A case-control study of medical, psychological and socio-economic factors influencing the severity of chronic rhinosinusitis

BACKGROUND: Chronic rhinosinusitis (CRS) is a common and debilitating disorder. Little is known about the epidemiology of this disease. The aims of the study were to identify differences in socio-economic variables and quality of life between patients with chronic rhinosinusitis and healthy controls, to identify any significant associations between CRS and other medical co-morbidities, psychiatric disease or environmental exposure and to explore the experience of CRS from the perspective of CRS sufferers. METHODS: Participants were recruited from ENT clinics from 30 centres across the UK. They completed a study-specific questionnaire considering environmental, medical and socio-economic factors, and SF-36 and SNOT-22 scores. All participants with CRS were diagnosed by a clinician and categorised as having CRS (with polyposis, without polyposis or allergic fungal rhinosinusitis (AFRS)). Controls included family and friends of those attending ENT outpatient clinics and hospital staff who had no diagnosis of nose or sinus problems and had not been admitted to hospital in the previous 12 months. RESULTS: A total of 1470 study participants (1249 patients and 221 controls) were included in the final analysis. Highly significant differences were seen in generic and disease-specific quality of life scores between CRS sufferers and controls; mean SNOT-22 score 45.0 for CRS compared with 12.1 amongst controls. There were no clear differences in socioeconomic variables including social class, index of multiple deprivation and educational attainment between cases and controls. Common comorbidities with a clear association included respiratory and psychiatric disorders, with a higher frequency of reported upper respiratory tract infections. CONCLUSIONS: CRS is associated with significant impairment in quality of life and with certain medical co-morbidities. In contrast to other common ENT disorders, no socioeconomic differences were found between patients and controls in this study

The Burden of Revision Sinonasal Surgery in the UK – Data from the Chronic Rhinosinusitis Epidemiology Study (CRES); a cross sectional study

Objectives/Hypothesis The aim of this study was to investigate the surgical revision rate in patients with Chronic Rhinosinusitis (CRS) in the UK CRS Epidemiology Study (CRES). Previous evidence from national Sinonasal Audit showed that 1459 CRS patients demonstrated a surgical revision rate 19.1% at 5 years, with highest rates seen in those with polyps (20.6%). Setting Thirty secondary care centres around the UK. Participants A total of 221 controls and 1249 patients with CRS were recruited to the study including those with polyps (CRSwNPs), without polyps (CRSsNPs) and with allergic fungal rhinosinusitis (AFRS). Interventions Self-administered questionnaire. Primary outcome measure The need for previous sinonasal surgery. Results A total of 651 patients with CRSwNPs, 553 with CRSsNPs and 45 with AFRS were included. A total of 396 (57%) of patients with CRSwNPs/AFRS reported having undergone previous endoscopic nasal polypectomy (ENP), of which 182 of the 396 (46%) reported having received more than one operation. The mean number of previous surgeries per patient in the revision group was 3.3 (range 2 to 30) and a mean duration of time of 10 years since the last procedure. The average length of time since their first operation up to inclusion in the study was 15.5 years (range 0-74). Only 27.9% of all patients reporting a prior ENP had received concurrent endoscopic sinus surgery (ESS) (n=102). For comparison, surgical rates in patients with CRSsNPs were significantly lower; 13% of cases specifically reported ESS and of those only 30% reported multiple procedures (chi-squared p < 0.001). Conclusions This study demonstrated there is a high burden of both primary and revision surgery in patients with CRS, worst in those with AFRS and least in those with CRSsNPs. The burden of revision surgery appears unchanged in the decade since the Sinonasal Audit

A Systems Approach to Design and Plan Sustainable Antifragile Infrastructure Based on Aggregate Footprint and Satisfaction

The concepts of robustness and sustainability in planning and design of water and energy infrastructures have been extensively explored in previous research, primarily focusing on system reliability, environmental considerations, and economic aspects. This study aims to broaden the understanding of these concepts by offering comprehensive frameworks that capture the essence of robustness and sustainability at two distinct levels. The first level of investigation focuses on the performance of infrastructure networks during natural disasters. Traditionally, this has been addressed using reliability, resilience, and vulnerability metrics. However, these methods rely on static, deterministic, and non-stationary data, which is inadequate when dealing with the uncertainties of natural hazards. To overcome this limitation, the research introduces the concept of “antifragility” as an alternative metric. Antifragility surpasses robustness by measuring a system’s ability to improve, rather than degrade or remain unchanged, under sudden, low-probability, high-impact events. This approach is better suited for capturing extreme conditions, making it an objectively superior index for designing resilient systems. The study demonstrates the application of antifragility in a case study involving a water drainage system’s performance under various flooding scenarios. The results show that focusing solely on reliability metrics cannot fully capture the system’s behavior during intense flooding or climate change, underscoring the importance of considering antifragility in infrastructure design. At the second level, the research delves into sustainable infrastructure planning. It highlights the limitations of solely focusing on the carbon footprint of projects and emphasizes the need to consider social and technical aspects in sustainability assessments. Additionally, the study advocates for the inclusion of local resource availability in planning decisions. To address these concerns, a comprehensive frame-work for assessing sustainability is proposed, encompassing environmental, economic, social, and technical footprints, along with resource availability. A case study is conducted, evaluating common energy generation technologies based on their aggregate footprints and resource attributes in specific regions. The prioritization of energy sources using an updated version of the Relative Aggregate Footprint (RAF) index showcases the framework’s effectiveness. Furthermore, the study compares the sustainability levels of existing energy portfolios to an optimal case with minimal overall footprint. In summary, this research explores the concepts of robust and sustainable infrastructure networks from both theoretical and practical perspectives, seeking improvements for the future. By enhancing the current understanding of sustainability and reliability, this work offers valuable insights into engineering antifragile systems that can withstand natural disasters and evolve over time

Novel formulation and evaluation of a Q10-loaded solid lipid nanoparticle cream: in vitro and in vivo studies

Solid lipid nanoparticles (SLNs) of coenzyme Q10 (CoQ10) were formulated by a high-pressure homogenization method. The best formulation of SLN dispersion consisted of 13% lipid (cetyl palmitate or stearic acid), 8% surfactant (Tween 80 or Tego Care 450), and water. Stability tests, particle size analysis, differential scanning calorimetry, transmission electron microscopy, and release study were conducted to find the best formulation. A simple cream of CoQ10 and a cream containing CoQ10-loaded SLNs were prepared and compared on volunteers aged 20–30 years. SLNs with particle size between 50 nm and100 nm exhibited the most suitable stability. In vitro release profiles of CoQ10 from simple cream, SLN alone, and CoQ10-loaded SLN cream showed prolonged release for SLNs compared with the simple cream, whereas there was no significant difference between SLN alone and SLN in cream. In vitro release studies also demonstrated that CoQ10-loaded SLN and SLN cream possessed a biphasic release pattern in comparison with simple cream. In vivo skin hydration and elasticity studies on 25 volunteers suggested good dermal penetration and useful activity of Q10 on skin as a hydratant and antiwrinkle cream

Priprava želatinksih mikrosfera s mliječnom kiselinom: Učinak umrežavanja na oslobađanje ljekovite tvari

In this study, gelatin microspheres containing lactic acid were prepared by the polymerization technique using glutaraldehyde as the cross-linking agent. Dried microspheres were loaded by immersing them in an aqueous solution of lactic acid. In order to prepare microspheres with an appropriate drug release profile, the effect of time of cross-linking and the amount of cross-linking agent on the swelling properties of microspheres and their release profile were investigated. The microencapsulation efficiency, microspheres appearance, particle size, swelling ratio and drug release profile were also studied. Microspheres prepared with a larger amount of crosslinking agent, or after longer crosslinking time, showed a reduced swelling ratio in aqueous media. In vitro release pattern of lactic acid from gelatin microspheres showed a biphasic profile and the release rates were reduced upon increasing the amount of cross-liking agent and prolonging the cross-linking time.U radu je opisana priprava želatinskih mikrosfera s mliječnom kiselinom metodom polimerizacije koristeći glutaraldehid kao sredstvo za umrežavanje. Osušene mikrosfere su uronjene u vodenu otopinu mliječne kiseline. Ispitivan je utjecaj vremena umrežavanja i količine sredstva za umrežavanje na bubrenje mikrosfera i njihov profil oslobađanja. Također je proučavan izgled mikrosfera, veličina čestica, bubrenje i profil oslobađanja ljekovite tvari. Mikrosfere pripravljene s većim sadržajem sredstva za umrežavanje ili uz produljeno vrijeme umrežavanja, u vodenom mediju manje bubre. Oslobađanje mliječne kiseline iz želatinskih mikrosfera in vitro je bifazičnog profila, a smanjuje se ako je tijekom priprave povećana količina sredstva za umrežavanje i produljeno vrijeme umrežavanja. Mikrosfere s odgovarajućim profilom oslobađanja ljekovite tvari mogu se pripraviti podešavanjem ta dva faktora tijekom priprave mikrosfera

Beyond Profitable Shifts to Green Energies, Towards Energy Sustainability

The traditional carbon-based approach towards sustainability has long caused the concepts of green and sustainable energies to be used interchangeably. Recent studies have tried to advance this archaic view by considering more aspects of sustainability. However, almost all major studies have been concerned with only the economic and environmental aspects of electricity generation, whereas the concept of sustainability is beyond these two criteria. In this paper, we seek to provide a methodology for a more comprehensive definition of electricity generation sustainability based on the lessons learned from previous studies and additional metrics suggested by them. The main characteristics of select electricity generation technologies were studied, and their environmental, economic, social, and technical criteria as well as the uncertainties associated with them were selected as the four major factors in our paper. It has also been argued that the utilization of regional resources in addition to the inherent characteristics of electricity generation technologies is vital in providing a realistic view of sustainability. Of the sustainability assessment methods previously introduced, the Relative Aggregate Footprint (RAF) method was used in conjunction with the previously selected criteria as the basis of the study due to its ability to incorporate additional criteria and regional considerations. As such, the framework for sustainability assessment presented in this research accounts for major criteria identified in the literature and takes the available regional resources that affect the feasibility of each electricity technology into account. This study paves the way for the presentation of new guidelines for the creation of more comprehensive electricity generation sustainability measures to distinguish between the concepts of green and profitable vs. sustainable energies to support the development of sustainable energy portfolios

An improved high throughput protein-protein interaction assay for nuclear hormone receptors

The Glutathione-S-Transferase (GST) “pulldown” assay has been used extensively to assay protein interactions in vitro. This methodology has been especially useful for investigating the interactions of nuclear hormone receptors with a wide variety of their interacting partners and coregulatory proteins. Unfortunately, the original GST-pulldown technique relies on multiple binding, washing and elution steps performed in individual microfuge tubes, and requires repeated centrifugation, aspiration, and suspension steps. This type of batch processing creates a significant liquid handling bottleneck, limiting the number of sample points that can be incorporated into one experiment and producing inherently less efficient washing and elution than would a flow-through methodology. In this manuscript, we describe the adaptation of this GST-pulldown assay to a 96-well filter plate format. The use of a multi-well filter plate makes it possible to assay more samples in significantly less time using less reagents and more efficient sample processing than does the traditional single tube assay