Artificial Neural Networks and Concentration Residual Augmented Classical Least Squares for the Simultaneous Determination of Diphenhydramine, Benzonatate, Guaifenesin and Phenylephrine in their Quaternary Mixture

Purpose: To develop two multivariate calibration methods for the simultaneous spectrophotometric determination of a quaternary mixture composed of diphenhydramine HCl, benzonatate, guaifenesin and phenylephrine HCl in Bronchofree ™ capsules in the ratio of 2.5 : 10 : 10 : 1, respectively.Methods: Novel artificial neural networks (ANNs) and concentration residual augmented classical least squares (CRACLS) methods were developed for the quantitative determination of the quaternary mixture. For proper analysis, a four-level, four-factor experimental design was established resulting in a training set of 16 mixtures containing different ratios of the four analytes. A validation set consisting of six mixtures was used to validate the prediction ability of the suggested models.Results: ANNs and CRACLS methods were successfully applied for the analysis of raw materials and capsules. For ANNs method, % recovery of diphenhydramine HCl, benzonatate, guaifenesin and phenylephrine HCl in the capsules was 102.21 ± 1.34, 100.30 ± 1.17, 99.31 ± 2.00 and 98.50 ± 1.27, respectively. On the other hand, % recovery of the four analytes by CRACLS was 99.84 ± 2.22, 100.07 ± 0.63, 98.37 ± 1.42 and 97.99 ± 0.96, respectively.Conclusion: The proposed methods can be applied for the quantitative determination of the four components without interference from excipients, thus obviating the need for preliminary extraction of analytes from the pharmaceutical formulation. The ability of the methods to deconvolute the highly overlapped UV spectra of the four components’ mixtures using low-cost and easy-to-handle instruments such as UV spectrophotometer is also an advantage.Keywords: Artificial neural networks, Concentration residual augmented classical least squares, Quaternary mixture, Simultaneous determinatio

Photometric and Radiometric hoof capsule evaluation in normal and long toeunderrun heel in donkey

There is limited information documenting the normal and long toe-under run heels in donkeys. The objectives of the study were to describe the photometric and radiometric parameters of long toe-under run heel in comparison with normal healthy donkeys in Egypt.  Lateral photographs and lateromedial and dorso-palmar radiographs of the fore feet were obtained for both normal and long toe groups. Angular and linear parameters variables were compared between long toe and normal donkeys' hooves. Morphologically, the toe and heel angles were significantly decreased in long toe-under run heel. The difference between toe and heel angles was higher in normal healthy hooves and decreased in long toe feets. The hoof pastern axis was significantly  increased while the hoof base of support showed significant decrease in long toe-under run heel hooves. Radiographically, long toe-under run heels showed significant decrease in the distal phalanx angle, the axis of the distal phalanx angle, the proximal palmar cortex angle and the distal phalanx solar border angle had a negative value. There were no significant variations in the distal phalanx to ground distance, distal phalanx to frog distance, dorsal coronary band height, palmar coronary band height, and heel height index. However, the determined values were consistently less than the healthy hooves. The foot length showed significant decrease and the hoof balance % was significantly increased in long toe hooves. Dorso palmar radiographic parameters of the medial wall length, lateral wall length, lateral coronet to bottom distance, and medial coronet to bottom distance showed no significant difference between normal and long toe-under run heel. The distal phalanx to lateral hoof wall distance had a significant decrease in long toe hooves. This study may help the veterinarians and farriers to take the correct decision for corrective trimming of long toe-under run heel hooves in donkeys

Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study.

BACKGROUND: Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. METHODS: This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days. RESULTS: 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33-4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76-2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6%) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42-0.71, p < 0.001) and SSIs (OR 0.22, 95% CI 0.14-0.33, p < 0.001). In propensity-score matched groups within low-/middle-HDI countries, laparoscopy was still associated with fewer overall complications (OR 0.23 95% CI 0.11-0.44) and SSI (OR 0.21 95% CI 0.09-0.45). CONCLUSION: A laparoscopic approach is associated with better outcomes and availability appears to differ by country HDI. Despite the profound clinical, operational, and financial barriers to its widespread introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments. TRIAL REGISTRATION: NCT02179112

Reproductive Outcomes Following Ectopic Pregnancy: Register-Based Retrospective Cohort Study

Using Scottish national registry data, Sohinee Bhattacharya and colleagues investigate pregnancy outcomes following ectopic pregnancy in comparison to livebirth, miscarriage, or termination in a first pregnancy

Validated spectrophotometric methods for determination of Alendronate sodium in tablets through nucleophilic aromatic substitution reactions

<p>Abstract</p> <p>Background</p> <p>Alendronate (ALD) is a member of the bisphosphonate family which is used for the treatment of osteoporosis, bone metastasis, Paget's disease, hypocalcaemia associated with malignancy and other conditions that feature bone fragility. ALD is a non-chromophoric compound so its determination by conventional spectrophotometric methods is not possible. So two derivatization reactions were proposed for determination of ALD through the reaction with 4-chloro-7-nitrobenzo-2-oxa-1,3-diazole (NBD-Cl) and 2,4-dinitrofluorobenzene (DNFB) as chromogenic derivatizing reagents.</p> <p>Results</p> <p>Three simple and sensitive spectrophotometric methods are described for the determination of ALD. Method I is based on the reaction of ALD with NBD-Cl. Method II involved heat-catalyzed derivatization of ALD with DNFB, while, Method III is based on micellar-catalyzed reaction of the studied drug with DNFB at room temperature. The reactions products were measured at 472, 378 and 374 nm, for methods I, II and III, respectively. Beer's law was obeyed over the concentration ranges of 1.0-20.0, 4.0-40.0 and 1.5-30.0 μg/mL with lower limits of detection of 0.09, 1.06 and 0.06 μg/mL for Methods I, II and III, respectively. The proposed methods were applied for quantitation of the studied drug in its pure form with mean percentage recoveries of 100.47 ± 1.12, 100.17 ± 1.21 and 99.23 ± 1.26 for Methods I, II and III, respectively. Moreover the proposed methods were successfully applied for determination of ALD in different tablets. Proposals of the reactions pathways have been postulated.</p> <p>Conclusion</p> <p>The proposed spectrophotometric methods provided sensitive, specific and inexpensive analytical procedures for determination of the non-chromophoric drug alendronate either per se or in its tablet dosage forms without interference from common excipients.</p> <p>Graphical abstract</p> <p><display-formula><graphic file="1752-153X-6-25-i3.gif"/></display-formula></p

Pooled analysis of who surgical safety checklist use and mortality after emergency laparotomy

Background: The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods: In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results: Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89⋅6 per cent) compared with that in countries with a middle (753 of 1242, 60⋅6 per cent; odds ratio (OR) 0⋅17, 95 per cent c.i. 0⋅14 to 0⋅21, P &lt; 0⋅001) or low (363 of 860, 42⋅2 percent; OR 0⋅08, 0⋅07 to 0⋅10, P &lt; 0⋅001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference −9⋅4 (95 per cent c.i. −11⋅9 to −6⋅9) per cent; P &lt; 0⋅001), but the relationship was reversed in low-HDI countries (+12⋅1 (+7⋅0 to +17⋅3) per cent; P &lt; 0⋅001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0⋅60, 0⋅50 to 0⋅73; P &lt; 0⋅001). The greatest absolute benefit was seen for emergency surgery in low-and middle-HDI countries. Conclusion: Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries

Search for central exclusive production of top quark pairs in proton-proton collisions at √s=13 TeV with tagged protons

A search for the central exclusive production of top quark-antiquark pairs (tt) is performed for the frst time using proton-tagged events in proton-proton collisions at the LHC at a centre-of-mass energy of 13 TeV. The data correspond to an integrated luminosity of 29.4 fb−1 . The tt decay products are reconstructed using the central CMS detector, while forward protons are measured in the CMS-TOTEM precision proton spectrometer. An observed (expected) upper bound on the production cross section of 0.59 (1.14) pb is set at 95% confdence level, for collisions of protons with fractional momentum losses between 2 and 20%

Search for decays of the 125 GeV Higgs boson into a Z boson and a ρ or ϕ meson

Decays of the 125 GeV Higgs boson into a Z boson and a ρ^0(770) or ϕ(1020) meson are searched for using proton-proton collision data collected by the CMS experiment at the LHC at √s = 13 TeV. The analysed data set corresponds to an integrated luminosity of 137 fb⁻¹. Events are selected in which the Z boson decays into a pair of electrons or a pair of muons, and the ρ and ϕ mesons decay into pairs of pions and kaons, respectively. No significant excess above the background model is observed. As different polarization states are possible for the decay products of the Z boson and ρ or ϕ mesons, affecting the signal acceptance, scenarios in which the decays are longitudinally or transversely polarized are considered. Upper limits at the 95% confidence level on the Higgs boson branching fractions into Zρ and Zϕ are determined to be 1.04–1.31% and 0.31–0.40%, respectively, where the ranges reflect the considered polarization scenarios; these values are 740–940 and 730–950 times larger than the respective standard model expectations. These results constitute the first experimental limits on the two decay channels