Search

In the present study, co-processed excipients from chitosan, and maize starch were prepared by co-dispersion, and co-granulation methods in 1:1 ratio. The resultant products were then characterized physically by their micrometric properties and hygroscopic characters. The co-processed excipient prepared by co-granulation was chosen and was added to a directly compressible oral sustained-release tablet (Batch F1-F4) containing ibuprofen as a model drug. A well-known marketed ibuprofen tablet (Motrin) was taken for comparison purposes of the dissolution characteristics. Pre-compression parameters, as well as post-compression parameters of all the batches, were performed. The pre-compression parameters, and post-compression parameters of F3, containing chitosan to maize in the ratio of 2:1, were found to be comparable with the marketed product. F3 batch showed 74.7 % of drug release up to 8 h, which reflect the release retardant properties of co-processed excipient. Collectively, co-processed excipients of chitosan, and maize starch improve the physical properties of individual materials, and can be used as a directly compressible excipient as a release retardant material for oral sustained-release tablets.

Objectives: To describe and compare caregiver perceptions of their emergency department (ED) experiences with and without child life specialist (CLS) involvement in their child's overall care. Study design: A descriptive cross-sectional survey of caregivers of children aged 0-17 years at a tertiary care pediatric ED was completed from March to August 2021. Survey themes included perceived experience and satisfaction and the impact of child life specialists. Results: A total of 179 caregivers completed the survey; mean age was 38.9 years (SD 8.4), and 68.1% (122/179) were mothers. Caregivers of children with CLS involvement (CLS+) ranked their overall experience (P = .021) and satisfaction (P = .009) greater than without CLS involvement (CLS–). More CLS+ caregivers ranked their experience (55.7%, 34/61) and their satisfaction (77.0%, 47/61) as excellent (5/5 Likert scale rating) compared with CLS– caregivers (34.8%, 40/115 and 52.2%, 60/115 respectively). CLS+ families were more likely to be offered nonpharmacologic interventions (eg, iPad, sensory lights, toys) (98.4% vs 31.3%, P = .003); they were also more likely to have a health care worker explore their feelings and fears (52.5% vs 27.0%, P = .0008), help them prepare for a procedure or examination (73.8% vs 31.3%, P

Summary: In 2019, Germany passed the Digital Healthcare Act, which, among other things, created a “Fast-Track” regulatory and reimbursement pathway for digital health applications in the German market. The pathway explicitly provides for flexibility in how researchers can present evidence for new digital products, including the use of real-world data and real-world evidence. Against this backdrop, the Digital Medicine Society and the Health Innovation Hub of the German Federal Ministry of Health convened a set of roundtable discussions to bring together international experts in evidence generation for digital medicine products. This Viewpoint highlights findings from these discussions with the aims of (1) accelerating and stimulating innovative approaches to digital medical product evaluation, and (2) promoting international harmonisation of best evidentiary practices. Advancing these topics and fostering international agreement on evaluation approaches will be vital to the safe, effective, and evidence-based deployment and acceptance of digital health applications globally.

Background: Despite limited randomized trial data demonstrating clinical efficacy, the utilization of Impella in ST-elevation myocardial infarction (STEMI) patients complicated with cardiogenic shock (CS) has increased over time. Methods: We identified 75,769 hospitalizations with STEMI complicated by CS between October 2015 and December 2018 using International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes. From this cohort, hospitalizations were stratified according to IABP or Impella placement. The primary outcome was all-cause in-hospital mortality. Secondary outcomes were divided into efficacy, safety, and device-related complications. Propensity-score matching was used to account for differences in the baseline characteristics between the groups. Logistic regression was performed to get the odds ratio and confidence intervals. Results: Among 75,769 admissions with STEMI and CS, hospitalizations with

The unique conditions of space harbor considerable challenges for astronauts to overcome. Namely, the ionizing content of space radiation and the effects of microgravity have been implicated in the pathogenesis of cardiovascular disease. Post-flight carotid arterial stiffness was demonstrated in astronaut studies while early arteriosclerosis has been linked with microgravity-induced oxidative stress in cellular studies. Similarly, radiation has been shown to disrupt molecular pathways, enhance reactive oxygen species and increase risk of cardiovascular disease in exposed populations. These results may bear even more significance in space owing to the propensity for microgravity and space radiation to yield synergistic and/or additive interactions. Potential countermeasures such as α-tocopherol and captopril target these oxidative pathways and may help to protect against the effects of microgravity and radiation-induced cardiac damage. However, more research needs to be conducted in this area to facilitate a safe passage for humans to the Moon, Mars and beyond.