Stability of Biologics and the Quest for Polysorbate Alternatives

Most biopharmaceutical formulations use polysorbates: surfactants that are highly efficient but difficult to manage in terms of compositional variability, quality, and stability. Alternatives, such as poloxamers, albumin, and cyclodextrin, are becoming popular and are being explored for their potential to protect biopharmaceuticals against physical and mechanical stresses.

All up in smoke: vaping-associated lung injury

The electronic cigarette (EC), was initially introduced as a safe alternative to conventional cigarette smoking While initially seemingly innocuous, over 2800 E-cigarette, or Vaping, product use-associated lung injury (EVALI) cases have been reported in the USA, with a spectrum of clinical severity ranging from mild dyspnea to overt respiratory failure In this report we highlight three EVALI cases whom presented with dyspnea and a variety of non-specific symptoms. Diagnostic imaging demonstrated bilateral reticular infiltrates and ground-glass opacities with lymphadenopathy. Clinically, patients failed to respond to empiric antibiotics but improved after initiating steroids. Consistent with prior case series, our patients reported exposure to EC liquids containing tetrahydrocannabinol (THC)/cannabidiols (CBD) additives, suggesting Vitamin E acetate as the potentially harmful constituent. In this case series and review, we not only summarize prior clinical studies that have evaluated the effects of vaping on cardiopulmonary function as well as case reports on EVALI, but also discuss the pathophysiology of vaping and EVALI. It remains unclear not only why some individuals develop EVALI, but why the clinical and pathological presentations vary. EVALI remains a significant public health concern and clinicians must maintain a high index of suspicion for this novel phenomenon.

Effect of the Cationic Head Group on Cationic Surfactant-Based Surfactant Mediated Gelation (SMG)

The surfactant-mediated gelation (SMG) method allows us to formulate hydrogels using a water-insoluble organogelator. In this study, we formulated hydrogels using three cationic surfactants, hexadecyltrimethylammonium bromide (CTAB), hexadecyltrimethylammonium chloride (CTAC), and hexadecylpyridinium chloride (CPC)] and an organogelator (12-hydroxyoctadecanoic acid (12-HOA), and studied their structures and mechanical properties. A fiber-like structure similar to that found in the 12-HOA-based organogels was observed by optical microscopy. Small- and wide-angle X-ray scattering profiles showed Bragg peaks derived from the long- and short-spacing of the crystalline structures in the gel fibers and a correlation peak from the surfactant micelles in the small-angle region. Furthermore, the formation of micelles in the hydrogels was confirmed by UV-vis spectroscopic measurements of the gel samples in the presence of Rhodamine 6G. We concluded that the hydrogels prepared by the SMG method in the present systems are orthogonal molecular assembled systems in which two different molecular assembled structures coexist. Among the three surfactant systems, the CTAB system presented the lowest critical gelation concentration and highest sol-gel transition temperature and viscoelasticity. These differences in gel fiber formation and gel properties were discussed from the viewpoint of the degree of solubilization of the gelator molecules in micelles coexisting with gel fibers and diffusion of the gelator molecules in the gel formation process.

A national survey on use of less invasive surfactant administration in Turkey

BACKGROUND

The aim of the study was to assess the rate of utilization, policy of premedication, technique, equipment, experience on safety and efficacy for less invasive surfactant administration or minimally invasive surfactant therapy (LISA/MIST) use in Turkey.

METHODS

An online survey was designed and distributed via Google Forms tool to 350 neonatologists from 173 units through NICU-Turk mailing list of the Turkish Neonatal Society. Participants were asked to answer the survey for their own neonatal intensive care unit (NICU).

RESULTS

LISA/MIST use rate was 81.6% among 87 NICUs which responded (response rate was 50.2%). LISA was used regularly in 23 of the units (26.4%), occasionally in 35 (40.2%), rarely in 12 (13.8%), and only for clinical trials in 1 (1.1%). LISA/MIST has been never applied in 16 units (18.4%).

CONCLUSIONS

LISA/MIST is widely used in Turkey similar to several regions in Europe but unlike the USA. Future studies are expected to further clarify some questions about LISA/MIST procedure, especially on its efficacy and safety.

Use of a Zwitterionic Surfactant to Improve the Biofunctional Properties of Wool Dyed with an Onion (Allium cepa L.) Skin Extract

To improve the loadability and antioxidant properties of wool impregnated with onion skin extract, the introduction of SB3-14 surfactant in the dyeing process was evaluated. A preliminary investigation on the surfactant-quercetin interaction indicated that the optimal conditions for dye solubility, stability, and surfactant affinity require double-distilled water (pH = 5.5) as a medium and SB3-14 in a concentration above the c.m.c. (2.5 × 10-3 M). The absorption profile of textiles showed the flavonoid absorption band (390 nm) and a bathochromic feature (510 nm), suggesting flavonoid aggregates. The higher absorbance for the sample dyed with SB3-14 indicated greater dye uptake, which was further confirmed by HPLC analysis. The Folin-Ciocalteu method was applied to evaluate the total phenol content (TPC) released from the treated wool, while the assays FRAP, DPPH, ABTS, and ORAC were applied to evaluate the corresponding total antioxidant activity (TAC). Higher TPCs (about 20%) and TACs (5-55%) were measured with SB3-14, highlighting textiles with improved biofunctional properties. Spectrophotometric analyses were also performed with an artificial sweat. The potential cytotoxic effect of SB3-14 in both monomeric and aggregated forms, cell viability, and induction of apoptosis were evaluated in RAW 264.7 cells. These analyses revealed that SB3-14 is safe at concentrations below the c.m.c.

Push/Pull Inequality Based High-Speed On-Chip Mixer Enhanced by Wettability

In this paper, a high-speed on-chip mixer using two effects is proposed, i.e., push/pull inequality and wettability. Push/pull inequality and wettability are effective for generating a rotational fluid motion in the chamber and for enhancing the rotational speed by reducing the viscous loss between the liquid and channel wall, respectively. An on-chip mixer is composed of three components, a microfluidic channel for making the main fluid flow, a circular chamber connected to the channel for generating a rotational flow, and an actuator connected at the end of the channel allowing a push/pull motion to be applied to the liquid in the main channel. The flow patterns in the chamber under push/pull motions are nonreversible for each motion and, as a result, produce one-directional torque to the fluid in the circular chamber. This nonreversible motion is called push/pull inequality and eventually creates a swirling flow in the chamber. Using hydrophilic treatments, we executed the experiment with a straight channel and a circular chamber to clarify the mixing characteristics at different flow speeds. According to the results, it is confirmed that the swirling velocity under appropriately tuned wettability is 100 times faster than that without tuning.

Effect of Cleaning Multiple-Funnel Traps on Captures of Bark and Woodboring Beetles in Northeastern United States

Simple Summary

Semiochemical-baited traps are used to survey insect communities and detect invasive species. These traps are left in the field during the growing season where large amounts of pollen and other debris can build up on smooth trapping surfaces. There was a concern this buildup would provide an escape route for some insects and interfere with trapping results. We tested the effects of this pollen buildup on captures of bark and woodboring beetles in northeastern forests in two experiments. While many beetles did not respond to treatments, we found a positive effect of trap cleaning for three bark beetles and one cerambycid species. The response of other species was more nuanced.

Abstract

Two experiments were conducted in mixed hardwood-conifer forests in the northeastern United States to test the effects of cleaning surfactant and non-surfactant treated multiple-funnel traps used to catch bark and woodboring beetles. Large amounts of pollen and other debris often form a crust on the interior of traps (personal observations). Such surface deposits may provide footholds for beetles to escape capture in traps. In one experiment, we tested cleaned surfactant and non-surfactant traps against non-cleaned surfactant and non-surfactant traps. In a second experiment, we tested field cleaning of modified multiple-funnel traps as an alternative to substituting clean traps on each collection visit. There was no effect of surfactant treated traps, cleaned or not, on total beetles or individual bark beetle species captured. However, in situ cleaned traps were statistically better at capturing total beetles, total bark beetles, and several bark beetle species than non-cleaned control traps. Surfactant-treated non-modified traps and cleaned modified traps had higher species richness and abundance than other treatments at the site level. Our results suggest that cleaning traps to remove accumulated pollen and debris may be helpful for some species but would have limited benefit for broad-scale trapping of bark and woodboring beetles in northeastern forests.

Nanoemulsion Stabilized by Safe Surfactin from Bacillus Subtilis as a Multifunctional, Custom-Designed Smart Delivery System

The developing field of bio-nanotechnology aims to advance colloidal research via the introduction of multifunctional nanoparticles to augment the dermal effectiveness of active substances. Self-emulsifying drug delivery systems (SEDDS)-isotropic mixtures of oils, surfactants, solvents and co-solvents or surfactants-are attracting interest in the cosmeceutical field. As part of this study, SEDDS systems containing vitamin C or vitamin E and curcumin were developed, whereby the bioavailability of the active compounds increased by enhancing their permeability to deeper layers of the skin. A composition consisting of 50% surfactin from Bacillus subtilis, 30% Transcutol and 20% oil phase was designed to encapsulate the active substances, i.e., vitamin C or vitamin E and curcumin, contained in the oil phase. The developed carriers were characterized by average particle sizes of 69-183 nm. The formulations with the vitamins were found to be physically and chemically stable for 6 months. Transdermal tests were carried out, showing that the carriers enable the transport of active substances deep into the skin, stopping at the dermis border. The formulations with vitamin C and vitamin E reduced the discoloration, the vascular lesions, and the depth of the wrinkles on the tested skin, which can be useful in cosmetics in the treatment of problem skin, including capillary and sensitive skin.

Investigation of Surfactant-Polymer Interactions Using Rheology and Surface Tension Measurements

The interactions between surfactants and a drag-reducing polymer were investigated at a low polymer concentration of 500 ppm, using measurements of the rheology and surface activity of surfactant-polymer solutions. A well-known drag-reducing polymer (anionic sodium carboxymethyl cellulose) and five different surfactants (two anionic, two non-ionic, and one zwitterionic) were selected for the interaction studies. The surfactant-polymer solutions were shear thinning in nature, and they followed the power law model. The interaction between the surfactant and polymer had a strong effect on the consistency index of the solution and a marginal effect on the flow behavior index. The surface tension versus surfactant concentration plots were interpreted in terms of the interactions between surfactant and polymer. The critical aggregation concentration (CAC) of the surfactant was estimated based on the surface tension and rheological data. The CAC values of the same charge surfactants as that of the polymer were found to be significantly higher than other combinations of surfactant and polymer, such as non-ionic surfactant/anionic polymer, and zwitterionic surfactant/anionic polymer.

Preparation of Co-Amorphous Systems by Freeze-Drying

Freeze-drying was evaluated as a production technique for co-amorphous systems of a poorly water-soluble drug. Naproxen was freeze-dried together with arginine and lysine as co-former. To increase the solubility of naproxen in the starting solution, the applicability of five surfactants was investigated, namely sodium dodecyl sulfate, pluronic F-127, polyoxyethylene (40) stearate, tween 20 and TPGS 1000. The influence of the surfactant type, surfactant concentration and total solid content to be freeze-dried on the solid state of the sample was investigated. X-ray powder diffraction and differential scanning calorimetry showed that the majority of systems formed co-amorphous one-phase systems. However, at higher surfactant concentrations, and depending on the surfactant type, surfactant reflections were observed in the XRPD analysis upon production. Crystallization of both naproxen and amino acid occurred from some combinations under storage. In conclusion, freeze-drying was shown to be a feasible technique for the production of a selection of co-amorphous drug–amino acid formulations.

Developing a cosmetic series: Results from the ESSCA network, 2009-2018

BACKGROUND

There is considerable variability across European patch test centres as to which allergens are included in local and national cosmetics series.

OBJECTIVES

To propose a standardized, evidence-based cosmetic series for Europe based on up-to-date analysis of relevant contact allergens.

METHODS

We collated data from the European Surveillance System on Contact Allergies (ESSCA) from 2009 to 2018 to determine which cosmetic allergens produce a high yield of contact allergy. Contact allergens with a prevalence of >0.3% that were considered relevant were included. Rare contact allergens were excluded if deemed no longer relevant or added to a supplemental cosmetic series for further analysis.

RESULTS

Sensitization prevalences of 39 cosmetic contact allergens were tabulated. Thirty of these allergens yielded >0.3% positive reactions and are therefore included in our proposed European cosmetic series. Six were considered no longer relevant and therefore excluded. Three were included in a supplementary European cosmetic series. An additional nine allergens were included in either the core or supplemental European cosmetic series following literature review.

CONCLUSION

We have derived a potential European cosmetic series based upon the above methods. This will require ongoing investigation based upon the changing exposure profiles of cosmetic allergens as well as new and evolving substances.

Optimization of a Method for the Concentration of Genetic Material in Bacterial and Fungal Communities on Fresh Apple Peel Surfaces

Apples are the most consumed fruit in the United States and have recently been shown to exhibit some vulnerability to contamination across the supply chain. It is unclear what role a fruit microbiome analysis may serve in future food safety programs interested in understanding changes in the product and the processing environment. Ultimately, sample integrity is key if any of these approaches are to be employed; low microbial loads on apple surfaces, the inability to sample the entire surface, and inefficiency of removal may act as barriers to achieving high-quality DNA. As such, the objective of this study was to identify a reproducible method to concentrate and quantify bacterial and fungal DNA from fresh apple surfaces. Five methods were evaluated: two variations of wash solutions for bath sonication, wash filtration, epidermis excision, and surface swabbing. Epidermis excision returned the highest mean DNA quantities, followed by the sonicated washes and wash filtration. Surface swabbing was consistently below the limit of detection. Based on the quantity of host DNA contamination in surface excision, the sonicated wash solution containing a surfactant presents the greatest opportunity for consistent, high-yielding DNA recovery from the entire apple surface.

Magnetic Imprinted Polymer-Based Quartz Crystal Microbalance Sensor for Sensitive Label-Free Detection of Methylene Blue in Groundwater

Tiny changes in the mass of the sensor in a quartz crystal microbalance with dissipation monitoring (QCM-D) can be observed. However, the lack of specificity for target species has hindered the use of QCM-D. Here, molecularly imprinted polymers (MIPs) were used to modify a QCM-D sensor to provide specificity. The MIPs were formed in the presence of sodium dodecyl benzene sulfonate. Imprinted layers on Fe3O4 nanoparticles were formed using pyrrole as the functional monomer and cross-linker and methylene blue (MB) as a template. The MIPs produced were then attached to the surface of a QCM-D sensor. The MIPs-coated QCM-D sensor could recognize MB and gave a linear response in the concentration range 25 to 1.5 × 102 µg/L and a detection limit of 1.4 µg/L. The QCM-D sensor was selective for MB over structural analogs. The MIPs-coated QCM-D sensor was successfully used to detect MB in river water and seawater samples, and the recoveries were good. This is the first time MB has been detected using a QCM-D sensor. Mass is an intrinsic property of matter, so this method could easily be extended to other target species by using different MIPs.

A Comprehensive Scientific Survey of Excipients Used in Currently Marketed, Therapeutic Biological Drug Products

PURPOSE

The steady development of biotechnology-derived therapeutic biologics over the last few decades has generated drugs that are now standard medical treatments for a range of indications. While the development of protein products has surged in recent years, the formulation and delivery of these complex molecules have relied on drug-specific studies and, in some instances, data from non-proteinaceous drug products. The commonalities, trends, and gaps in excipient technologies used to support the development of therapeutic proteins largely remain unexplored due to the drug-specific nature of many formulations.

METHODS

Using a comprehensive and relational database approach, we aimed to provide a scientific survey of all approved or licensed biotechnology-derived drug products with the goal of providing evidence-based information on common attributes and trending features in protein product excipients. We examined 665 formulations, and 395 unique formulations based on having unique excipients within them, that supported 211 therapeutic proteins as of June 2020.

RESULTS

We report the prevalence of each excipient class and excipient chemical used in eight different drug types including monoclonal antibodies, antibody conjugates, cytokines and growth factors, enzymes, polypeptide hormones, pulmonary surfactants, recombinant fusion proteins, and toxins. We also report the prevalence by excipient type among all therapeutic proteins, in the context of each drug's recommended pH range, concentration ranges for excipients, and route of administration.

CONCLUSIONS

The results of our analyses indicate certain excipients common to monoclonal antibodies, cytokines, and polypeptide hormones. We also report on excipients unique to protein drug products, such as amino acids, solubilizers, and lyoprotectants. Overall, our report summarizes the current landscape of excipients used in marketed biotechnology-derived therapeutic biologic products.

Emerging potential of niosomes in ocular delivery

INTRODUCTION

Niosomes have recently grabbed attention as one of the best tools for various site-specific drug delivery systems, including ophthalmic drug delivery. Surfactants (nonionic; tweens and spans) of different HLB values and cholesterol are the fundamental components for these formulations. It is an alternative controlled ocular drug delivery system to liposomes to overcome the problems associated with sterilization, large-scale production, and stability. It also enhances the adhesion or retention ability of drug at the ocular site. Hydrophilic or lipophilic or amphoteric drugs can be easily encapsulated in niosomes. Besides, niosomes are a leading vesicular system compatible with most of the drugs for site-specific delivery.

AREAS COVERED

This article reveals challenges and barriers for ocular drug delivery, various transporters and receptors present in the ocular region for the transportation of therapeutics as well as nutrients, and various method of preparations, loading methods and application potential of niosomes in ocular drug delivery.

EXPERT OPINION

Niosomes, a vesicular system offers numerous advantages and applicability because of its good stability, non-immunogenicity, permeation potential, and controlled release ability etc. This drug delivery system has been efficiently used in the treatment of many ocular diseases.

Hidden Microatelectases Increase Vulnerability to Ventilation-Induced Lung Injury

Mechanical ventilation of lungs suffering from microatelectases may trigger the development of acute lung injury (ALI). Direct lung injury by bleomycin results in surfactant dysfunction and microatelectases at day 1 while tissue elastance and oxygenation remain normal. Computational simulations of alveolar micromechanics 1-day post-bleomycin predict persisting microatelectases throughout the respiratory cycle and increased alveolar strain during low positive end-expiratory pressure (PEEP) ventilation. As such, we hypothesize that mechanical ventilation in presence of microatelectases, which occur at low but not at higher PEEP, aggravates and unmasks ALI in the bleomycin injury model. Rats were randomized and challenged with bleomycin (B) or not (H = healthy). One day after bleomycin instillation the animals were ventilated for 3 h with PEEP 1 (PEEP1) or 5 cmH₂O (PEEP5) and a tidal volume of 10 ml/kg bodyweight. Tissue elastance was repetitively measured after a recruitment maneuver to investigate the degree of distal airspace instability. The right lung was subjected to bronchoalveolar lavage (BAL), the left lung was fixed for design-based stereology at light- and electron microscopic level. Prior to mechanical ventilation, lung tissue elastance did not differ. During mechanical ventilation tissue elastance increased in bleomycin-injured lungs ventilated with PEEP = 1 cmH₂O but remained stable in all other groups. Measurements at the conclusion of ventilation showed the largest time-dependent increase in tissue elastance after recruitment in B/PEEP1, indicating increased instability of distal airspaces. These lung mechanical findings correlated with BAL measurements including elevated BAL neutrophilic granulocytes as well as BAL protein and albumin in B/PEEP1. Moreover, the increased septal wall thickness and volume of peri-bronchiolar-vascular connective tissue in B/PEEP1 suggested aggravation of interstitial edema by ventilation in presence of microatelectases. At the electron microscopic level, the largest surface area of injured alveolar epithelial was observed in bleomycin-challenged lungs after PEEP = 1 cmH₂O ventilation. After bleomycin treatment cellular markers of endoplasmic reticulum stress (p-Perk and p-EIF-2α) were positive within the septal wall and ventilation with PEEP = 1 cmH₂O ventilation increased the surface area stained positively for p-EIF-2α. In conclusion, hidden microatelectases are linked with an increased pulmonary vulnerability for mechanical ventilation characterized by an aggravation of epithelial injury.

pH-Responsive Wormlike Micelles Formed by an Anionic Surfactant Derived from Rosin

A novel pH-responsive wormlike micellar viscoelastic solution was constructed by a rosin-based anionic surfactant (Na-MPA-AZO-Na) in the presence of cetyltrimethylammonium bromide (CTAB). The viscoelasticity, aggregate morphology, and pH-responsiveness of the pH-responsive wormlike micelles have been investigated through the method of rheology and cryogenic-transmission electron microscopy. Its corresponding mechanism has been studied using ¹H NMR and ¹H-¹H 2D NOESY HNMR. The zero-shear viscosity (η₀) of the wormlike micellar solution rapidly decreases by 3 orders of magnitude as the pH increases from 5.21 to 9.56. The viscoelastic fluids and water-like solutions can be converted by tuning the pH between 3.62 and 12.00, and the corresponding aggregates also transform between wormlike micelles and spherical micelles. In addition, the wormlike micellar cross-sectional diameter is approximately 10 nm, which is remarkably larger than that of the common wormlike micelles. The phenomenon can be attributed to the large steric volume of the rosin rigid skeleton. When the pH is 12.00, a "pseudo" Gemini surfactant is constructed by Na-MPA-AZO-Na and CTAB through the electrostatic interactions. Wormlike micelles also can be formed with the increasing concentrations. The η₀ of the wormlike micellar system shows strong dependence on concentration with an exponent of 9.6 (η₀ ∝ C^9.6). This work further promotes new applications of forest resources.

A Novel Experimental Study on the Rheological Properties and Thermal Conductivity of Halloysite Nanofluids

Nanofluids obtained from halloysite and de-ionized water (DI) were prepared by using surfactants and changing pH for heat-transfer applications. The halloysite nanotubes (HNTs) nanofluids were studied for several volume fractions (0.5, 1.0, and 1.5 vol%) and temperatures (20, 30, 40, 50, and 60 °C). The properties of HNTs were studied with a scanning electron microscope (SEM), energy-dispersive X-ray analysis (EDX), Fourier-transform infrared (FT-IR) spectroscopy, X-ray powder diffraction (XRD), Raman spectroscopy and thermogravimetry/differential thermal analysis (TG/DTA). The stability of the nanofluids was proven by zeta potentials measurements and visual observation. With surfactants, the HNT nanofluids had the highest thermal conductivity increment of 18.30% for 1.5 vol% concentration in comparison with the base fluid. The thermal conductivity enhancement of nanofluids containing surfactant was slightly higher than nanofluids with pH = 12. The prepared nanofluids were Newtonian. The viscosity enhancements of the nanofluid were 11% and 12.8% at 30 °C for 0.5% volume concentration with surfactants and at pH = 12, respectively. Empirical correlations of viscosity and thermal conductivity for these nanofluids were proposed for practical applications.

Intratracheal budesonide/surfactant attenuates hyperoxia-induced lung injury in preterm rabbits

Recent clinical trials have shown improvements in neonatal outcomes after intratracheal administration of a combination of budesonide/surfactant (ITBS) in infants at risk of bronchopulmonary dysplasia. However, the effect of ITBS on lung function and alveolar structure is not known. We aimed to determine the effect of ITBS on lung function, parenchymal structure, and inflammatory cytokine expression in a relevant preterm animal model for bronchopulmonary dysplasia. Premature neonatal rabbits were administered a single dose of ITBS on the day of delivery and exposed to 95% oxygen. Following 7 days of hyperoxia, in vivo forced oscillation and pressure-volume maneuvers were performed to examine pulmonary function. Histological and molecular analysis was performed to assess alveolar and extracellular matrix (ECM) morphology, along with gene expression of connective tissue growth factor (CTGF), IL-8, and CCL-2. ITBS attenuated the functional effect of hyperoxia-induced lung injury and limited the change to respiratory system impedance, measured using the forced oscillation technique. Treatment effects were most obvious in the small airways, with significant effects on small airway resistance and small airway reactance. In addition, ITBS mitigated the decrease in inspiratory capacity and static compliance. ITBS restricted alveolar septal thickening without altering the mean linear intercept and mitigated hyperoxia-induced remodeling of the ECM. These structural changes were associated with improved inspiratory capacity and lung compliance. Gene expression of CTGF, IL-8, and CCL-2 was significantly downregulated in the lung. Treatment with ITBS shortly after delivery attenuated the functional and structural consequences of hyperoxia-induced lung injury to day 7 of life in the preterm rabbit.

Role of Formulation Parameters on Intravitreal Dosing Accuracy Using 1 mL Hypodermic Syringes

PURPOSE

Evaluation of product viscosity, density and aeration on the dose delivery and accuracy for intravitreal injections with commonly used commercially available hypodermic 1 mL syringes.

METHODS

Six commercially available hypodermic 1 mL syringes with different specifications were used for the study. Syringes were filled with the test solutions with different densities and viscosities. Syringes were also subjected to shaking stress to introduce aeration in the test solutions in the presence of different surfactant concentrations with and without high antibody concentration. Target intravitreal volumes of 100 μL, 50 μL and 30 μL were tested to assess dosing accuracy in a controlled simulated administration setup using DIN ISO 11040-4 guidelines and Zwick/Roell Z010 TN instrument.

RESULTS

With increasing product viscosity, higher volumes and hence doses were delivered especially for very low volumes like 50 μL and 30 μL. No impact of increasing product density was found on the delivered dose. The presence of surfactants or high protein concentration can lead to aeration, which also negatively affects the dose accuracy and precision.

CONCLUSION

Formulation parameters like viscosity can have an impact on dose delivery using hypodermic syringes for intravitreal injections and on the resulting glide force.

Lung function and exercise capacity in prematurely born young people

OBJECTIVES

To determine if lung function abnormalities in young people born very prematurely routinely exposed to antenatal corticosteroids and postnatal surfactant were associated with reduced exercise capacity.

WORKING HYPOTHESIS

In the current era, lung function abnormalities would not be associated with exercise intolerance STUDY DESIGN: Follow-up of young people from the United Kingdom Oscillation study (UKOS).

PATIENT-SUBJECT SELECTION

One hundred twenty-six young people of 797 recruited to UKOS, born at a mean gestational age of 27 weeks were assessed at a mean age of 17 years.

METHODOLOGY

Forced expiratory flow at 75% of the expired vital capacity (FEF₇₅ ), forced expiratory volume in 1 second (FEV₁ ) and lung volumes (forced vital capacity [FVC]) and residual volume (RV) and functional residual capacity (FRC_pleth ) were assessed. Abnormal lung function was below the fifth centile and very abnormal lung function below the 2.5th centile. Exercise capacity was assessed using a modified shuttle sprint test and self-reported hours of exercise.

RESULTS

Thirty-nine young people had an abnormal FEF₇₅ with an adjusted reduction in sprint distance of 114 m (P = .018) and an adjusted difference in self-reported exercise of 0.73 hours (P = .036). Twenty-seven young people had a very abnormal FEF₇₅ with an adjusted reduction in sprint distance of 159 m (P = .002) and adjusted reduction in self-reported exercise of 1.15 hours (P = .002).

CONCLUSION

Very prematurely born young people with abnormal airway function had a significant reduction in exercise capacity.

A Newly Observed Mutation of the ABCA3 Gene Causing Lethal Respiratory Failure of a Full-Term Newborn: A Case Report

Respiratory distress syndrome caused by a secondary surfactant deficiency is one of the most common diagnoses requiring admission to the Neonatal Intensive Care Unit. We illustrate the case of a term female newborn without prenatal and peripartal risks. There had been significant signs of respiratory distress 4 h after delivery. The condition gradually worsened to the point of needing oscillatory ventilation. The most common infectious and non-infectious causes were excluded. Considering the course of illness, a congenital surfactant deficiency was suspected. There nevertheless was no significant improvement after administration of surfactant. Following a short period of palliative care, the child died at 34 days of age due to respiratory failure. DNA diagnostics revealed compound heterozygosity of ABCA3 functional mutations leading to the p.Pro147Leu and p.Pro246Leu exchanges. The second identified mutation of ABCA3 c.737C>T had not to date been described in connection with primary surfactant deficiency.

Improving lung aeration in ventilated newborn preterm rabbits with a partially aerated lung

Preterm newborns commonly receive intermittent positive pressure ventilation (iPPV) at birth, but the optimal approach that facilitates uniform lung aeration is unknown, particularly in a partially aerated lung. As both inflation time and exogenous surfactant facilitate uniform lung aeration, we investigated whether they can improve lung aeration and lung mechanics in a partially aerated lung immediately after birth. Preterm rabbit kittens (29 days of gestation, term ~32 days) were delivered by caesarean section and partial lung aeration was created by intubating and mechanically ventilating the right lung. The tube was then withdrawn to ventilate both lungs using inflation times of 0.2 s or 1.0 s, with or without exogenous surfactant (200 mg/kg; Curosurf) and a tidal volume (Vt) of 8 mL/kg. Simultaneous phase contrast X-ray imaging and plethysmography were used to measure lung aeration and mechanics. Kittens ventilated with longer inflation times (1.0 s) reached their target Vt with fewer inflations, required lower inflation pressures (28.5 ± 1.1 vs. 33.5 ± 1.3 cmH₂O, P = 0.01) and had higher dynamic lung compliances (0.54 ± 0.3 vs. 0.40 ± 0.3 cmH₂O·mL^-1·kg^-1, P = 0.003). Surfactant increased functional residual capacity (FRC; 31.9 ± 3.2 vs. 18.0 ± 3.9 mL/kg, P = 0.02) and the proportion of the Vt entering the previously unaerated lung but had no effect on dynamic lung compliance. Combining early surfactant treatment with longer inflation times increases FRC levels, improves dynamic lung compliance, reduces inflation pressures and markedly increases the proportion of the lungs being ventilated during iPPV in preterm kittens with a partially aerated lung.NEW & NOTEWORTHY Preterm newborns commonly receive intermittent positive pressure ventilation (iPPV) at birth, but the optimal approach that facilitates uniform lung aeration is unknown, particularly in a partially aerated lung. Using phase contrast X-ray imaging, we showed that combining a long inflation time (1.0 s) with surfactant improved lung mechanics and aeration in the immediate newborn period. The current clinical practice of using short inflation times during iPPV might be suboptimal and a different approach is needed.

Enhancement of Diversity in Production and Application Utilizing Electrolytically Polymerized Rubber Sensors with MCF: 1st Report on Consummate Fabrication Combining Varied Kinds of Constituents with Porous Permeant Stocking-Like Rubber

To satisfy the requirement of haptic sensibility in rubber such as in the proposed hybrid skin (H-Skin), the authors have demonstrated a new method for solidifying rubber using electrolytic polymerization together with configured magnetic clusters of magnetic compound fluid (MCF) incorporated into the rubber by the application of a magnetic field. However, the rubber and magnetic fluid (MF) involved in the MCF rubber were water-soluble. In addition, the authors have demonstrated the practicability of using electrolytic polymerization with an emulsifier, polyvinyl alcohol (PVA), in which natural rubber (NR) or chloroprene rubber (CR) and silicone rubber (Q) can be mixed as water-soluble and water-insoluble rubbers, respectively. In this study, to enhance production, the feasibility of solidifying rubber by electrolytic polymerization is verified using varied water-insoluble rubber, varied water-insoluble MF, and varied surfactants to aid emulsion polymerization, except in the case of other kinds of rubber and MF which have been demonstrated until recent by the authors. Based on these diverse constituents, the authors propose a consummate fabrication process for multi-layered MCF rubber, which involves porous stocking-like rubber that can be permeated by any liquid. The investigation of this application is presented in the sequential second report.