Management of transgender patients in critical care

As clinicians working in critical care, it is our duty to provide all of our patients with the high-quality care they deserve, regardless of their gender identity. The transgender community continues to suffer discrimination from the media, politicians and general public. As healthcare workers we often pride ourselves on our ability to safely care for all patients. However, there remains a distinct lack of understanding surrounding the care of critically ill transgender patients. This is likely in part because the specific care of transgender patients is not included in the Faculty of Intensive Care Medicine’s, Royal College of Anaesthetists’, Royal College of Physician’s, or Royal College of Emergency Medicine’s curriculum. There are several important considerations relevant for transgender patients in critical care including anatomical changes to the airway, alterations to respiratory and cardiovascular physiology and management of hormone therapy. Alongside this, there are simple but important social factors that exist, such as the use of patient pronouns and ensuring admittance to correctly gendered wards. In this review we will address the key points relevant to the care of transgender patients in critical care and provide suggestions on how education on the subject may be improved

Functional block copolymer nanoparticles: toward the next generation of delivery vehicles

The self-assembly of functional block copolymers (BCPs) into dispersed nanoparticles is a powerful technique for the preparation of novel delivery vehicles with precise control of morphology and architecture. Well-defined BCPs containing an alkyne-functional, biodegradable polylactide (PLA) block were synthesized and conjugated with azide-functional coumarin dyes via copper catalyzed azide alkyne cycloaddition ‘click’ chemistry. Self-assembled nanoparticles with internal nanophase-separated morphologies could then be accessed by carefully controlling the composition of the BCPs and release of the covalently attached model payload was shown to occur under physiological conditions via the degradation of the PLA scaffold. These results demonstrate the potential of self-assembled nanoparticles as modular delivery vehicles with multiple functionalities, nanostructures, and compartmentalized internal morphology

Supramolecular guests in solvent driven block copolymer assembly: from internally structured nanoparticles to micelles

Supramolecular interactions between different hydrogen-bonding guests and poly(2-vinylpyridine)-block-poly(styrene) can be exploited to prepare remarkably diverse self-assembled nanostructures in dispersion from a single block copolymer (BCP). The characteristics of the BCP can be efficiently controlled by tailoring the properties of a guest which preferentially binds to the P2VP block. For example, the incorporation of a hydrophobic guest creates a hydrophobic BCP complex that forms phase separated nanoparticles upon self-assembly. Conversely, the incorporation of a hydrophilic guest results in an amphiphilic BCP complex that forms spherical micelles in water. The ability to tune the self-assembly behavior and access dramatically different nanostructures from a single BCP substrate demonstrates the exceptional versatility of the self-assembly of BCPs driven by supramolecular interactions. This approach represents a new methodology that will enable the further design of complex, responsive self-assembled nanostructures

Mesostructured Block Copolymer Nanoparticles: Versatile Templates for Hybrid Inorganic/Organic Nanostructures

We present a versatile strategy to prepare a range of nanostructured poly(styrene)-block-poly(2-vinyl pyridine) copolymer particles with tunable interior morphology and controlled size by a simple solvent exchange procedure. A key feature of this strategy is the use of functional block copolymers incorporating reactive pyridyl moieties which allow the absorption of metal salts and other inorganic precursors to be directed. Upon reduction of the metal salts, well-defined hybrid metal nanoparticle arrays could be prepared, whereas the use of oxide precursors followed by calcination permits the synthesis of silica and titania particles. In both cases, ordered morphologies templated by the original block copolymer domains were obtained

Monitoring arthropods in a tropical landscape: relative effects of sampling methods and habitat types on trap catches

To discuss the challenge of monitoring multi-species responses of tropical arthropods to disturbance, we considered a large dataset (4 × 105 individuals; 1,682 morphospecies representing 22 focal taxa) based on the work of parataxonomists to examine the effects of anthropogenic disturbance on arthropods at Gamba, Gabon. Replication included three sites in each of four different stages of forest succession and land use after logging, surveyed during a whole year with four sampling methods: pitfall, Malaise, flight-interception and yellow pan traps. We compared the suitability of each sampling method for biological monitoring and evaluated statistically their reliability for 118 arthropod families. Our results suggest that a range of sampling methods yields more diverse material than any single method operated with high replication. Multivariate analyses indicated that morphospecies composition in trap catches was more strongly influenced by habitat type than by sampling methods. This implies that for multi-species monitoring, differences in trap efficiency between habitats may be neglected, as far as habitat types remain well contrasted. We conclude that for the purpose of monitoring large arthropod assemblages in the long-term, a protocol based on operating a set of different and non-disruptive traps appears superior in design than summing a series of taxa-specific protocols

Temperature‐induced self‐assembly and metal‐ion stabilization of histidine functional block copolymers

Histidine functional block copolymers are thermally self‐assembled into polymer micelles with poly‐N‐isopropylacrylamide in the core and the histidine functionality in the corona. The thermally induced self‐assemblies are reversible until treated with Cu2+ ions at 50 °C. Upon treatment with 0.5 equivalents of Cu2+ relative to the histidine moieties, metal‐ion coordination locks the self‐assemblies. The self‐assembly behavior of histidine functional block copolymers is explored at different values of pH using DLS and 1H NMR. Metal‐ion coordination locking of the histidine functional micelles is also explored at different pH values, with stable micelles forming at pH 9, observed by DLS and imaged by atomic force microscopy. The thermal self‐assembly of glycine functional block copolymers at pH 5, 7, and 9 is similar to the histidine functional materials; however, the self‐assemblies do not become stable after the addition of Cu2+, indicating that the imidazole plays a crucial role in metal‐ion coordination that locks the micelles. The reversibility of the histidine‐copper complex locking mechanism is demonstrated by the addition of acid to protonate the imidazole and destabilize the polymer self‐assemblies