Biorefinery: a design tool for molecular gelators

Molecular gels, the macroscopic products of a nanoscale bottom-up strategy, have emerged as a promising functional soft material. The prospects of tailoring the architecture of gelator molecules have led to the formation of unique, highly tunable gels for a wide spectrum of applications from medicine to electronics. Biorefinery is a concept that integrates the processes of converting biomass/renewable feedstock and the associated infrastructure used to produce chemicals and materials, which is analogous to petroleum-based refinery. The current review assimilates the successful efforts to demonstrate the prospects of the biorefinery concept for developing new amphiphiles as molecular gelators. Amphiphiles based on naturally available raw materials such as amygdalin, vitamin C, cardanol, arjunolic acid, and trehalose that possess specific functionality were synthesized using biocatalysis and/or chemical synthesis. The hydrogels and organogels obtained from such amphiphiles were conceptually demonstrated for diverse applications including drug-delivery systems and the templated synthesis of hybrid materials.

A computer-assisted recording, diagnosis and management of the medically ill system for use in the intensive care unit: a preliminary report

BACKGROUND

Computerized medical information systems have been popularized over the last two decades to improve quality and safety, and for decreasing medical errors.

AIM

To develop a clinician-friendly computer-based support system in the intensive care unit (ICU) that incorporates recording, reminders, alerts, checklists and diagnostic differentials for common conditions encountered in critical care.

MATERIALS AND METHODS

This project was carried out at the Medical ICU CMC Hospital, Vellore, in collaboration with the Computer Science Department, VIT University. The first phase was to design and develop monitoring and medication sheets. Terminologies such as checklists (intervention list that pops up at defined times for all patients), reminders (intervention unique to each patient) and alerts (time-based, value-based, trend-based) were defined. The diagnostic and intervention bundles were characterized in the second phase. The accuracy and reliability of the software to generate alerts, reminders and diagnoses was tested in the third phase. The fourth phase will be to integrate this with the hospital information system and the bedside monitors.

RESULTS

Alpha testing was performed using six scenarios written by intensivists. The software generated real-time alerts and reminders and provided diagnostic differentials relevant to critical care. Predefined interventions for each diagnostic possibility appeared as pop-ups. Problems identified during alpha testing were rectified prior to beta testing.

CONCLUSIONS

The use of a computer-assisted monitoring, recording and diagnostic system appears promising. It is envisaged that further software refinements following beta testing would facilitate the improvement of quality and safety in the critical care environment.

1-Iodo-2 methylundecane [1I2MU]: an estrogen-dependent urinary sex pheromone of female mice

In our previous investigations, urine of female mice contained specific compounds, namely isocroctylhydrazine, 4-methyl-2-heptanone, and azulene during proestrus, whereas during estrus it contained 1-H-cyclopop.e.azulene, caryophyllene, and copanene. Furthermore, 1-iodo-2 methyl undecane (1I2MU), present during both proestrus and estrus, was regarded as a putative estrus-specific chemo-signal. The primary objective of the present study was to determine the estrogen-dependency of the above-mentioned compounds, including 1I2MU. Furthermore, the effect of these compounds on pre-mating behavior, e.g., sniffing, licking, and grooming, were recorded to determine their role as sex pheromones. Based on gas chromatography linked mass spectrometry (GC-MS) of urine samples, profiles in oophorectomized female mice had 14 major peaks. Furthermore, neither 1I2MU (nor other estrus-specific compounds) were detected in the urine of these mice, although they were detected in urine of proestrus and estrus mice. In addition, 1I2MU was not detected in urine of prepubertal mice. It was noteworthy that both 1I2MU and 4-methyl-2-heptanone reappeared in estrogen-treated females. Based on pre-mating behavioral analysis, 1I2MU was the compound most preferred by males. In conclusion, production of 1I2MU was estrogen-dependent in females, and it enhanced reproductive activities in males.

Respiratory movement of upper abdominal organs and its effect on radiotherapy planning in pancreatic cancer

AIMS

Radiotherapy for pancreatic cancer is complicated by the frequent overlapping of the planning target volume (PTV) and the organ at risk (OAR), limiting the dose that can be safely delivered to the tumour. Individualising the margins applied to the clinical target volume (CTV) may reduce OAR irradiation without increasing the risk of geographical miss. We quantified the movement of the pancreas with respiration and evaluated whether individualised margins based on this motion reduced the dose to OARs.

MATERIALS AND METHODS

Planning computed tomography scans were acquired in quiet breathing, held expiration and held inspiration. Organ motion was evaluated from displacement of a reproducible point within the pancreas in all directions. Two sets of plans (standard plan: P(stan); individualised plan incorporating movement data: P(ind)) were generated for each patient. The PTV and doses to OARs were evaluated for both sets of plans.

RESULTS

The mean (standard deviation) movement of the pancreas in the superior-inferior, lateral and anterior-posterior directions were 15.3 mm (4.3), 5.2 mm (3.5) and 9.7 mm (6.1), respectively. The use of individualised margins reduced the mean PTV volume by 33.5% (9.8) (P=0.0051). The proportional reductions in the percentage of kidney receiving >10 Gy, small bowel >45 Gy and liver >30 Gy were 63.7% (P=0.0051), 29.3% (P=0.0125) and 29.2% (P=0.0107), respectively. For the same level of OAR constraints, individualised margins allowed dose escalation in six of the 10 patients to a mean dose of 63.2 Gy.

CONCLUSIONS

The present study shows a simple way of incorporating organ motion into the planning process and can be adopted by any centre without major strain on healthcare resources. The use of individualised margins reduced PTV volume and the dose to OARs. This may offer an opportunity for dose escalation to try and further improve local control.

Early hypocaloric enteral nutritional supplementation in acute organophosphate poisoning--a prospective randomized trial

INTRODUCTION

Early institution of enteral feeds may be associated with improved outcomes in the critically ill. This study evaluated the effect of hypocaloric enteral nutritional supplementation in acute organophosphate(OP)-poisoned patients requiring invasive mechanical ventilation.

SETTINGS AND DESIGN

Prospective randomized controlled trial conducted in the medical intensive care unit (ICU) of a tertiary care university teaching hospital.

PATIENTS AND METHODS

During a 13-month period, 87 OP-poisoned patients were admitted. Twenty-seven patients who were not ventilated were excluded. Thirty patients were randomized to the control arm and 29 to the intervention arm. The intervention arm received hypocaloric nasogastric feeds within 48 h of intubation whilst the control arm received intravenous fluids. Primary outcome was infectious complications. Secondary outcomes included hospital mortality, duration of ventilation, ICU stay, and hospital stay.

RESULTS

An infectious complication occurred in 14 patients (48%) in the intervention group and 15 patients (50%) in the control group (p = 0.898). Three patients in each group died (p = 0.965). Duration of ventilation (p = 0.19) and ICU stay (p = 0.41) were similar. Duration of hospital stay was shorter in the control group (p = 0.05). Gastric stasis occurred in two patients (6.9%) receiving enteral feeds. Feeding related complications were less frequent than in other published trials.

CONCLUSIONS

In OP-poisoned patients, early hypocaloric enteral feeding was not associated with improvements in clinical endpoints, albeit longer hospital stay was observed in the enterally fed group. Feeding related complications were infrequent. Further studies would help define the status of early enteral feeding in this subset of patients.