An Eight-Atom Iridium-Aluminum Oxide Cluster IrAlO6+ Catalytically Oxidizes Six CO Molecules.

Fundamental understanding regarding oxygen storage capacity involving how and why an active site can buffer a large number of oxygen atoms in redox processes is vital to the design of advanced oxygen storage materials, while it is challenging because of the complexity of heterogeneous catalysis. Herein, we identified that an eight-atom iridium-aluminum oxide cluster IrAlO6+ can transfer all the oxygen atoms to catalytically oxidize six CO molecules. This finding represents a breakthrough in cluster catalysis where at most three oxygen atoms from a heteronuclear metal oxide cluster can be catalytically involved in CO oxidation. We found that oxygen prefers to be stored on aluminum to form an O3-• radical in the energetically unfavorable IrAlO6+ isomer and generate the low-coordinated iridium that is pivotal to capturing CO and triggering the catalysis. The powerful electron cycling capability of iridium and the cooperative iridium-aluminum interplay are emphasized to drive the oxygen atom-transfer behavior.

Multimedia Exercise Training Program Improves Distance Walked, Heart Rate Recovery, and Self-efficacy in Cardiac Surgery Patients.

BACKGROUND: Patient education has been shown to be more effective when delivered using multimedia than written materials. However, the effects of using multimedia to assist patients in cardiac rehabilitation have not been investigated. OBJECTIVE: The purpose of this study is to examine the effect of an inpatient multimedia exercise training program on distance walked in the 6-minute walking test (6MWT), heart rate recovery, and walking self-efficacy of patients who had undergone heart surgery. METHODS: For this longitudinal quasi-experimental study, 60 consecutive patients were assigned to an experimental (n = 20; inpatient multimedia exercise training program) or control (n = 40; routine care) group. Data were collected at 3 times (before surgery, 1 to 2 days before hospital discharge, and 1 month after hospital discharge) and analyzed with the generalized estimating equation approach. RESULTS: Most subjects were men (66.7%), had a mean age of 61.32 ± 13.4 years and left ventricular ejection fraction of 56.96% ± 13.28%, and underwent coronary artery bypass graft surgery (n = 34, 56.7%). Subjects receiving the exercise training program showed significantly greater improvement than those in the control group in the 6MWT walking distance (P < .001), heart rate recovery (P = .04), and self-efficacy (P = .002) at hospital discharge. Furthermore, the intervention effects on 6MWT distance (P < .001) and self-efficacy (P < .001) were sustained at 1 month after hospital discharge. CONCLUSION: Our inpatient multimedia exercise training program safely improved distance walked in the 6MWT, heart rate recovery, and self-efficacy at hospital discharge in patients after heart surgery and maintained their improvement in 6MWT and self-efficacy 1 month later.

Syntheses, crystal structures, weak interaction, magnetic and photoluminescent properties of two new organic-inorganic molecular solids with disubstituted benzyl triphenylphosphinium and tetra(isothiocyanate)cobalt(II) anion.

Two new organic-inorganic molecular solids of tetra(isothiocyanate)cobalt(II) dianion and disubstituted benzyl triphenylphosphinium, [2Cl4FBzTPP]2[Co(NCS)4] (1) and [2Cl4ClBzTPP]2[Co(NCS)4] (2) ([2Cl4FBzTPP](+)=1-(2'-chloro-4'-fluorobenzyltriphenylphosphonium) and [2Cl4ClBzTPP](+)=1-(2',4'-dichlorobenzyltriphenylphosphonium), were synthesized and characterized by elemental analysis, FT-IR, UV-Vis spectra, ESI-MS and single crystal X-ray diffraction method. Compounds 1 and 2 crystallize in the monoclinic Pc and triclinic P-1, respectively. The Co(II) ion of the [Co(NCS)4](2-) anion shows a distorted tetrahedral coordination geometry. The [2Cl4FBzTPP](+) cations containing P(2) atoms in 1 form a column by the Cl⋯π interactions, while the [2Cl4ClBzTPP](+) cations in 2 form two columns by the C-H⋯π and π⋯π interactions. The anion and the cation are linked by C-H⋯S hydrogen bonds and Cl⋯S interactions. Magnetic susceptibility measurement in the temperature range 2-300K shows that both 1 and 2 exhibit a weak antiferromagnetic exchange interaction as the temperature falls, and ultraviolet fluorescence emission in the solid state at room temperature.

Syntheses, crystal structures, luminescent and magnetic properties of two molecular solids containing naphthylmethylene triphenylphosphinium cations and tetra(isothiocyanate)cobalt(II) dianion.

The reaction of CoCl2 with the naphthalene methylated triphenylphosphinium bromide [n-NAPMeTPP]Br (n=1, 2) and KSCN, in a methanolic medium at ambient temperature, leads to the self-assembly formation of hybrid 2:1 organic-inorganic molecular solids, [1-NAPMeTPP]2[Co(NCS)4](1) and [2-NAPMeTPP]2[Co(NCS)4](2) ([NAPMeTPP](+)=(naphthylmethylene)(triphenyl)phosphinium), which have been characterized by elemental analyses, IR spectroscopy, UV-Vis spectra, ESI-MS, molar conductivity and single-crystal X-ray diffraction structural analyses. Compound 1 crystallizes in the orthorhombic space group Pna21, while 2 does in the monoclinic space group C2/c. The cations form a dimer through the weak intermolecular C-H⋯π interactions in 1 and π⋯π interaction in 2, while the anion and cation are linked by the C-H⋯S hydrogen bond in 1. Two molecular solids show dual functionalities: (1) the broad fluorescence emission around 400nm in the solid state at room temperature; (2) the weak antiferromagnetic coupling behavior.

[New life from the heart: assessment and management of heart transplant patients].

Patients who receive heart transplantation surgery following end-stage cardiac failure benefit from efforts to improve their post-surgical quality of life. Assessing and managing perioperative care play an important role in heart transplantation. Evaluations of donor and recipient should be conducted carefully and recommended candidates should by vetted by a qualified heart transplantation committee. The operative procedure is different from general cardiac surgery, and organ preservation is a key step in linking the donor to the recipient. Postoperative infection control and administration of immunosuppressive agents further affect the outcome of heart transplantation. Based on a review of articles and our clinical care experience, we focus on the assessment and the management of heart transplantation in this article.

[Nurses' self-perception of nursing competence after completing a 2-year training program at a medical center].

BACKGROUND: Taiwan's Department of Health (DOH) promotes a standardized 2-year training program to raise the competence of newly certified nurses in the realms of patient care, nursing professionalism and communication skills as well as to ensure professional nurse training program quality. PURPOSE: This study evaluated training program participants' self-perception of nursing competency. METHOD: We used a cross-sectional approach and structured questionnaire to evaluate the nursing competency of 128 nurse trainees at a medical center. Questionnaires were filled out independently by participants and thus reflect participant self-assessments of questionnaire items. Descriptive and correlation analyses further explored data. RESULT: Results showed: mean scores were 3.80 ± .60 for clinical technique; 3.78 ± .67 for administrative skill; and 3.21 ± .88 for educational and research skills . Nursing ability correlated significantly with age, seniority, nursing grade, and courses taken. The relationship between participant total score and program completion ratio formed a "V"-shaped distribution. CONCLUSIONS / IMPLICATIONS FOR PRACTICE: The DOH training program was has a positive effect on nursing competency in nurse trainees. Results also provide valuable information and suggestions for revising the DOH's nurse training program in the future.

[Pathophysiological changes in patients who have undergone coronary artery bypass graft surgery].

Coronary artery bypass graft (CABG) surgery is indicated for patients with coronary artery disease in order to relieve symptoms, improve life quality and prolong life. Gradual improvements in operative techniques and perioperative care have made CABG surgery an increasingly common treatment option for those with coronary artery disease. Injury to the myocardium, inflammatory responses due to intraoperative events and potential complications with extracorporeal circulation are primary issues that may negatively impact patient outcomes. This article describes concepts related to the pathophysiology of one patient who underwent a coronary artery bypass graft surgery and offers a single case study to compare clinical findings against established theoretical and empirical knowledge. The individualized nursing intervention for this case is presented and discussed as well.