APTES functionalization in SBA-15: the effect on SO2 capture and detection applications.

The development of adsorbents for air pollutant remediation and effective monitoring is of interest. Then, the effect of the APTES functionalization ratio on the impact of the adsorption and detection of SO2 molecules was evaluated. The higher APTES functionalization material (SBA-15_6.1APTES) shows a high uptake of 1.15 mmol g-1 at 0.001 bar and 298 K. Fluorescence, time-resolved photoluminescence, and quantum yield experiments revealed a turn-on effect specifically for SO2 molecules, indicating high selectivity, suggesting host-to-guest energy transfer. Attractively, XPS measurement provided an understanding of the mechanism, suggesting hydrogen bonding and dipole-dipole interactions as the main interactions between SO2 molecules and SBA-15_6.1APTES. DFT calculations were performed to confirm these interactions. Furthermore, this study highlights the application of SBA-15 materials with different amino modifications for SO2 treatment and provides insight into the interaction mechanism using experimental techniques.

Giant Lipoma on the Left Shoulder: A Case Report.

A lipoma is a tumor of adipose tissue cells that can develop anywhere in the body, usually at the subcutaneous level without invading adjacent structures. Its most common location is on the back and extremities. According to the literature, it is considered common in both sexes; however, it is mentioned that it occurs more frequently in females. Clinically, it presents as a slow-growing, painless mass. Although the diagnosis is clinical, an imaging study is usually performed for confirmation and to obtain information about its location, relationship with adjacent structures, and surgical planning. The definitive treatment involves surgical resection with histopathological analysis, providing a definitive diagnosis to rule out malignancy. In the present case report, we will present a 45-year-old female patient, with no significant medical history, who comes for evaluation due to a tumor in her right shoulder approximately 5 cm in size with gradual growth to 20 cm over 12 years, seeking evaluation due to clinical manifestations. A surgical protocol was initiated, with magnetic resonance imaging (MRI) considered the imaging study of choice according to the literature, where a superficial location was observed. A surgical plan was made that included complete resection and histopathological analysis, with post-surgical evaluations at two, four, and six months post-surgery showing no signs of recurrence, remission of symptoms of nerve compression, and appropriate wound healing.

CYCU-3: an Al(III)-based MOF for SO2 capture and detection.

The Al(III)-based MOF CYCU-3 exhibits a relevant SO2 adsorption performance with a total uptake of 11.03 mmol g-1 at 1 bar and 298 K. CYCU-3 displays high chemical stability towards dry and wet SO2 exposure. DRIFTS experiments and computational calculations demonstrated that hydrogen bonding between SO2 molecules and bridging Al(III)-OH groups are the preferential adsorption sites. In addition, photoluminescence experiments demonstrated the relevance of CYCU-3 for application in SO2 detection with good selectivity for SO2 over CO2 and H2O. The change in fluorescence performance demonstrates a clear turn-on effect after SO2 interaction. Finally, the suppression of ligand-metal energy transfer along with the enhancement of ligand-centered π* → π electronic transition was proposed as a plausible fluorescence mechanism.

Fetal Lipoblastoma Presenting as a Retroperitoneal Tumor in Adults: A Case Report.

Lipoblastoma (LB) is a rare benign mesenchymal soft tissue neoplasm that most frequently occurs in childhood. In this case, we describe a 33-year-old female with intermittent abdominal pain due to the presence of a slowly growing abdominal tumor. We will explain the ideal diagnostic protocol and compare it with the diagnostic approach performed at a second level of care with limited resources. A simple abdominal tomography confirmed the presence of the retroperitoneal tumor, which led to the planning of surgical management for these tumor cases. A "complete resection" is considered the ideal approach, along with the follow-up to rule out any complications.

SO2 Capture at Low Pressure in a Prototypical MIL-53 Aluminum MOF Family: The Influence of Pore Expansion.

Not only is excellent performance in SO2 capture by porous materials (uptake above 17 mmol g-1) relevant, but also finding a correlation between the architecture changes into a family and their SO2 adsorption is very useful. In this contribution, we studied the SO2 adsorption behavior (at very low pressure) of an Al(III)-MOF family that shares the pore architecture of MIL-53. The results indicate an inversely proportional trend for the SO2 capture and pore expansion, since by increasing the length of the channel pore, the SO2 uptake gradually decreases. In addition, this trend is clearly observed in the heat of adsorption, which describes the interaction between the SO2 molecule and the µ-OH functional group. These finding are supported by experimental analysis and computational studies.

Evaluation of the catalytic activity of Zn-MOF-74 for the alcoholysis of cyclohexene oxide.

In the present work, nanocrystalline Zn-MOF-74 is shown to be a heterogeneous catalyst for the acid-catalyzed ring-opening alcoholysis of cyclohexene oxide. The results corroborated that accessible open metal sites within the material are critical conditions (Zn(ii) Lewis acid sites) for this reaction. Zn-MOF-74 was tested at three different temperatures (30, 40, and 50 °C) for the alcoholysis reaction. Furthermore, the cyclohexene oxide conversion was 94% in less than two days. A comparison of the catalytic activity with different crystal sizes of Zn-MOF-74 and the homogenous phase, zinc acetate, was conducted. Zn-MOF-74 exhibited excellent catalytic cyclability for three cycles without losing its activity. The material showed chemical stability by retaining its crystalline structure after the reaction and cyclability process.

Cannulation Technique of Vascular Access in Hemodialysis and the Impact on the Arteriovenous Fistula Survival: Systematic Review and Meta-Analysis.

Adequate cannulation technique (CT) methods and successful puncture are essential for hemodialysis (HD) and arteriovenous fistula (AVF) maintenance. This systematic review and meta-analysis was designed to identify which CT allows better AVF primary patency and lower rates of complications in HD patients. The search was carried out on the CINAHL, MEDLINE, Cochrane Library, and Joanna Briggs Institute Library databases to identify all randomized controlled trials (RCTs) and observational studies comparing clinical outcomes of buttonhole (BH) versus rope ladder cannulation (RL) from 2010 to 2022. The Risk-of-Bias (Rob 2) tool was used for RCTs and the ROBINS-I was used for non-randomized studies. RevMan 5.4 was used for the meta-analysis. A total of five RCTs, one quasi-randomized controlled trial, and six observational studies were included. When compared with RL cannulation, BH cannulation significantly increased bacteremia (RR, 2.76, 95% CI (1.14, 6.67), p = 0.02) but showed no differences in AVF primary patency (HR, 1.06, 95% CI (0.45, 4.21), p = 0.90). There was no thrombosis reduction (RR, 0.51, 95% CI (0.23, 1.14), p = 0.10) or intervention number reduction (RR, 0.93, 95% CI (0.49, 1.80), p = 0.84) with BH. Outcomes like pain, hematoma, and aneurism could not be merged due to a lack of data, reported as medians, as well as due to different definitions. The quality in general was poor and the heterogeneity among the studies prevented us from merging the outcomes.

Low-Valent Metals in Metal-Organic Frameworks Via Post-Synthetic Modification.

Metal-organic frameworks (MOFs) provide uniquely tunable, periodic platforms for site-isolation of reactive low-valent metal complexes of relevance in modern catalysis, adsorptive applications, and fundamental structural studies. Strategies for integrating such species in MOFs include post-synthetic metalation, encapsulation and direct synthesis using low-valent organometallic complexes as building blocks. These approaches have each proven effective in enhancing catalytic activity, modulating product distributions (i.e., by improving catalytic selectivity), and providing valuable mechanistic insights. In this minireview, we explore these different strategies, as applied to isolate low-valent species within MOFs, with a particular focus on examples that leverage the unique crystallinity, permanent porosity and chemical mutability of MOFs to achieve deep structural insights that lead to new paradigms in the field of hybrid catalysis.

MOF-based catalysts: insights into the chemical transformation of greenhouse and toxic gases.

Metal-organic framework (MOF)-based catalysts are outstanding alternative materials for the chemical transformation of greenhouse and toxic gases into high-add-value products. MOF catalysts exhibit remarkable properties to host different active sites. The combination of catalytic properties of MOFs is mentioned in order to understand their application. Furthermore, the main catalytic reactions, which involve the chemical transformation of CH4, CO2, NOx, fluorinated gases, O3, CO, VOCs, and H2S, are highlighted. The main active centers and reaction conditions for these reactions are presented and discussed to understand the reaction mechanisms. Interestingly, implementing MOF materials as catalysts for toxic gas-phase reactions is a great opportunity to provide new alternatives to enhance the air quality of our planet.

SU-101: a Bi(III)-based metal-organic framework as an efficient heterogeneous catalyst for the CO2 cycloaddition reaction.

A non-porous version of SU-101 (herein n-SU-101) was evaluated for the CO2 cycloaddition reaction. The findings revealed that open metal sites (Bi3+) are necessary for the reaction. n-SU-101 displays a high styrene oxide conversion of 96.6% under mild conditions (3 bar and 80 °C). The catalytic activity of n-SU-101 demonstrated its potential application for the cycloaddition of CO2 using styrene oxide.

Gas-phase organometallic catalysis in MFM-300(Sc) provided by switchable dynamic metal sites.

MFM-300(Sc) was explored as a catalyst for the gas-phase hydrogenation of acetone. The catalysis results support the presence of non-permanent open Sc(III) sites within the structure due to the requirement of Lewis acid sites for the reaction to proceed. The open Sc(III) sites are generated in situ due to the presence of hemilabile Sc-O bonds. MFM-300(Sc) showed high mechanical and chemical stability, and the crystalline structure was maintained after the catalytic reaction. The catalytic activity of the material was quantified by performing a gas-phase reaction using a continuous flow reactor. The acetone conversion in MFM-300(Sc) was estimated to be 27.7% with no loss of activity after catalytic cycles.

Engineering Catalysis within a Saturated In(III)-Based MOF Possessing Dynamic Ligand-Metal Bonding.

Metal-organic frameworks have developed into a formidable heterogeneous catalysis platform in recent years. It is well established that thermolysis of coordinated solvents from MOF nodes can render highly reactive, coordinatively unsaturated metal complexes which are stabilized via site isolation and serve as active sites in catalysis. Such approaches are limited to frameworks featuring solvated transition-metal complexes and must be stable toward the formation of "permanent" open metal sites. Herein, we exploit the hemilability of metal-carboxylate bonds to generate transient open metal sites in an In(III) MOF, pertinent to In-centered catalysis. The transient open metal sites catalyze the Strecker reaction over multiple cycles without loss of activity or crystallinity. We employ computational and spectroscopic methods to confirm the formation of open metal sites via transient dissociation of In(III)-carboxylate bonds. Furthermore, the amount of transient open metal sites within the material and thus the catalytic performance can be temperature-modulated.

Switchable Metal Sites in Metal-Organic Framework MFM-300(Sc): Lewis Acid Catalysis Driven by Metal-Hemilabile Linker Bond Dynamics.

Uncommon reversible guest-induced metal-hemilabile linker bond dynamics in MOF MFM-300(Sc) was unraveled to switch on/switch off catalytic open metal sites. The catalytic activity of this MOF with non-permanent open metal sites was demonstrated using a model Strecker hydrocyanation reaction as a proof-of-concept. Conclusively, the catalytic activity was evidenced to be fully reversible, preserving the conversion performance and structure integrity of MFM-300(Sc) over multiple cycles. These experimental findings were corroborated by quantum-calculations that revealed a reaction mechanism driven by the Sc-open metal sites. This discovery paves the way towards the design of new effective and easily regenerable heterogeneous MOF catalysts integrating switchable metal sites.

Vaccination against SARS-CoV-2 in Haemodialysis Patients: Spike's Ab Response and the Influence of BMI and Age.

Patients with chronic kidney disease (CKD-5D) in dialysis have been associated with higher rates of SARS-CoV-2 infection. Objective: To identify the CKD-5D patients' immune system behavior regarding the Pfizer-BioNTech (BNT162b2 mRNA) vaccine (Comirnaty©). This was a multicenter study carried out in 38 dialysis units in NephroCare Portugal. Eligible patients from two cohorts­one composed of completely vaccinated patients with Comirnaty© (vaccinated group) against a second cohort of patients who recovered from SARS-CoV-2 infection (control group)­were selected through representative sampling for each cohort. Humoral response was assessed at 3 (t0) and 6 months (t1) after complete vaccination and, in the control group, 6 months after COVID-19 recovery. In the vaccinated group, at t0, the median anti-Spike IgG level was 1120 AU/mL and, at t1, all participants' antibody level decreased to a median of 455 AU/mL. In the control group, the median serum SARS-CoV-2 antibodies level was 1836 AU/mL. In the vaccinated group, at t0, patients < 70 years presented a significantly (p = 0.002) higher level of anti-Spike IgG titres. In contrast, older patients from the control group presented a significantly (p = 0.038) higher IgG. No correlation was found between age and anti-Spike IgG antibodies level in any of the studied groups. Patients with a higher body mass index showed a greater immune response in both the vaccinated and control group, although without significance. We concluded that, in the vaccinated group, elderly patients developed a lower immune response than younger patients and the levels of anti-Spike IgG antibodies declined faster between t0 and t1, while in the control group, the oldest and overweight patients developed the best humoral response.

Intramolecular Tricarbonyl-Ene Reactions and α-Hydroxy-ß-Diketone Rearrangements Inspired by the Biosynthesis of Polycyclic Polyprenylated Acylphloroglucinols.

Structurally unique natural products pose biosynthetic puzzles whose solution can inspire new chemical reactions. Herein, we propose a unified biosynthetic pathway towards some complex meroterpenoids-the hyperireflexolides, biyoulactones, hybeanones and hypermonones. This hypothesis led to the discovery of uncatalyzed, intramolecular carbonyl-ene reactions that are spontaneous at room temperature. We also developed an anionic cascade reaction featuring an α-hydroxy-ß-diketone rearrangement and an intramolecular aldol reaction to access four distinct natural product scaffolds from a common intermediate.

A randomised control trial protocol of MuST for vascular access cannulation in hemodialysis patients (MuST Study): contributions for a safe nursing intervention.

BACKGROUND: The vascular access preservation and the maintenance of a complication-free fistula remains an Achilles' heel of hemodialysis in chronic kidney patients due to its substantial contribution to the morbidity and mortality. Systematic studies in the area of examining cannulation practices, achieving complication-free cannulation, and strategies to improve fistula survival are needed. For this reason, we consider it essential to create and investigate new methodologies for approaching fistula in patients on regular HD. The Multiple Single Cannulation Technique (MuST) is based on the association between the rope-ladder (RL) using the arteriovenous vessel through progressive rotation, and the buttonhole (BH) since there are three specific cannulation sites for each cannulation day during the week. The MuST is simple to implement and seems to be a very promising technique in terms of patient safety. Previous studies already showed an arteriovenous fistula survival similar to RL but significantly higher than BH. METHODS: This MuST study is a multicenter, prospective, non-blind, parallel-group, randomized controlled trial with the intervention group submitted to MuST and a control group undergoing the rope-ladder, up to 100 subjects for each group. Patients will be randomized 1:1 to one of two cannulation technique (CT), and the follow-up period of this study will be 12 months. Primary outcome is to evaluate the arteriovenous fistula survival rate at 12 months determined by the percentage of fistulas in use from the beginning of the study to the date of the first clinical intervention by angioplasty or vascular surgery, to maintain or restore patency (unassisted patency). Secondary outcome is to evaluate arteriovenous fistula survival rate at 12 month determined by the percentage of fistulas in use from the study start to the date of access abandonment due to dysfunction, patient abandonment, or death, treatment change modality or study end. We will also evaluate the assisted primary patency and include the following secondary outcomes associated with the cannulation technique: Infection, Hematoma, Aneurysm development, and pain. DISCUSSION: The study will investigate whether fistula survival can be improved when using cannulation by MuST compared to the RL. MuST study will provide important information on fistula survival when cannulated by MuST but also information related to its use in fistulas previously cannulated by other CTs. TRIAL REGISTRATION: ClinicalTrials.gov identifier NCT05081648 registered on 18 October 2021.

[Vaccination Against COVID-19 in a Network of Hemodialysis Units in Portugal: A Promising Experience].

INTRODUCTION: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) responsible for coronavirus disease 2019 (COVID-19) seriously affected Portugal, particularly in the elderly population with a high number of comorbidities, including patients with chronic kidney disease in stage 5 (CKD-5D) undergoing a regular dialysis program. The aims of this study were to identify the impact of vaccination on the incidence of new daily cases and mortality in the CKD-5D population. MATERIAL AND METHODS: Prospective, observational study, involving patients with CKD-5D from 38 NephroCare clinics, Portugal. Daily SARS-CoV-2 infections and mortality among these patients was compared with the incidence in the general population. Three periods were analysed: before vaccination, during the vaccination process, and a third period after complete vaccination with the Pfizer-BioNTech' Comirnaty® vaccine. The primary outcome was infection by the SARS-CoV-2 virus and the secondary outcome was death associated with the infection. RESULTS: A total of 4617 patients (average of 69.37 years of age) were analysed. During the first period, there was a significantly higher COVID-19 incidence of 14.9% in patients with CKD-5D compared with the general population (7.9%; p < 0.001). During the fifteen days after the complete vaccination, results reverted to a significant decrease in COVID-19 cases was observed (p < 0.001). The mortality rate among CKD-5D was significantly higher than in the general population (p < 0.001). DISCUSSION: A high incidence rate of infection was observed in CKD-5D patients, probably due to several factors such as advanced age, number of comorbidities, inability to remain in confinement, among others. After vaccination there was a significant reduction of new cases. CONCLUSION: Vaccination significantly reduced SARS-CoV-2 infection in patients with CKD-5D.

Introdução: Portugal foi atingido severamente pela síndrome respiratória aguda grave (SARS-CoV-2), responsável pela doença por coronavírus 2019 (COVID-19). A população idosa e com comorbilidades, na qual estão incluídas as pessoas com doença renal crónica em estádio 5 em programa regular de hemodiálise (CKD-5D), foi particularmente afetada. Definimos como objetivos deste estudo a identificação do impacto da vacinação no surgimento de novos casos diários e a sua influência na mortalidade na população CKD-5D.Material e Métodos: Estudo observacional, prospetivo, envolvendo doentes com CKD-5D de 38 clínicas da NephroCare, Portugal. A infeção e a mortalidade diárias por SARS-CoV-2 destes doentes foi comparada com a taxa de incidência na população em geral. Foram analisados três períodos: antes da vacinação, durante, e um terceiro período após a vacinação completa pela vacina Comirnaty ®, da Pfizer-BioNTech. Foi considerado desfecho primário a infeção pelo vírus SARS-CoV-2 e como desfecho secundário, a morte associada à infeção.Resultados: Foram analisados 4617 doentes com uma média de 69,37 anos. Durante o primeiro período, verificou-se uma taxa de incidência de COVID 19 de 14,9%, significativamente maior nos doentes CKD-5D quando comparado com a taxa de incidência de 7,9% da população em geral (p < 0,001). Durante os quinze dias após a vacinação completa observámos uma reversão, com diminuição significativa de casos de COVID-19 (p < 0,001). A mortalidade atribuível a COVID-19 no grupo CKD-5D foi significativamente superior ao da população em geral (p < 0,001).Discussão: Observámos uma elevada taxa de incidência de infeção nos doentes CKD-5D, presumivelmente correlacionada com vários fatores como a idade avançada, as comorbilidades, a impossibilidade de confinar, entre outros. Após a vacinação verificou-se uma redução significativa de novos casos.Conclusão: A vacinação reduziu significativamente a infeção por SARS-CoV-2 nos doentes CKD-5D.

Multiple single cannulation technique of arteriovenous fistula: A randomized controlled trial.

INTRODUCTION: Despite the impact needling has had on vascular access survival and patient outcome, there is no universal or standardized method proposed for proper cannulation. Rigorous studies are needed, examining cannulation practices, and challenges to achieving complication-free cannulation. METHODS: This randomized, open-label trial was conducted at 18 dialysis units owned by a large private dialysis provider operating in Portugal. Eligible patients were adults on chronic hemodialysis, with a new arteriovenous fistula (AVF); cannulated for at least 4 weeks complication-free. Patients were randomly assigned in a 1:1 ratio to one of three cannulation techniques (CT): Multiple Single cannulation Technique (MuST), rope-ladder (RLC), and buttonhole (BHC). The primary endpoint was AVF primary patency at 1 year. FINDINGS: One hundred seventy-two patients were enrolled between March 2014 and March 2017. Fifty-nine patients were allocated to MuST, 56 to RLC, and 57 to BHC. MuST and RLC were associated with a better AVF primary patency than BHC. Primary patency at 12 months was 76.3% in MuST, 59.6% in BHC, and 76.8% in RLC group. Mean AVF survival times were 10.5 months (95% CI = 9.6, 11.3) in the MuST group, 10.4 months (95% CI = 9.5, 11.2) in RLC, and 9.5 months (95% CI = 8.6, 10.4) in BHC. BHC was a significant risk predictor for AVF survival with 2.13 times more events than the other two CT (HR 2.13; 95% CI = 1.07, 4.21; p = 0.03). DISCUSSION: MuST was easy to implement without a diagram and there is no need to use blunt needles. This study showed MuST was efficacious and safe in maintaining the longevity of AVF in dialysis patients.

Development and Validation of a Machine Learning Model Predicting Arteriovenous Fistula Failure in a Large Network of Dialysis Clinics.

Background: Vascular access surveillance of dialysis patients is a challenging task for clinicians. We derived and validated an arteriovenous fistula failure model (AVF-FM) based on machine learning. Methods: The AVF-FM is an XG-Boost algorithm aimed at predicting AVF failure within three months among in-centre dialysis patients. The model was trained in the derivation set (70% of initial cohort) by exploiting the information routinely collected in the Nephrocare European Clinical Database (EuCliD®). Model performance was tested by concordance statistic and calibration charts in the remaining 30% of records. Features importance was computed using the SHAP method. Results: We included 13,369 patients, overall. The Area Under the ROC Curve (AUC-ROC) of AVF-FM was 0.80 (95% CI 0.79-0.81). Model calibration showed excellent representation of observed failure risk. Variables associated with the greatest impact on risk estimates were previous history of AVF complications, followed by access recirculation and other functional parameters including metrics describing temporal pattern of dialysis dose, blood flow, dynamic venous and arterial pressures. Conclusions: The AVF-FM achieved good discrimination and calibration properties by combining routinely collected clinical and sensor data that require no additional effort by healthcare staff. Therefore, it can potentially enable risk-based personalization of AVF surveillance strategies.

Cannulation Technique of Vascular Access in Haemodialysis and the Impact on the Arteriovenous Fistula Survival: Protocol of Systematic Review.

BACKGROUND: Based on a literature review of various studies, comparisons between BH and RL are inconclusive regarding some outcomes. However, in the last 5 years, some studies have been published that may contribute to clarifying which cannulation technique (CT) allows better fistula survival. AIM: To review which cannulation technique allows better primary patency of the arteriovenous fistula in haemodialysis patients. METHODS: We will include all randomised controlled trials and observational studies that include comparisons among CTs and thus define the benefits and risks of each CT. A PRISMA-compliant systematic review and meta-analysis will be performed in accordance with the quality and homogeneity of studies. A comprehensive search strategy will be applied to the CINAHL, MEDLINE and Embase electronic databases from January 2000 to September 2021. The primary outcome is the arteriovenous fistula primary patency. To assess the risk of bias in randomised controlled trials or quasi-experimental studies, we will use the tool Revised Cochrane Risk-of-Bias Tool for Randomized Trials (RoB 2). For nonrandomised studies, the Risk of Bias In Non-Randomized Studies of Interventions (ROBINS-I) will be used. DISCUSSION: The evidence generated from this systematic review of current evidence could inform the design and implementation of continuous quality improvement programs in cannulation techniques in haemodialysis patients, as well as contributing to improving the curricula within haemodialysis courses. This protocol was registered with the National Institute for Health Research PROSPERO database prior to commencement (registration number CRD42021237050).