Role of Diffusion Weighted Imaging in Musculoskeletal Infections: Current Perspectives.

Accurate diagnosis and prompt therapy of musculoskeletal infections are important prognostic factors. In most cases, clinical history, examination and laboratory findings help one make the diagnosis, and routine magnetic resonance imaging (MRI) is useful to identify the extent of the disease process. However, in many situations, a routine MRI may not be specific enough especially if the patient cannot receive contrast intravenously, thereby delaying the appropriate treatment. Diffusion-weighted imaging (DWI) can help in many such situations by providing additional information, accurate characterization and defining the extent of the disease, so that prompt treatment can be initiated. In this article, we illustrate the imaging findings of the spectrum of musculoskeletal infections, emphasizing the role of DWI in this domain. KEY POINTS: • Abscess in background cellulitis is detected on DWI. • Infectious tenosynovitis shows diffusion restriction as compared to mechanical tenosynovitis. • Pyomyositis with abscess can be differentiated from diabetic myonecrosis on DWI. • Intraosseous abscess is bright on DWI versus devitalized tissue, sequestrum and air. • DWI can be used to differentiate spine infection from simple Modic changes.

A generalized kinetic model for heterogeneous gas-solid reactions.

We present a generalized kinetic model for gas-solid heterogeneous reactions taking place at the interface between two phases. The model studies the reaction kinetics by taking into account the reactions at the interface, as well as the transport process within the product layer. The standard unreacted shrinking core model relies on the assumption of quasi-static diffusion that results in a steady-state concentration profile of gas reactant in the product layer. By relaxing this assumption and resolving the entire problem, general solutions can be obtained for reaction kinetics, including the reaction front velocity and the conversion (volume fraction of reacted solid). The unreacted shrinking core model is shown to be accurate and in agreement with the generalized model for slow reaction (or fast diffusion), low concentration of gas reactant, and small solid size. Otherwise, a generalized kinetic model should be used.

A Standardized Dataset of a Spontaneous Adverse Event Reporting System.

One of the largest spontaneous adverse events reporting databases in the world is the Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS). Unfortunately, researchers face many obstacles in analyzing data from the FAERS database. One of the major obstacles is the unstructured entry of drug names into the FAERS, as reporters might use generic names or trade names with different naming structures from all over the world and, in some cases, with typographical errors. Moreover, report duplication is a known problem in spontaneous adverse event-reporting systems, including the FAERS database. Hence, thorough text processing for database entries, especially drug name entries, coupled with a practical case-deduplication logic, is a prerequisite to analyze the database, which is a time- and resource-consuming procedure. In this study, we provide a clean, deduplicated, and ready-to-import dataset into any relational database management software of the FAERS database up to September 2021. Drug names are standardized to the RxNorm vocabulary and normalized to the single active ingredient level. Moreover, a pre-calculated disproportionate analysis is provided, which includes the reporting odds ratio (ROR), proportional reporting ratio (PRR), Chi-squared analysis with Yates correction (x2), and information component (IC) for each drug-adverse event pair in the database.

Curation of an international drug proprietary names dataset.

A drug dataset containing international proprietary names is essential for researchers investigating different drugs from different countries worldwide. However, many websites on the internet offer free access for a single drug searching service to identify international drug trade names, but not for a list of drugs to be searched and identified. Therefore, it will be problematic if the researcher has a list of hundreds or thousands of drug trade names to be identified. In this project, we have created an International Drug Dictionary (IDD) by curating collected drug lists from open access websites belonging to official drug regulatory agencies, official healthcare systems, or recognized scientific bodies from 44 countries around the world in addition to the European public assessment reports (EPAR) and the DRUGBANK vocabulary published in the public domain. Researchers interested in pharmacovigilance, pharmacoepidemiology, or pharmacoeconomics can benefit from this dataset, especially when identifying lists of proprietary drug names, particularly of multi-national origin. To enhance its adaptability, we also mapped the IDD to the standardized drug vocabulary RxNorm. The IDD can also be used as a tool for mapping international drug trade names to RxNorm. Each drug entity in the IDD mapped to a unique identification number for each entity called Atom Unique Identifier (RXAUI) from RxNorm.

2D MHD Mixed Convection in a Zigzag Trapezoidal Thermal Energy Storage System Using NEPCM.

In a magnetic field, two-dimensional (2D) mixed convection is investigated within a zigzagged trapezoidal chamber. The lower side of the trapezoidal chamber is irregular, in particular, a zigzagged wall with different zigzag numbers N. The fluid particles move in the room due to the motion of the upper wall, while the porosity-enthalpy approach represents the melting process. The thermal parameters of the fluid are enhanced by what is called a nano-encapsulated phase change material (NEPCM) consisting of polyurethane as the shell and a nonadecane as the core, while water is used as the base fluid. In order to treat the governing equations, the well-known Galerkin finite element method (GFEM) is applied. In addition, the heat transfer (HT) irreversibility and the fluid friction (FF) irreversibility are compared in terms of the average Bejan number. The main results show that the melt band curve behaves parabolically at smaller values of Reynolds number (Re) and larger values of Hartmann number (Ha). Moreover, minimizing the wave number is better in order to obtain a higher heat transfer rate.

Higher carbohydrate intake in relation to non-alcoholic fatty liver disease in patients with type 2 diabetes.

Background: Non-alcoholic fatty liver disease (NAFLD) is an overlooked complication of type 2 diabetes (T2D). Current recommendations for the management of NAFLD are mainly focused on weight reduction, overlooking the role of macronutrient composition. Although dietary carbohydrates play a major role in intrahepatic fat synthesis, their association with the progression of liver steatosis has not been fully investigated in patients with T2D. Aim: To investigate the association between higher carbohydrate intake and the presence of liver steatosis in patients with T2D. Methods: This cross-sectional study included men and women aged 18-60 years diagnosed with T2D. Anthropometric measurements, hepatic steatosis assessment using the controlled attenuation parameter (CAP), blood samples, and dietary data were analyzed. Participants were divided into two groups: NAFLD and NAFLD-free. A two-sample t-test was used to evaluate the differences between the two groups. Stepwise multiple linear regression models adjusted for potential confounders were used to determine the association between CAP values and higher carbohydrate intake. Results: In total, 358 participants were included. NAFLD was present in 79.3% of the participants. Body mass index, waist circumference, ALT, HbA1c, and triglycerides showed direct, while HDL-Cholesterol revealed inverse associations with CAP values. No significant relationship was found between carbohydrate intake and steatosis in the total study sample; however, multiple linear regression analysis revealed a significant relationship between carbohydrate intake and CAP values in patients aged ≤50 years. Conclusion: In patients with T2D, higher carbohydrate intake was associated with liver steatosis in those aged 50 years and below. Further studies are required to confirm the causality between carbohydrate intake and liver steatosis.

Natural Convection within Inversed T-Shaped Enclosure Filled by Nano-Enhanced Phase Change Material: Numerical Investigation.

Energy saving has always been a topic of great interest. The usage of nano-enhanced phase change material NePCM is one of the energy-saving methods that has gained increasing interest. In the current report, we intend to simulate the natural convection flow of NePCM inside an inverse T-shaped enclosure. The complex nature of the flow results from the following factors: the enclosure contains a hot trapezoidal fin on the bottom wall, the enclosure is saturated with pours media, and it is exposed to a magnetic field. The governing equations of the studied system are numerically addressed by the higher order Galerkin finite element method (GFEM). The impacts of the Darcy number (Da = 10-2-10-5), Rayleigh number (Ra = 103-106), nanoparticle volume fraction (φ = 0-0.08), and Hartmann number (Ha = 0-100) are analyzed. The results indicate that both local and average Nusselt numbers were considerably affected by Ra and Da values, while the influence of other parameters was negligible. Increasing Ra (increasing buoyancy force) from 103 to 106 enhanced the maximum average Nusselt number by 740%, while increasing Da (increasing the permeability) from 10-5 to 10-2 enhanced both the maximum average Nusselt number and the maximum local Nusselt number by the same rate (360%).

Enhancing the Melting Process of Shell-and-Tube PCM Thermal Energy Storage Unit Using Modified Tube Design.

Recently, phase change materials (PCMs) have gained great attention from engineers and researchers due to their exceptional properties for thermal energy storing, which would effectively aid in reducing carbon footprint and support the global transition of using renewable energy. The current research attempts to enhance the thermal performance of a shell-and-tube heat exchanger by means of using PCM and a modified tube design. The enthalpy-porosity method is employed for modelling the phase change. Paraffin wax is treated as PCM and poured within the annulus; the annulus comprises a circular shell and a fined wavy (trefoil-shaped) tube. In addition, copper nanoparticles are incorporated with the base PCM to enhance the thermal conductivity and melting rate. Effects of many factors, including nanoparticle concentration, the orientation of the interior wavy tube, and the fin length, were examined. Results obtained from the current model imply that Cu nanoparticles added to PCM materials improve thermal and melting properties while reducing entropy formation. The highest results (27% decrease in melting time) are obtained when a concentration of nanoparticles of 8% is used. Additionally, the fins' location is critical because fins with 45° inclination could achieve a 50% expedition in the melting process.

Sesame Oil-Based Nanostructured Lipid Carriers of Nicergoline, Intranasal Delivery System for Brain Targeting of Synergistic Cerebrovascular Protection.

Nicergoline (NIC) is a semisynthetic ergot alkaloid derivative applied for treatment of dementia and other cerebrovascular disorders. The efficacy of sesame oil to slow and reverse the symptoms of neurodegenerative cognitive disorders has been proven. This work aimed to formulate and optimize sesame oil-based NIC-nanostructured lipid carriers (NIC-NLCs) for intranasal (IN) delivery with expected synergistic and augmented neuroprotective properties. The NIC-NLC were prepared using sesame oil as a liquid lipid. A three-level, three-factor Box-Behnken design was applied to statistically optimize the effect of sesame oil (%) of the total lipid, surfactant concentration, and sonication time on particle size, zeta potential, and entrapment efficacy as responses. Solid-state characterization, release profile, and ex vivo nasal permeation in comparison to NIC solution (NIC-SOL) was studied. In vivo bioavailability from optimized NIC-NLC and NIC-SOL following IN and IV administration was evaluated and compared. The optimized NIC-NLC formula showed an average particle size of 111.18 nm, zeta potential of -15.4 mV, 95.11% entrapment efficacy (%), and 4.6% loading capacity. The NIC-NLC formula showed a biphasic, extended-release profile (72% after 48 h). Permeation of the NIC-NLC formula showed a 2.3 enhancement ratio. Bioavailability studies showed a 1.67 and 4.57 fold increase in plasma and brain following IN administration. The results also indicated efficient direct nose-to-brain targeting properties with the brain-targeting efficiency (BTE%) and direct transport percentage (DTP%) of 187.3% and 56.6%, respectively, after IN administration. Thus, sesame oil-based NIC-NLC can be considered as a promising IN delivery system for direct and efficient brain targeting with improved bioavailability and expected augmented neuroprotective action for the treatment of dementia.

Natamycin solid lipid nanoparticles - sustained ocular delivery system of higher corneal penetration against deep fungal keratitis: preparation and optimization.

BACKGROUND: Fungal keratitis (FK) is a serious pathogenic condition usually associated with significant ocular morbidity. Natamycin (NAT) is the first-line and only medication approved by the Food and Drug Administration for the treatment of FK. However, NAT suffers from poor corneal penetration, which limits its efficacy for treating deep keratitis. PURPOSE: The objective of this work was to prepare NAT solid lipid nanoparticles (NAT-SLNs) to achieve sustained drug release and increased corneal penetration. METHODS: NAT-SLNs were prepared using the emulsification-ultrasonication technique. Box- Behnken experimental design was applied to optimize the effects of independent processing variables (lipid concentration [X1], surfactant concentration [X2], and sonication frequency [X3]) on particle size (R1), zeta potential (ZP; R2), and drug entrapment efficiency (EE%) (R3) as responses. Drug release profile, ex vivo corneal permeation, antifungal susceptibility, and cytotoxicity of the optimized formula were evaluated. RESULTS: The optimized formula had a mean particle size of 42 r.nm (radius in nanometers), ZP of 26 mV, and EE% reached ~85%. NAT-SLNs showed an extended drug release profile of 10 hours, with enhanced corneal permeation in which the apparent permeability coefficient (Papp) and steady-state flux (Jss) reached 11.59×10-2 cm h-1 and 3.94 mol h-1, respectively, in comparison with 7.28×10-2 cm h-1 and 2.48 mol h-1 for the unformulated drug, respectively. Antifungal activity was significantly improved, as indicated by increases in the inhibition zone of 8 and 6 mm against Aspergillus fumigatus ATCC 1022 and a Candida albicans clinical isolate, respectively, and minimum inhibitory concentration values that were decreased 2.5-times against both of these pathogenic strains. NAT-SLNs were found to be non-irritating to corneal tissue. NAT-SLNs had a prolonged drug release rate, that improved corneal penetration, and increased antifungal activity without cytotoxic effects on corneal tissues. CONCLUSION: Thus, NAT-SLNs represent a promising ocular delivery system for treatment of deep corneal keratitis.