ZIF-67 MOF-Derived Mn3O4 @ N-Doped C as a Supercapacitor Electrode in Different Alkaline Media

Transition-metal oxide has been identified as an auspicious material for supercapacitors due to its exceptional capacity. The inadequate electrochemical characteristics, such as prolonged cycle stability, can be ascribed to factors, such as low electrical conductivity, sluggish reaction kinetics, and a deficiency of active sites. The transition-metal oxides derived from the MOF materials offer a larger surface area with enriched active sites and a faster reaction rate along with good electrical conductivity. The manganese (Mn)-based metal-organic framework (MOF)-derived materials were produced using the pyrolysis method. Zeolitic imidazolate frameworks (ZIF-67) were fabricated in water at ambient temperature with the aid of triethylamine. Multiple techniques were used to examine the characteristics of the fabricated electrode materials. The influence of the electrolyte on the electrochemical activity of the Mn3O4@N-doped C electrode materials was determined in KOH, NaOH, and LiOH. For manufacturing of "Mn3O4@N-doped C", ZIF-67 was used as a precursor. The capacitive performance of the Mn3O4@N-doped C electrode increased as a result of nitrogen-doped carbon; after 5000th cycles, the electrode retained an excellent rate capability and a high specific capacitance (Cs) of 980 F g-1 at 1 A g-1 under 2.0 KOH electrolyte in a three electrode system. The carbonized manganese oxide displays also had a high Cs of 686 F g-1 in two electrode systems in 2.0 M KOH. Materials made from MOFs show promise as capacitive materials for applications in energy conversion storage owing to their straightforward synthesis and strong electrochemical performance.

Optimization of hyaluronan-enriched cubosomes for bromfenac delivery enhancing corneal permeation: characterization, ex vivo, and in vivo evaluation

To design and evaluate hyaluronan-based cubosomes loaded with bromfenac sodium (BS) for ocular application to enhance the corneal permeation and retention in pterygium and cataract treatment. BS-loaded cubosomes were prepared by the emulsification method, employing 2³ full factorial design using Design-Expert® software. Glycerol monoolein (GMO) and poloxamer 407 (P407) as lipid phase and polyvinyl alcohol (PVA) as stabilizer were the used ingredients. The optimized formulation (OBC; containing GMO (7% w/w), P407 (0.7% w/w) and PVA (2.5% w/w)) was further evaluated. OBC had an entrapment efficiency of 61.66 ± 1.01%, a zeta potential of -30.80 ± 0.61 mV, a mean particle size of 149.30 ± 15.24 nm and a polydispersity index of 0.21 ± 0.02. Transmission electron microscopy confirmed its cubic shape and excellent dispersibility. OBC exhibited high stability and no ocular irritation that was ensured by histopathology. Ex vivo permeation study showed a significant increase in drug deposition and permeability parameters through goat cornea, besides, confocal laser microscopy established the superior permeation capability of OBC, as compared to drug solution. In vivo pharmacokinetics in aqueous humor indicated higher AUC_0-tlast (18.88 µg.h/mL) and mean residence time (3.16 h) of OBC when compared to the marketed eye drops (7.93 µg.h/mL and 1.97 h, respectively). Accordingly, hyaluronan-enriched cubosomes can be regarded as a promising carrier for safe and effective topical ocular delivery.

Prompt Pain Relief: Advanced Practice Provider Led Rapid Access Palliative Radiotherapy Clinic

PURPOSE/OBJECTIVE(S)

Patients (pts) commonly present to radiation oncology with painful bone metastases requiring urgent palliative radiotherapy (RT). Unfortunately, the pre-existing scheduling workflow for palliative referrals can be inefficient, causing significant delays before pts are seen by a radiation oncologist (RO). Our institution implemented an alternative workflow, which led to the creation of an advanced practice provider (APP) led Rapid Access Palliative RT Clinic (PRC). We investigated the impact of the PRC in reducing time from referral to consultation for pts in need of palliative RT.

MATERIALS/METHODS

In March 2022, we initiated an outpatient APP led PRC focused on the APP driving consultations supervised by the weekly on-call RO. Pts are offered a variety of options for consultation such as virtual, in clinic with reserved simulation time, and when appropriate virtual simulation, using diagnostic imaging for RT planning, and same day treatment requiring only one visit to the department. The clinic provides a point of contact that fosters multidisciplinary interaction and proactive continuity of care and follow up. Following institutional review board approval, pts who received palliative RT for painful bone metastases from June 2021 to December 2022 were retrospectively reviewed. Data was collected with respect to when the referral was placed for palliative RT and when the pts was seen for consultation by a provider. The cohort of pts seen between June 2022 and December 2022 represented the PRC cohort. A comparison cohort of pts treated between June 2021 and December 2021 represented the pre-PRC cohort. Unpaired T-test was used to analyze time from referral to consultation (TTC) between groups. P value < 0.05 was considered statistically significant.

RESULTS

During the pre-PRC period, 91 patients were treated, including 12 inpatients and 79 outpatients, while during the PRC period, 101 pts were treated, including 7 inpatients and 94 outpatients. The median dose was 8 Gy in 1 fraction for both cohorts. During the PRC period, there was a 19% increase in outpatients treated for bone metastases. Restricted to just outpatients, the average TTC was 10.4 days (SD 10.2) for pre-PRC cohort versus 6.3 days (SD 6.6) for the PRC cohort, which was statistically significant (p = 0.003). This was a 39% reduction in TTC. During the PRC period, 17 pts were not seen in the APP led PRC while 77 were seen in the PRC. The most common reason was an erroneous referral for curative intent treatment instead of palliative bone treatment. During the PRC period, those pts seen in the APP led PRC had an average TTC of 5.1 days (SD 4.6) versus 11.5 days (SD 10.64) for those not seen in the PRC (p = 0.03) with a 56% reduction in TTC.

CONCLUSION

The APP led PRC clinic significantly decreased time from referral to consultation for pts requiring urgent palliative RT for painful bone metastases. Further research is underway to determine if the PRC increases referrals, patients treated, patient satisfaction, and the impact on staffing RO.

Prompt Pain Relief from Bone Metastases: Mature Results from the Virtual Simulation Program

PURPOSE/OBJECTIVE(S)

Rapidpain relief for patients with bone metastases can be a challenge due to the lengthy and complex radiotherapy workflow. The purpose of this study was to evaluate the time (in days) between initial radiation oncology consultation and start of palliative radiation treatment after implementing an alternative virtual simulation palliative workflow.

MATERIALS/METHODS

Patients meeting strict criteria were selected for virtual simulation, which included only those with painful bone metastases who were recommended palliative radiotherapy using standard AP/PA or opposed lateral fields. A recent (within 30 days) diagnostic CT scan clearly visualizing the target volume was required for treatment planning. For comparison, a reference group of 40 consecutive patients with bone metastases that underwent in-person CT simulation prior to virtual simulation implementation was reviewed.

RESULTS

Forty-five patients were treated for painful bone metastases as part of the virtual simulation program from May 2021 to October 2022. Regarding travel distance, 23 patients lived locally (<50 miles from treatment center) and 22 patients were distant (≥50 miles from treatment center). Average time from consult to treatment for all virtual simulation patients was 3.7 days compared to 7.5 days for in-person CT simulation patients (3.8 days sooner on average, p = <0.001). For outpatient treatments, average time from consult to treatment for distant virtual simulation patients was 4.0 days compared to 8.9 days for distant in-person CT simulation patients (4.9 days sooner on average, p = 0.003).

CONCLUSION

The virtual simulation program decreased the time from consult to start of treatment for patients recommended palliative radiotherapy for painful bone metastases by over 50%. This benefit was most significant for outpatients traveling ≥ 50 miles for treatment. Virtual simulation-based planning can be considered for patients anxious to proceed with radiotherapy quickly, or in underserved settings with limited transportation options to regional treatment centers.

New phthalimide analog ameliorates CCl4 induced hepatic injury in mice via reducing ROS formation, inflammation, and apoptosis

The present study aimed, for the first time, to examine the biochemical effects of new phthalimide analog, 2-[2-(2-Bromo-1-ethyl-1H-indol-3-yl) ethyl]-1H-isoindole-1,3(2H)-dione, compared to thalidomide drug against liver injury induced in mice. Carbon tetrachloride was intraperitoneal injected in mice for 6 consecutive weeks at a dose of 0.4 mL/kg twice a week for liver injury induction. Histopathological examination, levels of malondialdehyde, nitric oxide, and antioxidant enzymes were determined. Additionally, the protein levels of vascular endothelial growth factor, proliferating cell nuclear protein, tumor necrosis factor-alfa, nuclear factor kappa B-p65, B-cell lymphoma-2, and cysteine-aspartic acid protease-3 were determined. Results revealed that the treatment with phthalimide analog improved the detected liver damage and presented an obvious antioxidant activity through decreasing malondialdehyde and nitric oxide levels accompanied by increasing the levels of the antioxidant enzymes. Furthermore, the analog exhibited an effective inhibitory activity towards the studied protein expressions in liver tissues. Moreover, the B-cell lymphoma-2 protein level was increased while the cysteine-aspartic acid protease-3 level was suppressed after the treatment with phthalimide analog. Together, these results propose that phthalimide analog can ameliorate carbon tetrachloride-induced liver injury in mice through its potent inhibition mediating effect in oxidative stress, inflammation, and apoptosis mechanisms.

547 QUALITY IMPROVEMENT PROJECT IN PRESCRIBING THICKENERS POST STROKE

Introduction

One of the therapies that Speech and Language Therapy SALT) provide is a level to which fluids must be thickened to ensure a safe swallow. The thickening agent should be supplied by the hospital to the patient on discharge. This requires the thickening agent to be added to the electronic discharge letter (EDL) and, ‘To Take Out’ (TTO) medication list by ward doctors.

Method

samples of 10-20 EDLs, taken from SALT list of stroke patients between interventions. Cycle 1: SALT were initially attempting to contact the physicians responsible for writing the EDL Cycle 2: SALT kept a register of patients that they had seen the recommended thickener prescription. This list was kept in the doctor’s office. This list was mentioned in handover every morning for doctors to update EDL Cycle 3: The aforementioned list was continued, and responsibility for transfer onto EDLs was delegated to the on call Senior House Officer (SHO) Cycle 4: In addition to the above measures, custom made stickers were added to the prescription chart as an indicator to add thickener to the TTO.

Results

Cycle 1: 20% Prescribed (n = 10) Cycle 2: 78% Prescribed n = 18) Cycle 3: 93% Prescribed (n = 14) Cycle 4: 100% Prescribed (n = 10).

Conclusion

This project has built up a multidisciplinary system to a multidisciplinary problem. Through repeated cycles and system improvement, we have seen and demonstrated a collaborative effort resulting in consistent and improving results.

Multi-institutional competing risks analysis of distant brain failure and salvage patterns after upfront radiosurgery without whole brain radiotherapy for brain metastasis

Background

In this study, we use a competing risks analysis to assess factors predictive of early-salvage whole brain radiotherapy (WBRT) and early death after upfront stereotactic radiosurgery (SRS) alone for brain metastases in an attempt to identify populations that benefit less from upfront SRS.

Patients and methods

Patients from eight academic centers were treated with SRS for brain metastasis. Competing risks analysis was carried out for distant brain failure (DBF) versus death prior to DBF as well as for salvage SRS versus salvage WBRT versus death prior to salvage. Linear regression was used to determine predictors of the number of brain metastases at initial DBF (nDBF).

Results

A total of 2657 patients were treated with upfront SRS alone. Multivariate analysis (MVA) identified an increased hazard of DBF associated with increasing number of brain metastases (P < 0.001), lowest SRS dose received (P < 0.001), and melanoma histology (P < 0.001), while there was a decreased hazard of DBF associated with increasing age (P < 0.001), KPS < 70 (P < 0.001), and progressive systemic disease (P = 0.004). MVA for first salvage SRS versus WBRT versus death prior to salvage revealed an increased hazard of first salvage WBRT seen with increasing number of brain metastases (P < 0.001) and a decreased hazard with widespread systemic disease (P = 0.002) and increasing age (P < 0.001). Variables associated with nDBF included age (P = 0.02), systemic disease status (P = 0.03), melanoma histology (P = 0.05), and initial number of brain metastases (P < 0.001).

Conclusions

Patients with a higher initial number of brain metastases were more likely to experience DBF, have a higher nDBF, and receive early-salvage WBRT, while patients who were older, had lower KPS, or had more systemic disease were more likely to experience death prior to DBF or salvage WBRT.

The ASOS Surgical Risk Calculator: development and validation of a tool for identifying African surgical patients at risk of severe postoperative complications

BACKGROUND

The African Surgical Outcomes Study (ASOS) showed that surgical patients in Africa have a mortality twice the global average. Existing risk assessment tools are not valid for use in this population because the pattern of risk for poor outcomes differs from high-income countries. The objective of this study was to derive and validate a simple, preoperative risk stratification tool to identify African surgical patients at risk for in-hospital postoperative mortality and severe complications.

METHODS

ASOS was a 7-day prospective cohort study of adult patients undergoing surgery in Africa. The ASOS Surgical Risk Calculator was constructed with a multivariable logistic regression model for the outcome of in-hospital mortality and severe postoperative complications. The following preoperative risk factors were entered into the model; age, sex, smoking status, ASA physical status, preoperative chronic comorbid conditions, indication for surgery, urgency, severity, and type of surgery.

RESULTS

The model was derived from 8799 patients from 168 African hospitals. The composite outcome of severe postoperative complications and death occurred in 423/8799 (4.8%) patients. The ASOS Surgical Risk Calculator includes the following risk factors: age, ASA physical status, indication for surgery, urgency, severity, and type of surgery. The model showed good discrimination with an area under the receiver operating characteristic curve of 0.805 and good calibration with c-statistic corrected for optimism of 0.784.

CONCLUSIONS

This simple preoperative risk calculator could be used to identify high-risk surgical patients in African hospitals and facilitate increased postoperative surveillance.

CLINICAL TRIAL REGISTRATION

NCT03044899.

Development of novel bioadhesive granisetron hydrochloride spanlastic gel and insert for brain targeting and study their effects on rats

The aim of this study was to formulate granisetron hydrochloride (GH) spanlastic in mucoadhesive gels and lyophilized inserts for intranasal administration to improve GH bioavailability and brain targeting. Carpapol 934 and HPMC were incorporated in GH spanlastic in nasal gels (GHSpNGs). Gelatin and HPMC as matrix former, glycine as a collapse protecting and mannitol as an insert filler and sweeting agent were used to prepare GH spanlastic loaded in lyophilized inserts (GHSpNIs). The prepared GHSpNGs were characterized for pH measurement, drug content, rheology, and in vitro drug release. The prepared GHSpNIs were characterized for drug content, surface pH, GH release, and mucoadhesion. Biological investigations including pharmacokinetics studies and brain drug targeting efficiency dimensions were performed on rats (LC–MS/MS). The results showed thixotropic pseudoplastic gels and white insert with pH values in a physiological range, drug content (89.9–98.6%), (82.4–98.38%) for gel and insert, respectively and rapid release rate of GH. Biological studies showed that C_max and AUC_0–6 h in brain and plasma after intranasal administration of gel and insert were higher compared to IV administration of GH solution. A high brain targeting efficiency (199.3%, 230%) for gel and insert, respectively and a direct nose to brain transport (49.8%, 56.95%) for gel and insert, respectively confirmed that there is a direct nose to brain transport of GH following nasal administration of GH spanlastic loaded in nasal gel and insert. GHSpNIs can be considered as potential novel drug delivery system intended for brain targeting via the nasal rout of administration than GHSpNGs.

Growth performance and certain body measurements of ostrich chicks as affected by dietary protein levels during 2–9 weeks of age

The present work was conducted to examine the effects of dietary crude protein (CP) levels (18, 21 and 24%) on growth performance (Initial and final body weight, daily body weight gain, feed consumption, feed conversion and protein efficiency ratio) during 2-9 weeks of age and certain body measurements (body height, tibiotarsus length and tibiotarsus girth) at 9 weeks of age. A total of 30 African Black unsexed ostrich chicks were used in the present study in simple randomized design. The results of the present work indicated that initial and final live body weight, body weight gain, feed consumption, feed conversion of ostrich chicks were insignificantly affected by dietary protein level used. Protein efficiency ratio was high in the group of chicks fed diet contained 18% CP. Results obtained indicated that tibiotarsus girth was decreased (P≤0.01) with the increasing dietary protein level, where the highest value of tibiotarsus girth (18.38 cm) was observed in chicks fed 18% dietary protein level. Body height and tibiotarsus length were not significantly different. In conclusion, the results of the present study indicate that ostrich chicks (during 2-9 weeks of age) could grow on diets contain lower levels of CP (18%).

A technique for murine irradiation in a controlled gas environment

NASA’s extra-vehicular activities (EVAs) involve exposure to high energy photons while breathing 100% oxygen. Using previously verified mouse models, our laboratory is studying whether low dose irradiation under these hyperoxic conditions could lead to an increase in carcinogenic potential. To simulate the environment astronauts encounter during an EVA, enclosed chambers were constructed that allowed for mouse movement, controlled gas conditions, and uniform radiation dose delivery. Custom-built gas chambers with input/output gas valves and dividers that allowed for uniform gas flow were used to keep 6 unanesthetized mice separated while they were irradiated. The chambers were supplied with 100% oxygen or air using ball valves linked together with T-splitters. A calibrated ion chamber was used to verify the radiation dose distribution across an entire chamber. Mice were placed in the gas environments for 0.5 h, irradiated with a 10 or 18 MV photon beam from a medical linear accelerator, and left in their gas environment for 2 h post-irradiation. We irradiated 200 mice (5 different doses between 0-1000 mGy) under normoxic or 100% oxygen conditions. For the next step of this research, these mice will be euthanized 9 months post-irradiation, and lung tumors will be counted and sized to determine if hyperoxia increases the carcinogenic effect for this model.