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A Multi-Criteria Framework for Sustainable Cooling Strategy Selection in Turning of Inconel 600 via MCDM Methods
No full textOptimizing critical care pharmacotherapy: dynamic prospective evaluation of the medication regimen complexity-intensive care unit (MRC-ICU) score in critically ill patients.
No full textMedication regimens in critically ill patients are generally complex, increasing the risk of drug-related problems (DRPs) and unfavorable outcomes. This study aimed to evaluate associations between medication complexity and clinical pharmacist (CP) interventions as well as clinical outcomes using the Medication Regimen Complexity-Intensive Care Unit (MRC-ICU) scoring tool. This prospective cohort study was conducted between June 2024 and April 2025 in a medical ICU of a tertiary university hospital. Throughout the study period, medication regimen complexity was assessed daily. CP interventions were systematically documented, and their potential impact was evaluated using the Clinical, Economic and Organizational (CLEO) tool. A total of 202 patients over 2,287 patient-days were evaluated, during which 748 CP interventions were performed. The number of identified DRPs and CP interventions was significantly higher in patients with high MRC-ICU scores (≥ 8) (p < 0.001), among whom interventions with a moderate clinical impact (p < 0.001) and cost-decreasing economic impact (p = 0.002) were also more frequently observed. The MRC-ICU score at 24 h correlated with the number of CP interventions (r = 0.554; p < 0.001). Multivariable regression analysis revealed each one-point increase in the MRC-ICU score at 24 h was associated with a 3.9% increase in the number of CP interventions [incidence rate ratio (IRR): 1.039; p < 0.001]. According to the patient-day analysis, each one-point increase in the daily MRC-ICU score was associated with an 8.4% increase in daily interventions (IRR: 1.084; p < 0.001). Additionally, strong correlations were observed between the MRC-ICU score and the Acute Physiology and Chronic Health Evaluation II (APACHE II) (r = 0.618), the Sequential Organ Failure Assessment (SOFA) (r = 0.720), and the Modified Nutrition Risk in the Critically Ill (mNUTRIC) (r = 0.614) (for all p < 0.001). Furthermore, the MRC-ICU score demonstrated good predictive performance for ICU mortality, with an area under the curve (AUC) of 0.813. The MRC-ICU score stands out not only as a tool to evaluate regimen complexity but also as a valuable and dynamic instrument for predicting the need for CP interventions, supporting patient prioritization, and integrating with clinical risk scoring systems.</p
Resonant singular problems with unbalanced growth
No full textWe consider a Dirichlet problem driven by a differential operator with unbalanced growth and a reaction exhibiting the combined effects of a parametric singular term and a resonant perturbation. Using a combination of variational tools and critical groups, we show that, for all small values of the parameter, the problem has at least two bounded positive solutions.</p
Development and in vitro/in vivo evaluation of polymeric dissolving microneedle formulation for psoriasis treatment.
No full textFundamentals and Therapeutic Applications of Liposomes
No full textParkinson's disease (PD), the most common neurodegenerative disease after Alzheimer's disease, is characterized by motor symptoms such as rigidity, bradykinesia, resting tremor, and postural instability. Clinical diagnosis based on motor symptoms is generally not useful for early diagnosis. Although functional imaging modalities such as magnetic resonance imaging (MRI), positron emission tomography (PET), and single photon emission computed tomography (SPECT) provide important benefits in early and differential diagnosis, there is still no ideal method for diagnosis. Although many advances have been made in the treatment of PD, current treatment options are aimed at alleviating motor and non-motor symptoms. The blood–brain barrier poses the biggest problem in both transporting diagnostic and therapeutic agents to the brain. Liposomes are promising delivery systems to overcome this problem.</p
Assessment of intranasal permeability and pharmacological activity of glyburide-loaded nanosuspension formulation for Alzheimer's disease
No full textGlyburide is an anti-diabetic drug with promising potential implications for Alzheimer's disease. This study evaluated the permeability and activity of glyburide via intranasal administration in Alzheimer's disease using both in vivo and ex vivo studies. A glyburide nanosuspension, was used as the drug delivery system. Stability studies demonstrated that the nanosuspension formulation presented suitable stability during in vitro and in vivo studies. The chosen in vivo glyburide dose demonstrated a non-toxic profile via MTT. Additionally, the in vitro permeability of the nanosuspension was assessed. Pharmacological activity was further evaluated through in vivo behavioural tests, including the Morris water maze and novel object recognition tests, and amyloid-beta levels were measured in mice brain tissues with ELISA. Ex vivo quantification of glyburide concentration in various tissues was also conducted. In vitro permeability studies showed that the nanosuspension formulation significantly enhanced permeability of glyburide. In vivo behavioural tests demonstrated that the nanosuspension formulation yielded favourable and promising outcomes even it was administered intranasally. This study suggests that, through the solubility enhancement provided by nanocrystal technology increased the bioavailability of glyburide comparing the intranasal administration of glyburide, leading to improve in vivo activity compared to the raw glyburide suspension in the treatment of Alzheimer's disease
High Tibial Osteotomy Is Associated with Improvements in Both Knee and Ankle Alignment in Medial Compartment Osteoarthritis
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