME was used to sample the headspace over the following: MDMA tablets (12–40 ng detected of piperonal), high explosives (Pentolite) (0.6 ng detected of TNT), and several smokeless powders (26–35 ng of 2,4-DNT and 11–74 ng DPA detected). PSPME-IMS technology is flexible to end-user needs, is low-cost, rapid, sensitive, easy to use, easy to implement, and effective. ^

Pollen and dinoflagellate cyst counts on sediment core M72/5_628-1 (MD72/5-25-GC1) from the Black Sea

High-resolution pollen and dinoflagellate cyst records from sediment core M72/5-25-GC1 were used to reconstruct vegetation dynamics in northern Anatolia and surface conditions of the Black Sea between 64 and 20 ka BP. During this period, the dominance of Artemisia in the pollen record indicates a steppe landscape and arid climate conditions. However, the concomitant presence of temperate arboreal pollen suggests the existence of glacial refugia in northern Anatolia. Long-term glacial vegetation dynamics reveal two major arid phases ~64-55 and 40-32 ka BP, and two major humid phases ~54-45 and 28-20 ka BP, correlating with higher and lower summer insolation, respectively. Dansgaard-Oeschger (D-O) cycles are clearly indicated by the 25-GC1 pollen record. Greenland interstadials are characterized by a marked increase in temperate tree pollen, indicating a spread of forests due to warm/wet conditions in northern Anatolia, whereas Greenland stadials reveal cold and arid conditions as indicated by spread of xerophytic biomes. There is evidence for a phase lag of ~500 to 1500 yr between initial warming and forest expansion, possibly due to successive changes in atmospheric circulation in the North Atlantic sector. The dominance of Pyxidinopsis psilata and Spiniferites cruciformis in the dinocyst record indicates brackish Black Sea conditions during the entire glacial period. The decrease of marine indicators (marine dinocysts, acritarchs) at ~54 ka BP and increase of freshwater algae (Pediastrum, Botryococcus) from 32 to 25 ka BP reveals freshening of the Black Sea surface water. This freshening is possibly related to humid phases in the region, to connection between Caspian Sea and Black Sea, to seasonal freshening by floating ice, and/or to closer position of river mouths due to low sea level. In the southern Black Sea, Greenland interstadials are clearly indicated by high dinocyst concentrations and calcium carbonate content, as a result of an increase in primary productivity. Heinrich events show a similar impact on the environment in the northern Anatolia/Black Sea region as Greenland stadials.

Absolute abundances of dinoflagellate cysts in surface sediment samples from four sites: Lycopodium marker-grain method

Absolute abundances (concentrations) of dinoflagellate cysts are often determined through the addition of Lycopodium clavatum marker-grains as a spike to a sample before palynological processing. An inter-laboratory calibration exercise was set up in order to test the comparability of results obtained in different laboratories, each using its own preparation method. Each of the 23 laboratories received the same amount of homogenized splits of four Quaternary sediment samples. The samples originate from different localities and consisted of a variety of lithologies. Dinoflagellate cysts were extracted and counted, and relative and absolute abundances were calculated. The relative abundances proved to be fairly reproducible, notwithstanding a need for taxonomic calibration. By contrast, excessive loss of Lycopodium spores during sample preparation resulted in non-reproducibility of absolute abundances. Use of oxidation, KOH, warm acids, acetolysis, mesh sizes larger than 15 µm and long ultrasonication (> 1 min) must be avoided to determine reproducible absolute abundances. The results of this work therefore indicate that the dinoflagellate cyst worker should make a choice between using the proposed standard method which circumvents critical steps, adding Lycopodium tablets at the end of the preparation and using an alternative method.

Desenvolvimento de aplicações móveis baseadas em sistemas de informações web existentes

Considerando a era da computação móvel percebe-se que os sistemas de informaçãoestão passando por um processo de metamorfose para possibilitar que seus usuários utilizemnovas formas de acessos às informações a partir de dispositivos móveis. Isso se deveprincipalmente ao aumento da popularidade de dispositivos como smartphones e tablets.Impulsionado por esse novo cenário de computação, que está mudando velhos hábitos ecriando novas maneiras da sociedade acessar informações que até então só eram acessíveisatravés de computadores tradicionais, crescem as demandas por aplicações móveis corporativas.Esse aumento é ocasionado pela necessidade das empresas garantirem aos seusclientes novas formas de interações com seus serviços. Dessa forma, esse trabalho tem oobjetivo de apresentar um estudo referente ao desenvolvimento de aplicações móveis eum processo denominado Metamorphosis, que provê um conjunto de atividades organizadasem três fases: requisitos, projeto e implantação, para auxiliar no desenvolvimentode aplicações móveis corporativas baseadas em sistemas de informações web existentes.

Uma proposta de solução para funcionamento offline em aplicações android

Given the growing demand for the development of mobile applications, driven by use increasingly common in smartphones and tablets grew in society the need for remote data access in full in the use of mobile application without connectivity environments where there is no provision network access at all times. Given this reality, this work proposes a framework that present main functions are the provision of a persistence mechanism, replication and data synchronization, contemplating the creation, deletion, update and display persisted or requested data, even though the mobile device without connectivity with the network. From the point of view of the architecture and programming practices, it reflected in defining strategies for the main functions of the framework are met. Through a controlled study was to validate the solution proposal, being found as the gains in reducing the number of lines code and the amount of time required to perform the development of an application without there being significant increase for the operations.

Uma proposta de solução para funcionamento offline em aplicações android

Given the growing demand for the development of mobile applications, driven by use increasingly common in smartphones and tablets grew in society the need for remote data access in full in the use of mobile application without connectivity environments where there is no provision network access at all times. Given this reality, this work proposes a framework that present main functions are the provision of a persistence mechanism, replication and data synchronization, contemplating the creation, deletion, update and display persisted or requested data, even though the mobile device without connectivity with the network. From the point of view of the architecture and programming practices, it reflected in defining strategies for the main functions of the framework are met. Through a controlled study was to validate the solution proposal, being found as the gains in reducing the number of lines code and the amount of time required to perform the development of an application without there being significant increase for the operations.

Pollen and non-pollen palynomorphs counting data from Borsteler Moor (Germany)

In order to reconstruct regional vegetation changes and local conditions during the fen-bog transition in the Borsteler Moor (northwestern Germany), a sediment core covering the period between 7.1 and 4.5 cal kyrs BP was palynologically in vestigated. The pollen diagram demonstrates the dominance of oak forests and a gradual replacement of trees by raised bog vegetation with the wetter conditions in the Late Atlantic. At ~ 6 cal kyrs BP, the non-pollen palynomorphs (NPP) demonstrate the succession from mesotrophic conditions, clearly indicated by a number of fungal spore types, to oligotrophic conditions, indicated by Sphagnum spores, Bryophytomyces sphagni, and testate amoebae Amphitrema, Assulina and Arcella, etc. Four relatively dry phases during the transition from fen to bog are clearly indicated by the dominance of Calluna and associated fungi as well as by the increase of microcharcoal. Several new NPP types are described and known NPP types are identified. All NPP are discussed in the context of their palaeoecological indicator values.