RESUMEN
Healthcare workers are at a high risk of violence all over the world. The hostility toward nurses, physicians, and hospital staff has reached the point that it can be considered a public health problem. In this paper, we focus on the harassment, aggression, and violence that many healthcare workers have encountered while treating unstable psychiatric patients in the middle of the COVID-19 pandemic. We present a case with a history of violence toward mental health workers, review psychopathological and clinical aspects, and discuss how both the COVID-19 pandemic and current challenges in psychiatric hospital settings increase the frequency and severity of these attacks and how this affects the team on inpatient psychiatric units. We used the CARE guidelines to provide the most accurate and transparent information about the patient and relevant psychosocial aspects. We also pooled more than 20 unique sources to cover all aspects of violent behaviors in all psychiatric settings for all age groups. We concluded that a lack of nursing staff, the mental burden imposed by difficult patients, and poor communication between team members are some of the factors contributing to patient violence. An incomplete understanding of the problem creates barriers to change on both personal and systematic levels. Constant violence and abuse against healthcare workers cause stress, decreased productivity, and work dissatisfaction. To improve the safety of healthcare professionals, especially in inpatient psychiatric settings, several system-based changes should be implemented.
RESUMEN
Methanol soluble and stable guanosine octamers were successfully achieved via H-bond self-assembly. Through structural conformational design, we developed a new class of guanosine derivatives with modification on guanine (8-aryl) and ribose (2',3'-isopropylidene). This unique design led to the formation of the first discrete G8-octamer with its structure characterized by single crystal X-ray diffraction, MS and NMR spectroscopy. The G8-octamer showed unique cation recognition properties, including the formation of a stable Rb+ templated G-quadruplex. Based on this observation, further modification on the 8-aryl moiety was performed to incorporate a cross-layer H-bond or covalent linkage. Similar G-octamers were obtained in both cases with structures confirmed by single crystal X-ray diffraction. Furthermore, the covalently linked G-quadruplex exhibited excellent stability even in MeOH and DMSO, suggesting a promising future for this new H-bond self-assembly system in biological and material applications.
RESUMEN
We report inducible dimerization strategies for controlling protein positioning, enzymatic activity, and organelle assembly inside synthetic cell-like compartments upon photostimulation. Using a photocaged TMP-Haloligand compound, we demonstrate small molecule and light-induced dimerization of DHFR and Haloenzyme to localize proteins to a compartment boundary and reconstitute tripartite sfGFP assembly. Using photocaged rapamycin and fragments of split TEV protease fused to FRB and FKBP, we establish optical triggering of protease activity inside cell-size compartments. We apply light-inducible protease activation to initiate assembly of membraneless organelles, demonstrating the applicability of these tools for characterizing cell biological processes in vitro. This modular toolkit, which affords spatial and temporal control of protein function in a minimal cell-like system, represents a critical step toward the reconstitution of a tunable synthetic cell, built from the bottom up.
Asunto(s)
Dimerización , Endopeptidasas/química , Tetrahidrofolato Deshidrogenasa/química , Compartimento Celular/efectos de los fármacos , Compartimento Celular/genética , Compartimento Celular/efectos de la radiación , Luz , Orgánulos/química , Orgánulos/efectos de la radiación , Transporte de Proteínas/efectos de los fármacos , Transporte de Proteínas/genética , Transporte de Proteínas/efectos de la radiación , Sirolimus/química , Bibliotecas de Moléculas Pequeñas/química , Bibliotecas de Moléculas Pequeñas/farmacología , Tetrahidrofolato Deshidrogenasa/efectos de la radiaciónRESUMEN
The primary goal of this anatomic study was to measure the average bone volume of the edentulous maxilla with a cone-beam computerized tomography (CBCT) scan and to determine its suitability for implant treatment without additional bone grafting. The secondary goal of the study was to estimate the degree of sinus pneumatization (SP) in reviewed CBCT scans, assess the sinus-to-maxillary bone interrelationship in edentulism, and attempt to classify maxillary sinuses based on the degree of their pneumatization. This retrospective radiographic quantitative study consisted of the analysis of CBCT scans of 30 randomly selected maxillary edentulous patients who presented in 2008-2010 to the University of the Pacific, Arthur A. Dugoni School of Dentistry, for evaluation and treatment of their edentulism. A volume of edentulous maxillary bone mesial to the maxillary sinuses (intersinal region) that can be used for a full-arch implant treatment was evaluated based on specifically selected and clinically relevant measurement criteria. There were 30 CBCT scans of maxillary edentulous patients reviewed (9 men, 21 women) with a mean age of 67.3 years (range, 41 to 92 years). The total mean maxillary bone volume (MMBV) suitable for implantation was 4 408.1 mm(3) and ranged from 1489.7 to 7263.1 mm(3). The MMBV in the study was higher than an assumed or hypothetical bone volume minimally suitable for 4-implant treatment as proposed by the authors for comparative purposes (3500 mm(3)). The degree of SP as seen on a CBCT scan (60 sinuses analyzed on panoramic images of 30 CBCT scans) had the following results in the study: SP0 (clear: not interfering with implant treatment in cases of high/small sinus), 2 sinuses or 3.3%; SP1 (mild sinus enlargement), 29 sinuses or 48.3%; SP2 (moderate SP), 16 sinuses or 26.7%; SP3 (severe SP), 9 sinuses or 15.0%; and SP4 (extreme), 4 sinuses or 6.7%. Most analyzed maxillary sinuses (47 of 60, or 78.3%) were in the clear, mild, or moderate categories of SP (SP0, SP1, and SP2), which have a sufficient amount of maxillary bone beneath the maxillary sinuses to allow a full-arch implant treatment. An inverse correlation between SP and MMBV was observed. Although many other clinical criteria are important (bone quality, alveolar crest anatomy, etc), the results of this CBCT radiographic study indicate that in many maxillary edentulous cases, the existing bone quantity (volume) can be sufficient for a full-arch maxillary implant treatment with at least 4 implants without the additional trauma or expense of bone grafts and sinus lifts. A variety of implant treatment options can be proposed based on maxillary bone availability and bone-to-sinus interrelationship. It appears that with age and edentulism, the amount of available maxillary bone is steadily decreasing.