Using AI/ML to predict blending performance and process sensitivity for Continuous Direct Compression (CDC)

Utilising three artificial intelligence (AI)/machine learning (ML) tools, this study explores the prediction of fill level in inclined linear blenders at steady state by mapping a wide range of bulk powder characteristics to processing parameters. Predicting fill levels enables the calculation of blade passes (strain), known from existing literature to enhance content uniformity. We present and train three AI/ML models, each demonstrating unique predictive capabilities for fill level. These models collectively identify the following rank order of feature importance: RPM, Mixing Blade Region (MB) size, Wall Friction Angle (WFA), and Feed Rate (FR). Random Forest Regression, a machine learning algorithm that constructs a multitude of decision trees at training time and outputs the mode of the classes (classification) or mean prediction (regression) of the individual trees, develops a series of individually useful decision trees. but also allows the extraction of logic and breakpoints within the data. A novel tool which utilises smart optimisation and symbolic regression to model complex systems into simple, closed-form equations, is used to build an accurate reduced-order model. Finally, an Artificial Neural Network (ANN), though less interrogable emerges as the most accurate fill level predictor, with an r2 value of 0.97. Following training on single-component mixtures, the models are tested with a four-component powdered paracetamol formulation, mimicking an existing commercial drug product. The ANN predicts the fill level of this formulation at three RPMs (250, 350 and 450) with a mean absolute error of 1.4%. Ultimately, the modelling tools showcase a framework to better understand the interaction between process and formulation. The result of this allows for a first-time-right approach for formulation development whilst gaining process understanding from fewer experiments. Resulting in the ability to approach risk during product development whilst gaining a greater holistic understanding of the processing environment of the desired formulation.

Utilizing a quality of life tool to examine the presence of fatigue in subjects with diabetes mellitus

Introduction

The prevalence of fatigue in patients with diabetes mellitus (DM) can be as high as 50 %. Physical, mental, and psychosocial components of fatigue negatively impact quality of life (QOL), morbidity and mortality. Several tools have been developed to address fatigue, but none specifically for measuring fatigue in DM. The aim of this study was to assess the impact of diabetes and neuropathy on fatigue using the Norfolk QOL-Fatigue (QOL-F) survey.

Methods

605 adult participants from [Anonymous] were recruited (400 subjects with type 1 or type 2 DM and 205 subjects without diabetes (controls)). All subjects completed the Norfolk QOL-F. Demographics, weight, BMI, and duration of diabetes were obtained. The Norfolk QOL-F, a 35-item validated questionnaire, assesses five domains: subjective fatigue, physical and cognitive fatigue, reduced activities, impaired activities of daily living, and depression.

Results

Subjects with DM reported significantly higher fatigue total scores (52.63vs33.89, p < 0.0001) and in all five domains when compared to controls. Patients with DM with neuropathy were significantly more fatigued than those without (59.72vs27.83, p < 0.0001). Fatigue scores in patients with DM without neuropathy were similar to controls (27.83vs33.89, p = NS). In multivariate analysis, age, gender, and presence of neuropathy significantly impacted fatigue scores.

Conclusions

The Norfolk QOL-F questionnaire can potentially identify the impact of chronic diseases such as diabetes on fatigue. Assessing the different components of fatigue is important for clinicians in improving disease management and outcomes. Further investigations are needed to confirm these observations in specific cohorts with other comorbidities.

Application of Positron Emission Particle Tracking (PEPT) for the evaluation of powder behaviour in an incline linear blender for Continuous Direct Compression (CDC)

Positron Emission Particle Tracking (PEPT) is a non-invasive measurement technique which offers the ability to track the motion of individual particles with high temporal and spatial resolution, and thus build up an understanding of the bulk behaviour of a system from its microscopic (particle level) dynamics. Using this measurement technique, we have developed a series of novel metrics to better understand the behaviours of powders during the steady-state operation of a continuous blender system. Results are presented concerning the response of particle motion to processing parameters (mixing blade configuration and RPM), quantifying the motion in terms of predicted mixing performance. It was found that both increasing rpm and increasing hold-up mass (by selecting fewer transport blades and more mixing blades) provided improved mixing conditions. Interestingly, under specific conditions, there is evidence of convection-like mixing occurring at the interface of the transport and mixing region. This suggests the existence of a potential 'folding region' whereby powder is transported up the barrel (and away from the powder bulk bed) before being reconstituted back into the bulk mass. The results also provide valuable experimental data for the development, calibration and validation of future Discrete Element Method (DEM) simulations.

A synopsis of global frontiers in fertility preservation

Since 2007, the Oncofertility Consortium Annual Conference has brought together a diverse network of individuals from a wide range of backgrounds and professional levels to disseminate emerging basic and clinical research findings in fertility preservation. This network also developed enduring educational materials to accelerate the pace and quality of field-wide scientific communication. Between 2007 and 2019, the Oncofertility Consortium Annual Conference was held as an in-person event in Chicago, IL. The conference attracted approximately 250 attendees each year representing 20 countries around the world. In 2020, however, the COVID-19 pandemic disrupted this paradigm and precluded an in-person meeting. Nevertheless, there remained an undeniable demand for the oncofertility community to convene. To maintain the momentum of the field, the Oncofertility Consortium hosted a day-long virtual meeting on March 5, 2021, with the theme of "Oncofertility Around the Globe" to highlight the diversity of clinical care and translational research that is ongoing around the world in this discipline. This virtual meeting was hosted using the vFairs ® conference platform and allowed over 700 people to participate, many of whom were first-time conference attendees. The agenda featured concurrent sessions from presenters in six continents which provided attendees a complete overview of the field and furthered our mission to create a global community of oncofertility practice. This paper provides a synopsis of talks delivered at this event and highlights the new advances and frontiers in the fields of oncofertility and fertility preservation around the globe from clinical practice and patient-centered efforts to translational research.

Positron Emission Particle Tracking of Granular Flows

Positron emission particle tracking (PEPT) is a noninvasive technique capable of imaging the three-dimensional dynamics of a wide variety of powders, particles, grains, and/or fluids. The PEPT technique can track the motion of particles with high temporal and spatial resolution and can be used to study various phenomena in systems spanning a broad range of scales, geometries, and physical states. We provide an introduction to the PEPT technique, an overview of its fundamental principles and operation, and a brief review of its application to a diverse range of scientific and industrial systems.

Giant visible and infrared light attenuation effect in nanostructured narrow-bandgap glasses

A unique effect of Bi on the optical and electrical properties of mixed Ga-containing Ge-Se and Ge-Te glasses is discovered. It is shown that glass with a low Bi content is completely transparent in a 3-16 μm spectral range, while the glass with a slightly higher Bi content possesses a large (>10  db/mm) attenuation coefficient, making a ∼millimeter thick glass sample fully opaque to VIS-IR radiation. Despite this contrast, both types of glass are found to retain their semiconducting properties, the DC conductivity at room temperature, σ_DC∼10^-3  S/m, being comparable to that of silicon.

Free-Volume Nanostructurization in Ga-Modified As2Se3 Glass

Different stages of intrinsic nanostructurization related to evolution of free-volume voids, including phase separation, crystalline nuclei precipitation, and growth, were studied in glassy As2Se3 doped with Ga up to 5 at. %, using complementary techniques of positron annihilation lifetime spectroscopy, X-ray powder diffraction, and scanning electron microscopy with energy-dispersive X-ray analysis. Positron lifetime spectra reconstructed in terms of a two-state trapping model testified in favor of a native void structure of g-As2Se3 modified by Ga additions. Under small Ga content (below 3 at. %), the positron trapping in glassy alloys was dominated by voids associated with bond-free solid angles of bridging As2Se4/2 units. This void agglomeration trend was changed on fragmentation with further Ga doping due to crystalline Ga2Se3 nuclei precipitation and growth, these changes being activated by employing free volume from just attached As-rich glassy matrix with higher content of As2Se4/2 clusters. Respectively, the positron trapping on free-volume voids related to pyramidal AsSe3/2 units (like in parent As2Se3 glass) was in obvious preference in such glassy crystalline alloys.

Effect of rare-earth doping on the free-volume structure of Ga-modified Te20As30Se50glass

Doping with 500 ppmw of Pr³⁺ions is found to depress positron trapping in Te₂₀As₂₉Ga₁Se₅₀glass, this effect being explained in terms of competitive contribution of different occupancy positions available for rare-earth ions and trapped positrons.

Positron annihilation lifetime study of polyvinylpyrrolidone for nanoparticle-stabilizing pharmaceuticals

Positron annihilation lifetime spectroscopy was applied to characterize free-volume structure of polyvinylpyrrolidone used as nonionic stabilizer in the production of many nanocomposite pharmaceuticals. The polymer samples with an average molecular weight of 40,000 g mol(-1) were pelletized in a single-punch tableting machine under an applied pressure of 0.7 GPa. Strong mixing in channels of positron and positronium trapping were revealed in the polyvinylpyrrolidone pellets. The positron lifetime spectra accumulated under normal measuring statistics were analysed in terms of unconstrained three- and four-term decomposition, the latter being also realized under fixed 0.125 ns lifetime proper to para-positronium self-annihilation in a vacuum. It was shown that average positron lifetime extracted from each decomposition was primary defined by long-lived ortho-positronium component. The positron lifetime spectra treated within unconstrained three-term fitting were in obvious preference, giving third positron lifetime dominated by ortho-positronium pick-off annihilation in a polymer matrix. This fitting procedure was most meaningful, when analysing expected positron trapping sites in polyvinylpyrrolidone-stabilized nanocomposite pharmaceuticals.

Evaluating the impact of summer vacation on the visual acuity of AMD patients treated with ranibizumab

PURPOSE

To evaluate the impact of traditional French summer vacation on visual acuity and spectral domain-optical coherence tomography (SD-OCT) of Wet AMD patients being treated with intravitreal Ranibizumab.

METHODS

This was a consecutive, comparative, single-centre, prospective analysis. All patients who were being treated with intravitreal injection of 0.5 mg ranibizumab at Cergy Pontoise Hospital, Department of Ophthalmology between July 2013 and September 2014 were included. Patients were divided into two groups: (A) patients who skipped one ranibizumab intravitreal injection during holidays, and (B) patients who received injection during their holidays. Evaluations occurred prior to traditional holiday (baseline) and 2 months later, consisting of BCVA using ETDRS, and a complete ophthalmic examination that included slit-lamp biomicroscopy, fundus examination, fluorescein angiography (FA), indocyanine green angiography (ICGA), and spectral domain-optical coherence tomography (SD-OCT). All patients were being treated with PRN anti-VEGF regimen and criteria for reinjection included a visual acuity loss >5 ETDRS letters and/or an increase of central retinal thickness, presence of subretinal fluid, intraretinal fluid, or pigment epithelium detachment. If reinjection criteria were not met, patients were advised to return in 4 weeks.

RESULTS

The mean visual acuity change was -0.071 ± 0.149 (LogMAR) in group A and + 0.003 ± 0.178 in group B (P = 0.041). At the second visit (2 months after preholidays visit), 61.8% of patients in group A had SRF and/or intraretinal cysts, and only 27.6% of patients in group B. There was a significant difference in the persistence of fluid between the two groups (P = 0.007, χ(2)-test).

CONCLUSION

This cases series demonstrated the detrimental impact of holidays on visual acuity in patients treated with ranibizumab for AMD, which, in spite of their treatment regimen, still leave in vacation. Therefore, it is important to convey the message of treatment adherence to patients, despite their need of holidays.

Identifying an Education Gap in Wound Care Training in United States Dermatology

IMPORTANCE

As restoration of the integument is paramount to wound healing, dermatologists should be central to managing wounds; yet this is often not the case. If a training gap exists during residency training, this may account for the observed discrepancy.

OBJECTIVES

To identify United States (US) dermatology residents' impressions regarding their preparedness to care for wounds, and to assess the amount and type of training devoted to wound care during residency.

DESIGN, SETTING, AND PARTICIPANTS

An online survey among current US dermatology residents enrolled in a residency training program.

MAIN OUTCOMES AND MEASURES

The primary goal was to determine whether dermatology residents believe more wound care education is needed, evaluate preparedness to care for wounds, and identify future plans to manage wounds.

RESULTS

Responses were received from 175 of 517 (33.8%) US Dermatology residents contacted. The majority of residents did not feel prepared to manage acute (78.3%) and chronic (84.6%) wounds. Over three quarters (77.1%) felt that more education is needed. Fewer than half (49.1% and 35.4%) of residents planned to care for acute and chronic wounds, respectively, when in practice.

CONCLUSIONS AND RELEVANCE

There is a gap in wound care education in US dermatology residency training. This translates to a low percentage of dermatology residents planning to care for wounds in future practice. Dermatology residents need to receive focused wound care training in order to translate the underpinnings of wound healing biology and ultimately better serve patients.

Flow Visualisation in Co-rotating Twin Screw Extruders: Positron Emission Particle Tracking and Numerical Particle Trajectories

Co-rotating twin-screw extruders are widely used compounding machines. They are mainly configured based on extensive experience and iterative approaches to optimise output and composite quality. The visualisation technology developed in the EU-project PEPTFlow allows visualisation of composite flow in twin-screw extruders under realistic processing conditions by tracking radioactive tracer particles in the polymer melt, using a specially developed camera system. This new approach allows polymer flow to be studied in different screw elements and screw configurations under realistic compounding conditions at normal temperatures and melt pressures. The paper presents the latest developments in the camera systems as well as the different ways to use and interpret the results. Detailed analysis of residence times and residence time distributions for standard compound screw elements, like kneading discs, conveying elements and reverse elements are presented. In addition for a better understanding of the flow field inside twin-screw extruders, numerical particle tracking is done. The Stokes equation, using XFEM method, are solved and the numerical RTD's (residence time distribution) are compared for various screw designs.

Clinical and cost effectiveness evaluation of low friction and shear garments

OBJECTIVE

To determine the effectiveness of Parafricta low-friction garments in reducing the incidence and prevalence of pressure ulceration and to evaluate the curative aspects of these products on pre-existing skin breakdown within a hospital setting.

METHOD

Patients with a Waterlow score of >15 and who were unable to reposition independently were offered the low-friction undergarments and bootees. A total of 650 patient cases were initially reviewed. Of these, 204 met the criteria for use of the products in the 3 months prior to the start of the evaluation (cohort 1) and 165 patients met the criteria during the period when the garments were used (cohort 2). Data collected included pressure ulcer incidence, location, grading, and outcome of ulcer on discharge. Locally derived costs for length of stay, wound dressings, pressure-redistributing mattresses and additional cost of the low-friction garments were applied to build a cost-effectiveness model.

RESULTS

In patients at risk of skin breakdown there was a statistically significant reduction in the number of patients who developed pressure ulcers following use of the low-friction garments in cohort 2 when compared with cohort 1 (16% reduction; p = 0.0286). In addition, the number of patients who were ulcer free on admission but who developed ulcers and then improved or completely healed before discharge was also statistically significant (41% increase; p = 0.0065) when cohort 2 was compared with cohort 1. Fewer patients admitted with ulcers deteriorated when using the low-friction garments (21% reduction; p = 0.0012). The costs, which were calculated by comparing patient throughput for these patients, suggest that the savings associated with preventing skin breakdown outweighed the cost of the products used (base case model indicated a saving of over £63,000 per 100 at risk patients).

CONCLUSION

The results support the conclusion that low-friction garment products have a role to play in the prevention of skin breakdown, and appear to be both clinically effective and cost effective.

DECLARATION OF INTEREST

The authors have no conflicts of interest to declare. APA Parafricta provided the products, as well as financial support for training of the ward staff who participated in the evaluation and for the data collection and analysis (which was performed by Xcelerate Health Outcomes Unit, NHS Innovations London).