Acute Medicine and Pandemics: Getting It Right Next Time!

2021 ◽  
Vol 20 (3) ◽  
pp. 158-160
Author(s):  
M Holland ◽  
Keyword(s):  
General Medicine ◽  
Cost Effective ◽  
Acute Medicine ◽  
Orthopaedic Care ◽  
First Time ◽  
Effective Treatments ◽  
Poor Practice

For those of you who are not aware of what GIRFT (Getting It Right First Time) is, let me start by saying it is a brilliant idea, genius perhaps. The vision of its founder, Professor Tim Briggs CBE, was to optimise orthopaedic care by using the most clinically and cost effective treatments, minimising waste, reducing variation and eliminating poor practice. Since 2014 in orthopaedics alone, operational and financial opportunities to save the NHS £696 million have been generated. Acute medicine, coupled with general medicine, has been part of the GIRFT programme since 2017. The mischievous reader might question the name, as clearly this is about getting things right at the second time of asking at the very earliest. Apart from that pedantic note, GIRFT is a force for good.

Green Synthesis and Spectroscopic Studies of Ag-rGO Nanocomposites for Highly Selective Mercury (II) Sensing

2018 ◽  
Vol 9 (1) ◽  
pp. 101-108 ◽  
Author(s):  
Shubhangi J. Mane-Gavade ◽  
Sandip R. Sabale ◽  
Xiao-Ying Yu ◽  
Gurunath H. Nikam ◽  
Bhaskar V. Tamhankar
Keyword(s):  
Green Synthesis ◽  
Color Change ◽  
Limit Of Detection ◽  
Aqueous Media ◽  
Suitable Condition ◽  
Cost Effective ◽  
Spectroscopic Studies ◽  
Calibration Plot ◽  
First Time

Introduction: Herein we report the green synthesis and characterization of silverreduced graphene oxide nanocomposites (Ag-rGO) using Acacia nilotica gum for the first time. Experimental: We demonstrate the Hg2+ ions sensing ability of the Ag-rGO nanocomposites form aqueous medium. The developed colorimetric sensor method is simple, fast and selective for the detection of Hg2+ ions in aqueous media in presence of other associated ions. A significant color change was noticed with naked eye upon Hg2+ addition. The color change was not observed for cations including Sr2+, Ni2+, Cd2+, Pb2+, Mg2+, Ca2+, Fe2+, Ba2+ and Mn2+indicating that only Hg2+ shows a strong interaction with Ag-rGO nanocomposites. Under the most suitable condition, the calibration plot (A0-A) against concentration of Hg2+ was linear in the range of 0.1-1.0 ppm with a correlation coefficient (R2) value 0.9998. Results & Conclusion The concentration of Hg2+ was quantitatively determined with the Limit of Detection (LOD) of 0.85 ppm. Also, this method shows excellent selectivity towards Hg2+ over nine other cations tested. Moreover, the method offers a new cost effective, rapid and simple approach for the detection of Hg2+ in water samples.

scholarly journals Innovating on Inhaled Bioequivalence: A Critical Analysis of the Current Limitations, Potential Solutions and Stakeholders of the Process

Pharmaceutics ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 1051
Author(s):  
Jonattan Gallegos-Catalán ◽  
Zachary Warnken ◽  
Tania F. Bahamondez-Canas ◽  
Daniel Moraga-Espinoza
Keyword(s):  
New Technologies ◽  
Innovation Process ◽  
Cost Effective ◽  
Regulatory Agencies ◽  
Drug Products ◽  
Effective Strategies ◽  
Rate Analysis ◽  
Orally Inhaled Drug Products ◽  
Next Generation Impactor ◽  
First Time

Orally inhaled drug products (OIDPs) are an important group of medicines traditionally used to treat pulmonary diseases. Over the past decade, this trend has broadened, increasing their use in other conditions such as diabetes, expanding the interest in this administration route. Thus, the bioequivalence of OIDPs is more important than ever, aiming to increase access to affordable, safe and effective medicines, which translates into better public health policies. However, regulatory agencies leading the bioequivalence process are still deciding the best approach for ensuring a proposed inhalable product is bioequivalent. This lack of agreement translates into less cost-effective strategies to determine bioequivalence, discouraging innovation in this field. The Next-Generation Impactor (NGI) is an example of the slow pace at which the inhalation field evolves. The NGI was officially implemented in 2003, being the last equipment innovation for OIDP characterization. Even though it was a breakthrough in the field, it did not solve other deficiencies of the BE process such as dissolution rate analysis on physiologically relevant conditions, being the last attempt of transferring technology into the field. This review aims to reveal the steps required for innovation in the regulations defining the bioequivalence of OIDPs, elucidating the pitfalls of implementing new technologies in the current standards. To do so, we collected the opinion of experts from the literature to explain these trends, showing, for the first time, the stakeholders of the OIDP market. This review analyzes the stakeholders involved in the development, improvement and implementation of methodologies that can help assess bioequivalence between OIDPs. Additionally, it presents a list of methods potentially useful to overcome some of the current limitations of the bioequivalence standard methodologies. Finally, we review one of the most revolutionary approaches, the inhaled Biopharmaceutical Classification System (IBCs), which can help establish priorities and order in both the innovation process and in regulations for OIDPs.

scholarly journals Facile Green, Room-Temperature Synthesis of Gold Nanoparticles Using Combretum erythrophyllum Leaf Extract: Antibacterial and Cell Viability Studies against Normal and Cancerous Cells

Antibiotics ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. 893
Author(s):  
Olufunto T. Fanoro ◽  
Sundararajan Parani ◽  
Rodney Maluleke ◽  
Thabang C. Lebepe ◽  
Jose R. Varghese ◽  
...  
Keyword(s):  
Gold Nanoparticles ◽  
Cell Viability ◽  
Leaf Extract ◽  
Room Temperature ◽  
Klebsiella Oxytoca ◽  
Cost Effective ◽  
Average Diameter ◽  
Antibacterial Activities ◽  
Inhibition Concentration ◽  
First Time

We herein report a facile, green, cost-effective, plant-mediated synthesis of gold nanoparticles (AuNPs) for the first time using Combretum erythrophyllum (CE) plant leaves. The synthesis was conducted at room temperature using CE leaf extract serving as a reducing and capping agent. The as-synthesized AuNPs were found to be crystalline, well dispersed, and spherical in shape with an average diameter of 13.20 nm and an excellent stability of over 60 days. The AuNPs showed broad-spectrum antibacterial activities against both pathogenic Gram-positive (Staphylococcus epidermidis (ATCC14990), Staphylococcus aureus (ATCC 25923), Mycobacterium smegmatis (MC 215)) and Gram-negative bacteria (Proteus mirabilis (ATCC 7002), Escherichia coli (ATCC 25922), Klebsiella pneumoniae (ATCC 13822), Klebsiella oxytoca (ATCC 8724)), with a minimum inhibition concentration of 62.5 µg/mL. In addition, the as-synthesized AuNPs were highly stable with exceptional cell viability towards normal cells (BHK- 21) and cancerous cancer cell lines (cervical and lung cancer).

scholarly journals Frequency-diverse multimode millimetre-wave constant-ϵr lens-loaded cavity

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
M. A. B. Abbasi ◽  
V. F. Fusco ◽  
O. Yurduseven ◽  
T. Fromenteze
Keyword(s):  
Signal To Noise Ratio ◽  
Cost Effective ◽  
Doa Estimation ◽  
Frequency Diversity ◽  
Millimetre Wave ◽  
Single Lens ◽  
Dielectric Lens ◽  
Diversity Principle ◽  
First Time ◽  
Multi Mode

AbstractThis paper presents a physical frequency-diverse multimode lens-loaded cavity, designed and used for the purpose of the direction of arrival (DoA) estimation in millimetre-wave frequency bands for 5G and beyond. The multi-mode mechanism is realized using an electrically-large cavity, generating spatio-temporally incoherent radiation masks leveraging the frequency-diversity principle. It has been shown for the first time that by placing a spherical constant dielectric lens (constant-ϵr) in front of the radiating aperture of the cavity, the spatial incoherence of the radiation modes can be enhanced. The lens-loaded cavity requires only a single lens and output port, making the hardware development much simpler and cost-effective compared to conventional DoA estimators where multiple antennas and receivers are classically required. Using the lens-loaded architecture, an increase of up to 6 dB is achieved in the peak gain of the synthesized quasi-random sampling bases from the frequency-diverse cavity. Despite the fact that the practical frequency-diverse cavity uses a limited subset of quasi-orthogonal modes below the upper bound limit of the number of theoretical modes, it is shown that the proposed lens-loaded cavity is capable of accurate DoA estimation. This is achieved thanks to the sufficient orthogonality of the leveraged modes and to the presence of the spherical constant-ϵr lens which increases the signal-to-noise ratio (SNR) of the received signal. Experimental results are shown to verify the proposed approach.

scholarly journals Right ventricular thrombus, a challenge in imaging diagnostics: a case series

2021 ◽  
Author(s):  
Massimo Barbagallo ◽  
Daryl Naef ◽  
Pascal Köpfli ◽  
Urs Hufschmid ◽  
Tilo Niemann ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Case Series ◽  
General Medicine ◽  
High Sensitivity ◽  
Cost Effective ◽  
Ventricular Thrombus ◽  
Threatening Condition ◽  
Life Threatening ◽  
Therapeutic Decision Making ◽  
Sensitivity Specificity

Abstract Background Presence of right ventricular thrombus (RVT) is a rare but life-threatening condition, thus immediate diagnosis and therapy are mandatory. Unfortunately, detection and distinction from intraventricular tumor masses or vegetations represents a complex task. Furthermore, consecutive therapy is principally led by clinical presentation without considering morphological features of the thrombus. Current literature suggests a multimodal non-invasive imaging approach. In this paper, we discuss the role of cardiac magnetic resonance (CMR) for the detection of RVT in patients with pulmonary embolism (PE). We consider the relatively expensive and not broadly available imaging procedure and weigh it up to its assumed high sensitivity, specificity and importance for differential diagnosis and therapeutic decision making. Case Summary In this case series we report three cases of RVT with concomitant PE, whereof two were missed during routine cardiac workup by transthoracic echocardiography (TTE) and computer tomography (CT). CMR led to detection and further characterization of the thrombi in both cases. These patients were diagnosed and treated at the Cantonal Hospital of Baden in the division of General Medicine. Conclusions CMR reliably detects and characterizes RVT, even under unfavourable conditions for echocardiography such as arrhythmia, adiposity or in posterior position of RVT. Obtained information could facilitate the choice of therapeutic approach (anticoagulation vs. systemic lysis, vs. surgical thrombectomy). Future risk-stratification scores will promote cost-effective use of CMR.

The Islamic gold dinar: a hedge against exchange rate volatility

2018 ◽  
Vol 44 (6) ◽  
pp. 722-738 ◽  
Author(s):  
Calvin W.H. Cheong
Keyword(s):  
Management Practices ◽  
Exchange Rate Volatility ◽  
Cost Effective ◽  
Market Volatility ◽  
Content Type ◽  
Sample Country ◽  
Islamic Financial Institutions ◽  
Cost Efficient ◽  
Lower Magnitude ◽  
First Time

Purpose The purpose of this paper is to investigate the ability of the Islamic gold dinar to hedge against two well-established foreign exchange (FX) risk factors namely, the dollar risk factor and global FX volatility innovations. Design/methodology/approach The paper uses a combination of the Markowitz (1952) portfolio optimization, visual data representations and the classic Fama-Macbeth (1973) two-pass procedure regressions. Findings The findings show that the Islamic gold dinar can serve as a hedge against market volatility, outperforms a diversified currency portfolio, and through its inclusions into the diversified currency portfolio, improve said portfolio’s ability to hedge against market volatility. Research limitations/implications Due to the spread of the sample, country-specific factors could not be taken into account. Practical implications The Islamic gold dinar is a cost-efficient, cost-effective, and Shariah-compliant instrument that provides a solid hedge for investors and/or firms that have financial positions denominated in foreign currencies. Should these investors or firms find it costly to maintain a dinar-only portfolio, including the dinar into their currency portfolios also provides the same benefit, albeit at a lower magnitude. Originality/value This study is timely as the Accounting and Auditing Organization for Islamic Financial Institutions has recently for the first time recognized gold as a Shariah-compliant investment. The findings of this study provide the first look as to how investors and firms can benefit through the use of the Islamic gold dinar in their risk management practices.

Measuring impact of telephone triage in Acute Medicine

2017 ◽  
Vol 16 (3) ◽  
pp. 104-106
Author(s):  
Huma Asmat ◽  
◽  
Shah Khalid Shinwari ◽  
Timothy Cooksley ◽  
Roger Duckitt ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practitioners ◽  
Emergency Departments ◽  
Local Context ◽  
Telephone Triage ◽  
Time Data ◽  
Acute Medicine ◽  
The Impact ◽  
First Time

The Society for Acute Medicine’s Benchmarking Audit (SAMBA) was undertaken for the 5th time in June 2016. For the first time, data on telephone triage calls prior to admission to Acute Medical Units were collected: 1238 patients were referred from Emergency Departments, 925 from General Practitioners (GPs), 52 from clinics and 147 from other sources. Calls from Emergency Departments rarely resulted in admission avoidance. Calls from Primary Care resulted in avoidance of an admission in 115 (12%) patients; the percentage of avoided admissions was highest if the call was taken by a Consultant. Consultant triage might result in admission avoidance but the impact of local context on the effectiveness is not clear.

scholarly journals A Step by Step Methodology for Building Sustainable Cementitious Matrices

2020 ◽  
Vol 10 (8) ◽  
pp. 2955 ◽  
Author(s):  
Styliani Papatzani ◽  
Kevin Paine
Keyword(s):  
Fly Ash ◽  
Portland Cement ◽  
Silica Fume ◽  
Carbon Footprint ◽  
State Of The Art ◽  
Cost Effective ◽  
Strength Development ◽  
Low Carbon ◽  
Current State ◽  
First Time

In an effort to produce cost-effective and environmentally friendly cementitious binders. mainly ternary (Portland cement + limestone + pozzolanas) formulations have been investigated so far. Various proportions of constituents have been suggested, all, however, employing typical Portland cement (PC) substitution rates, as prescribed by the current codes. With the current paper a step by step methodology on developing low carbon footprint binary, ternary and quaternary cementitious binders is presented (PC replacement up to 57%). Best performing binary (60% PC and 40% LS (limestone)) and ternary formulations (60% PC, 20% LS, 20% FA (fly ash) or 43% PC, 20% LS 37% FA) were selected on the grounds of sustainability and strength development and were further optimized with the addition of silica fume. For the first time a protocol for successfully selecting and testing binders was discussed and the combined effect of highly pozzolanic constituents in low PC content formulations was assessed and a number of successful matrices were recommended. The present paper enriched the current state of the art in composite low carbon footprint cementitious binders and can serve as a basis for further enhancements by other researchers in the field.

scholarly journals Effect of Protocatechuic Acid on Euglena gracilis Growth and Accumulation of Metabolites

2020 ◽  
Vol 12 (21) ◽  
pp. 9158
Author(s):  
Xiaomiao Tan ◽  
Jiangyu Zhu ◽  
Minato Wakisaka
Keyword(s):  
Euglena Gracilis ◽  
Large Scale ◽  
Protocatechuic Acid ◽  
Biomass Yield ◽  
Growth Promotion ◽  
Low Cost ◽  
Cost Effective ◽  
Control Group ◽  
Biological Functions ◽  
First Time

The development of efficient, environmentally friendly, low-cost approaches used to boost the growth of microalgae is urgently required to meet the increasing demands for food supplements, cosmetics, and biofuels. In this study, the growth promotion effects of protocatechuic acid (PCA) in the freshwater microalga Euglena gracilis were confirmed for the first time. PCA is a simple phenolic compound derived from natural plants and has a range of biological functions. The highest biomass yield, 3.1-fold higher than that of the control, used at 1.3 g·L−1, was obtained at 800 mg·L−1 of PCA. The yields of the metabolites chlorophyll a, carotenoids, and paramylon in the presence of PCA at 800 mg·L−1 were 3.1, 3.3, and 1.7 times higher than those of the control group, respectively. The highest paramylon yield was achieved at a lower dosage of PCA (100 mg·L−1), which is considered to be feasible for economic paramylon production. The growth and biosynthesis of metabolites stimulated by phytochemicals such as PCA could be an efficient and cost-effective strategy to enhance the productivity of microalgae in large-scale cultivations.

Cost-effective, low density, carbon soot doped resorcinol formaldehyde composite for ablative applications

RSC Advances ◽  
2015 ◽  
Vol 5 (30) ◽  
pp. 23622-23634 ◽  
Author(s):  
Yutika Badhe ◽  
Balasubramanian K ◽  
Rohit Gupta
Keyword(s):  
Cost Effective ◽  
Low Density ◽  
Resorcinol Formaldehyde ◽  
Carbon Soot ◽  
First Time

Successful in situ polymerization of highly ablation-resistant composites of resorcinol formaldehyde (RF) modified with carbon soot (CS) was carried out for the first time.

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