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Formulation and development of tablets based on Ludipress and scale-up from laboratory to production scale.

In spite of the wealth of experience available in the pharmaceutical industry, tablet formulations are still largely developed on an empirical basis, and the scale-up from laboratory to production is a time-consuming and costly process. Using Ludipress greatly simplifies formulation development and the manufacturing process because only the active ingredient Ludipress and a lubricant need to be mixed briefly before being compressed into tablets. The studies described here were designed to investigate the scale-up of Ludipress-based formulations from laboratory to production scale, and to predict changes in tablet properties due to changes in format, compaction pressure, and the use of different tablet presses. It was found that the tensile strength of tablets made of Ludipress increased linearly with compaction pressures up to 300 MPa. It was also independent of the geometry of the tablets (diameter, thickness, shape). It is therefore possible to give an equation with which the compaction pressure required to achieve a given hardness can be calculated for a given tablet form. The equation has to be modified slightly to convert from a single-punch press to a rotary tableting machine. Tablets produced in the rotary machine at the same pressure have a slightly higher tensile strength. The rate of increase in pressure, and therefore the throughput, has no effect on the tensile strength of Ludipress tablets. It is thought that a certain minimum dwell time is responsible for this difference. The production of tablets based on Ludipress can be scaled up from one rotary press to another without problem if the powder mixtures are prepared with the same mixing energy. The tensile strength curve determined for tablets made with Ludipress alone can also be applied to tablets with a small quantity (< 10%) of an active ingredient.

Chemistry, Pharmaceutical↗

Development and validation of a scale to measure work-related fatigue and recovery: the Occupational Fatigue Exhaustion/Recovery Scale (OFER).

OBJECTIVE: Various empirical studies link persistent failure to recover from acute fatigue to the evolution of chronic fatigue. However, existing fatigue measurement scales do not tend to distinguish between acute and chronic fatigue elements well, and none include a measure of effective recovery from fatigue. METHODS: The 15 item Occupational Fatigue Exhaustion Recovery (OFER) scale has been developed and validated in three study populations specifically to measure work-related fatigue. RESULTS: The OFER scale possesses robust, gender-bias free psychometric characteristics. Its three subscales identify and distinguish between chronic work-related fatigue traits, acute end-of-shift states and effective fatigue recovery between shifts. CONCLUSION: These studies confirm the mediating role of intershift-shift recovery in the evolution of adaptive end-of-shift fatigue states to maladaptive persistent fatigue traits. The OFER scale is suggested as a potentially valuable new tool for use in work-related fatigue research.

Adult↗

Symmetry breaking, anomalous scaling, and large-scale flow generation in a convection cell.

We consider a convection process in thin loops of different geometries. At Ra=Ra(')(cr) a first transition leading to the generation of corner vortices is observed. At higher Ra (Ra>Ra(cr)) a coherent large-scale flow, which persists for a very long time, sets up. The mean velocity nu mass flux m, and the Nusselt number Nu in this flow scale with Ra as nu proportional to m proportional to Ra0.45 and Nu proportional to Ra0.9, respectively, in a wide range of r=(Ra-Ra(cr))/Ra(cr) variation. The "normal" scaling nu proportional to sqrt[Ra] is detected as r-->0 and its range shrinks with decrease of the aspect ratio. The time evolution of the coherent flow is well described by the Landau amplitude equation with the appropriate selection of the Ra-dependent Landau constants. Analysis of the aspect ratio influence on the range of validity of anomalous scaling, observed in this paper, indicates the important role played by both thermal boundary conditions and geometry of the system.

Journal Article↗

Effect of large-scale intermittency and mean shear on scaling-range exponents in a turbulent jet.

The present study investigates the combined impact of the intermittency associated with the turbulent-nonturbulent interface and the mean shear rate in an axisymmetric jet on the structure of turbulence in the scaling range, where the spectrum exhibits a power-law behavior. Second-order structure functions, autocorrelations of the dissipation rate, and spectra of both the longitudinal velocity fluctuation and the passive temperature fluctuation are measured at a distance of 40 diameter downstream from the nozzle exit. All the scaling range exponents are influenced by the large-scale intermittency and the mean shear. The scalar fluctuation is much more sensitive to the variation in large-scale intermittency than the velocity fluctuation.

Journal Article↗

Nonequilibrium phase transitions and finite-size scaling in weighted scale-free networks.

We consider nonequilibrium phase transitions, such as epidemic spreading, in weighted scale-free networks, in which highly connected nodes have a relatively smaller ability to transfer infection. We solve the dynamical mean-field equations and discuss finite-size scaling theory. The theoretical predictions are confronted with the results of large scale Monte Carlo simulations on the weighted Barabási-Albert network. Local scaling exponents are found different at a typical site and at a node with very large connectivity.

Journal Article↗

Validation of the Bech-Rafaelsen Melancholia Scale and the Hamilton Depression Scale in patients with major depression; is the total score a valid measure of illness severity?

OBJECTIVE: Evaluation of antidepressant drug efficacy requires adequate rating scales for measuring the severity of depression. However, to measure the illness severity by such a total score, the scale needs to fulfil criteria of unidimensionality. On this background, we aimed at comparing the unidimensionality of the Bech-Rafaelsen Melancholia Scale (MES) and the 17-item Hamilton Depression Rating Scale (HAM-D(17)). METHOD: A total of 1629 patients aged between 18 and 65 years with a major depressive episode were treated openly with sertraline at a fixed oral dose of 50 mg daily during 4 weeks. The HAM-D(17) and the MES were applied at baseline and at weeks 2 and 4. Unidimensionality was tested with Mokken and Rasch analysis. RESULTS: Unidimensionality of the HAM-D(17) could not be confirmed. However, the 6-item Hamilton Depression Subscale (HAM-D(6)), was accepted by the Rasch analysis both at baseline and after 2 and 4 weeks of therapy. For the MES (as well as for the HAM-D(6)), a Loevinger coefficient of homogeneity above 0.40 (suggesting acceptance) was found at week 4. CONCLUSION: The HAM-D(6) and the MES did fulfil criteria for unidimensionality while the HAM-D(17) did not. Therefore, the extended use of the HAM-D(17) in drug trials may be questioned.

Adolescent↗

Development of a modified Winchester disability scale--the elderly at risk rating scale.

OBJECTIVE: To show that the elderly at risk rating scale (EARRS) satisfies the requirements of an assessment tool for routine health checks in people over 75 and would also be suitable as a method of collecting epidemiological data on the needs of the elderly in a locality. DESIGN: Development and validation of a questionnaire based on a modification of the Winchester rating scale, by a series of prospective, comparative studies before the use of the instrument in a community survey. SETTING: Elderly care day hospital and the community. SUBJECTS: Elderly patients referred to an elderly care day hospital; population survey of subjects over 75 living at home. MAIN OUTCOME MEASURES: Reliability of responses using the kappa statistic; comparison of the scale with the Barthel index of daily living. RESULTS: EARRS has satisfactory validity and reliability when repeated by the same observer or a different observer, with a mean weighted kappa score above 0.80 in both instances. As a measure of disability in the community, it is better than the Barthel score in that it avoids the ceiling effect. The score is correlated with age, social situation, and receipt of support services, and individual questions scale appropriately to adverse outcomes. CONCLUSION: The EARRS satisfies the requirements of an assessment tool for health checks in the elderly, It is suitable for both population surveys and routine practice in primary care, has proved popular with practice nurses, and is easy to complete.

Aged↗

"Specific" scale compared with "generic" scale: a double measurement of the quality of life in a French community sample of obese subjects.

STUDY OBJECTIVE: To determine the aspects of quality of life that are affected by weight in the general population, to develop a specific questionnaire (OSQOL) that can measure with reliability and validity the impact of overweight and obesity on well being, and to compare the results with those obtained using a well known generic tool (the "SF 36" scale). DESIGN: Cross sectional survey with matched control group. SETTING: Community. PATIENTS: A permanent survey base of approximately 10,000 representative ordinary households were screened for weight and height. Five hundred subjects were randomly drawn from the sub-sample of adult people with a body mass index equal or greater than 27. A control sample of 500 subjects matched for sex, age, and employment status was drawn from the non-obese population. MAIN RESULTS: A short specific Quality Of Life scale, the OSQOL, was produced that comprises 11 items belonging to four independent dimensions. Using this scale and the SF36, it was found that: (1) moderately obese subjects (27 < or = BMI < 30) did not significantly differ from the control group except for physical capacity; (2) in the group of obese subjects with a BMI > 30, quality of life seemed to be impaired for five of nine dimensions of the SF36 compared with the control population, all related to physical consequences of obesity. This population essentially perceived itself in terms of poor general health. (3) No significant difference was observed between the samples for the psychological and social dimensions of the SF36. CONCLUSION: The quality of life of patients with severe obesity is impaired, but it mainly affects the physical consequences of the disease. The psychological and social repercussions that could have been expected to affect this population were not demonstrated. The hypothesis of a process of adaptation of the person and their social environment cannot therefore be excluded. Methodologically, comparison of the specific OSQOL with the generic SF3 shows clearly that the two kinds of scales correspond to different objectives and should be considered as complementary.

Adolescent↗

A scale to assess severity in organophosphorus intoxication: POP scale.

We have developed a clinical scale to assess severity or organophosphorus (OP) intoxication. Five common clinical manifestations of OP poisoning have been selected as parameters, each to be assessed on a 3 point scale varying from 0-2. Poisoning can then be graded as mild (score 0-3), moderate (score 4-7) or severe (score 8-11) when the patient first presents. The scale was validated using two consecutive series of 173 patients with OP poisoning. Correlations between the scores obtained on admission and three outcome variables, namely, death, the need for ventilatory support and the dose of atropine required in the first 24 hours after admission were significant. We believe that this scale would assist in grading severity of OP intoxication at first contact and help in predicting possible outcome.

Bradycardia↗

An MMPI-2 scale to detect malingered depression (Md scale).

A specialized Minnesota Multiphasic Personality Inventory-2 (MMPI-2) validity scale was constructed to detect individuals who are knowledgeable about either depression or MMPI-2 detection strategies and who subsequently attempt to malinger depressive symptoms on the MMPI-2. The Malingered Depression (Md) scale consists of 32 items that discriminated college students who feigned depression from those who were genuinely depressed. Further information about the incremental validity and the utility of the Md scale was obtained in a cross-validation study with additional college students who feigned depression and a sample of students with clinically significant depressive symptoms. The results indicate that the Md scale possesses promising value in detecting malingered symptoms of depression.

Adult↗

Correlations between the Functional-Cognitive Assessment Scale and the Alzheimer's Disease Assessment Scale when administered to patients with dementia residing in long-term care.

The Alzheimer Disease Assessment Scale (ADAS) and the Functional Cognitive Assessment Scale (FUCAS) examine the cognitive performance of patients with dementia. ADAS has been widely used as a clinical instrument, mainly in clinical trials. FUCAS is a useful tool in diagnosing early dementia since it examines executive skills. Moreover, it is sensitive to the subtle changes that occur during the progress of the disease. The aim of this study was to examine the possible correlations between FUCAS and ADAS. The 2 neuropsychological scales were administered to 32 patients with dementia residing in long-term care. They were 12 men and 20 women, 65 to 90 years old, with 4 to 12 years of education. Twenty-four patients were reassessed 3 months after the first assessment, with the same scales. Pearson's correlation showed that the total score of FUCAS correlated significantly with the total score of ADAS: r = 0.80 (P < .01). The t test showed that changes over the 3 months for FUCAS were more significant than ADAS, suggesting that FUCAS is a more sensitive tool.

Aged↗

Incremental validity of the Rorschach Prognostic Rating Scale over the MMPI Ego Strength Scale and IQ.

A recent meta-analysis found that the Rorschach Prognostic Rating Scale (RPRS) had a strong ability to predict subsequent outcome (r = .44, N = 783; Meyer & Handler, 1997, this issue). However, that review did not directly address questions of incremental validity. This article focuses on the ability of the RPRS to predict outcome after taking into account other sources of data. Across studies that examined both the RPRS and the MMPI Ego Strength scale, the RPRS had a strong ability to predict outcome (r = .40, N = 187), whereas the MMPI scale did not (r = .02, N = 280). Nine studies examined the RPRS along with an intelligence test and allowed direct numerical estimates of incremental validity to be calculated. Across studies, the RPRS demonstrated strong incremental validity after controlling for intelligence (incremental r = .36, N = 358). It is clear that the Rorschach can make unique contributions to understanding clinically relevant processes in ways that self-reports or measured intelligence cannot. Contemporary Rorschach scales should continue to be evaluated for their distinctive and incremental contribution to clinical practice.

Ego↗

[Evaluation scale of autistic behavior. Validity and reliability of a scale for autistic behavior detection].

This study aimed to translate, to adapt and to validate the scale of autistic traits (ATA) developed by Ballabriga et al. in Barcelona, by the analysis of 31 patients with mental deficiency and 30 patients with autism, according to the DSM-IV criteria. The "cut off point" found was 15 (p = 0.05); the reliability coefficient was 0.27; the construct validity showed low agreement (kappa = 0.04) and the internal validity was 100%, with all evaluated patients having their clinical diagnosis confirmed through the scale application. The correlation index was 0.42, showing that it is specific for autism. The scale presents discrimination capacity and internal consistency, and the Cronbach's alpha was 0.71. We consider that achieved results show that the scale is reliable to be used in our population.

Adolescent↗

Lingual vibrotactile threshold shift during magnitude-estimation scaling: effects on magnitude-estimation responses and scaling behavior across age.

The purpose of this study was to investigate the effects of age on tactile threshold shifts occurring during magnitude-estimation scaling of vibratory stimuli presented to the dorsal surface of the tongue. Relationships of the lingual vibrotactile threshold shifts to suprathreshold stimulus intensity, magnitude-estimation responses, and over-all scaling behavior were explored. Three groups differing in mean age participated in this study (Group 1 8.05 yr., Group 2 19.46 yr., and Group 3 56.2 yr.). Each subject performed two magnitude-estimation tasks. In one task, threshold of sensitivity was measured after every suprathreshold numerical response to the subject. If a threshold shift was recorded, threshold was allowed to return to the pretest baseline level continuing to the next suprathreshold stimulus presentation. The results showed that threshold shift during magnitude-estimation scaling took place for all three age groups and that the shift was related to the intensity of the suprathreshold vibratory stimulus being applied to the tongue. They also showed that Group 2 (young adults) performed magnitude-estimation scaling differently when threshold shift was controlled than when it was not. The other two groups of subjects were not similarly affected.

Adolescent↗

Comparison of the Hamilton Depression Rating Scale and the Geriatric Depression Scale: detection of depression in dementia patients.

The present longitudinal prospective study compared results from the Geriatric Depression Scale with those from the Hamilton Depression Rating Scale for 30 dementia patients. The criterion measure was presence of depression as indicated by the psychiatric diagnosis. The psychiatrist and physician's assistant made the Hamilton ratings while the psychology staff administered the Geriatric Depression Scale. The two measures were statistically unrelated from Times 1 and 2 (rs = .26 and .41). Eleven (37%) patients were depressed and nine received antidepressant medications. Sensitivity ratings were 82% and 9%, respectively, and specificity ratings were 88% and 92%, respectively. Possible explanations for the success of the Geriatric Depression Scale and lack of success of the Hamilton ratings in detecting depression in this population are discussed.

Aged↗

The visual analogue mood scale: can a single-item scale accurately classify depressive mood state?

Visual analogue mood scales provide extremely rapid, single-item assessment of affective states. This study examined discrimination on a single-item visual analogue depression scale between dysphoric or mildly depressed and nondepressed individuals in a sample of 284 college students. The visual analogue mood scale significantly discriminated subjects by mood category and achieved comparable hit rate, sensitivity, and specificity relative to other well validated mood scales.

Adolescent↗

Reliability of a modified People of Color Racial Identity Attitude Scale and a White Racial Identity Attitude Scale for a sample of master's counseling students.

The reliabilities of Helms' People of Color Racial Identity Attitude Scale and White Racial Identity Attitude Scale when used with a sample of master's counseling students were explored for modified versions. Reliabilities were assessed using Cronbach alpha as a measure of internal consistency, and temporal stabilities were measured. Results were consistent with previous findings, with coefficients alpha ranging from .67 to .77 for the modified People of Color Racial Identity Attitude Scale, and from .36 to .84 for the modified White Racial Identity Attitude Scale. Analyses also identified items that may suppress internal consistencies in responding by this sample.

Adolescent↗

Interrater reliability of the Peabody Developmental Motor Scales: fine motor scale.

OBJECTIVE: The interrater reliability of the Peabody Developmental Motor Scales (PDMS) fine motor scale was examined in 23 children with developmental disabilities who were between 2 years and 5 years of age. METHOD: Three occupational therapists viewed videotapes of the children and scored each child's performance on the fine motor section of the test. Data were analyzed with the intraclass correlation (ICC) approach; ICC values ranged from 0.90 to 0.97 for the subskills of Grasping, Hand Use, Eye-Hand Coordination, and Manual Dexterity. RESULTS: The ICC interrater reliability value for the total fine motor score was 0.99. Reliability values were additionally computed with the PDMS fine motor scale age-equivalent scores and Z scores. The ICC values for these methods of scoring the PDMS were 0.99 and 1.00, respectively. CONCLUSION: The PDMS fine motor scale can be used consistently to evaluate fine motor delays in this population of young children.

Child, Preschool↗