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ABSTRACT: A growing number of studies have documented a wide variety of neurological manifestations associated with the novel SARS-CoV-2 (COVID-19). Of the available literature, cranial neuropathies and central nervous system disorders, such as encephalopathy and ischemic strokes, remain the predominant discussion. Limited investigations exist examining peripheral neuropathies of those with COVID-19. This case series discusses eight patients who tested positive for COVID-19 and presented with localized weakness after a prolonged course of mechanical ventilation (>21 days). We retrospectively reviewed all patients' charts who received electrodiagnostic evaluation between March and November 2020 in the outpatient clinic or in the acute care hospital at the JFK Medical Center/JFK Johnson Rehabilitation Institute and Saint Peter's University Hospital of New Jersey. A total of eight COVID-19-positive patients were identified to have a clinical presentation of localized weakness after a prolonged course of mechanical ventilation. All patients were subsequently found to have a focal peripheral neuropathy of varying severity that was confirmed by electrodiagnostic testing. Patient demographics, clinical, and electrodiagnostic findings were documented. The findings of local weakness and focal peripheral neuropathies after diagnosis of COVID-19 raise significant questions regarding underlying pathophysiology and overall prognosis associated with COVID-19.
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COVID-19/complicações , Doenças do Sistema Nervoso Periférico/virologia , SARS-CoV-2 , Adulto , Idoso , COVID-19/fisiopatologia , Eletrodiagnóstico/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças do Sistema Nervoso Periférico/diagnóstico , Doenças do Sistema Nervoso Periférico/etiologia , Respiração Artificial/efeitos adversos , Estudos RetrospectivosRESUMO
OBJECTIVES: Bilateral diaphragmatic dysfunction results in severe dyspnoea, usually requiring oxygen therapy and nocturnal ventilatory support. Although treatment options are limited, phrenic nerve reconstruction (PR) offers the opportunity to restore functional activity. This study aims to evaluate combination treatment with PR and placement of a diaphragm pacemaker (DP) compared to DP placement alone in patients with bilateral diaphragmatic dysfunction. METHODS: Patients with bilateral diaphragmatic dysfunction were prospectively enrolled in the following treatment algorithm: Unilateral PR was performed on the more severely impacted side with bilateral DP implantation. Motor amplitudes, ultrasound measurements of diaphragm thickness, maximal inspiratory pressure, forced expiratory volume, forced vital capacity and subjective patient-reported outcomes were obtained for retrospective analysis following completion of the prospective database. RESULTS: Fourteen male patients with bilateral diaphragmatic dysfunction confirmed on chest fluoroscopy and electrodiagnostic testing were included. All 14 patients required nocturnal ventilator support, and 8/14 (57.1%) were oxygen-dependent. All patients reported subjective improvement, and all 8 oxygen-dependent patients were able to discontinue oxygen therapy following treatment. Improvements in maximal inspiratory pressure, forced vital capacity and forced expiratory volume were 68%, 47% and 53%, respectively. There was an average improvement of 180% in motor amplitude and a 50% increase in muscle thickness. Comparison of motor amplitude changes revealed significantly greater functional recovery on the PR + DP side. CONCLUSIONS: PR and simultaneous implantation of a DP may restore functional activity and alleviate symptoms in patients with bilateral diaphragmatic dysfunction. PR plus diaphragm pacing appear to result in greater functional muscle recovery than pacing alone.
Assuntos
Diafragma , Diafragma/diagnóstico por imagem , Humanos , Masculino , Nervo Frênico , Paralisia Respiratória/diagnóstico por imagem , Paralisia Respiratória/etiologia , Paralisia Respiratória/terapia , Estudos RetrospectivosRESUMO
A series of 16 conjugates of the tubulin polymerization inhibitor combretastatin A4 (CA-4) and other functionally related stilbene with four 18-carbon fatty acids, namely, stearic, oleic, linoleic, and linolenic acids, have been synthesized in good yields. These new derivatives have been evaluated against the KB-3-1 (human epidermoid carcinoma), NCI-H460 (human lung cancer), HEK293 (human embryonic kidney), and MCF-7 (human breast adenocarcinoma) cell lines for antiproliferative activity, with the exhibited cytotoxic activities comparable with those of CA-4 and colchicine. Compounds 22 and 23, CA-4 conjugates of linoleic and linolenic acids, respectively, were determined to have exhibited the most active in vitro assays, with compound 23 exhibiting very similar activity to the parent compound against the NCI-H460 cell line. Our studies further delineated the structurally required Z-geometry of the stilbene moiety and that conjugation of the less active E-stilbenes with the most active fatty acid had minimal or no improvement in their respective activities.
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Antineoplásicos/farmacologia , Neoplasias da Mama/tratamento farmacológico , Proliferação de Células/efeitos dos fármacos , Colchicina/farmacologia , Neoplasias Pulmonares/tratamento farmacológico , Estilbenos/farmacologia , Moduladores de Tubulina/farmacologia , Linhagem Celular Tumoral , Ácidos Graxos/farmacologia , Células HEK293 , Humanos , Estrutura Molecular , Estilbenos/químicaRESUMO
OBJECTIVE: To analyze health care disparities in pediatric quality of care measures and determine the impact of data imputation. DATA SOURCES: Five HEDIS measures are calculated based on 2012 administrative data for 145,652 children in two public insurance programs in Florida. METHODS: The Bayesian Improved Surname and Geocoding (BISG) imputation method is used to impute missing race and ethnicity data for 42 percent of the sample (61,954 children). Models are estimated with and without the imputed race and ethnicity data. PRINCIPAL FINDINGS: Dropping individuals with missing race and ethnicity data biases quality of care measures for minorities downward relative to nonminority children for several measures. CONCLUSIONS: These results provide further support for the importance of appropriately accounting for missing race and ethnicity data through imputation methods.
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Etnicidade/estatística & dados numéricos , Disparidades em Assistência à Saúde/etnologia , Pediatria/estatística & dados numéricos , Qualidade da Assistência à Saúde/estatística & dados numéricos , Grupos Raciais/estatística & dados numéricos , Adolescente , Teorema de Bayes , Benchmarking , Criança , Pré-Escolar , Florida , Mapeamento Geográfico , Humanos , Lactente , Revisão da Utilização de Seguros/estatística & dados numéricos , Indicadores de Qualidade em Assistência à Saúde , Estados Unidos , Adulto JovemRESUMO
New phenstatin-fatty acid conjugates have been synthesized and tested against the KB-3-1, H460, MCF-7 and HEK293 cell lines, with an increase in anti-proliferative activity being observed at the micro-molar level paralleling an increase in un-saturation in the fatty acid component.
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Antineoplásicos/farmacologia , Benzofenonas/farmacologia , Ácidos Graxos/farmacologia , Organofosfatos/farmacologia , Antineoplásicos/síntese química , Antineoplásicos/química , Benzofenonas/química , Linhagem Celular Tumoral , Proliferação de Células/efeitos dos fármacos , Relação Dose-Resposta a Droga , Ensaios de Seleção de Medicamentos Antitumorais , Ácidos Graxos/química , Células HEK293 , Humanos , Células MCF-7 , Estrutura Molecular , Organofosfatos/química , Relação Estrutura-AtividadeRESUMO
We report a simple and rapid method to prepare multifunctional free-standing single-walled carbon nanotube (SWCNT) films with variable thicknesses ranging from a submonolayer to a few micrometers having outstanding properties for a broad range of exceptionally performing devices. We have fabricated state-of-the-art key components from the same single component multifunctional SWCNT material for several high-impact application areas: high efficiency nanoparticle filters with a figure of merit of 147 Pa(-1), transparent and conductive electrodes with a sheet resistance of 84 Ω/â» and a transmittance of 90%, electrochemical sensors with extremely low detection limits below 100 nM, and polymer-free saturable absorbers for ultrafast femtosecond lasers. Furthermore, the films are demonstrated as the main components in gas flowmeters, gas heaters, and transparent thermoacoustic loudspeakers.
RESUMO
We demonstrate an aerosol CVD process to dry deposit large-area SWCNT networks with tunable conductivity and optical transmittance on a wide range of substrates including flexible polymers. These SWCNT networks can be chemically doped to reach a sheet resistance of as low as 110 Ω/⟨ at 90% optical transmittance. A wide application potential of these networks is demonstrated by fabricating SWCNT network-based devices such as a transparent capacitive touch sensors, thin-film transistors (TFTs), and bright organic light-emitting diodes (OLEDs).
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Aerossóis/química , Cristalização/métodos , Nanotecnologia/métodos , Nanotubos de Carbono/química , Nanotubos de Carbono/ultraestrutura , Condutividade Elétrica , Substâncias Macromoleculares/química , Teste de Materiais , Conformação Molecular , Tamanho da Partícula , Propriedades de SuperfícieRESUMO
Mode-locked sub-picosecond operation of Yb-, Er- and Tm:Hodoped fiber lasers operating at 1.05 microm, 1.56 microm and 1.99 microm, respectively, is demonstrated using the same sample carbon nanotube-based saturable absorber mirror. A mesh of single-walled carbon nanotubes was deposited on an Ag-mirror using a one-step dry-transfer contact press method to combine broadband saturable absorption and high reflectance properties. The novel fabrication method of the polymer-free absorber and device parameters determined using nonlinear reflectivity measurement are described in detail. To our knowledge the observed operation bandwidth of approximately 1 microm is the broadest reported to date for a single carbon nanotube-based saturable absorber.
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Tecnologia de Fibra Óptica/instrumentação , Lasers , Membranas Artificiais , Nanotecnologia/instrumentação , Nanotubos de Carbono/química , Nanotubos de Carbono/ultraestrutura , Telecomunicações/instrumentação , Desenho Assistido por Computador , Desenho de Equipamento , Análise de Falha de Equipamento , Reprodutibilidade dos Testes , Sensibilidade e EspecificidadeRESUMO
The evolution of iron catalyst particles during aerosol (floating catalyst) Chemical Vapor Deposition (CVD) synthesis of Carbon Nanotubes (CNTs) from CO is computed using a multi species Computational Fluid Dynamics (CFD) model incorporating a lognormal aerosol method of moments (MOM) to describe their dynamics and a combined chemical kinetics and equilibrium model for catalytic production of CO2. The influence of the presence of iron at the reactor walls, the fed particle size, number concentration and polydispersity and the effect of the catalytic production of CO2 at the reactor wall are studied in terms of particle size, concentration and polydispersity and reagent concentration during CNT synthesis. It is found that iron catalyst particle dynamics are essentially insensitive to wall iron concentrations and, for a wide range of particle sizes and concentrations, it is found that the catalyst particles are stable up to a critical CNT window in which CNT nucleation and growth occurs. Concentrations of catalyst particles significantly above 1 x 10(14) #/m3, however, lead to poor control over catalyst particle size and polydispersity at the CNT nucleation front which, in turn, leads to poor control over CNT diameter. The location of the growth window is shown to be directly associated with the availability of catalytically produced CO2 diffusing from the reactor walls to the reactor core. These results help to explain the large variations in CNT diameter and chirality and the inefficient use of catalyst material in other floating catalyst CNT processes based on in-situ catalyst particle synthesis.
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Both fullerenes and single-walled carbon nanotubes (SWNTs) exhibit many advantageous properties. Despite the similarities between these two forms of carbon, there have been very few attempts to physically merge them. We have discovered a novel hybrid material that combines fullerenes and SWNTs into a single structure in which the fullerenes are covalently bonded to the outer surface of the SWNTs. These fullerene-functionalized SWNTs, which we have termed NanoBuds, were selectively synthesized in two different one-step continuous methods, during which fullerenes were formed on iron-catalyst particles together with SWNTs during CO disproportionation. The field-emission characteristics of NanoBuds suggest that they may possess advantageous properties compared with single-walled nanotubes or fullerenes alone, or in their non-bonded configurations.
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Cristalização/métodos , Fulerenos/química , Nanotecnologia/métodos , Nanotubos de Carbono/química , Nanotubos de Carbono/ultraestrutura , Substâncias Macromoleculares/química , Teste de Materiais , Conformação Molecular , Tamanho da Partícula , Propriedades de SuperfícieRESUMO
We presented detailed studies of the formation of single-walled carbon nanotubes by an aerosol method based on the introduction of pre-formed catalyst particles into conditions leading to carbon nanotube synthesis. Carbon monoxide and iron nanoparticles were used as a carbon source and a catalyst, respectively. The vital role of etching agents such as CO2 and H2O in CNT formation was demonstrated on the basis of on-line Fourier-transform infrared spectroscopy measurements. Hydrogen was shown to participate in the reaction of carbon release and to prevent the oxidation of the catalyst particles and the hot wire. The addition of H2 and small amounts of CO2 and H2O led to an increase in the carbon nanotube lengths. The catalyst particle evaporation process inside the reactor was found to become significant at temperatures higher than 1100 degrees C. The carbon nanotube growth was found to occur at a temperature of around 900 degrees C in the heating section of the reactor by in situ sampling and the growth rate was calculated to exceed 1.1 microm/s. A detailed analysis of possible processes during carbon nanotube formation revealed heptagon transformation as a limiting stage. A mechanism for carbon nanotube formation was proposed.