Among individuals who carry the apolipoprotein E ε4 (APOE*ε4) allele, women are more susceptible to Alzheimer disease (AD) than men only between the ages of 65 and 75 years, according to a new study published in JAMA Neurology.

Dolichoectasia, a condition of unknown cause characterized by elongation, twisting and dilation of the basilar artery in old age, is common among young patients admitted for acute stroke, a new study shows. This finding highlights the need to consider vascular abnormalities as a risk factor for stroke in young adults.

Monoclinic paracetamol is notorious as a poorly compactible model drug that exhibits reduced plastic deformation, resulting in fragile tablets with high capping tendency during tabletting. Polyvinylpyrrolidone is a polymer that can act as effective additive to improve the stability and physicomechanical properties of paracetamol, since it could adsorb onto the surfaces of paracetamol crystals via hydrogen bonding. It is surprising however that the role of blending process on paracetamol–polyvinylpyrrolidone (PA–PVP) interactions and the tableting performance of PA–PVP mixture is ignored in many studies. Therefore, the purpose of this study was to investigate the influence of blending conditions of the physicochemical and mechanical properties of PA–PVP mixtures (95:5, w:w). PA–PVP mixtures were prepared using low shear (using V–shaped mixer for 30 min), medium shear (hand blending for 10 min), and dry high shear (Tefal high speed blender, Berkshire, UK, for 1 min) blending conditions. The high shear blender consists of two faced flat knife-like blades (6.5 cm × 1.5 cm) rotating at ~500 rpm in a bowel of 186 cm2). The results showed that all PA–PVP mixtures demonstrated improved tabletting compared to commercial paracetamol, regardless of the blending method. PA–PVP mixtures processed using high shear blending conditions demonstrated the best compactibility at a range of compaction pressures. For example, the mixtures processed using lower shear, medium shear and high shear blending conditions produced tablets with tensile strengths of 0.37 MPa, 0.38 MPa, and 1.36 MPa respectively. Fourier transform infrared spectroscopy analysis showed that, with the increase in blending shear, there was a reduction in absorption intensities (i.e. increased band broadening) between 3150 cm-1 and 3250 cm-1 compared to the sharp peak observed with the commercial drug. This could be due to the higher level of hydrogen bond interaction obtained in the PA–PVP mixture processed by high shear blending in comparison to the mixtures processed by low and medium shear blending. Powder X-Ray diffraction analyses showed PA–PVP mixture processed by high shear blending to have a slightly reduced degree of crystallinity compared to the mixtures processed by low and medium shear blending. PA–PVP mixture processed using dry high shear blending showed higher bulk porosity than the mixtures processed using low shear and medium shear blending, as indicated by its lower bulk density (0.31 ± 0.01 g/cm3 versus (0.66 to 0.69) g/cm3). Particle blending is a critical process during the preparation of interactive mixtures for tableting. Blending alters the physicochemical and mechanical properties of PA–PVP mixture. Future studies will concentrate on engineering paracetamol-polyvinylpyrrolidone mixtures with optimised physicochemical and mechanical properties.

The variability of axon and dendrite orientations — termed neurite orientation dispersion — is reduced in the spinal cords of patients with multiple sclerosis (MS), according to new research. This finding could provide a new biomarker for MS prognosis and therapeutic efficacy.

We apologise for not having noticed earlier Adrion and colleagues’ comments on our study comparing the effectiveness of intratympanic Methylprednisolone to Gentamicin in refractory Ménière’s disease [1], covered by the BMJ [2]. Contrary to our expectations, both drugs were equally effective in controlling vertigo (primary outcome).

The negative effects of stress at work in terms of emotional disorders and organisational difficulties have urged the need for new solutions and especially direct-to-user tools such as mobile applications. While new technology can support the architecture of such tools adaptive coping behaviours have also been identified as an important factor for promoting new strategies to cope effectively with stress at work. A study being reported in this paper investigates how technology has been used to influence adaptive coping behaviours and synthesises the key aspects into a conceptual model for creating a new mobile application. A literature review concerning coping behaviours and technology was conducted to gather evidence for the foundation of the conceptual model. The empirical findings of the research will be tested and verified against the theoretical framework consisting of the “Nudging theory” and the “Acceptance and Commitment Theory – ACT”. Particularly, ACT is an empirically-based psychological intervention that uses acceptance and mindfulness strategies mixed in different ways with commitment and behaviour-change strategies, to increase psychological flexibility. In our study, ACT resulted predominant to design the App’s solutions to cope with stress. Other aspects used to design the mobile application were: the customisation to the user, the use of relevant and tailored information and feedback, the use of positive reinforcement, and indirect suggestions. The conceptual model provides further knowledge of key aspects to be considered when developing persuasive tools that aim to encourage more efficient ways of coping with stressful events