Advantageous Option Research Articles

Comparison of intravitreal ranibizumab, aflibercept and bevacizumab therapies in diabetic macular edema with serous retinal detachment.

To compare the effects of ranibizumab, aflibercept and bevacizumab treatments in treatment-naive diabetic macular edema(DME) patients with serous retinal detachment(SRD). This is a retrospective, comparative study. In a sample of 86 eyes of 86 untreated DME patients with accompanying SRD, 23 patients were treated with ranibizumab (IVR), 28 patients with aflibercept (IVA), and 35 patients with bevacizumab (IVB). All were injected intravitreally once a month for a 3-month loading dose. Subsequently, all participants were evaluated every months and if neccessary they received additional intravitreal treatments.Mean changes in best corrected visual acuity (BCVA), central retinal thickness (CRT), and SRD height over the 6-months study period were compared. At baseline, the groups did not differ in mean BCVA,CRT and SRD height. During the first 3 months, in IVA group the mean decrease in CRT and SRD height were significantly more than in the other two groups (p < 0.05 for all). However, these differences disappeared at 6 months.The number of injections was similar between the groups during the study period. In patients with DME accompanied by SRD, IVA is a more advantageous option in terms of reduction in CRT and SRD height from baseline to 3 months. In the 6-month period of treatment, IVR, IVA and IVB therapies areanatomically and functionally similar and significant effective modalities.

Comparative Study on Hybrid Rocket Fuels for Space Launch Vehicles Moving in Higher Orbits

The current research is focused on understanding the propulsive parameters of hybrid rocket motors. A comparative study is prepared from various research papers. The fuels paraffin wax, hydroxyl-terminated polybutadiene (HTPB) and polymethyl methacrylate (PMMA) with added additives (Al/Mg) were combined with two oxidizers, liquid oxygen (LOX), nitrous oxide (N2O). The propulsive parameters examined were the combustion efficiency, combustion or adiabatic flame temperature, characteristics velocity and regression rate. The propellant pair paraffin-N2O provided the highest performance for all parameters studied. This study provides an advantageous propellant option for future rocket propulsion based on a comparative investigation

Six months multicentre pilot open label single-arm study to evaluate patient experience, acceptability and satisfaction of switching certolizumab pegol from a prefilled syringe or autoinjection pen to an AVA® e-Device in rheumatoid arthritis, psoriatic arthritis and axial spondyloarthritis patients.

The study aimed to assess acceptability and patient experience of Certolizumab (CZP) self-injection with AVA® and clarify patient device preference after switching CZP from the syringe or auto-injection pen to AVA® in rheumatoid arthritis (RA), psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA) patients. A multicentre open-label, cross-sectional and prospective study among four Spanish hospitals was performed. Adult RA, PsA, axSpA patients treated for at least 6 months with the CZP syringe or pen were recruited. At the first visit, patients completed Pre-AVA® questionnaire. Patients were instructed on proper administration of CZP by AVA®. After 2 and 6 months of CZP self-injections using the AVA®, patient experience, adherence, preference and safety of each administration was assessed using post-AVA® questionnaire. Thirty four patients were included (28 women). All patients self-administered CZP AVA® the full dose of CZP was injected. Patients reported >90% adherence to CZP AVA® assessed with the injection log. Pain at the injection site was reduced after switching to AVA®. Twenty nine patients preferred CZP AVA® and five patients preferred the CZP pen. No safety-related findings related to AVA® CZP administration were identified. The AVA® is an advantageous delivery option for CZP in patients with RA, PsA, axSpA.

Nuclear Analyses of ITER Diagnostics Lower Ports

The present work is devoted to the nuclear analyses of International Thermonuclear Experimental Reactor (ITER) diagnostics lower ports (LPs) with the aim to select an optimal shielding layout considering various requirements, such as shielding performance, reduced and simplified remote handling (RH) operations, standardization across all LPs, and cost-effective solutions. The LP configuration with back rack, RH shield, and front rack with stainless-steel (SS) ribs for all diagnostic LP ports is the most advantageous option to address these requirements.

Effects of triazole plant growth regulators on molting mechanism in Chinese mitten crab (Eriocheir sinensis)

Rice crab co-culture is a new integrated farming model in China. The application of triazole plant growth regulators (PRGs) is often used as an advantageous option to combat rice lodging. However, there is still a gap regarding the toxicity of these PRGs on the growth and development of the Chinese mitten crab (Eriocheir sinensis, E. sinensis). Here the effect of triazoles (paclobutrazol and uniconazole) on the molting mechanism of E. sinensis was investigated. Monitoring of regulatory genes associated with molting showed that the two PRGs were found to inhibit the expression of ecdysteroid hormone (EH), ecdysteroid receptors gene (EcR), and retinoid X receptors gene (RXR) and induce secretion of molt-inhibiting hormone (MIH) gene. In addition, the activities of chitinase (CHIA) and N-acetyl-β-d-aminoglucosidase (β-NAGase) were also inhibited by exposure to PRGs. Exposure to PRGs also elevated the mRNA expression of the growth-related myostatin gene (MSTN). These results revealed that there is a long-term risk of exposure to triazoles PRGs that may inhibit molting and affect normal development and immune system of E. sinensis.

Make or Buy Choices: Strategic, Profitability and Financial Aspects

Make-or-buy choices are often analysed only from an income point of view, i.e. comparing the costs of the production process implemented within the company with the costs of the service acquired outside the company from third-party economies. This attitude can lead to severe problems in the decision-making process. In choosing the best option, point make or buy alternatives must be implemented primarily based on the strategic impact of the chance to be executed or from comparing the strategic implications of the two options. The strategic aspect of make-or-buy choices is an essential element to be considered since the lack of this type of analysis can lead to choices that are perhaps the most profitable. However, these choices have severe consequences at the level of the company's overall strategy, which is why top management must implement make-or-buy decisions, not the heads of operational departments. Alongside the strategic and profitability aspects, it must also implement make-or-buy choices by considering the financial impacts of the two options. The static and dynamic financial aspects analysed through ratios and flows, respectively, represent an essential element of analysis for the decision to fall on the most convenient option for the cartel, where the concept of convenience is understood in a broad sense and, therefore, also financial. The analysis of the strategic, profitability and financial aspects, thus, appears to be fundamental to analysing the make or buy choices from every point of view. The decision can fall on the most advantageous option for the enterprise where the concept of convenience contains elements of a strategic, profitability and financial nature within it.

Co-Production of Dimethyl Carbonate, Dimethoxymethane and Dimethyl Ether from Methanol: Process Design and Exergy Analysis

Dimethyl carbonate is an important green chemical that has been widely used in the chemical industry. In the production of dimethyl carbonate, methanol oxidative carbonylation has been studied, but the conversion ratio of dimethyl carbonate using this method is too low, and the subsequent separation requires a large amount of energy due to methanol and dimethyl carbonate being azeotrope. In this paper, the strategy of “reaction instead of separation” is proposed. Based on this strategy, a novel process is developed to combine the production of DMC with that of dimethoxymethane (DMM) and dimethyl ether (DME). The co-production process was simulated using Aspen Plus software, and the product purity was up to 99.9%. The exergy analysis of the co-production process and the existing process was carried out. The exergy destruction and exergy efficiency were compared with those of the existing production processes. The results show that the exergy destruction of the co-production process is about 276% less than that of the single-production processes, and the exergy efficiencies in the developed co-production process are significantly improved. The utility loads of the co-production process are significantly lower than that of the single-production process. The developed co-production process increases the methanol conversion ratio to 95%, with a reduced energy requirement. It is proved that the developed co-production process can provide an advantageous option over the existing processes with improved energy efficiency and material savings. The strategy of “reaction instead of separation” is feasible. A new strategy is proposed for azeotrope separation.

Arterial Accesses in Coronary Angiography and Intervention-Review with a Focus on Prognostic Relevance.

Arterial access in coronary angiography has always been an important issue. Convincing prognostic data from large randomized controlled trials (RCTs) in the first place but also safe performance of same-day-discharge after diagnostic and interventional procedures, improved patient comfort and cost-effectiveness led to a paradigm shift from the transfemoral approach (TFA) to the transradial approach (TRA) in several clinical situations. Consequently, today's relevant guidelines recommend a radial-first strategy as default approach. However, there is still strong controversy among interventional cardiologists resulting in delayed spread of the TRA causing significant regional differences. One major critics point is the rate of postprocedural radial artery occlusion (RAO) after using the traditional puncture site at the proximal radial artery (pTRA) which was registered too high in certain centers. A new access using the distal radial artery (dTRA) in the area of the snuff box (SB) and the dorsal box (DB) has been proven to minimize RAO and enabling even complex interventions using 7F guiding catheters. Although, dTRA seems to be an advantageous option, this approach is still not widely used. This review-addressed to beginners and even advanced interventionalists-presents all arterial access routes in interventional cardiology. It focusses on those to be routinely preferred and also on the possibility to guide the puncture with ultrasound. Thereby, the various approaches, including the transulnar (TRU) but also the still relevant TFA approach, are discussed in detail. Thereby, we introduce our philosophy of "radial freedom" and a new classification for TRA.

Proposal for the conversion of Eucalyptus urograndis into bioethanol via acid hydrolysis, using the concepts of biorefineries

Abstract The production of bioethanol from materials of renewable origin is an important matter for a more sustainable economic development, and at the same time it challenges researchers to seek more efficient technologies that can make it viable. Wood is a profitable and advantageous option, with special emphasis on eucalyptus, whose cultivation has high turnover in Brazil, where land is available for this purpose. Therefore, the goal of this research was to optimize the hydrolysis stage using acid instead of enzymes for the conversion of chips of Eucalyptus urograndis into bioethanol, with additional co-production of furfural and commercial lignin, in order to make the process more advantageous. To obtain bioethanol, a pre-treatment adapted from autohydrolysis was performed to remove the hemicelluloses, followed by soda pulping to remove the lignin and, finally, the acid hydrolysis of the β-(1→4) glycosidic bonds between the C1–C4 cellulose carbons releasing β-D-glucose monomers to be fermented into bioethanol. In the acid hydrolysis step, sulfuric acid of concentration 1127 gL−1 was used. After the experimental analyses performed, it could be observed that in acid hydrolysis, treatments using 70 mL and 80 mL of sulfuric acid did not differ statistically in relation to glucose production. However, by increasing the volume of acid to 90 mL, there was an increase in the production of fermentable sugars into bioethanol, 63.7 %, which began decreasing when adding acid above 93 mL, because the excess of acid also caused the degradation of sugars into 5-hydroxymethylfurfural (HMF); and in the treatment of 100 mL there was a higher production of HMF. The production of bioethanol proved to be competitive after the fermentation of the sample from the 90 mL treatment with a production of 103.7 L of bioethanol/ton of wood, in addition to being beneficial to the process as a whole with the co-production of furfural, 28.8 kg of furfural ton−1 of wood, and commercial lignin, 428.3 kg of lignin per ton of wood, precursors to various chemicals such as resins, coatings and inks.

Improving old-age hayfi elds in the forest-steppe zone of Western Siberia

The results of research on the improvement of old-age hayfi elds in the forest-steppe zone of Western Siberia carried out in 2016–2020 were presented. A grass mixture of perennial leguminose grasses was sown, consisting of alfalfa (Medicago varia Mart.) of the Siberian variety 8, meadow clover (Trifolium pratense L.) of SibNIIK variety 10 and sandy esparcet (Onobrychis arenaria D.S.) of SibNIIK variety 41. The largest number of cereal plants (77,3 %) was in the variant with disking in 1 trace without sowing. The largest number of perennial leguminose grasses (86,5 %) was observed in the variant with a radical improvement of old-age hayfi elds and ordinary sowing of a mixture of perennial leguminose grasses. In the botanical composition of the herbage of old–age hayfi elds, the proportion of diff erent grasses with various turf treatments and sowing of perennial leguminose grasses decreased from 19,4 to 9,4–12,9 %. The highest yield of green and dry mass was obtained in a variant with a radical improvement and ordinary sowing of the grass mixture of perennial leguminose grasses. The yield of green mass was 12,09 and dry one 3,51 t/ ha. The amount of digestible protein per 1 feed unit was 111 g. Slightly inferior in yield was the option with a strip sowing of the grass mixture of perennial leguminose grasses. The yield of green and dry mass was 10,02 and 2,91 t/ha, respectively. The amount of digestible protein per 1 feed unit was 106 g. The lowest yield was obtained in the control version of the fi eld experiment (old-age hayfi eld). The yield of green and dry mass was 3,28 and 1,02 t/ha, respectively. The amount of digestible protein per 1 feed unit was 85 g. There was no butyric acid in the haylage of perennial grasses of improved old-age hayfi eld. The sum of lactic and acetic acids was small and amounted to 1,01–2,35 %, which indicates the high quality of the haylage mass obtained. It has been established that the most energetically advantageous option among the methods of improving old–age hayfi elds is strip sowing of the grass mixture of perennial leguminose grasses. Thus, among the considered methods of improving old-age hayfi elds, strip sowing of perennial leguminose grasses turned out to be the most energetically advantageous.

A high throughput method for Monitoring of Sorafenib, regorafenib, cabozantinib and their metabolites with UPLC-MS/MS in rat plasma

As multi-targeted tyrosine kinase inhibitors, sorafenib, regorafenib and cabozantinib are widely used in hepatocellular carcinoma (HCC) for systemic therapies with anti-proliferative and anti-angiogenic effects. Nevertheless, adverse effects or insufficient efficacy appear frequently due to the plasma concentration with individual variability of these drugs. To ensure the curative effect and safety by therapeutic drug monitoring (TDM), this study developed a high throughput method to quantify sorafenib, regorafenib, cabozantinib and their active metabolites in plasma simultaneously. The chromatographic separation analysis achievement was performed on a Waters-ACQUITY UPLC BEH C18 column by UPLC-MS/MS system using a gradient elution of solvent A (acetonitrile) and solvent B (water with 0.1% formic acid) in 3.0 min. This method presented satisfactory results of specificity, precision (the intra-day coefficient of variation was between 2.5% and 6.6%, and the inter-day coefficient of variation was between 4.0% and 11.1%) and accuracy (within ±15% for intra-day and inter-day), as well as the stability under certain conditions, the matrix effect in plasma, and extraction recovery (75.6%–94.4%). The linearity of each analyte in the proper concentration scope indicated excellent. This study strictly complied with the performance rules of assay validation in biological medium proposed by FDA and was successfully applied to the pharmacokinetic study in rats. Thus, it would be an advantageous option to research the relationship between concentration-efficacy and concentration-toxic in HCC patients who were supposed to take these medications.

Banana bunch cover: evaluation of promising bag materials

Now days there has been an increase in the consumers demand for great food, produced in environmentally cost-effective and friendly processes, being increasingly necessary new cultivation techniques able to ensure the required standards for banana growers and consumers. Therefore, the research aimed to evaluate the effects of bunch cover materials on development and quality of ‘BRS Platina’ banana fruits. The experimental design was in randomized blocks, with six treatments, four replications and four plants per plot, being the treatments: WB – without bagging; BBTK – black polypropylene bag (TNT) + kraft paper; BBPK - black polyethilene bag + kraft paper; KP – kraft paper; WBT – non-woven polypropylene white bag (TNT) and WBP - white polyethylene plastic bag. The ‘BRS Platina’ banana bunches cover improved fruits quality and the treatment polyethylene white bag (WBP) can be an advantageous option for the banana growers because of its effectiveness on the reduction of damages caused by flowers thrips (Frankliniella spp), providing a good agronomic performance and also does not delay the harvesting.

Increasing Faculty Resources and Student Capacity Through Shared Faculty Expertise.

The ongoing nurse faculty shortage has resulted in a need for schools of nursing to become both innovative and creative in their approach to nursing education. A literature review revealed some schools of nursing across the United States are sharing faculty for undergraduate and pre-licensure nursing programs. The purpose of this pilot project was to explore the effectiveness of a shared faculty content expert in a live-streamed lecture modality to improve nursing schools' access to high quality specialty content. The feasibility and satisfaction of sharing a course and faculty between two independent schools of nursing were evaluated. An online synchronous format was utilized to share a mental health nursing course between two independent schools of nursing. Results indicated that theoretical classroom content and experiences can be shared and delivered synchronously among schools of nursing; however, challenges existed related to scheduling conflicts. Additionally, technology issues were found to negatively impact the student experience at times. Given the challenges identified in the project, an asynchronous content delivery modality may be a more advantageous option. Future research is needed to identify ways to mitigate the challenges experienced.

Underwater Remote Skimming of Slow Sand Filters for Sustainable Water Production

Slow sand filters (SSF) are a simple water treatment technology providing an important alternative to conventional drinking water treatment. SSF are extensive in terms of carbon cost and chemical use but require a large land area and are complex to operate, as periodic cleaning is required to prevent filter clogging. Therefore, redundant SSF beds are required to enable water production to occur during long cleaning downtimes. Underwater skimming (UWS) is a cleaning innovation where the foulant layer (containing sand and particles) is removed using a skimmer consisting of a shrouded blade mounted on a vehicle platform. Sand, particles, and biofilm are skimmed prior to ex situ washing of the recovered sand. In this Viewpoint, we posit that the introduction of an in situ underwater skimmer operated remotely can substantially help to offset the aforementioned challenge of downtime, with its associated loss of production, enabling the technology to operate more efficiently and remain a pertinent and advantageous process option within modern water treatment facilities or possibly resource constrained settings. Otherwise, this resilient biotechnological process could be replaced by chemical and energy-intensive processes which increase the entropy of water treatment more than SSF. The anticipated benefits and challenges of UWS of SSF are discussed.

Treatment with β-blocker nebivolol ameliorates oxidative stress and endothelial dysfunction in tenofovir-induced nephrotoxicity in rats.

BackgroundTenofovir disoproxil fumarate (TDF), a widely prescribed component in antiretroviral regimens, has been associated with nephrotoxicity. Nebivolol is a third generation selective β-1 adrenergic receptor blocker and may protect renal structure and function through the suppression of oxidative stress and enhancement of nitric oxide (NO) synthesis. We aimed to investigate whether nebivolol could be an effective therapeutic strategy to mitigate tenofovir-induced nephrotoxicity.MethodsWe allocated Wistar rats to four groups: control (C), received a standard diet for 30 days; NBV, received a standard diet for 30 days added with nebivolol (100 mg/kg food) in the last 15 days; TDF, received a standard diet added with tenofovir (300 mg/kg food) for 30 days; and TDF+NBV, received a standard diet added with tenofovir for 30 days and nebivolol in the last 15 days.ResultsLong-term exposure to tenofovir led to impaired renal function, induced hypertension, endothelial dysfunction and oxidative stress. Nebivolol treatment partially recovered glomerular filtration rate, improved renal injury, normalized blood pressure and attenuated renal vasoconstriction. Administration of nebivolol contributed to reductions in asymmetric dimethylarginine (ADMA) levels as well as increases in endothelial nitric oxide sintase (eNOS) accompanied by renin-angiotensin-aldosterone system downregulation and decreases in macrophage and T-cells infiltrate. Furthermore, nebivolol was responsible for the maintenance of the adequate balance of thiobarbituric acid reactive substances (TBARS) and glutathione (GSH) levels and it was associated with reductions in NADPH oxidase (NOX) subunits.ConclusionNebivolol holds multifaceted actions that promote an advantageous option to slow the progression of kidney injury in tenofovir-induced nephrotoxicity.

Oral Ivermectin for the Treatment of Rosacea-Associated Blepharitis: Case Report

Blepharitis is an inflammatory condition of the eyelids managed by primary care providers, ophthalmologists, and dermatologists. It can be associated with allergies, infections, seborrheic dermatitis, rosacea, eczema, and psoriasis. In both cutaneous and ocular rosacea, overgrowth of Demodex has been implicated as a causative factor. We present a case of recalcitrant rosacea-associated blepharitis treated successfully with oral ivermectin. Oral ivermectin can be an advantageous option for rosacea-associated blepharitis resistant to other treatment options due to its targeted action, once-a-day dosing and minimal adverse effects.

Efficacy of Acupuncture and Moxibustion in Alopecia: A Narrative Review.

Acupuncture is the practice of applying needles to target specific pressures points in the body. Since originating in China, acupuncture has been practiced for thousands of years to treat numerous conditions including chronic pain and mood disorders. Alopecia is a common dermatologic condition associated with psychological distress and decreased quality of life. Although it remains underexplored in western medicine, recent evidence suggests that acupuncture may be efficacious in the treatment of alopecia. In this review, we discuss the available evidence describing the efficacy of acupuncture or moxibustion alone (ACU) and in combination with other traditional and alternative interventions (ACU + TRAD) for hair loss. Additionally, the proposed physiologic mechanisms, targeted acupuncture points, and the benefits and barriers to treatment will be further described. An exploratory search using PubMed, EMBASE and Scopus databases was performed for studies that evaluated the effect of acupuncture and moxibustion on alopecia. In these studies, both ACU and ACU + TRAD were efficacious for numerous etiologies of hair loss including alopecia areata, androgenetic alopecia, and seborrheic alopecia. Given their ability to modulate the immune system, as well as neuronal networks associated with emotional cognition, the most frequently targeted acupoints were ST 36, GV 20, and LR 3. The proposed mechanistic effect is dependent upon disease etiology and is theorized to be twofold: reduction of inflammation and decrease in testosterone levels. The limited side effect profile of acupuncture makes it an advantageous treatment option, however, factors including cost, time, limited access, and aversion to needles may serve as barriers to treatment.

A novel direct SPT method to accurately estimate ultimate axial bearing capacity of bored PHC nodular piles with 81 case studies in Vietnam

Bored PHC nodular piles (BPNP) are an eco-friendly and advantageous option for pile foundations of medium-rise to high-rise buildings. As none of the current methods to estimate the ultimate axial load-bearing capacity is accurate enough for BPNP in engineering practice, this study aims to achieve that objective by developing a new direct SPT method. To that end, we use static pile load test and SPT data of 81 PHC nodular piles collected in Vietnam. The ultimate bearing capacity is interpreted from the load–displacement curve in pile static load tests by various methods to determine the most suitable method for the nodular piles. Furthermore, 8 methods to determine axial load pile capacity directly from the standard penetration test are examined. Each method’s effectiveness is evaluated by comparing its predicted values with the measured values. Finally, the genetic algorithm for function optimization is employed to develop a new direct SPT method that can accurately predict the ultimate axial load-bearing capacity of nodular piles. The reliability of the proposed formula is justified by comparing the proportion of end bearing capacity with other published works. It is verified that the developed directed SPT method outperforms all current methods and could be implemented directly in engineering practice.

Protoporphyrin IX Associated with Visible Light for the Treatment of Trichophyton rubrum Causing Onychomycosis - An Updated Review

Systemic medications used during the treatment of onychomycosis caused by Trichophyton rubrum may have relapse, making them costly and insignificant for the patient. Photodynamic therapy (PDT) is an advantageous therapeutic option for disease control, mainly due to the absence of risk of microbial resistance. The action of PDT is combined by three elements: photosensitizer (PS), visible light (VL) and molecular oxygen, leading to the formation of reactive oxygen species (ROS) or singlet oxygen formation (1O2), both ROS (type I mechanism) as 1O2 (type II mechanism) induce damage and death to microbial cells. This research was proposed as a study through a non-systematic review, to investigate the action of PS "Protoporphyrin IX" (Pp IX) associated with visible light on T. rubrum, contemplating clinical and relevant data regarding the treatment of onychomycosis by PDT. PubMed survey was conducted from June 2021 to April 2022. The research strategy included clinical trials, randomized trials, systematic reviews, meta-analyses and reviews in English. Pp IX has affinity for T. rubrum, which is justified by the incorporation of Pp IX into the cell membrane, which led to inhibition by LV irradiation. Thus, the photodynamic process of Pp IX may lead to cell death by type I and II mechanisms. The data found are promising, however, new studies in vitro and in vivo are suggested, since few studies have been found related to the theme.

Having several options does not increase the time it takes to make a movement to an adequate end point

Throughout the day, people constantly make choices such as where to direct their gaze or place their foot. When making such movement choices, there are usually multiple acceptable options, although some are more advantageous than others. How much time does it take to make such choices and to what extent is the most advantageous option chosen from the available alternatives? To find out, we asked participants to collect points by tapping on any of several targets with their index finger. It did not take participants more time to direct their movements to an advantageous target when there were more options. Participants chose targets that were advantageous because they were easier to reach. Targets could be easier to reach because the finger was already moving in their direction when they appeared, or because they were larger or oriented along the movement direction so that the finger could move faster towards them without missing them. When the target’s colour indicated that it was worth more points they chose it slightly less fast, presumably because it generally takes longer to respond to colour than to respond to attributes such as size. They also chose it less often than they probably should have, presumably because the advantage of choosing it was established arbitrarily. We conclude that having many options does not increase the time it takes to move to an adequate target.