A proposed anatomy syllabus for entry-level physiotherapists in the United Kingdom: A modified Delphi methodology by physiotherapists who teach anatomy.

The ever-increasing scope of physiotherapy practice is raising questions on what anatomical knowledge and skills ought to be taught within qualifying physiotherapy degree programmes in the United Kingdom (UK). The aim of the study was to create core anatomical knowledge and skills learning objectives to inform knowledge and skills for entry-level physiotherapists in the UK. A two phased modified Delphi methodology created a consensual anatomy curriculum. A Research-Team-Expert-Panel of four physiotherapists who teach anatomy proposed Anatomy Learning Objectives (Anat-LOs) and accompanying clinical rationales relevant for newly qualified entry-level physiotherapists. A Teacher-Expert-Panel of nine physiotherapists who taught anatomy to physiotherapy students in the UK reviewed Anat-LOs in two consecutive Delphi Rounds, and rated and commented on each Anat-LO. After each Delphi Round, the Research-Team-Expert-Panel reviewed the ratings and comments from the Teacher-Expert-Panel and banked Anat-LOs that passed the 85% acceptance threshold. There were 182 banked Anat-LOs that spanned all eight areas: Introductory Concepts, Principles and Basic Histology; Head and Neck; Thorax; Abdomen, Pelvis and Perineum; Upper Limb; Lower Limb; Spine; and Neuroanatomy regions/systems. The Anat-LOs develop both anatomical knowledge and key anatomical skills, such as palpation and conducting manual tests on model patients. A first ever core anatomy curriculum for entry-level physiotherapists has been created for entry-level physiotherapists, typically Band-5 NHS physiotherapists, and takes an integrated learning approach. The anatomy curriculum brings clarity to students, teachers, clinical supervisors and future employers on the expected anatomical standards for entry-level physiotherapists.

Application of Mathematical Models to Determine the Feasibility of Amorphous Drug Layering in Pan Coaters.

Oral solid dosage forms that contain APIs in the amorphous state have become commonplace because of many drug substances exhibiting poor water solubility, which negatively impacts their absorption in the human GI tract. While micronization, solvent spray-drying, and hot-melt extrusion can address solubility issues, spray coating of the APIs onto beads and tablets offers another option for producing amorphous drug products. High-level comparisons between bead and tablet coating technologies have the potential for simpler equipment and operation that can reduce the cost of development and manufacturing. However, spray coating directly onto tablets is not without challenges, especially with respect to meeting uniformity acceptance value (AV) criteria, comprising accuracy (mean) and precision (variance) objectives. The feasibility of meeting AV criteria is examined, based on mathematical models for accuracy and precision. The results indicate that the main difficulty in manufacturing satisfactory drug-layered tablets by spray coating is caused by the practical limitations of achieving the necessary coating precision. Despite this limitation, it is shown that AV criteria can be consistently met by appropriate materials monitoring and control as well as processing equipment setup, operation, and maintenance.

Interrelationships Between Coating Uniformity and Efficiency in Pan Coating Processes.

The relationships between coating uniformity and efficiency were explored for tablet coating processes in pan coaters. The factors affecting the size of the spray zone were modeled using one-dimensional deposition analysis of spray droplets. This model was incorporated into the analytical model developed for coating uniformity by Choi et al. (AAPS PharmSciTech 22(7), 2021) that farther elucidated the effects of tablet shape and bed porosity. The results were compared with literature data on coating efficiency. The variables examined included tablet shape and size, coating time, pan speed, atomizing and pattern air flow rates, bed porosity, spray rate, batch size, coating solution concentration, spray gun-to-bed distance, and pan diameter. It is shown that, except for pan diameter and atomizing air flow rate, variables that improve coating efficiency adversely affected coating uniformity and vice versa. Implications of these relationships are discussed to improve formulation, process, and equipment designs.

Novel Coating Uniformity Models for Tablet Pan Coaters.

Novel mathematical models were developed to predict inter-tablet coating uniformity in terms of coefficients of variation (CV) and acceptance values (AV) for cylindrical tablet pan coaters, operating in batch and continuous modes. The models, based on binomial coating spray and tablet movement distribution functions and on bed geometry, yielded equations and results that are in good agreement with previously reported experimental data, most empirical expressions, and more computationally intensive models. The new model equations are readily useable for process analysis, optimization, scale-up, and manufacturing design and control.

High-Q Tuneable 10-GHz Bragg Resonator for Oscillator Applications.

This paper describes the design, simulation, and measurement of a tuneable 9.365-GHz aperiodic Bragg resonator. The resonator utilizes an aperiodic arrangement of non ( /4) low-loss alumina plates ( , loss tangent of to ) mounted in a cylindrical metal waveguide. Tuning is achieved by varying the length of the center section of the cavity. A multi-element bellows/probe assembly is presented. A tuning range of 130 MHz (1.39%) is demonstrated. The insertion loss varies from -2.84 to -12.03 dB while the unloaded Q varies from 43 788 to 122 550 over this tuning range. At 10 of the 13 measurement points, the unloaded Q exceeds 1 00 000, and the insertion loss is above -7 dB. Two modeling techniques are discussed; these include a simple ABCD circuit model for rapid simulation and optimization and a 2.5-D field solver, which is used to plot the field distribution inside the cavity.

Development and evaluation of a dimensionless mechanistic pan coating model for the prediction of coated tablet appearance.

A mathematical, mechanistic tablet film-coating model has been developed for pharmaceutical pan coating systems based on the mechanisms of atomisation, tablet bed movement and droplet drying with the main purpose of predicting tablet appearance quality. Two dimensionless quantities were used to characterise the product properties and operating parameters: the dimensionless Spray Flux (relating to area coverage of the spray droplets) and the Niblett Number (relating to the time available for drying of coating droplets). The Niblett Number is the ratio between the time a droplet needs to dry under given thermodynamic conditions and the time available for the droplet while on the surface of the tablet bed. The time available for drying on the tablet bed surface is critical for appearance quality. These two dimensionless quantities were used to select process parameters for a set of 22 coating experiments, performed over a wide range of multivariate process parameters. The dimensionless Regime Map created can be used to visualise the effect of interacting process parameters on overall tablet appearance quality and defects such as picking and logo bridging.

A 3D assessment and feedback tool for Ankylosing Spondylitis from the perspective of healthcare professionals.

To investigate the utility of 3D visualization technology to augment assessment and feedback for Ankylosing Spondylitis (AS), a visualization prototype was developed, and both subjective and objective measures of current assessment instruments were compared. To verify and establish a base-line for the prototype's effectiveness, motion data and measurement data from a healthy adult in a laboratory environment were collected. To validate the prototype, a qualitative evaluation was undertaken using multiple methods including a pilot study, focus groups, and individual interviews. Research subjects comprised physiotherapists in clinical practice and academia and content analysis of their responses was used to substantiate the findings. The prototype enhanced both assessment and feedback of AS from the physiotherapist's perspective and they believed it to be superior to the current methods used in practice for assessing the condition and in documenting variations for subsequent treatment. The physiotherapists believed that such a system had potential to encourage multidisciplinary working, and to be patient-centric, both with respect to the process of treatment and with regard to the convenience it offered to patients in managing their own condition. 3D visualization of AS symptoms and its treatment via exercise is a valuable technique as demonstrated by the prototype system.

Investigation of the interactions of enteric and hydrophilic polymers to enhance dissolution of griseofulvin following hot melt extrusion processing.

OBJECTIVES: This study focuses on the application of hot melt extrusion (HME) to produce solid dispersions containing griseofulvin (GF) and investigates the in-vitro dissolution performance of HME powders and resulting tablet compositions containing HME-processed dispersions. METHODS: Binary, ternary and quaternary dispersions containing GF, enteric polymer (Eudragit L100-55 or AQOAT-LF) and/or vinyl pyrrolidone-based polymer (Plasdone K-12 povidone or S-630 copovidone) were processed by HME. Two plasticizers, triethyl citrate (TEC) and acetyl tributyl citrate (ATBC), were incorporated to aid in melt processing and to modify release of GF in neutral media following a pH-change in dissolution. Products were characterized for GF recovery, degrees of compositional amorphous character, intermolecular interactions and non-sink dissolution performance. KEY FINDINGS: Binary dispersions exhibited lower maximum observed concentration values and magnitudes of supersaturated GF in neutral media dissolution in comparison with the ternary dispersions. The quaternary HME products, 1 : 2 : 1 : 0.6 GF : L100-55 : S-630 : ATBC and GF : AQOAT-LF : K-12 : ATBC, were determined as the most optimal concentration-enhancing compositions due to increased hydrogen bonding of enteric functional groups with carbonyl/acetate groups of vinyl pyrrolidone-based polymers, reduced compositional crystallinity and presence of incorporated hydrophobic plasticizer. CONCLUSIONS: HME products containing combinations of concentration-enhancing polymers can supersaturate and sustain GF dissolution to greater magnitudes in neutral media following the pH-transition and be compressed into immediate-release tablets exhibiting similar dissolution profiles.

An update on pharmaceutical film coating for drug delivery.

INTRODUCTION: Pharmaceutical coating processes have generally been transformed from what was essentially an art form in the mid-twentieth century to a much more technology-driven process. AREAS COVERED: This review article provides a basic overview of current film coating processes, including a discussion on polymer selection, coating formulation additives and processing equipment. Substrate considerations for pharmaceutical coating processes are also presented. EXPERT OPINION: While polymeric coating operations are commonplace in the pharmaceutical industry, film coating processes are still not fully understood, which presents serious challenges with current regulatory requirements. Novel analytical technologies and various modeling techniques that are being used to better understand film coating processes are discussed. This review article also examines the challenges of implementing process analytical technologies in coating operations, active pharmaceutical ingredients in polymer film coatings, the use of high-solids coating systems and continuous coating and other novel coating application methods.

Techniques to assess film coatings and evaluate film-coated products.

BACKGROUND: Polymeric film coatings have been applied to pharmaceutical solids for decorative, protective, or functional purposes. The application process is quite complex, with variables related to the coating formulation, substrate properties, processing parameters, and interactions thereof, all of which can affect product performance. OBJECTIVE: This article describes a number of experimental techniques used to determine the physical, mechanical, adhesive, thermal, and permeability properties of free and applied films. These analytical tools can be used to optimize product performance, advance our knowledge of the film formation process, and investigate interactions between the coating and the solid surface. CONCLUSION: Through a better understanding of film-coating processes, the cause of problems that arise during manufacturing, defects observed in the coating, and changes in performance upon subsequent storage may be more quickly and accurately resolved.

A visualisation tool for augmenting assessment of ankylosing spondylitis.

Ankylosing Spondylitis (AS) is a chronic condition which requires clinical assessment to inform the management of AS, the intent being to alleviate the symptoms and to improve the health of the suffering person. An integral part of the current assessment is the measurements taken of a number of subjective and objective factors that affect the person's health status. There is growing awareness that the protocols and means of taking the measurements are both inaccurate and inconsistent. This paper addresses how such assessments may be augmented by utilizing 3-dimensional visualisation technology to collect and present data of this multifaceted condition. The final goal of the research is to provide a relevant tool for AS that can be used in both clinical and home settings. It is designed to directly support the therapeutic regime, to enhance assessment, to provide meaningful feedback to both AS sufferers and clinicians alike and to facilitate the collection of objective evidence relating to the condition.

Improving children's physical activity in out-of-school hours care settings.

ISSUES ADDRESSED: Improving children's opportunities for and participation in physical activity at out-of-school hours (OOSH) care. METHODS: A needs assessment, 12-month implementation and evaluation were conducted. Strategies included feedback and support to improve physical activity programs and policies; staff training; resource distribution; and grants to disadvantaged services. Strategies were developed in partnership with an advisory committee from the OOSH sector. Physical activity policies, the types of after-school activities offered and children's participation in these activities were evaluated before and after implementation. RESULTS: Statistically significant improvements were seen in the proportion of moderate or vigorous activities programmed each week. Children's participation showed a significant shift from lower to higher-intensity activities. Improvements were also seen in the number of services with planned physical activity programs and physical activity policies. CONCLUSION: The OOSH sector is an effective setting for promoting children's physical activity.