Use of Advanced Hybrid Closed-Loop System during Pregnancy: Strengths and Limitations of Achieving a Tight Glycemic Control.

Background: Pregnant women with type 1 diabetes mellitus (T1DM) face an elevated risk of complications for both themselves and their newborns. Experts recommend strict glycemic control. The advanced hybrid closed-loop (AHCL) system, though not officially approved for pregnant T1DM patients, is promising for optimal glycemic control. Methods: We collected CGM metrics, HbA1c levels, insulin pump settings, and doses from a 33-year-old pregnant woman with 23-year history of T1DM from the 6th week of gestation to birth. She was initially on continuous insulin pump therapy with CGM and switched to the AHCL system (MiniMedTM 780G, Medtronic, Northridge, CA, USA) between weeks 13 and 14. Results: The AHCL system improved glycemic control from weeks 14 to 26, achieving international guidelines with TIR = 72%, TAR = 24%, TBR = 4%. At week 30, TIR was 66%, TAR 31%. By altering diet and adding 'fake carbohydrates', she maintained TIR ≥ 70%, TBR ≤ 4%, TAR ≤ 26% from week 34 to birth. A healthy 4 kg, 53 cm baby boy was born at week 38. Conclusions: The use of the AHCL system holds significant promise for improving glycemic control in pregnancy. Optimal glycemic control with MiniMedTM 780G in pregnancy requires accurate carbohydrate counting, specific timing of insulin doses in relation to meal consumption and dietary choices that reduce the glycemic load of meals continue to be crucial factors in achieving optimal glycemic control during pregnancy using the MiniMedTM 780G system. Further research and clinical studies are needed to explore the full potential of these advanced systems in managing T1DM during pregnancy and optimizing maternal and neonatal outcomes.

Optimizing the Distillation of Greek Oregano-Do Process Parameters Affect Bioactive Aroma Constituents and In Vitro Antioxidant Activity?

The aim of the present work was to optimize the conditions of the distillation process at a pilot scale to maximize the yield of specific bioactive compounds of the essential oil of oregano cultivated in Greece, and subsequently to study the in vitro antioxidant activity of these oils. Steam distillation was conducted at an industrial distillery and a Face-Centered Composite (FCC) experimental design was applied by utilizing three distillation factors: time, steam pressure and temperature. Essential oil composition was determined by static headspace gas chromatography-mass spectrometry (HS-GC/MS). To obtain a comprehensive profile of the essential oils, instrumental parameters were optimized, including sample preparation, incubation conditions, sampling process, injection parameters, column thermal gradient and MS conditions. With the applied GC-MS method, more than 20 volatile compounds were identified in the headspace of the oregano essential oils and their relative percentages were recorded. Carvacrol was the most prominent constituent under all distillation conditions applied. Data processing revealed time as the main factor which most affected the yield. The Desired Space (DSc) was determined by conducting a three-dimensional response surface analysis of the independent and dependent variables, choosing yields of thymol and carvacrol as optimization criteria. The in vitro antioxidant activity of the essential oils of all samples was measured in terms of the interaction with the stable free radical 2,2-diphenyl-1-picrylhydrazyl (DPPH) after 20 and 60 min. The most prominent essential oils at different distillation conditions were also tested as inhibitors of lipid peroxidation. Higher % values of carvacrol and thymol were correlated to higher antioxidant activity. Evaluating the impact of the distillation conditions on the in vitro results, it seems that lower pressure, less time and higher temperature are crucial for enhanced antioxidant activities.

µ-Raman Determination of Essential Oils' Constituents from Distillates and Leaf Glands of Origanum Plants.

A novel, inexpensive and simple experimental setup for collecting µ-Raman spectra of volatile liquids in very small quantities was developed. It takes advantage of capillary forces to detain minute volatile liquid volumes. Spectra of volatile and even scattering or absorbing media can be measured more effectively. The method is used to facilitate the collection of intensity-consistent Raman spectra from a series of reference compounds present in Origanum essential oils, in order to quantify their constituents by multiple linear regression. Wild grown Origanum plants, collected from five different regions in Greece and taxonomically identified as O. onites, O. vulgare subsp. hirtum and O. vulgare subsp. vulgare, were appropriately distilled to acquire their essential oils. Comparison of the Raman results with those from headspace gas chromatography-mass spectrometry (HS GC-MS) confirmed the successful relative quantification of the most abundant essential oil constituents, highlighting the similarities and differences of the three Origanum taxa examined. Finally, it is demonstrated that directly measuring the leaf peltate glandular hairs yields exploitable results to identify the main components of the essential oil they contain, underlining the potential of in situ (field or industry) measurements utilizing microscope-equipped portable Raman spectrometers.

Unravelling the Chemotaxonomic Identity of "White" and "Black" Oregano (Origanum vulgare) in Northern Greece.

The two types of oregano used by the inhabitants of the villages of Μount Belles (GR1260001), the "white" oregano with white flowers and "black" oregano with purple flowers, were studied. The two oregano types were collected from five localities along an altitudinal gradient from 217 m up to 1299 m. "White" oregano, was found in the three lowland regions (up to 752 m) where the Pannonian-Balkanic turkey oak-sessile oak forest habitat (code 91M0) dominates. The "black" oregano was collected from the two higher altitudes, at 1177 m and 1299 m, where the Asperulo-Fagetum beech forest habitat (9130) occurs. Measurements of the density and size of peltate glandular hairs (sessile glands) on calyces, bracts, and leaves suggest that "white" oregano is distinguished by its conspicuous - apparently larger - glands. These differences were reflected in the total essential oil content, with the "white" oregano being much richer (up to 4.3 mL/100 g dry weight) than the "black" (up to 0.6%). Striking differences have also been found in the volatile fraction of their essential oil composition. The "white" oregano oils were characterized by the high content of carvacrol (up to 92.6% of identified peaks, by Headspace GC-MS). On the other hand, the two "black" oregano oils have a different aromatic profile, first reported from Greece, with main components including the sesquiterpenes ß-caryophyllene, D-germacrene, δ-cadinene and ß-bisabolene. The results so far indicate that "white" and "black" oregano, Origanum vulgare subsp. hirtum and subsp. vulgare respectively, can be clearly distinguished either by their morphological (glandular) differences or by chemical (essential oil) composition.

Headspace gas chromatography-mass spectrometry in the analysis of lavender's essential oil: Optimization by response surface methodology.

A static headspace gas chromatography - mass spectrometry (HS-GC/MS) method was developed and optimized with the aim to be applied in the analysis of lavender essential oil. To obtain a comprehensive profile of the essential oil, the optimum HS-GC/MS method parameters were selected based on a Design of Experiments (DοE) process. Plackett-Burman experimental design was applied by utilizing seven parameters of the HS injection system. Incubation equilibration temperature and time, agitator's vortex speed, post injection dwell time, inlet temperature, split ratio and injection flow rate were screened to select the optimum conditions on the basis of the number and the intensity of the identified compounds. Other parameters, such as sample volume and dilution solvent ratio, were also examined to achieve a comprehensive profile in a chromatographic run of 55 min. With the obtained optimum method, more than 40 volatile compounds were identified in lavender's essential oils from different geographical regions in Greece. The method can be utilized for the quality assessment of lavender's essential oil and provide information on its characteristic aroma and discrimination among species based on the acquired GC-MS profiles.

Quality Risk Management and Quality by Design for the Development of Diclofenac Sodium Intra-articular Gelatin Microspheres.

The aim of the present study was to evaluate the development of an intra-articular nonsteroidal anti-inflammatory drug gelatin microsphere formulation based on quality risk management and quality by design approaches. Specifically, after setting the quality target product profile and the critical quality attributes, risk assessment was performed by constructing Ishikawa fishbone diagrams based on preliminary hazard analysis. A Plackett-Burman screening experimental design was applied in order to identify the factors (previously classified by risk assessment analysis as having high risk of failure) having a statistically significant impact on the formation of gelatin microspheres. Particle size, polydispersity index, and drug loading were used as responses, while diclofenac sodium was selected as a model drug. All drug-loaded gelatin microspheres were prepared by emulsion-crosslinking process. Screening results showed that gelatin type, surfactant type and quantity, oil phase type, emulsification speed, and glutaraldehyde's concentration had a statistically significant impact on microsphere's final and intermediate critical quality attributes. A design space was then constructed based on central composite design overlaying contour plots, while verification experiments for the optimum suggested formulation (derived from a set control strategy) showed good agreement between the predicted and the experimentally observed results. In addition, the physicochemical characterization of the optimum formulation showed the formation of significant molecular interactions between the drug and the gelatin matrix, leading to the complete amorphization of diclofenac within the microsphere structure, while dissolution release experiments showed a biphasic release profile which extended the drug's release for up to 30 days, governed by a Fickian diffusion release mechanism.