Machine Learning Methods to Investigate Drug Delivery in Infusion Pump

In the current scenario, usage of the smart medical pump is predominant in the medical field. The precise drug dosage, flow accuracy should be maintained to increase the performance of an infusion pump. In this work, an attempt has been made to predict and control the speed of the infusion pump for suitable infusion flowrate using machine learning technique and Linear Quadratic Gaussian (LQG) controller. The data for this study is considered from the publicly available online database, electronic Medicines Compendium (eMC). The speed of the infusion pump has been calculated using the drug dosage and flow rate for two different drugs. The prediction of infusion pump speed is achieved using Linear regression with Principal Component analysis (PCR) and Support Vector Machine Regression (SVR). The performance of the prediction schemes is evaluated using standard metrics. To validate the optimal control of the predicted speed, two different medical graded motors are considered. Further, the optimal control of the pump speed is investigated using Proportional–Integral–Derivative (PID), Linear Quadratic Regulator (LQR), and LQG controllers for its stability criteria. The prediction of the pump speed using regression models PCR, SVR has been verified and then the transient response analysis with rise time, settling time for both the motors have been examined. Results demonstrate that the LQG optimal control strategy achieves fast rise time, settling time of motor1 with 0.653s, 1.15s, and 0.22, 0.392s for motor2 respectively.

A Multiscale, Systems-Level, Neuropharmacological Model of Cortico-Basal Ganglia System for Arm Reaching Under Normal, Parkinsonian, and Levodopa Medication Conditions

In order to understand the link between substantia nigra pars compacta (SNc) cell loss and Parkinson's disease (PD) symptoms, we developed a multiscale computational model that can replicate the symptoms at the behavioural level by incorporating the key cellular and molecular mechanisms underlying PD pathology. There is a modelling tradition that links dopamine to reward and uses reinforcement learning (RL) concepts to model the basal ganglia. In our model, we replace the abstract representations of reward with the realistic variable of extracellular DA released by a network of SNc cells and incorporate it in the RL-based behavioural model, which simulates the arm reaching task. Our results successfully replicated the impact of SNc cell loss and levodopa (L-DOPA) medication on reaching performance. It also shows the side effects of medication, such as wearing off and peak dosage dyskinesias. The model demonstrates how differential dopaminergic axonal degeneration in basal ganglia results in various cardinal symptoms of PD. It was able to predict the optimum L-DOPA medication dosage for varying degrees of cell loss. The proposed model has a potential clinical application where drug dosage can be optimised as per patient characteristics.

The Influence of Anaesthetic Choice on Electroconvulsive Therapy Parameters; Etomidate Versus Methohexital

Background Many of the anaesthetic drugs used for electroconvulsive therapy have anticonvulsant properties and may influence efficacy of electroconvulsive therapy. With this study we aim to provide more information on the effect of etomidate and methohexital on seizure duration. We explore the relationship between induction drug, motor and electroencephalography seizure duration. Moreover, we study the relationship of seizure duration and number of therapies. Methods In this retrospective study we collected data from patient records from 2005 until 2016. Inclusion criteria were the use of etomidate and/or methohexital and documentation of dosage, electroconvulsive therapy dosage and seizure duration. Exclusion criteria were missing data on either induction drug, dosage or seizure duration. Results Thirty seven patients were analysed. The mean age was 52 years and seventy six percent were female. Most patients were suffering from affective disorders (81%). Motor and electroencephalography seizure duration were analysed in 679 and 551 electroconvulsive therapies, respectively. Compared to methohexital, motor and electroencephalography seizures under etomidate were 7 and 13 seconds longer, respectively. Furthermore, there was a negative association between seizure duration and number of treatment and a negative association between seizure duration and electroconvulsive therapy dosage. Conclusions This study demonstrates significant longer motor and electroencephalography seizure duration using etomidate compared to methohexital. Etomidate might therefore increase the effectiveness of electroconvulsive therapy. Moreover, we observed a negative association between seizure duration, number of treatment and electroconvulsive therapy dosage. With this study we contribute to the available literature comparing methohexital and etomidate as induction agents for electroconvulsive therapy.

Pathfinder Nanosponges for Drug Targeting by Factorial Design: A Glance Review

For a long time, drug delivery systems (DDS) have been targeted to get expected results. With nanotechnology-based DDS, a wide assortment of flawless challenges can be tackled at present. Known as a nanosponge, a nanosponge is a modern division of material consisting of tiny particles that transmit only a few nanometers. The nano-formulations are highly effective for the delivery of low-solubility drugs. Many drugs with narrow therapeutic windows can benefit from improving water solubility. It has even been claimed they can be utilized to target and control delivery. In addition, huge amounts of money have been spent on developing new formulations of the DDS in recent times. Learn how nanosponges are prepared, its advantages, and its disadvantages. Resources were consulted to comprehend recent enhancements and patents in the domain. The ideal DDS has been developed by combining many different formulations; nano sponges are one of them. Analysts have examined them and found that they produce positive results and can improve the stability of poorly water-soluble drugs. The drug will be released at the precise target site when it reaches the body and sticks to the surface of the target site. As medication maximum action declines, it is more difficult to formulate impotent drugs. Considering this, nanosponges are organized and examined to determine whether they are problematic. Nanosponges in drug delivery can be characterized by their characteristics, preparation, factors, and applications. The article was written based on research articles about nanosponges. Data on nanosponges drug delivery systems from the past decade was collected using a factorial design. Study authors report that factor design plays an imperative role in optimizing drug dosage forms. Researchers will save time by reviewing the literature on nanosponges via factorial designs instead of searching for it.

Relationship between coronavirus disease 2019 and Parkinson’s disease

New literature shows that COVID-19 has negative effects on patients with Parkinson’s disease (PD). COVID-19 is known to produce neurological manifestations and infects the central nervous system. Similarly, the virus also causes neuromuscular complications and involves the peripheral nervous system. Studies show PD patients with a severe COVID-19 infection have a higher mortality rate, worsening in symptoms, and require an increase in drug dosage. These studies suggest that COVID-19 may lead to a more rapid onset of PD, or may increase the risk of developing PD. Furthermore, researchers observed that Motor and nonmotor symptoms significantly worsened in PD patients with COVID compared to PD patients.

Description of on-farm treatment compliance and risk factors for culling in sows

Background In commercial pig farming, sick or injured sows are often treated by producers or hired staff. To date, limited quantitative data exists on treatment compliance and the possible effect on sow longevity post-treatment. The objective of the study was to quantify on-farm compliance of treatment selection, frequency, and dosage, as well as to investigate the association between body condition scores (BCS) and other sow-level factors on post-treatment cull risk. Results On-farm treatment records, including culling reason or reason of death up to 6 months post-treatment, production records and sow characteristics were obtained for 134 sows over an 8-week period. Treatment compliance was based on the accuracy of recorded treatments compared to the herd veterinarian’s established treatment guidelines. Univariable and multivariable logistic regression models including treatment reason, treatment compliance, BCS, parity, production stage and production metrics, were constructed to investigate associations between those variables and sow culling or death. This study found low compliance for on-farm sow treatment protocols, with only 22.4% (30/134) of the sows receiving correct and complete treatment during the duration of the study. No effect of individual treatment components (drug, dosage, or frequency) on sow culling was observed. A trend for an interaction between treatment compliance and BCS was found, and parity and number of piglets born alive were identified as predictors for sow maintenance in the herd. Conclusions On-farm sow treatment compliance was low, resulting in that approximately 80% of the enrolled sows were not treated according to existing guidelines. Non-compliance of treatment guidelines did not seem to affect the risk of culling in treated sows but may have prolonged any associated pain, recovery time and negatively impacted the sow welfare during that time period.

The need for area under the curve measurements in the field of ganciclovir therapeutic drug monitoring in children: a case report

Background Ganciclovir pharmacokinetics is characterized by a high variability in drug exposure. Usually, monitoring of ganciclovir exposure is performed by measuring trough concentration. However, due to the specificity of pediatric pharmacokinetics, trough concentration measurements may not be a relevant surrogate of ganciclovir exposure. Area under the curve of concentration (AUC) may be a more appropriate biomarker. Case presentation We report the case of 3.6-year-old boy with Emberger syndrome with a cytomegalovirus reactivation occurring after allogenic hematopoietic stem cell transplantation. After a few days of treatment with intravenous ganciclovir, sub-therapeutic trough ganciclovir concentrations were measured (< 0.5 µg/mL) and viral load still increased. Ganciclovir dosage was increased by two-fold to deal with this treatment failure. Trough concentrations remained sub-therapeutic. The patient had hematologic disorder therefore it was decided to estimate ganciclovir AUC to assess more accurately drug exposure before any further dosage modification. AUC0–12 h was measured at 51 μg h/mL, which was within the therapeutic range (40–60 μg h/mL). Afterward, viral load decreased and became undetectable. Conclusions This case report highlights that monitoring ganciclovir exposure based on AUC should be performed to tailor drug dosage in order to improve treatment efficacy and safety in pediatric patients.

Tumor Cell Distinguishable Nanomedicine Integrating Chemotherapeutic Sensitization and Protection

Theoretically, with a high enough drug dosage, cancer cells could be eliminated. However, the dosages that can be administered are limited by the therapeutic efficacy and side effects of the given drug. Herein, a nanomedicine integrating chemotherapeutic sensitization and protection was developed to relieve the limitation of administration dosage and to improve the efficacy of chemotherapy. The nanomedicine was endowed with the function of synergistically controlled release of CO and drugs under near-infrared (NIR) light irradiation. CO photo-induced release system (COPIRS) was synthesized by constructing an electron excitation–electron transfer group–electron-induced CO release structure and was used as the hydrophobic part, and then hydrophilic polymer (polyethylene glycol; PEG) was introduced by a thermal-responsive groups (DA group), forming a near-infrared-induced burst-release nanocarrier. In vitro and in vivo experiments showed that the nanomedicine can distinguish between tumor and normal cells and regulates the resistance of these different cells through the controlled release of carbonic oxide (CO), simultaneously enhancing the efficacy of chemotherapy drugs on tumor cells and chemotherapeutic protection on normal cells. This strategy could solve the current limitations on dosages due to toxicity and provide a solution for tumor cure by chemotherapy.