Congruence rates for pharmacogenomic noninterruptive alerts

Meaningful clinical decision support (CDS) recommendations are vital for implementation of pharmacogenomics (PGx) into routine clinical care. PGx CDS alerts include interruptive and noninterruptive alerts. The objective of this study was to evaluate provider ordering behavior after noninterruptive alerts are displayed. A retrospective manual chart review was conducted from the time of noninterruptive alert implementation to the time of data analysis to determine congruence with CDS recommendations. The congruence rate for noninterruptive alerts was 89.8% across all drug-gene interactions. The drug-gene interaction with the most alerts for analysis included metoclopramide (n = 138). The high rate of medication order congruence after noninterruptive alerts were deployed suggests this modality may be appropriate for PGx CDS as a method for best practice adherence.

Inline dual-echo T2 quantification in brain using a fast mapping reconstruction technique

T2 mapping from 2D proton density and T2-weighted images (PD-T2) using Bloch equation simulations can be time consuming and introduces a latency between image acquisition and T2 map production. A fast T2 mapping reconstruction method is investigated and compared with a previous modeling approach to reduce computation time and allow inline T2 maps on the MRI console. Brain PD-T2 images from five multiple sclerosis patients were used to compare T2 map reconstruction times between the new subtraction method and the Euclidean norm minimization technique. Bloch equation simulations were used to create the lookup table for decay curve matching in both cases. Agreement of the two techniques used Bland-Altman analysis for investigating individual subsets of data and all image points in the five volumes (meta-analysis). The subtraction method resulted in an average reduction of computation time for single slices from 134 s (minimization method) to 0.44 s. Comparing T2 values between the subtraction and minimization methods resulted in a confidence interval ranging from -0.06 to 0.06 ms (95% of values were within ± 0.06 ms between the techniques). Using identical reconstruction code based on the subtraction method, inline T2 maps were produced from PD-T2 images directly on the scanner console. The excellent agreement between the two methods permits the subtraction technique to be interchanged with the previous method, reducing computation time and allowing inline T2 map reconstruction based on Bloch simulations directly on the scanner.

Diamond-Coated Silicon ATR Elements for Process Analytics

Infrared attenuated total reflection (ATR) spectroscopy is a common laboratory technique for the analysis of highly absorbing liquids or solid samples. However, ATR spectroscopy is rarely found in industrial processes, where inline measurement, continuous operation, and minimal maintenance are important issues. Most materials for mid-infrared (MIR) spectroscopy and specifically for ATR elements do not have either high enough infrared transmission or sufficient mechanical and chemical stability to be exposed to process fluids, abrasive components, and aggressive cleaning agents. Sapphire is the usual choice for infrared wavelengths below 5 µm, and beyond that, only diamond is an established material. The use of diamond coatings on other ATR materials such as silicon will increase the stability of the sensor and will enable the use of larger ATR elements with increased sensitivity at lower cost for wavelengths above 5 µm. Theoretical and experimental investigations of the dependence of ATR absorbances on the incidence angle and thickness of nanocrystalline diamond (NCD) coatings on silicon were performed. By optimizing the coating thickness, a substantial amplification of the ATR absorbance can be achieved compared to an uncoated silicon element. Using a compact FTIR instrument, ATR spectra of water, acetonitrile, and propylene carbonate were measured with planar ATR elements made of coated and uncoated silicon. Compared to sapphire, the long wavelength extreme of the spectral range is extended to approximately 8 μm. With effectively nine ATR reflections, the sensitivity is expected to exceed the performance of typical diamond tip probes.

Contact Tank PAC Dosing

Two pilot trials of powdered activated carbon (PAC)/(coagulation)/ceramic microfiltration were conducted to compare continuous 10-12 mg/L PAC inline dosing with 8-10 mg/L dosing to a 2 h-contact tank. Two low turbidity/low natural organic matter (NOM, total organic carbon <2 mg C/L) surface waters spiked with 7.2-10.3 µg/L total-pesticides were tested and the dosing options were compared towards operational performance, average removal of pesticides and NOM and costs. Removal differences between the two PAC dosing options depended on pesticides' amenability to adsorption and NOM characteristics (254 nm absorbance, A254). Waters containing low A254-absorbing NOM and only pesticides amenable to adsorption showed very high removals (all pesticides ≥93%) and no significant differences between the two PAC dosing options. Waters containing higher A254-absorbing NOM and high loads of pesticides less amenable to adsorption (dimethoate, bentazone) required higher inline PAC dose. Those or more severe conditions may require PAC doses higher than tested to comply with the Drinking Water Directive limits for pesticides. Cost analysis showed PAC inline dosing is more cost-effective than PAC dosing to the contact tank when identical PAC dose is sufficient or when the doses are low, even if 50% higher for inline dosing, and the plant is small.

Monitoring Viscosity and Total Solids Content of Milk Protein Concentrate Using an Inline Acoustic Flowmeter at Laboratory Scale

Control of milk concentrate viscosity and total solids (TS) content prior to spray drying can improve dairy ingredient manufacture. However, the availability of hygienic and appropriately pressure rated process viscometers for inline monitoring of viscosity is limited. An acoustic flowmeter (FLOWave) is an inline process analytical technology (PAT) tool that measures changes in acoustic signals in response to changes in liquid properties (i.e., acoustic transmission (AT), acoustic impedance (AI), temperature and volume flowrate). In this study, an acoustic flowmeter is evaluated as an inline PAT tool for monitoring viscosity of milk protein concentrate (MPC85), protein and TS content of (MPC85), and standardised MPC (sMPC). Laboratory scale experiments were carried out at 45 °C for five different concentrations (4–21%) of MPC85 and sMPC. Results showed that AT decreased with an increase in MPC85 viscosity (e.g., AT was 98.79 ± 0.04% and 86.65 ± 0.17% for 4% and 21% TS content, respectively). Non-linear regression was carried out to develop a relationship between AT and offline viscosity (R² (coefficient of determination) value = 0.97 and standard error of prediction = 1.86 mPa·s). AI was observed to increase at higher protein and TS content which was dependent on protein to total solid ratio (P_TSR). Multiple linear regression was carried out to develop the relationship between AI, protein content, TS content and P_TSR. Results demonstrated that AI could be used to monitor the protein and TS content of milk protein concentrate (R² > 0.96). Overall this study demonstrated the potential of an inline acoustic flowmeter for monitoring process viscosity, protein and TS during dairy concentrate processing.

Cylindrical IR-ATR Sensors for Process Analytics

Infrared attenuated total reflection (ATR) spectroscopy is a common laboratory technique for the analysis of highly absorbing liquids and solids. However, in a process environment, maintaining a sufficient sample exchange and cleaning of the sensitive surface of the element is a crucial issue. An important industrial application is the measurement of isocyanate concentrations. Isocyanates are necessary for the fabrication of polyurethane materials and are among the chemicals with the highest production volume worldwide. For process applications, narrowband photometers or MEMS spectrometers are more appropriate than the use of bulky FTIR instruments frequently encountered in a laboratory environment. Toluene diisocyanate (TDI) and hexamethylene diisocyanate (HDI) concentrations are measured with a planar ATR photometer setup. Using a miniature Fabry–Perot interferometer (FPI), trace concentrations below 100 ppm (m/m) are detected. By employing an ATR element of the cylindrical shape, sensors can be realized with a smooth surface ideally suited for an automatic cleaning system in a process environment. A laboratory setup with sapphire tubes as ATR elements for incorporation in a liquid flow system is described. Reflection and transmission configurations were investigated. Measurements with acetonitrile as a less toxic substitute showed that with cylindrical ATR sensors’ detection limits for isocyanate concentrations below 100 ppm (m/m) are feasible.

Effective filter screening approach with fractionation for enabling inline filtration of protein A eluate

Filtration of protein A eluates inline with a chromatography column is a common challenge for monoclonal antibody (mAb) purification due to the high system backpressure during elution, which can result in system shut down or require a decreased elution flow rate. The inability to filter inline not only poses a risk for process deviations, but can also lead to tank constraints and microbial ingress risk. Here, we evaluated and described a novel approach for identifying filters for inline filtration of protein A eluates at pilot scale. We fractionated the protein A eluates into 0.25 column volume fractions to screen filters under constant pressure or constant flow conditions. We observed that filtration properties for eluate fractions are significantly different from the offline eluate, and the conventional filter sizing study using elution pool is not able to predict inline filtration behavior. Through the submicron particle counts and size distribution in pre- and post-filtration samples, we determined that both attributes contribute to the high pressure across the filters. A successful proof-of-concept experiment on a column 10 cm in diameter inline with the filter train selected validated this fractionation method, and the approach was applied to a different mAb molecule to confirm effectiveness.