mL Of Volume Research Articles

P-1867. Under-Recognized Medication Loss with the Administration of Small-Volume Intermittent Infusions

Abstract Background Most antimicrobials administered via intermittent intravenous (IV) infusion are diluted in 50 to 100 mL of diluent. The primary infusion set for a smart pump can hold 25 mL of volume in its tubing, which can contribute up to a 50% drug loss if residual volume is present after administration is complete. For antimicrobials, this may lead to significant underdosing, contributing to poor treatment outcomes and antimicrobial resistance. Many organizations lack departmental policies and procedures (P&P) to ensure complete administration of small-volume intermittent infusions (SVIIs). Previous studies propose several recommendations, such as adding carrier fluids and flushing the line, but there is no easy fix to this common issue. Methods Our aim was to implement new guidance in 2 pilot patient units (an ICU and non-ICU) to address the administration of SVIIs and evaluate its effect on medication administration. This was an observational quality improvement initiative assessing the new guidance established for the administration of SVIIs to the current practices at North Shore University Hospital. The new guidance consisted of nursing education to reinforce proper administration techniques and to adjust infusion volumes for overfill. This study was IRB exempt. The primary outcome of this study was the incidence of residual drug volume in IV line before the air-detector, IV bag, or IV vial. This was done through direct observation and data was collected through a survey. Chi-square tests were used to analyze the primary outcomes. Results In total, 203 IV administrations were observed, 86% were antimicrobials. There were 124 IV administrations observed before policy guidance initiation, and 79 after initiation. There was a significant reduction in the incidence of fluid remaining in the IV line before the air-detector (85% vs 27%; p-value < 0.001), the IV bag (59% vs. 7.6%; p-value < 0.001), and in the IV vial (47% vs. 24%; p-value < 0.001). Conclusion The interventions significantly decreased the incidence of fluid remaining in the IV line, presumably decreasing medication loss. Since most medications were antimicrobials, this may improve clinical outcomes. This will be used to update P&P to standardize IV administration practices and improve patient care. Disclosures All Authors: No reported disclosures

Novel RP-HPLC Method Development and Validation of Budesonide Suppository

In the current study, a simple and cost-effective stability-indicating RP-HPLC method was developed and validated to estimate Budesonide from bulk and pharmaceutical dosage forms.0.1% formic acid and methanol (15:85 v/v) were employed as the mobile phase with an injection volume of 20μl, and detection was carried out at 244 nm. The developed method was validated as per ICH Q2 guidelines. The RT of Budesonide was determined to be 4.3 ± 0.328 minutes, providing a reliable marker for its identification. The method was found to be linear between 2-12 μg/ml concentration with (R²) of 0.997. This demonstrates the method's ability to measure varying concentrations of Budesonide accurately. Additionally, the percentage recovery of Budesonide was approximately 100%, confirming the accuracy of the developed method. The parameters for the system's suitability have also been found to be within acceptable limits. Force degradation studies reinforced the method's selectivity and sensitivity in detecting Budesonide under various degradation scenarios. In conclusion, our proposed RP-HPLC method provides a sensitive, accurate, and precise way to analyze Budesonide in bulk and pharmaceutical dosage forms.

Under-Recognized Medication Loss With the Administration of Small-Volume Intermittent Infusions.

Background: Most antibiotics administered via intermittent IV infusion are diluted in 50 to 100 ml of diluent. The primary infusion set for the BD Alaris® pumps can hold 25 ml of volume in its tubing, potentially contributing up to a 50% drug loss if residual volume is present after administration is complete. In the case of antibiotics, this may lead to significant underdosing, potentially contributing to reduced therapeutic response and emergence of antimicrobial resistance. Many organizations lack departmental policies and procedures for the administration of small-volume intermittent infusions. Developing a clear policy and procedure can increase drug delivery efficiency. Previous studies propose several recommendations, such as using a secondary infusion set, adding carrier fluids, and flushing the line to account for overfill. Objective: Our aim was to implement pilot new guidance in 2 patient units (an ICU and a non-ICU) to address the administration of small-volume intermittent infusions and determine if this results in more complete medication administration. Methods: This was an observational quality improvement initiative assessing the new guidance established for the administration of small-volume intermittent infusions to current practices. The primary outcome of this study was the incidence of residual drug volume in the IV line before the air-detector, IV bag, or IV vial. This was done through observation, and data collected through a survey. Results: In total, 203 IV administrations were observed, 86% of which were antibiotics. There were 124 IV administrations being observed before policy guidance initiation and 79 after initiation. The results showed a statistically significant reduction in the incidence of fluid remaining in the IV line before the air-detector (85% vs 27%; P < .001), the IV bag (59% vs 7.6%; P < .001), and in the IV vial (47% vs 24%; P < .001.). Conclusion: The proposed interventions significantly decreased the incidence of fluid remaining in the IV line before the air detector in the BD Alaris Pump, IV bag, and IV vial, presumably decreasing medication loss.

Kisspeptins Kiss1 and Kiss2 in fish modulate corticoliberin and gonadoliberin gene expression in brain structures of &lt;i&gt;Danio rerio&lt;/i&gt;

BACKGROUND: The kisspeptin system in the brain is crucial for regulating reproductive functions in humans and animals. In contrast to mammals, the brains of Danio rerio express two types of kisspeptins — Kiss1 and Kiss2. The role of these kisspeptins in hormonal regulation in fish remains an important area of investigation. AIM: To examine the effects of Kiss1 and Kiss2 on corticoliberin and gonadoliberin gene expression in the midbrain and diencephalon of Danio rerio. MATERIALS AND METHODS: Kisspeptins Kiss1 and Kiss2 are oligopeptides consisting of 13 and 9 amino acid residues, respectively. Danio rerio fish were administered intracerebroventricular injections of 1 ng and 4 ng of each peptide at 1 μL volumes. At 1 and 4 hours post-administration, the fish brains were extracted, and the midbrain and diencephalon were isolated as a single complex. Gene expression levels of corticoliberin and gonadoliberin were analyzed using real-time polymerase chain reaction (PCR). RESULTS: Intracerebroventricular administration of Kiss1 and Kiss2 significantly modulated corticoliberin and gonadoliberin gene expression in the midbrain and diencephalon of Danio rerio. In the group injected with 4 ng of Kiss1, corticoliberin gene expression increased 17- and 65-fold after 4 hours compared to the control groups. In the group administered 1 ng of Kiss2, corticoliberin gene expression increased by 23- and 92-fold compared to the control groups after 1 hour. In the group administered 4 ng of Kiss1, gonadoliberin gene expression decreased threefold compared to the control group euthanized at 1 hour. In the group administered 1 ng of Kiss2, gonadoliberin gene expression decreased fourfold compared to the control group after 1 hour. In the group administered 1 ng of Kiss2, gonadoliberin gene expression decreased threefold compared to the control group after 4 hours. CONCLUSION: The experimental results reveal that Kiss1 and Kiss2 kisspeptins in Danio rerio stimulate corticoliberin gene expression while suppressing gonadoliberin gene expression in the midbrain and diencephalon.

Temperature-Based Extraction, Characterization by Gas Chromatography-Mass Spectrometry and Fourier Transform Infrared Spectroscopy with Prospective Antibacterial Properties of Eri (Philosamia ricini) Pupal Oil.

Lepidopteran insects are novel source of omega-3 fatty acids as revealed by the studies recently. In the current study, we assessed the effects of four different drying temperatures (50, 60, 70, and80 ºC) of eri silkworm (Philosamia ricini) pupal oil (EPO)abbreviated asEPO50, 60, 70, and 80 followed by conducting the characterization and antibacterial efficacy studies. Gas chromatography-mass spectroscopy (GC-MS) and Fourier transform infrared (FTIR) were used for chemical profiling of EPOs. The agar-well diffusion method was performed to evaluate the antibacterial activities. The trend of this study clearly revealed that enhanced drying percentage of temperatures showed raising saturated fats and reduced unsaturated fats. However, the best suitable temperature was found at 60 ºC with high unsaturated fatty acids, including Omega-3. Further, at higher temperature, FTIR analysis revealed an increasing complexity of functional groups with potential bioactive compounds. EPOs were found to have significant antibacterial activity against S. typhi and S. aureus at all tested (10, 20, 30, and 40 µL) volumes used in the study.

Anticoagulant Effect of Snow mountain garlic: In Vitro Evaluation of Aqueous Extract.

Snow mountain garlic is traditionally eaten by Himalayan locals for its medicinal properties. Although different species of the genus Allium are known to have other biological effects, such as antiplatelet and antithrombotic activities, little is known about the anticoagulant effect of Snow mountain garlic, a member of the genus Allium. Therefore, the present study examined the in vitro anticoagulant effect of the aqueous extract, the lyophilized aqueous extract, and the isoflavone extract from the lyophilized aqueous extract of Snow mountain garlic in samples from 50 human blood donors. Compared to the control, concentrations of 25, 12.5, and 6.25 mg/100 µL lengthened the clotting times of prothrombin, and concentrations of 25 and 12.5 mg/100 µL lengthened the activated partial thromboplastin time (p ˂ 0.05). The isoflavone extract from the lyophilized aqueous extract containing isoflavones, organosulfur compounds, a polyphenol, and a steroid glycoside showed a significant effect (p ˂ 0.05) on the prothrombin time and the activated partial thromboplastin time at a dose of 20 µL (volume) compared to the control. The results regarding the use of Snow mountain garlic as a preventive measure and aid in treating thromboembolic disease are promising.

A-243 Quantitative Bacteriology Parameters for Seal-Packaged Agar Plates Challenged with Experimental Low-resource Tropical Field Clinic Stress

Abstract Background InTray® Mueller Hinton Chocolate (MHC) and Colorex™ Screen (CS) plates are in vitro diagnostic devices combining prepared bacteriological agar-media with Biomed’s ‘InTray®’ format (a double sealed-packaging cassette system that provides extended shelf-life 12 months past the date of manufacture). The devices are intended for use with clinical specimens to culture, isolate and identify potentially pathogenic bacteria. This study evaluated MHC and CS device performance at 7 and 13 months past the date of manufacture after product was experimentally challenged with stress replicating a low-resource tropical field clinic scenario. Methods MHC and CS plates were exposed to high temperature (40.5°C ± 0.5) and high humidity (74.5 ± 2.5% relative humidity) for an extended time-period (18 days). After the 18 days of heat treatment, the stress-group plates were stored in the lab at working room temperature (20-25°C) for the remainder of the study. Quantitative differences between control-groups (stored under refrigeration: 2-8°C) and heat-stress treatment groups for both MHC and CS were examined via CFU/mL measurements comparing three different lab-strain bacteria chosen based on clinical sub-culturing prevalence from blood bottles; Escherichia coli (ATCC 25922), Streptococcus pneumoniae (ATCC 6305), and Staphylococcus aureus (ATCC 25923). Briefly, 24-hour (18-30 h) old bacterial colony suspensions (grown on MHC) were prepared in 0.85% saline solution, adjusted to a 0.5 McFarland standard (here defined as 0.08-0.96 Absorbance @ 625 nm), measured in triplicate and diluted. A 20 μL volume from the lowest dilution (2.5 x 103 CFU/mL) was then spread-plated to each plate in order to count colony-forming units (CFU) in the acceptable range of 25-250. Results Quantitative CFU/mL differences between control-groups (stored under refrigeration: 2-8°C) and heat-stress-treatment groups (&amp;gt;40°C and high humidity) for MHC and CS for three different test bacteria (listed above) were not statistically significant when tested at 13 months. The CS stress and control group comparison for S. pneumoniae with a p value &amp;lt; 0.05 at 7 months had a p value &amp;gt; 0.05 at 13 months, suggesting that the difference between the CFU counts may not be significant in biological terms. Conclusions In conclusion, control and heat-stress treatment groups for both MHC and CS met acceptable performance criteria as expected for the products, 13 months after the date of manufacture.

Comparison of eye drop retention time using fluorophotometry in three commercially available lubricant eye drops.

This is the first study to evaluate the retention time of lubricating eye drops containing various concentrations of sodium hyaluronate using fluorophotometry in a symptomatic dry eye population. Information regarding eye drop retention may be useful for eye care practitioners to assist in the selection of more effective treatments for managing dry eye. This study aimed to use fluorophotometry to compare retention time on the ocular surface of three commercially available lubricating eye drops, each containing varying concentrations of sodium hyaluronic acid (HA), and their effects on tear film stability post-instillation in a population with symptoms of dry eye. Adults with symptoms of dry eye (Ocular Surface Disease Index score, >12) were enrolled in this prospective, double-masked comparison of eye drops containing 0.15% HA-hydroxypropyl guar (HPGuar), 0.2% HA, and 0.1% HA. Participants were randomized to the eye drop order and the study eye under evaluation. Each eye drop was admixed with a fluorescent tracer (70-kDa fluorescein isothiocyanate-dextran) at 10% wt/vol, and 10 μL volume was instilled for each evaluation. A fluorophotometer was used to measure the time for the tracer signal to return to baseline. Fluorescein tear breakup time was measured following fluorophotometry assessment. Retention time for 0.15% HA-HPGuar and 0.2% HA was significantly longer compared with 0.1% HA (p=0.02 and p=0.03). Fluorescein tear breakup time was significantly longer for the 0.15% HA-HPGuar eye drop compared with both the 0.1% HA eye drop (p=0.01) and 0.2% HA eye drop (p=0.003). Retention time on the ocular surface of the two eye drops containing higher concentrations of HA was longer than the eye drop with the lowest concentration of HA. The tear film was also more stable with the 0.15% HA-HPGuar eye drop compared with the eye drops containing HA alone, which may be attributable to the other components in the 0.15% HA-HPGuar eye drop.

An Introduction to Ventra: A Programmable Abdominal Phantom for Training, Educational, Research, and Development Purposes.

Intra-abdominal pressure (IAP) is a critical parameter in the care of critically ill patients, as elevated IAP can lead to reduced cardiac output and organ perfusion, potentially resulting in multiple organ dysfunction and failure. The current gold standard for measuring IAP is an indirect technique via the bladder. According to the Abdominal Compartment Society's Guidelines, new measurement methods/devices for IAP must be validated against the gold standard. This study introduces Ventra, an abdominal phantom designed to simulate different IAP levels, abdominal compliance, respiration-related IAP variations, and bladder dynamics. Ventra aims to facilitate the development and validation of new IAP measurement devices while reducing reliance on animal and cadaveric studies. Additionally, it offers potential applications in training and education for biomedical engineering students. This study provides a thorough explanation on the phantom's design and fabrication, which provides a low-cost solution for advancing IAP measurement research and education. The design concept, technical aspects, and a series of validation experiments determining whether Ventra is a suitable tool for future research are presented in this study. Ventra's performance was evaluated through a series of validation tests using a pressure gauge and two intra-gastric (Spiegelberg and CiMON) and two intra-bladder (Accuryn and TraumaGuard) pressure measurement devices. The mean and standard deviation of IAP recordings by each device were investigated. Bland-Altman analysis was used to evaluate bias, precision, limits of agreement, and percentage error for each system. Concordance analysis was performed to assess the ability of Ventra in tracking IAP changes. The phantom demonstrated excellent agreement with reference pressure measurements, showing an average bias of 0.11 ± 0.49 mmHg. A concordance coefficient of 100% was observed for the phantom as well. Ventra accurately simulated different abdominal compliances, with higher IAP values resulting in lower compliance. Abdominal volume changes showed a bias of 0.08 ± 0.07 L/min, and bladder fill volume measurements showed an average difference of 0.90 ± 4.33 mL for volumes ranging from 50 to 500 mL. The validation results were in agreement with the research guidelines of the world abdominal society. Ventra is a reliable tool that will facilitate the development and validation of new IAP measurement devices. It is an effective educational tool for biomedical engineering students as well.

Efficacy, safety of and adherence to adjustable compression wraps in the control phase of breast cancer-related lymphedema: A randomized controlled trial

Objective To evaluate efficacy, safety, and adherence to using adjustable compression wraps (ACWs) for upper limb volume control in women with breast cancer-related lymphedema. Design and Setting Randomized controlled trial at a reference hospital for breast cancer treatment in Brazil. Participants Women in control phase of the breast cancer-related lymphedema. Interventions Compared use of ACWs versus compressive mesh. Main Measures Evaluated before treatment, at 30 days, and 6 months after initiating therapy. The primary outcome was the change in excess limb volume. Secondary outcomes included adherence, incidence of adverse events, functionality, quality of life, and hand grip. Statistical analysis involved calculating the effect size (ES) with a 95% confidence interval. Results Were included 71 women with mean excess limb volume of 321.79 mL (±194.98). In the 30-day analysis (Time 1), a reduction of 37.6 mL in volume was observed only in the ACW group (p = .041, ES 0.20), with improved functionality (p = .013, ES 0.22). In the six months analysis (Time 2), the compressive mesh group increased by 2.48% in volume (p = .023, ES 0.26) and demonstrated improvement functionality (p = .036, ES 0.27). Mild adverse events and satisfactory adherence were observed. However, in the intergroup comparison, no statistically significant difference was observed for any evaluated outcome—excess volume, incidence of adverse events, adherence, hand grip, quality of life, and functionality between the groups (p > .05) at both times. Conclusions Both compression therapies achieved satisfactory adherence, were safe, effective and equivalent for controlling limb volume in breast cancer-related lymphedema.

Optical Fibers Functionalized with Single-Walled Carbon Nanotubes for Flexible Fluorescent Catecholamine Detection.

Despite the blockbuster popularity of drugs that act on catecholamine receptors, catecholamine dynamics in human health and disease remain an incomplete picture. Recent advances in fluorescent sensors have enabled unprecedented access to catecholamine dynamics in preclinical animal models, but the requirements of these technologies limit translational value for clinical diagnostics. Here, we present a flexible and convenient tool for fluorescent catecholamine detection by functionalizing optical fibers with single-walled carbon nanotube (SWNT)-based near-infrared catecholamine sensors (nIRCats), a form factor that has potential for more convenient and less invasive clinical translation. We show that these near-infrared functionalized (nIRF) fibers respond to dopamine in a biologically-relevant concentration range (10nM through 1 μM) with a mean ΔF/F0 of 0.022 through 0.411, with no statistically significant effect on signal magnitude after 16-hour exposure to human blood plasma. We further demonstrate the utility of these fibers in as little as 10 μL volumes of clinically relevant biofluids up to 24 weeks after preparation, with a ΔF/F0 of up to 0.059 through 1.127 for 10 nM through 1 μM dopamine. We also introduce a compact, mobile dual-near-infrared fiber photometry rig and demonstrate its success detecting dopamine with 0.005 ΔF/F0 in acute brain slices with nIRF fibers. Together, this fiber-based tool and photometry rig expand the toolbox of catecholamine detection technologies to a broader range of applications.

Study of the DNA Extraction from the Nail by Spin Column-based Nucleic Acid Purification

Abstract Background: Nails are one of the objects that are more durable than other witness objects. This study was interested in whether the Spin column-based nucleic acid purification technique could extract DNA from nails to give satisfactory results. Aims and Objectives: This study aimed to evaluate the yield and quality of DNA extracted from the nail. Materials and Methods: Nail samples from 15 males and 15 females over 18 were extracted using GeneAll® Exgene™ Cell SV Mini Kit. The DNA concentration and purity were measured using a NanoDrop Spectrophotometer, and the quality of DNA was assessed by polymerase chain reaction (PCR) using primers specific for human growth hormone (HGH). Results: The average yield of DNA was 0.816 μg (0.141–2.706 μg) obtained from the average nail weight of 30.2 mg (22.2–40.0 mg). The average DNA concentration was 27.2 ng/μL (4.7–90.2 ng/μL), corresponding to 30 μL in volume. Almost all DNA samples (96.7%) had high purity (A260/A280 ≥1.80) and gave a band of PCR product of the HGH gene on agarose gel electrophoresis. Conclusion: Spin column-based nucleic acid purification is recommended for nail DNA extraction due to its simplicity and high quality.

Evaluation of changes in lacrimal canaliculi width depending on temperature and viscosity of eye drops using spectral-domain optical coherence tomography in dogs.

To evaluate the changes in the width of the lower lacrimal canaliculi (LC) upon instillation of artificial tears (AT) at different temperatures and viscosities using spectral-domain optical coherence tomography (SD-OCT). Eight eyes of four client-owned adult dogs. Imaging of lower LC was performed under general anesthesia. AT at temperatures of 2°C, 20°C, and 38°C, and a high-viscosity tear gel of 20°C, were topically instilled in 100 μL volumes. SD-OCT tracked LC width changes following each instillation. The average baseline width of the LC was 96.38 ± 30.18 μm. The 2°C AT expanded LC width to 183.50 ± 44.11 μm, returning to baseline in 5.00 ± 1.31 min. The 20°C AT resulted in a width of 155.25 ± 35.79 μm, with a 3.88 ± 1.25 min return. The 38°C AT expanded LC width to 131.75 ± 29.49 μm, with a 2.25 ± 0.89 min return. The high-viscosity tear gel expanded LC width to 208.57 ± 56.31 μm, with remained expanded for 10 or more minutes. In temperature comparisons, the 2°C and 20°C AT significantly expanded the LC width more and had longer return times than the 38°C AT (p < .05). Viscosity comparisons showed higher viscosity eye drops significantly expanded LC width more than lower viscosity eye drops (p < .05). This study found that lower temperature and higher viscosity of eye drops had tendency to result in a wider expansion of the LC width. Additionally, the return time to baseline for LC width tended to be longer with eye drops of lower temperature and higher viscosity. This finding could be helpful in advancing future research on tear dynamics.

Haemorrhagic Complications After Microsurgical Treatment for Intracranial Aneurysms Under Acetylsalicylic Acid: An Impact Analysis.

Patients with intracranial aneurysms often have comorbidities that require them to take acetylsalicylic acid (ASA). In recent years, many patients with aneurysms have been prescribed ASA to prevent aneurysm enlargement. ASA is also prescribed to patients with intracranial aneurysms in preparation for surgical revascularization. From 2016 to 2021, 64 patients underwent microsurgical aneurysm clipping without revascularization, and an additional 20 patientsunderwent extracranial to intracranial (EC-IC) bypass. The following parameters were analysed: the frequency of hemorrhagic complications, the blood loss volume, the duration of surgery and inpatient treatment, the change inhemoglobin level (Hb), hematocrit (Ht), erythrocytes, and clinical outcomes according to the modified Rankin scale (mRS). At the time of surgery, laboratory-confirmed effect of the ASA was registered in 22 patients (main group). In 42 patients, the ASA was not functional on assay (control group). Hemorrhagic complications were noted in two patients in the ASA group. In both cases, the hemorrhagic component did not exceed 15 ml in volume and did not require additional surgical interventions. Statistical analysis showed no significant differences in hemorrhagic postoperative complications. Taking low doses of acetylsalicylic acid during planned microsurgical clipping of cerebral aneurysms does not affect intraoperative blood loss volume, risk of postoperative hemorrhagic complications, length of stay in the hospital, or functional outcomes.

Inhibition of Skin Cancer using Human Epidermal Keratinocytes (HaCaT) Cells from Siam Weeds (Chromolaena odorata L.)

Cancer can usually develop due to exposure to sunlight. UV radiation from sunlight is known to damage DNA and is bad for the skin. Skin P stem cell carcinogenesis is caused by UV-A rays that penetrate deep into the dermis layer. UV-B damages cell DNA by being absorbed by proteins in the epidermis. Chromolaena odorata was extracted using methanol solvent, then partitioned into 5 solutions in the form of n-Hexane, Ethyl Acetate, Acetonitrate, n-Buthanol, and Ethanol. The five extracts obtained were tested with Human Epidermal Keratinocyte cells using the bioassay method. Results obtained from the microplate reader after incubation. Each extract was divided into three concentrations, it is 100, 50, 20(µg/mL). Then in the positive control (Etoposide), it was divided into four concentrations, 100, 50, 20, 10(µg/mL). After being analyzed with the results of the microplate reader, the IC50 of Chromolaena odorata was 48% in the ethyl acetate extract with a concentration of 100µg/mL. HaCaT cell proliferation was determined at indicated intervals using the MTT colorimetric assay. This assay was based on the ability of live cell succinate dehydrogenase to reduce the yellow salt MTT (3-(4,5-dimethylthiazol-2-yl-2,5-diphenyltetrazolium bromide)) (Sigma-Aldrich, St. Louis, MO, USA) to insoluble purple-blue formazan precipitate. Experiments were carried out on 96-well plates containing a final volume of 100µl of medium/well.

Process Intensification of the Continuous Synthesis of Bio-Derived Monomers for Sustainable Coatings Using a Taylor Vortex Flow Reactor.

We describe the optimization and scale-up of two consecutive reaction steps in the synthesis of bio-derived alkoxybutenolide monomers that have been reported as potential replacements for acrylate-based coatings (Sci. Adv.2020, 6, eabe0026). These monomers are synthesized by (i) oxidation of furfural with photogenerated singlet oxygen followed by (ii) thermal condensation of the desired 5-hydroxyfuranone intermediate product with an alcohol, a step which until now has involved a lengthy batch reaction. The two steps have been successfully telescoped into a single kilogram-scale process without any need to isolate the 5-hydroxyfuranone between the steps. Our process development involved FTIR reaction monitoring, FTIR data analysis via 2D visualization, and two different photoreactors: (i) a semicontinuous photoreactor based on a modified rotary evaporator, where FTIR and 2D correlation spectroscopy (2D-COS) revealed the loss of the methyl formate coproduct, and (ii) our fully continuous Taylor Vortex photoreactor, which enhanced the mass transfer and permitted the use of near-stoichiometric equivalents of O2. The use of in-line FTIR monitoring and modeling greatly accelerated process optimization in the Vortex reactor. This led to scale-up of the photo-oxidation in 85% yield with a projected productivity of 1.3 kg day-1 and a space-time yield of 0.06 mol day-1 mL-1. Higher productivities could be achieved while sacrificing yield (e.g., 4 kg day-1 at 40% yield). The use of superheated methanol at 200 °C in a pressurized thermal flow reactor accelerated the second step, the thermal condensation of 5-hydroxyfuranone, from a 20 h batch reflux reaction (0.5 L, 85 g) to a space time of <1 min in a reactor only 3 mL in volume operating with projected productivities of >700 g day-1. Proof of concept for telescoping the two steps was established with an overall two-step yield of 67%, producing a process with a projected productivity of 1.1 kg day-1 for the methoxybutenolide monomer without any purification of the 5-hydroxyfuranone intermediate.

Purification of angiotensin converting enzyme inhibitory peptides and antihypertensive effect generated from Indonesian traditional fermented beef (Cangkuk).

Traditional fermented meat products can be considered a source of bioactive peptides. Cangkuk, a traditional Indonesian fermented beef product is one source of angiotensin converting enzyme (ACE) inhibitory peptides. This study aimed to identify ACE-inhibitory peptides from Cangkuk and analyze their antihypertensive effects. The water-soluble fraction of Cangkuk was fractionated to obtain ACE-inhibitory peptides using an ethanol solvent at several concentrations and solid-phase extraction with an OASIS HLB cartridge followed by purification with reversed-phase high-performance liquid chromatography (RP-HPLC). HPLC-MS was used to identify target peptides, followed by automatic protein sequencer analysis to detect peptide sequences. Antihypertensive effects were analyzed on the water-soluble fraction and synthesized peptides. The animal model comprised 14-16-week-old male spontaneously hypertensive rats (SHRs) (~320 g average body weight) with mean systolic blood pressures (SBPs) higher than 190 mmHg. All oral doses of peptides were 1 mL in volume. Distilled water was used as a control. The antihypertensive activities of the sample and control were observed by measuring the SBP at 0, 2, 4, 6, 8 and 24 h after oral administration. Two sequences of ACE inhibitory peptides were found, EAPLNPKANR (IC50 value of 44.6 μmol/L) and IVG (IC50 value of 97.3 μmol/L). The water-soluble fraction demonstrated an antihypertensive effect on SHRs after oral administration at 100 mg/kg body weight, maximally lowering the SBP by 14.9 mmHg 8 h after administration. The tripeptide IVG showed the highest reduction of SBP, 24.76±2.1 mmHg 8 h after administration. The decapeptide EAPLNPKANR showed the highest reduction of SBP, 21.0±1.9 mmHg, 8 h after administration. All the samples differed significantly from the control (p<0.01). Cangkuk has potential as a functional food ingredient acting as an antihypertensive agent.

Ultrasound-Guided Hydrodistention with Corticosteroid Instillation in Glenohumeral Joint for Relief in Frozen Shoulder: A Case Series

Abstract The frozen shoulder (FS) also known as adhesive capsulitis is one of the most common causes of shoulder pain and disability. It is marked by pain and limitation of movement resulting in progressive deterioration of quality of life. Although a few patients with an FS recover without any intervention, the majority of patients have persistent pain with or without movement restriction. Ultrasound (USG)-guided hydrodistension of the shoulder joint is an upcoming mode of treatment for FS which can theoretically lead to pain relief, functional improvement, and a better quality of life, especially if combined with the anti-inflammatory effects of intra-articular corticosteroids. Here, we are presenting our experience with USG-guided hydrodistention of the shoulder joint along with intra-articular corticosteroid in cases of FS both in terms of objective indices of shoulder functionality and subjective outcomes of pain. Eight patients who presented to the outpatient department of pain medicine in our hospital having FS (stage 2/3) were selected. Outcome measures included pain score, Shoulder Pain and Disability Index (SPADI) and Shortened Disabilities of the Arm, Shoulder, and Hand (QuickDASH), Visual Analogue Scale, and range of movement. Data were collected at baseline, as well as at 6 weeks, 12 weeks, and 6 months. We performed hydrodistension with 30 ml of volume constituted by adding lignocaine and triamcinolone acetate to normal saline immediately, followed by physiotherapy of the shoulder joint and cryotherapy. We found promising results with all our patients both in the short term as well as long term with both SPADI and QuickDASH scores as well as the range of motion of the shoulder joint improving significantly in all eight patients at 6 weeks and 12 weeks. This improvement notably persisted in all the patients when reassessed at 6 months indicating a long-term benefit of the intervention.

Subcranial Encephalic Temnograph-Shaped Helmet for Brain Stroke Monitoring.

In this contribution, a wearable microwave imaging system for real-time monitoring of brain stroke in the post-acute stage is described and validated. The system exploits multistatic/multifrequency (only 50 frequency samples) data collected via a low-cost and low-complexity architecture. Data are collected by an array of only 16 antennas moved by pneumatic system. Phantoms, built from ABS material and filled with appropriate Triton X-100-based mixtures to mimic the different head human tissues, are employed for the experiments. The microwave system exploits the differential scattering measures and the Incoherent MUSIC algorithm to provide a 3D image of the region under investigation. The shown results, although preliminary, confirm the potential of the proposed microwave system in providing reliable results, including for targets whose evolution is as small as 16 mL in volume.

In vitro Growth of Trichophyton Rubrum in the Presence of 80% Ethanolic Extract of Grapefruit Pepins as Antifungal Agent

Introduction: Many modern antifungal drugs have limits in terms of germ resistance, and to remedy this, plant compounds are being explored to find new more effective principles. Aim: With the aim of complementing the efforts of modern medicine against viral, bacterial, parasitic and fungal diseases, the plant extract of 80% hydroalcoholic grapefruit seed extract of Citrus paradisi was tested on the in vitro growth of Trichophyton rubrum. Methods: Antifungal tests were carried out on Sabouraud medium, to which the plant extracts were incorporated using the double dilution method in inclined tubes. A 10 µL volume of the Trichophyton rubrum suspension was inoculated on the culture medium contained in the test tubes. Results: Results showed that Trichophyton rubrum was sensitive to the 80% hydroethanolic extract of Citrus paradisi in a dose-dependent manner. Conclusion: The hydroethanolic extract may be a source for the development of Traditional Improved Medicines (TIM) against skin mycosis.