Fabrication of antibiotic-loaded dissolvable calcium sulfate beads: an in vitro mixing lab utilizing various antibiotic mixing formulas

Chronic periprosthetic joint infection (PJI) is a devastating complication that requires an aggressive eradication protocol. Local antimicrobial delivery via dissolvable calcium sulfate (CaSO4) using small-sized beads (3–8 mm) has been utilized as an adjunctive treatment combined with implant exchange, radical debridement, and antimicrobial loaded acrylic spacers. The non-exothermic setting of CaSO4 theoretically allows for any antimicrobial agent to be used, so long as mixing methods provide a consistent fabrication within a reasonable set time. This study performed the first in vitro mixing study, in which various antimicrobial agents, used singularly and in combination, were mixed with a synthetic CaSO4 product to observe and document their interactions. The study was performed in a simulated operating room environment. We report a standard mix formula with set times, testing 22 different antimicrobial agents, combinations, and doses. For some antimicrobials and combinations, set times using the standard formula were either too fast or exceedingly slow. For these 14 antimicrobial agents and combinations, we were able to arrive at individualized mixing methods. We present all mixing formulas and set times. In all, we were able to establish mixing methods that incorporate all antimicrobial agents and combinations that we have seen utilized via surgeon-directed use.

Gauge-invariant theories and higher-degree forms

A free differential algebra is generalization of a Lie algebra in which the mathematical structure is extended by including of new Maurer-Cartan equations for higher-degree differential forms. In this article, we propose a generalization of the Chern-Weil theorem for free differential algebras containing only one p-form extension. This is achieved through a generalization of the covariant derivative, leading to an extension of the standard formula for Chern-Simons and transgression forms. We also study the possible existence of anomalies originated on this kind of structure. Some properties and particular cases are analyzed.

Unified Functional Method for Solving General Polynomial Equations of Degree Less Than Five

A unified method for solving that incorporate a computational formula that relate the coefficients of the depressed equation and the coefficients of the standard polynomial equation is proposed in this study. This is to ensure that this method is valid for all It shall apply the undetermined parameter method of auxiliary function to obtain solutions to these polynomial equations of degree less than five in one variable. In particular, the result of our work is a unification and improvement on the work of several authors in the sense that only applicable for the case of polynomial equation of degree one. Finally, our results improve and generalize the result by applying standard formula methods for solving higher degree polynomials. It is recommended that the effort should be made toward providing other variant methods that are simpler and friendly.

SENSORY EVALUATION OF TURKISH COFFEE WITH COCONUT OIL

In this study, bringing a different perspective to Turkish coffee through an innovative formulation with coconut oil addition was aimed. It is important to create a new and desired taste and a marketable product other than the classical Turkish coffee, by sensorial analysis. For this purpose, after Turkish coffee was prepared in the standard formula, two different percentages of coconut oil (0.2 and 0.4%, by weight) were added to it. Turkish coffees prepared with the addition of coconut oil were presented to 22 untrained panelists for sensory evaluation. The panelists were also asked about their opinions on the product. Compared to Turkish coffee, most panelists noted that Turkish coffee samples with the addition of coconut oil had a pleasant aroma and left a smooth feel in the mouth. In addition, although sugar was not used in the preparation of Turkish coffee samples, most of the panelists mentioned that Turkish coffee samples with coconut oil have a sweeter taste compared to standard Turkish coffee. As a general evaluation of the panel, it was concluded that Turkish coffee samples with the addition of coconut oil were liked; the sample with one percentage was not preferred over the other percentage of coconut oil in formulation, significantly (p<0.05).

Lactose-Reduced Infant Formulas Are Over-Consumed Whereas Hypoallergenic Infant Formulas Are Not - When Compared to Medical Necessity

Objectives We aimed to report the macronutrient composition of powdered infant formula purchased from major US physical-location retailers from 2017 through 2019. We then compared the percentage of lactose-reduced and hypoallergenic powdered infant formula consumed with the estimated prevalence of infant conditions necessitating a lactose-reduced or hypoallergenic formula. We also compared the proportion of formula consumed that was lactose-reduced between WIC and non-WIC purchases. Methods Annual powdered infant formula volume and purchase data from all major brick-and-mortar stores in the United States (excluding Costco) from 2017 through 2019 was obtained from IRi (Information Resources Inc). Protein, carbohydrate, fat composition and scoop size for each formula was obtained from formula companies and equivalent liquid ounces (“formula consumed”) was calculated. Small can sizes of “standard” (intact and partially hydrolyzed protein) formulas served as proxies for WIC purchases. Proportions were compared to published medical prevalence by calculating a z-ratio, t-test. Results Average infant carbohydrate consumption consisted of 56.6% lactose, 37.7% glucose, and 5.7% sucrose. 21% of formula consumed contained sucrose. 55% of all formula and 47% of standard formula consumed was lactose-reduced, both higher than the estimated 7.5% prevalence of medical necessity (p &lt; 0.0002). Lactose-reduced standard formula represented 51% of non-WIC sales which was greater than the 44% of WIC sales (p = 0.003). Protein consumption consisted of 5.0% soy protein, 74.1% intact dairy, 11.1% partially hydrolyzed dairy, 7.1% fully hydrolyzed protein, and 0.3% amino acid based. Hypoallergenic (fully hydrolyzed and amino acid-based) formula represented 7.4% of formula consumed, which did not differ from liberal estimates of cow's milk allergy prevalence (7.5%). Conclusions Estimated consumption of hypoallergenic formula in the US matches liberal estimates of medical necessity. However, a high proportion of formula-fed infants are consuming non-lactose-based carbohydrate; more than is medically warranted, necessitating further research into metabolic implications. Funding Sources None.

The effect of Low Dietary Inflammatory Index score formula on inflammatory, metabolic and clinical outcomes in critically ill Traumatic Brain Injury patients: A Single-blind randomized controlled pilot Study

Aim: In Traumatic brain injury (TBI) patients, a complex cascade of inflammatory responses is frequently observed following trauma. Numerous dietary agents have long been found to have potential in modulating inflammatory responses. This pilot study, designed an enteral formula with low inflammatory properties based on the dietary inflammatory index (DII®) and evaluated its effect on inflammatory and metabolic factors in critically ill TBI patients. Methods: This Single-blind randomized controlled pilot study conducted at the Neurosurgical ICU of Shahid Kamyab Hospital (Mashhad, Iran). A total of 20 TBI patients were randomly assigned to receive either low-DII-score or standard formula at the Intensive Care Unit (ICU). The primary outcomes of the study included clinical status, inflammatory biomarkers, APACHE II, SAPS II, SOFA, and NUTRIC scores. Results: The trial groups did not differ significantly on baseline values. Following 14 days of intervention, there was a statistically significant decrease in the APACHE II, SAPS II, and NUTRIC scores and a significant increase in GCS score in the low-DII-score formula group compared to the standard formula group. Over two weeks, high sensitivity c-reactive protein (hs-CRP) values -2.73 (95% CI: -3.67, -1.79) mg/dL in the low-DII-score formula group vs. 0.65 (95% CI: -0.29, 1.58) mg/dL in controls. Moreover, the length of hospital stay was longer for the standard formula group than for the low-DII-score formula group. Conclusion: The low-DII-score formula improves inflammatory factors (serum hs-CRP) and metabolic biomarkers (LDL-c and FBS). Furthermore, clinical outcomes, including the length of hospital stay and disease severity appear to be enhanced.

Effects of Infant Formula Supplemented With Prebiotics and OPO on Infancy Fecal Microbiota: A Pilot Randomized Clinical Trial

Several lines of evidence suggest that the intestinal microbiota plays crucial roles in infant development, and that it is highly influenced by extrinsic and intrinsic factors. Prebiotic-containing infant formula may increase gastrointestinal tolerance and improve commensal microbiota composition. However, it remains unknown whether supplementation of milk-formulas with prebiotics and 1,3-olein-2-palmitin (OPO) can achieve feeding outcomes similar to those of breastfeeding. In the present study, we investigated the effects of two kinds of infant formula with different additives on the overall diversity and composition of the fecal microbiota, to determine which was closer to breastfeeding. A total of 108 infants were enrolled, including breastfeeding (n=59) and formula feeding group (n=49). The formula feeding infants were prospectively randomly divided into a standard formula group (n=18), and a supplemented formula group(n=31). The fecal samples were collected at 4 months after intervention. Fecal microbiota analysis targeting the V4 region of the 16S rRNA gene was performed using MiSeq sequencing. The overall bacterial diversity and composition, key functional bacteria, and predictive functional profiles in the two different formula groups were compared with breastfeeding group. We found that the alpha diversity of the gut microbiota was not significantly different between the OPO and breastfeeding groups with Chaos 1 index (p=0.346). The relative abundances of Enhydrobacter and Akkermansia in the OPO group were more similar to those of the breastfeeding group than to those of the standard formula group. The gut microbiota metabolism function prediction analysis showed that the supplemented formula group was similar to the breastfeeding group in terms of ureolysis (p=0.297). These findings suggest that, when formula supplemented with prebiotics and OPO was given, the overall bacterial diversity and parts of the composition of the fecal microbiota would be similar to that of breastfeeding infants.

A nonlinear partially-averaged Navier–Stokes model with near-wall correction for separated turbulent flow

A nonlinear Partially-Averaged Navier–Stokes model with near-wall correction is developed for separated turbulent flow simulations. The periodic hills flow is simulated to validate the new model and the results are compared with the standard [Formula: see text] model, MPANS model, MSST PNAS model, standard [Formula: see text] PANS model, and experimental/LES results. It is found that the new model shows better performance in the prediction of both mean velocity and turbulent statistics compared to the other models. From the prediction of the near-wall friction coefficient of periodic hills flow, the new model shows good resolution in the near-wall region by considering the near-wall damping function to turbulent viscosity, gradient production term, and turbulence scale correction term for the near-wall region. From the analysis of anisotropy-invariant and sub-filtered stress (SFS), it can be found that the nonlinear term is necessary for prediction accuracy improvement in turbulent flow simulation with strong separation.