Current Status Of Use Research Articles

The Role of Physiologically Based Oral Absorption Modelling in Formulation Development Under a Quality by Design Paradigm

Within the last decade, Quality by Design (QbD) has been getting increased attention in its implementation in the development of pharmaceutical drug products. Understanding of the impact of formulation composition and process on clinical performance is a centerpiece of QbD. Physiologically based pharmacokinetic modeling incorporating biorelevant dissolution and a systems parameter approach to gastrointestinal absorption has been gaining increased traction in the pharmaceutical industry as an important tool to guide early formulation development. Extension of the models to support QbD appears the next logical step. This commentary discusses the current status of use of these models in the pharmaceutical industry and the opportunities these models can offer in ensuring drug product quality moving forward, including the development of clinically relevant specifications.

Current Status of Use and Satisfaction with Family Support Services for Families of Children with Disabilities

연구목적: 본 연구는 장애인 가족의 삶의 질 제고를 위한 장애인 가족지원 서비스 및 장애인가족지원센터의 운영 개선 방안을 제안하고자 실시되었다. 가족지원 서비스의 유형은 장애인 가족의 삶의 질 척도 영역에 따라 분류한 가족지원 서비스의 신체적․물질적 안녕 지원, 양육 활동 지원, 가족 상호작용 지원, 정서적 안녕 지원, 장애 관련 지원 등 5개 하위유형과 각 16개 세부 항목으로 구분하였다. 연구방법: 장애인 가족의 어려움과 특성을 파악하기 위해‘장애인 가족지원 조사지’를 사용하였다. 조사지는 기초정보 조사용 12개 문항, 장애인가족지원 서비스와 장애인가족지원센터의 이용 현황 및 만족도 파악을 위해 서비스 이용 여부, 이용한 서비스의 유형, 이용기간 비용과 같은 이용 현황, 그리고 서비스 만족도 등이 11개 문항으로 총 23개 문항으로 구성하였다. 이를 전국장애인부모연대의 17개 시도지부, 전국의 40개 장애인가족지원센터의 도움을 받아 최종 1,140부를 분석 대상 자료로 선정하여 조사결과를 분석하였다. 연구결과: 장애인 가족의 10명중 7.5명 정도는 가족지원 서비스를 최소 1회 이상 이용한 경험이 있는 것으로 나타났으며, 서비스 유형별로는 ‘장애자녀 활동지원, 돌봄지원 등의 양육지원’서비스, 방과후학교 등은 높은데 반해, 가정의 주거환경 개선 지원, 부모 노후 대책 등 가족의 미래 설계 지원, 장애인 가족 사례관리 지원, 가족상담ㆍ가족치료 등은 낮은 것으로 나타났다. 또한, 장애인 부모 간 친교 활동 지원 영역의 경우 다른 서비스에 비해 만족도가 높게 나타났고, 장애인 가족 사례관리 지원에 대한 만족도는 낮은 것으로 나타났다. 또한 장애인가족지원센터를 통해 가족지원 서비스를 가장 많이 이용하고 있었다. 결론: 장애인 가족지원 서비스는 다양한 방법으로 제공될 필요가 있으며 장애인가족지원센터를 통한 전달체계 구축 마련을 제안하였다.

Presence of banking in social media: Indian evidence

The paper presents the current status of use of social networking sites particularly Facebook by the public and private sector banks in India. The data for this study is based upon a survey of Facebook pages of 47 banks explored during the period of February-March 2015. The paper is based on an instrument called Facebook Assessment Index (FAI) developed by Miranda et al. (2013), which uses three categories to evaluate the essential information on a firm's Facebook page: popularity, interactivity and content. The results found that only 48.9% of the banks observed had their official Facebook page. Amongst, the three measures of FAI, new private sector banks (ICICI Bank and Axis Bank) performed well as compared to other banks. In general, the banks were not fully harnessing the utility of Facebook and a great opportunity exists for the banks for improvement in their usage of Facebook.

Itaconic Acid Production by Microorganisms: A Review

Itaconic acid $(C_5 H_6 O_4)$ is an organic acid with unique structure and characteristics. In order to promote the bio-based economy, the US-Department of Energy (DOE) assigned a “top-12” of platform chemicals, which include numerous of organic acids. In particular di-carboxylic acids, like itaconic acid, can be used as monomers for bio-polymers. Thus the need to produce itaconic acid attracts much attention. The favored production process is fermentation of carbohydrates by fungi and <em>Aspergillus terreus</em> is the mostly frequently employed commercial producer of itaconic acid. This review reports the current status of use of microorganisms in enhancing productivity.

농촌주택 유형별 건축계획에 관한 연구 -농사규모에 따른 농가 각부공간 및 창고계획을 중심으로-

The purpose of this paper is to seek the dwelling conditions for comfortable life like urban apartment with agriculture in farming area. In order to do above things, we divide types of people who is planning to 'return farm' and need to heavily research and analyze current status of use for farm house's each spaces include outside spaces. so this paper aimed that at first, divide types of farmhouse following agriculture condition for people who is living in rural and survey the present condition and problems by analyzing of present status of space use and draw the improvement plans for those. after then, finally make a architectural basic data for Rural houses plan. For the future, the main purpose of this paper is that make architectural provision possible by researching types and size of storage following sort and size of farm.

Current Status of Use of Erythropoietic Agents in Cancer Patients

Anemia is frequently observed in cancer patients and can cause symptoms and result in red cell transfusions. The erythropoiesis stimulating agents (ESAs) have been shown to increase hemoglobin levels and reduce transfusion requirements in anemic subjects with cancer who are receiving chemotherapy. Initially, these benefits motivated broad use of the ESAs in oncology. Over the past 10 years, recognition of the adverse events that can be associated with ESA use in these patients, particularly venous thrombosis, has resulted in a rethinking of the issue of who are the correct candidates for treatment. Different health care systems have come to different conclusions based upon the available data and additional data are still being generated. This article will review the data concerning the safety of ESAs in cancer patients, including the results of additional trials published in the past 2 years. This will include a discussion of the potential of ESAs to impact tumor progression or survival. Thrombosis remains the most important and best documented adverse event associated with ESA therapy in oncology. The mechanism(s) through which ESAs alter thrombosis risk are still very poorly understood.

EPA-1124 - Use of lithium in the clinical practice: Results from a multicentric italian study

Introduction According to several international guidelines, lithium is still the first choice for treating mania and for prophylaxis of bipolar disorder. Nevertheless, in the last decades clinicians prefer to use anticonvulsivant drugs such as valproate and carbamazepine to lithium, which are easier to manage and with less side effects. Objectives 1)to describe prescribing patterns in Italian mental health centres in patients with bipolar I disorder;2)to assess clinical and social characteristics of patients receiving lithium. Aims to assess the current status of use of lithium in the Italian clinical practice. Methods The study, coordinated by the Department of Psychiatry of the University of Naples SUN, was carried out in 11 randomly recruited Italian mental health centres. In each site, 16 patients were recruited if they had a diagnosis of bipolar I disorder, were aged between 18-65 years, were on the caseload of the local mental health centre for at least six months, and had experienced at least one affective episode in the past three years. Data on pharmacological treatments were obtained from clinical records. Results The sample consisted of 140 patients, 118(84%) were receiving mood stabilizers, 84(60%) antipsychotics, 57(41%) antidepressants and 45(32%)benzodiazepines. Valproate was the mood stabilizer more frequently prescribed(58%); lithium was prescribed to 35% of patients. Those receiving lithium had a longer contact with the local mental health centre(105.9±77.6monthsvs. 79.0±68.5;p Conclusions Our data confirm the general principle that lithium is not frequently prescribed in clinical practice and it is given only to more severe patients.

Current status of the use of inferior vena cava filters in cases of pulmonary embolism in CCUs: From the Tokyo CCU Network

ObjectiveTo elucidate the current status of use of inferior vena cava filters (IVCFs) in cases of pulmonary embolism at institutions belonging to the Tokyo CCU Network. MethodsWe conducted a retrospective investigation of 832 consecutive cases of pulmonary embolism reported on survey forms to the Tokyo CCU Network between 2005 and 2010. ResultsOf 832 cases of pulmonary embolism, IVCFs were used in 338 (40.6%) and not used in 415 (49.9%). Their use was unclear in 79 (9.5%) cases. The use rate gradually increased each year from 2005 until 2008 but decreased from 2009 onward. Moreover, 68.9% of the IVCFs used in cases were non-permanent types. In terms of pulmonary embolism severity, the rate of use was 37.2% in non-massive cases, 49.4% in sub-massive cases, 46.9% in massive cases, and 31.9% in collapse cases. Thirty-day mortality in cases of collapse in which IVCFs were not used was extremely high at 75.8%, suggesting that in many cases, rapid deterioration may occur with insufficient time for IVCF insertion. The differences in IVCF usage rate among institutions were large in the range of 12.5–90% from 2005 to 2008, which slightly declined to the range of 25.0–72.2% from 2009 to 2010. ConclusionsWe elucidated the current IVCF use status in cases of pulmonary embolism at institutions belonging to the Tokyo CCU Network. Since the status of use differed among institutions, future studies of effective methods of use are required.

ゲンタマイシン硫酸塩注射液の使用状況に関する アンケート調査結果

Unlike what has been approved overseas, only a low dose is approved in Japan for the use of Gentamicin Sulfate Injection (hereinafter referred to as GM Injection). A change in dose and administration was requested to the Evaluation Committee on Unapproved or Off-labeled Drugs with High Medical Needs. As a consequence, high-dose GM Injection began to be developed in Japan. In order to assess the current use of GM Injection, a questionnaire survey was conducted among infectious disease specialists certified by the Japanese Association for Infectious Diseases, and physicians certified as specialists/instructors of antibiotic chemical treatment by the Japanese Society of Chemotherapy. Valid responses were obtained from as many as 38.0% of questionnaire recipients (719/1891 physicians). About 30% of the respondents used GM Injection in the year 2011. Major indications for adult patients included sepsis and infective endocarditis, and bacterial strains mainly included Pseudomonas aeruginosa, Staphylococcus, Enterococcus and Streptococcus species. Some diseases and bacterial strains domestically unapproved as indications were also treated with GM Injection. GM Injection is administered mainly as an intravenous infusion, usually once daily, which is not approved in Japan. Some physicians administered a fixed dose of GM (120 mg/day or less), not more than the upper limit approved in Japan. The majority of physicians, however, adopted a dosage of 3-5 mg/kgy/day, the standard dosage approved overseas. Physicians who implemented TDM outnumbered those who did not. The target blood level when administering 2-3 times a day was mostly 2 microg/mL or less as the trough level, and 4-10 microg/mL as the peak level. In particular, GM Injection was concurrently administered with other injectable antimicrobial agents to treat sepsis or infective endocarditis mainly in the following combinations: with penicillins or carbapenems for sepsis: with penicillins for infective endocarditis. Renal impairment was the most common adverse reaction requiring special care to be reported by the respondents. The survey revealed the current status of use, which is that GM Injection is used at the dose and administration approved in Japan, and that high-dose GM Injection, equivalent to the dosage approved overseas, is also used by quite a few physicians. The current use supports the request submitted to the Evaluation Committee on Unapproved or Off-labeled Drugs with High Medical Needs. Therefore, the same dosage that is approved overseas is recommended to be approved as soon as possible in Japan.

Tracer monitoring of enhanced oil recovery projects

In enhanced oil recovery (EOR), chemicals are injected into the oil reservoir, either to increase macroscopic sweep efficiency, or to reduce remaining oil saturation in swept zones. Tracers can be used to identify reservoirs that are specifically suited for EOR operations. Injection of a selection of partitioning tracers, combined with frequent sample analysis of produced fluids, provides information suited for estimation of residual oil saturation. Tracers can also be used to evaluate and optimize the application of EOR chemicals in the reservoir. Suitable tracers will follow the EOR chemicals and assist in evaluation of retention, degradation or trapping. In addition to field applications, tracers also have a large potential as a tool to perform mechanistic studies of EOR chemicals in laboratory experiments. By labelling EOR chemicals with radioactive isotopes of elements such as H, C and S, detailed studies of transport mechanisms can be carried out. Co-injection of labelled compounds in dynamic flooding experiments in porous media will give information about retention or separation of the unique compounds constituting the chemical formulation. Separation of such compounds may be detrimental to obtaining the EOR effect expected. The paper gives new information of specific methods, and discusses current status for use of tracers in EOR operations.

일부 치과의사의 구강보건보조인력 활용과 업무에 관한 조사

The objective of this study was to identify the current status of use and respective work scopes of dental hygienists and nursing assistants as perceived by dentists, thereby obtaining a model for how to efficiently use oral health assistance personnel. This study was based on a self-reported survey administered to a total of 126 dentists. The following findings were observed. Where competition among neighborhood clinics was relatively high, nursing assistants tended to be used as a resource to assist dental hygienists, whereas where it was relatively low, they were more likely to be considered to work as full substitutes for regular dental hygienists. Looking at the scopes of practice, dental hygienists were allowed to deal with matters of preventive care, oral health education, and health insurance claims. On the other hand, nursing assistants were allowed to be in charge of taking X-ray pictures from the outside and inside of mouth and keeping medical devices clean and safe. This study is expected to contribute to establishing more reasonable oral heath personnel structure design decisions.

Melanocytic Lesions: Current State of Knowledge—Part III

This third part of the Special Section on Melanoma and Melanocytic Proliferations concludes the series that started in the December 2010 issue of the Archives of Pathology & Laboratory Medicine. The goal was to include a very extensive review of clinical, morphologic, and molecular features of melanoma and related lesions. And we hope that the readership of the Archives will agree with us that the goal has now been achieved.Doina Ivan, MD, and Victor Prieto, MD, PhD, open the section with a description of histologic features recommended to be included in pathology reports involving melanoma. They discuss those features that probably should be included in all reports and the features that are recommended.Pedram Gerami, MD, and Artur Zembowicz, MD, PhD, review the current status of use of fluorescence in situ hybridization technique to help in the differential diagnosis of nevus and melanoma. This technique uses an algorithm including the results from a combination of 4 probes. The authors have first-hand knowledge in the application of such techniques to real cases and share their practical knowledge with the readership.In the third article, Jon Reed, MD, and Christopher Shea, MD, analyze the important topic of the distinction of melanoma in situ from other melanocytic proliferations in sun-damaged skin. This distinction becomes very important when dealing with small samplings of larger pigmented lesions.Equally interesting is the review of the topic of recurrent nevi. John Fox, MD; Jon Reed, MD; and Christopher Shea, MD, describe the morphologic features seen in melanocytic lesions that have suffered a trauma (including partial biopsies and accidental shaving). They emphasize the features that allow the distinction from melanoma as well as the use of immunoperoxidase as an adjunct in such differential diagnosis.With the demographic changes seen in our country, it is likely that the number of specimens from acral pigmented lesions (eg, acral nevi and acral melanocytic melanoma) will continue to rise. Therefore, the information provided by Francisco Bravo Puccio, MD, and Cesar Chian, MD, becomes very timely. Particularly important is their observation that clinicopathologic correlation is essential when dealing with these lesions, since small punches from a frank acral lentiginous melanoma may show minimal proliferation of benign-appearing melanocytes!Victor Prieto, MD, PhD, and Christopher Shea, MD, provide both a practical and comprehensive review of immunohistochemistry applied to the diagnosis of melanocytic lesions. They highlight the use of immunohistochemistry to detect melanocytic differentiation (eg, in the diagnosis of poorly differentiated lesions) and as an aid in the distinction between nevus and melanoma.Soheil Dadras, MD, PhD, completes the series with a review of what is known on molecular diagnostics in melanoma, that is, the current status and its perspectives.

Abstract 5739: Lifetime recreational physical activity, hormone therapy use and breast cancer risk in postmenopausal women

Abstract Studies consistently demonstrate that physical activity is inversely associated with postmenopausal breast cancer. Whether the strength of this association varies with exposure to menopausal hormone therapy (HT) is clearly important given the marked decline in HT use since 2002. The Women's Contraceptive and Reproductive Experiences Study, a multi-center population-based case-control study of invasive breast cancer recruited white women and black women ages 35-64 years, and collected histories of lifetime exercise activity and HT use. Unconditional logistic regression models assessed possible associations between lifetime exercise activity measures (hr/wk/yr and metabolic equivalents of energy expenditure [MET]-hrs/wk/yr) and breast cancer among postmenopausal women (1908 case patients, 2013 control subjects) stratified by duration of HT use (never, ≤5 years of use, or ≥5 years of use), and current HT-use status (current use of estrogen-alone therapy [ET], current use of estrogen plus progestin therapy [EPT], or past HT use). Breast cancer risk decreased as level of physical activity increased among women who had never used HT, among women who used HT for fewer than 5 years, and among current ET users; Ptrend values ranged from 0.004 to 0.019. Despite the lack of association among long-term HT users, current EPT users, and past HT users, no statistical heterogeneity of trends was observed across duration-of-use categories or by current-use status. Although the inverse association between physical activity and breast cancer was limited to women with no HT use, short duration of HT use or current ET use, this study did not demonstrate effect modification by HT use. Note: This abstract was not presented at the AACR 101st Annual Meeting 2010 because the presenter was unable to attend. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 5739.

The Current Status of Use with Sports Wheelchair by Athletes with Disability and Provide Suggestions for Improvement Solution

The Current Status of Use with Sports Wheelchair by Athletes with Disability and Provide Suggestions for Improvement Solution

Current status of use of transnasal endoscopy in personal health checkup and its accuracy in screening gastric cancers at multiple institutions

Current status of use of transnasal endoscopy in personal health checkup and its accuracy in screening gastric cancers at multiple institutions

Information and Communication Technology in Family Practice in Croatia

Family practice was the first privatized part of the health care system in Croatia. Recently, 84 % of family practices are privatized. Other 16% of them left within health centers. In order to assess current status of use of the information and communication technology (ICT) in family practice, physicians specializing in the family medicine, being also the postgraduate students of the University of Zagreb, School of Medicine in the year 2004/05, have been surveyed. The sample consisted of 159 physicians. Some kind of information system (IS) exists in 62 % of family practices under lease, 42 % within health centers, and 91 % of completely private offices. Having IS in their offices, physicians use it primarily for admini- stration: reporting, prescriptions, sick leaves, referrals and for billing. Usage of ICT in medical work, electronic medical records, was found at about 50 % of physicians. Doing research based on information stored in e-format, is conducting by 31 % of physicians. Based on e-information 35 % of physicians evaluate their work. About using e-sources of medical knowledge (bibliographic data bases, e-journals): 86 % physicians from private offices, 79% physicians working within health centers, 60 % physicians from offices under lease. Satisfaction with current information system is small (19 %). Their information needs are covered partially. 32 % of physicians said they can get enough information by using their information system. 40 % of physicians feel that ICT gave more efficiency to their work, and 25 % of physicians feel their patients are more satisfied since the IS was put into function. Considering different types of practices – young physicians working in health centers are less satisfied with their ISs than the other two groups of physicians coming from private practice. Data security was practiced by using a password, physical protection, and by daily archiving of data.

Farmer Experience with Precision Agriculture in Denmark and the US Eastern Corn Belt

Two mail surveys were carried out in Denmark and the Eastern Corn Belt, USA in 2002. Questionnaires were sent to 580 farmers who had used precision agriculture (PA) and 198 responses were received. The surveys focused on the current status of use of PA in both countries, including: PA practices, equipment and software, Internet and e-mail use, information sources for PA, satisfaction level from service providers, data handling, interpretation, storage and ownership, value of data for decision making, changes in management practices, desired information and services, and the next planned step in the practice of PA. The survey results showed more similarities in practicing PA between the two countries than differences. Time requirement and high cost of data handling were cited as the main problems. Survey respondents found soil maps to be more valuable than yield maps in management decisions. About 80% of the respondents would like to store the PA data themselves. The majority of the respondents indicated that they have changed their management practices due to PA, but not substantially. Some 90 of the respondents used the Internet and e-mail for agricultural purposes, but only a small number for PA websites.

Treatment of congestive heart failure--current status of use of digitoxin.

Digitalis glycosides exert a positive inotropic effect, i.e. an increase in myocardial contractility associated with a prolongation of relaxation period, and glycosides lower the heart rate (negative chronotropic), impede stimulus conduction (negative dromotropic) and promote myocardial excitability (positive bathmotropic). They seem to influence the activities of both the vagal and the sympathetic systems. Digitalis glycosides that belong to different substance classes are closely comparable concerning pharmacodynamics but differ substantially in regard to pharmacokinetics. Digoxin and its derivatives are less lipophilic, show lower protein binding and shorter half-life, are mainly eliminated via the kidney and accumulate rather rapidly in cases of insufficient kidney function. Digitoxin is highly lipophilic and extensively bound to plasma proteins, has a longer half-life, is mainly eliminated in the metabolized state via urine and faeces and does not accumulate in kidney dysfunction. As a result of a more stable pharmacokinetic profile, the incidence of toxic side effects seems to be lower with digitoxin than with digoxin. Since the beginning of the 1990s, the antagonists of the RAAS qualified as the standard treatment for congestive heart failure, often in combination with diuretics, vasodilators or beta-antagonists. However, the important role of digitalis glycosides as therapeutic comedication or alternative was never denied, especially in atrial fibrillation with tachycardia. The PROVED and RADIANCE trials proved a detrimental effect of the withdrawal of digoxin therapy on exercise capacity, left-ventricular ejection fraction and clinical symptoms. The DIG trial revealed that digoxin comedication in sinus rhythm patients with congestive heart failure was associated with a lower morbidity (as taken from death or hospitalization because of worsening heart failure) and an unchanged overall mortality--being a unique feature among the available inotropic drugs. Comparable studies for digitoxin have not yet been performed but, because of its higher pharmacological stability, it might well be associated with even more advantages in this regard than digoxin.

Treatment of congestive heart failure – current status of use of digitoxin

Digitalis glycosides exert a positive inotropic effect, i.e. an increase in myocardial contractility associated with a prolongation of relaxation period, and glycosides lower the heart rate (negative chronotropic), impede stimulus conduction (negative dromotropic) and promote myocardial excitability (positive bathmotropic). They seem to influence the activities of both the vagal and the sympathetic systems. Digitalis glycosides that belong to different substance classes are closely comparable concerning pharmacodynamics but differ substantially in regard to pharmacokinetics. Digoxin and its derivatives are less lipophilic, show lower protein binding and shorter half‐life, are mainly eliminated via the kidney and accumulate rather rapidly in cases of insufficient kidney function. Digitoxin is highly lipophilic and extensively bound to plasma proteins, has a longer half‐life, is mainly eliminated in the metabolized state via urine and faeces and does not accumulate in kidney dysfunction. As a result of a more stable pharmacokinetic profile, the incidence of toxic side effects seems to be lower with digitoxin than with digoxin. Since the beginning of the 1990s, the antagonists of the RAAS qualified as the standard treatment for congestive heart failure, often in combination with diuretics, vasodilators or β‐antagonists. However, the important role of digitalis glycosides as therapeutic comedication or alternative was never denied, especially in atrial fibrillation with tachycardia. The PROVED and RADIANCE trials proved a detrimental effect of the withdrawal of digoxin therapy on exercise capacity, left‐ventricular ejection fraction and clinical symptoms. The DIG trial revealed that digoxin comedication in sinus rhythm patients with congestive heart failure was associated with a lower morbidity (as taken from death or hospitalization because of worsening heart failure) and an unchanged overall mortality – being a unique feature among the available inotropic drugs. Comparable studies for digitoxin have not yet been performed but, because of its higher pharmacological stability, it might well be associated with even more advantages in this regard than digoxin.

Out-of-hospital use of neuromuscular-blocking agents in the united states

Objective. A national survey was mailed to state EMS directors to assess the current status of use of neuromuscular-blocking agents (NMBAs) by EMS systems across the United States. Methods. Initial and second mailings were completed in early 1996 and 1997, respectively. Results. Replies were received from all 50 (100%) states following the second mailing. Twenty-nine (58%) states use NMBAs. Eleven (22%) of the 29 use paralytic drugs only in aeromedical programs. Of the 18 states that use NMBAs in ground-based EMS systems, 11 (22%) use paramedic ambulance staffing exclusively. Registered nurses (RNs) or RN-paramedic teams comprised the majority of the remaining states' staffing configurations. The first reported date of implementation of use of NMBAs was 1985, and there has been a steady trend of additional states launching paralytic drug use over the last 12 years. Conclusion. This trend suggests that use of paralytic drugs by paramedics is becoming standard of care in many out-of-hospital systems.