Modified Small-Volume Jet Nebulizer Based on CFD Simulation and Its Clinical Outcomes in Small Asthmatic Children

Optimization of formulation and atomization of lipid nanoparticles for the inhalation of mRNA

Lipid nanoparticles (LNPs) have demonstrated efficacy and safety for mRNA vaccine administration by intramuscular injection; however, the pulmonary delivery of mRNA encapsulated LNPs remains challenging. The atomization process of LNPs will cause shear stress due to dispersed air, air jets, ultrasonication, vibrating mesh etc., leading to the agglomeration or leakage of LNPs, which can be detrimental to transcellular transport and endosomal escape. In this study, the LNP formulation, atomization methods and buffer system were optimized to maintain the LNP stability and mRNA efficiency during the atomization process. Firstly, a suitable LNP formulation for atomization was optimized based on the in vitro results, and the optimized LNP formulation was AX4, DSPC, cholesterol and DMG-PEG_2K at a 35/16/46.5/2.5 (%) molar ratio. Subsequently, different atomization methods were compared to find the most suitable method to deliver mRNA-LNP solution. Soft mist inhaler (SMI) was found to be the best for pulmonary delivery of mRNA encapsulated LNPs. The physico-chemical properties such as size and entrapment efficiency (EE) of the LNPs were further improved by adjusting the buffer system with trehalose. Lastly, the in vivo fluorescence imaging of mice demonstrated that SMI with proper LNPs design and buffer system hold promise for inhaled mRNA-LNP therapies.

A path forward in the development of new aerosol drug delivery devices for pediatrics

Inhaled medications are widely accepted as being the optimal route for treating pediatric respiratory diseases, a leading cause of hospitalization and death. Despite jet nebulizers being the preferred inhalation device for neonates and infants, current devices face performance issues with most of the drug never reaching the target lung location. Previous work has aimed to improve pulmonary drug deposition, yet nebulizer efficiency remains low. The development of an inhalant therapy that is efficacious and safe for pediatrics depends on a well-designed delivery system and formulation. To accomplish this, the field needs to rethink the current practice of basing pediatric treatments on adult studies. The rapidly evolving pediatric patient (i.e. neonates to eighteen) needs to be considered because they are different from adults with respect to airway anatomy, breathing patterns, and adherence. Previous research approaches to improve deposition efficiency have been limited due to the complexity of combining physics, which drives aerosol transport and deposition, and biology, especially within the area of pediatrics. To address these critical knowledge gaps, we need a better understanding of how patient age and disease state affect deposition of aerosolized drugs. The complexity of the multiscale respiratory system makes scientific investigation very challenging. The authors have simplified the complex problem into five components with these three areas as ones to address first: how the aerosol is (i) generated in a medical device, (ii) delivered to the patient, and (iii) deposited inside the lung. In this review, we discuss the technological advances and innovations made from experiments, simulations, and predictive models in each of these areas. In addition, we discuss the impact on patient treatment efficacy and recommend a clinical direction, with a focus on pediatrics. In each area, a series of research questions are posed and steps for future research to improve efficacy in aerosol drug delivery are outlined.

The Effect of a Child Model on Breath-Sounds Examination Skills and Satisfaction on Nursing Students

One of nursing students’ auscultation critical skills is listening to a child’s breathing sounds. Previously, learning this skill required a SimBaby, which was insufficient, causing nursing students to lack proficiency. Therefore, a CHIld Model (CHIM), an innovation emulating breathing sounds, has been invented based on Gagné’s learning theory to solve this insufficiency. This article reports on the CHIM invention, consisting of hardware, software, and programming, and its effect on nursing students’ breath-sounds examination skills and satisfaction. First, the CHIM was assessed for quality and satisfaction by experts. The results were good in quality and had the highest satisfaction for application in actual use. Second, the CHIM was assessed for auscultation skills and satisfaction among nursing students. Forty-four junior nursing students participated. Next, they were randomly divided into experimental and control groups. Then, both were taught the same about respiratory problems with the SimBaby, except the experimental group had training with the CHIM. After that, both groups’ auscultation skills and satisfaction in the experimental group were examined. Finally, the statistical analysis showed that after the intervention was applied, learning with the CHIM was better than without, with the highest satisfaction level. As intended, the CHIM can help effectively enhance students’ learning and proficiency.

A Proper Shape of the Trailing Edge Modification to Solve a Housing Damage Problem in a Gas Turbine Power Plant

To solve the housing damage problem of a fractured compressor blade (CB) caused by an impact on the inner casing of a gas turbine in the seventh stage (from 15 stages), modifications of the trailing edge (TE) of the CB have been proposed, namely 6.5 mm curved cutting and a combination of 4 mm straight cutting with 6.5 mm curved cutting. The simulation results of the modifications in both aerodynamics variables Cl and Cd and the pressure ratio, including structural dynamics such as a normalized power spectrum, frequency, total deformation, equivalent stress, and the safety factor, found that 6.5 mm curved cutting could deliver the aerodynamics and structural dynamics similar to the original CB. This result also overcomes the previous work that proposed 5.0 mm straight cutting. This work also indicates that the operation of a CB gives uneven pressure and temperature, which get higher in the TE area. The slightly modified CB can present the difference in the properties of both the aerodynamics and the structural dynamics. Therefore, any modifications of the TE should be investigated for both properties simultaneously. Finally, the results from this work can be very useful information for the modification of the CB in the housing damage problem of the other rotating types of machinery in a gas turbine power plant.

An Automated Jet Nebulizer with Dynamic Flow Regulation

Purpose

The present study is focused on designing an automated jet nebulizer that possesses the capability of dynamic flow regulation. In the case of existing equipment, 50% of the aerosol is lost to the atmosphere through the vent, during the exhalation phase of respiration. Desired effects of nebulization may not be achieved by neglecting this poor administration technique. There may be adverse effects like bronchospasm and exposure to high drug concentrations.

Methods

The proposed nebulizer is composed of two modes as "Compressed Air" mode and the "Oxygen Therapy" mode. The automated triggering from one mode to another will be dependent upon the percentage of oxygen saturation of the patient, monitored from the SpO₂ sensor. The compressed airflow will be delivered to the patient according to the minute ventilation, derived with the aid of a temperature sensor-based algorithm. The compressor controller circuitry ensures that the patient receives optimum level of compressed air as per the flow rate. At the end of the drug delivery, if the liquid level sensor detects the absence of medication within the nebulizer chamber, the nebulization process will be terminated. The dynamic regulation of the motor speed with respect to the minute ventilation was accomplished.

Results

A laminar flow was obtained from the outlet of the compressor towards the nebulizer tubing, and a turbulent flow was obtained within the chamber. No excessive turbulent flows or rotational flow patterns were detected.

Conclusion

Detecting the drug levels in the nebulizing chamber will prevent continuous workup and useful in situations where back-to-back nebulization is required. Oxygen therapy mode identifies the patient's desaturation and important where the patient can be already hypoxic or have a ventilation-perfusion mismatch, but may be disadvantageous in severe COPD patients. The aforesaid results could certainly lead to the improvements of the existing nebulizers.

A Novel Ultrasonic Cleaning Tank Developed by Harmonic Response Analysis and Computational Fluid Dynamics

The manufacturer of an ultrasonic cleaning tank (UCT) received advise from a customer to seek the cause to why the UCT could not clean their products effectively and develop a novel UCT to replace the conventional model. This UCT had a capacity of 10 L, a frequency of 28 kHz, four horn transducers, and a total power of 200 W. To resolve that problem and respond to customers’ needs, we presented new methods to develop the UCT using the harmonic response analysis (HRA) and computational fluid dynamics (CFD) to simulate the cleaning process which occurred within the UCT based on the actual conditions. Results from the HRA showed that the acoustic pressure in a problematic UCT was low, resulting in a smaller cleaning area, which was consistent with the results from the foil corrosion test, and thus caused the cleaning process to be ineffective. We developed a novel UCT with improved effectiveness by adjusting the design and adding a water circulation system. From the HRA, we were able to design the dimensions of the UTC and position of the transducer to be suitable to increase the acoustic pressure and cleaning area. CFD results enabled us to design proper inlet and outlet shapes, as well as simulate the water flow behavior to find the optimal cleaning condition so the novel UCT had a water circulation system that could eliminate the excess particles.