RESUMO
Metalation of metal-organic frameworks (MOFs) has been developed as a prominent strategy for materials functionalization for pore chemistry modulation and property optimization. By introducing exotic metal ions/complexes/nanoparticles onto/into the parent framework, many metallized MOFs have exhibited significantly improved performance in a wide range of applications. In this review, we focus on the research progress in the metalation of metal-organic frameworks during the last five years, spanning the design principles, synthetic strategies, and potential applications. Based on the crystal engineering principles, a minor change in the MOF composition through metalation would lead to leveraged variation of properties. This review starts from the general strategies established for the incorporation of metal species within MOFs, followed by the design principles to graft the desired functionality while maintaining the porosity of frameworks. Facile metalation has contributed a great number of bespoke materials with excellent performance, and we summarize their applications in gas adsorption and separation, heterogeneous catalysis, detection and sensing, and energy storage and conversion. The underlying mechanisms are also investigated by state-of-the-art techniques and analyzed for gaining insight into the structure-property relationships, which would in turn facilitate the further development of design principles. Finally, the current challenges and opportunities in MOF metalation have been discussed, and the promising future directions for customizing the next-generation advanced materials have been outlined as well.
RESUMO
OBJECTIVE: This study aims to analyze the clinical effects of combining carbamazepine and amitriptyline in the treatment of diabetic neuropathy with concurrent diabetic foot. METHODS: A total of 120 diabetic neuropathy patients treated at our hospital from June 2022 to November 2023 were included in the study. Patients meeting the inclusion criteria were registered, and their basic data were collected. The patients were randomly divided into two groups: the control group treated with amitriptyline and the study group treated with a combination of carbamazepine and amitriptyline. RESULTS: The study group demonstrated significantly better clinical efficacy compared to the control group (p < 0.05). There were no significant differences in psychological status and pain perception before treatment between the two groups (p > 0.05). However, post-treatment, the study group showed improved psychological status, reduced pain perception, and overall better quality of life in both physiological and psychological dimensions compared to the control group (p < 0.05). CONCLUSION: The combined use of carbamazepine and amitriptyline in the treatment of diabetic neuropathy with concurrent diabetic foot yields positive clinical outcomes. It effectively alleviates symptoms, improves psychological well-being, reduces pain sensation, and enhances overall quality of life. These findings can guide physicians in adopting a more evidence-based treatment approach and provide patients with more effective individualized treatment strategies.
RESUMO
In principle, porous physisorbents are attractive candidates for the removal of volatile organic compounds such as benzene by virtue of their low energy for the capture and release of this pollutant. Unfortunately, many physisorbents exhibit weak sorbate-sorbent interactions, resulting in poor selectivity and low uptake when volatile organic compounds are present at trace concentrations. Herein, we report that a family of double-walled metal-dipyrazolate frameworks, BUT-53 to BUT-58, exhibit benzene uptakes at 298 K of 2.47-3.28 mmol g-1 at <10 Pa. Breakthrough experiments revealed that BUT-55, a supramolecular isomer of the metal-organic framework Co(BDP) (H2BDP = 1,4-di(1H-pyrazol-4-yl)benzene), captures trace levels of benzene, producing an air stream with benzene content below acceptable limits. Furthermore, BUT-55 can be regenerated with mild heating. Insight into the performance of BUT-55 comes from the crystal structure of the benzene-loaded phase (C6H6@BUT-55) and density functional theory calculations, which reveal that C-H···X interactions drive the tight binding of benzene. Our results demonstrate that BUT-55 is a recyclable physisorbent that exhibits high affinity and adsorption capacity towards benzene, making it a candidate for environmental remediation of benzene-contaminated gas mixtures.
Assuntos
Estruturas Metalorgânicas , Compostos Orgânicos Voláteis , Adsorção , Benzeno/química , GasesRESUMO
Metal-organic frameworks (MOFs) have been attracting tremendous attention owing to their great structural diversity and functional tunability. Despite numerous inherent merits and big progress in the fundamental research (synthesizing new compounds, discovering new structures, testing associated properties, etc.), poor chemical stability of most MOFs severely hinders their involvement in practical applications, which is the final goal for developing new materials. Therefore, constructing new stable MOFs or stabilizing extant labile MOFs is quite important. As with them, some "potential" applications would come true and a lot of new applications under harsh conditions can be explored. Efficient strategies are being pursued to solve the stability problem of MOFs and thereby achieve and expand their applications.In this Account, we summarize the research advance in the design and synthesis of chemically stable MOFs, particularly those stable in acidic, basic, and aqueous systems, as well as in the exploration of their applications in several expanding fields of environment, energy, and food safety, which have been dedicated in our lab over the past decade. The strategies for accessing stable MOFs can be classified into: (a) assembling high-valent metals (hard acid, such as Zr4+, Al3+) with carboxylate ligands (hard base) for acid-stable MOFs; (b) combining low-valent metals (soft acid, such as Co2+, Ni2+) and azolate ligands (soft base, such as pyrazolate) for alkali-resistant MOFs; (c) enhancing the connectivity of the building unit; (d) contracting or rigidifying the ligand; (e) increasing the hydrophobicity of the framework; and (f) substituting liable building units with stable ones (such as metal metathesis) to obtain robust MOFs. In addition, other factors, including the geometry and symmetry of building units, framework-framework interaction, and so forth, have also been taken into account in the design and synthesis of stable MOFs. On the basis of these approaches, the stability of resulting MOFs under corresponding conditions has been remarkably enhanced.With high chemical stability achieved, the MOFs have found many new and significant applications, aiming at addressing global challenges related to environmental pollution, energy shortage, and food safety.A series of stable MOFs have been constructed for detecting and eliminating contaminations. Various fluorescent MOFs were rationally customized to be powerful platforms for sensing hazardous targets in food and water, such as dioxins, antibiotics, veterinary drugs, and heavy metal ions. Some hydrophobic MOFs even showed effective and specific capture of low-concentration volatile organic compounds.Novel MOFs with record-breaking acid/base/nucleophilic regent resistance have expanded their application scope under harsh conditions. BUT-8(Cr)A, as the most acid-stable MOF yet, showed reserved structural integrity in concentrated H2SO4 and recorded high proton conductivity; the most alkali-resistant MOF, PCN-601, retained crystallinity even in boiling saturated NaOH aqueous solution, and such base-stable MOFs composed of non-noble metal clusters and poly pyrazolate ligands also demonstrated great potential in heterogeneous catalysis in alkaline/nucleophilic systems for the first time.It is believed that this Account will provide valuable references on stable MOFs' construction as well as application expansion toward harsh conditions, thereby being helpful to promote MOF materials to step from fundamental research to practical applications.
RESUMO
Constructing stable palladium(II)-based metal-organic frameworks (MOFs) would unlock more opportunities for MOF chemistry, particularly toward applications in catalysis. However, their availability is limited by synthetic challenges due to the inertness of the Pd-ligand coordination bond, as well as the strong tendency of the Pd(II) source to be reduced under typical solvothermal conditions. Under the guidance of reticular chemistry, herein, we present the first example of an azolate Pd-MOF, BUT-33(Pd), obtained via a deuterated solvent-assisted metal metathesis. BUT-33(Pd) retains the underlying sodalite network and mesoporosity of the template BUT-33(Ni) and shows excellent chemical stability (resistance to an 8 M NaOH aqueous solution). With rich Pd(II) sites in the atomically precise distribution, it also demonstrates good performances as a heterogeneous Pd(II) catalyst in a wide application scope, including Suzuki/Heck coupling reactions and photocatalytic CO2 reduction to CH4. This work highlights a feasible approach to reticularly construct noble metal based MOFs via metal metathesis, in which various merits, including high chemical stability, large pores, and tunable functions, have been integrated for addressing challenging tasks.
RESUMO
Despite numerous inherent merits of metal-organic frameworks (MOFs), structural fragility has imposed great restrictions on their wider involvement in many applications, such as in catalysis. Herein, a strategy for enhancing stability and enabling functionality in a labile Zr(IV)-MOF has been proposed by in situ porphyrin substitution. A size- and geometry-matched robust linear porphyrin ligand 4,4'-(porphyrin-5,15-diyl)dibenzolate (DCPP2- ) is selected to replace the 4,4'-(1,3,6,8-tetraoxobenzo[lmn][3,8]phenanthroline-2,7(1H,3H,6H,8H)-diyl)dibenzoate (NDIDB2- ) ligand in the synthesis of BUT-109(Zr), affording BUT-110 with varied porphyrin contents. Compared to BUT-109(Zr), the chemical stability of BUT-110 series is greatly improved. Metalloporphyrin incorporation endows BUT-110 MOFs with high catalytic activity in the photoreduction of CO2 , in the absence of photosensitizers. By tuning the metal species and porphyrin contents in BUT-110, the resulting BUT-110-50%-Co is demonstrated to be a good photocatalyst for selective CO2 -to-CO reduction, via balancing the chemical stability, photocatalytic efficiency, and synthetic cost. This work highlights the advantages of in situ ligand substitution for MOF modification, by which uniform distribution and high content of the incoming ligand are accessible in the resulting MOFs. More importantly, it provides a promising approach to convert unstable MOFs, which mainly constitute the vast MOF database but have always been neglected, into robust functional materials.
RESUMO
The application scope of metal-organic frameworks (MOFs) is severely restricted by their weak chemical stability and limited pore size. A robust MOF with large mesopores is highly desired, yet poses a great synthetic challenge. Herein, two chemically stable Ni(II)-pyrazolate MOFs, BUT-32 and -33, were constructed from a conformation-matched elongated pyrazolate ligand through the isoreticular expansion. The two MOFs share the same sodalite-type net, but have different pore sizes due to the network interpenetration in BUT-32. Controlled syntheses of the two MOFs have been achieved through precisely tuning reaction conditions, where the microporous BUT-32 was demonstrated to be a thermodynamically stable product while the mesoporous BUT-33 is kinetically favored. To date, BUT-32 represents the first example of Ni4-pyrazolate MOF whose structure was unambiguously determined by single-crystal X-ray diffraction. Interestingly, the kinetic product BUT-33 integrates 2.6 nm large mesopores with accessible Ni(II) active sites and remarkable chemical stability even in 4 M NaOH aqueous solution and 1 M Grignard reagent. This MOF thus demonstrated an excellent catalytic performance in carbon-carbon coupling reactions, superior to other Ni(II)-MOFs including BUT-32. These findings highlight the importance of kinetic control in the reticular synthesis of mesoporous MOFs, as well as their superiority in heterogeneous catalysis.
RESUMO
As the Cr2O72- anion is highly toxic, new sensors have been developing for its effective detection from water, among which metal-organic frameworks (MOFs) show distinct superiority over many other materials. Herein, a new fluorescent Zr(IV)-based MOF, [Zr6O4(OH)8(H2O)4(sbtc)2] (referred to as BUT-28), based on the di-isophthalate ligand with a central CHâCH moiety, trans-stilbene-3,3',5,5'-tetracarboxylate (sbtc4-), has been prepared and structurally determined. The MOF shows excellent stability in neutral, highly acidic, and weakly basic aqueous solutions. Moreover, no essential uptake loss in three cycles of water vapor adsorption-desorption measurements was observed for BUT-28, suggesting the robustness of the porous framework and its great potential for long-term use. Fluorescent measurements were carried out for BUT-28 and an isostructural MOF, Zr-abtc, which is constructed from the di-isophthalate ligand with a central NâN moiety, azobenzene-3,3',5,5'-tetracarboxylate (abtc4-). Interestingly, Zr-abtc shows very weak fluorescent emission. In contrast, BUT-28 exhibits relatively strong fluorescence and serves as a promising sensory material for the detection of trace Cr2O72- (limit of detection: 36 ppb) in aqueous solutions by selective and sensitive fluorescence quenching effect.
RESUMO
Metal-organic frameworks (MOFs) have shown great potential for application in various fields, including CO2 capture and proton conduction. For promoting their practical applications, both optimization of a given property and enhancement of chemical stability are crucial. In this work, three base-stable isostructural MOFs, [Ni8 (OH)4 (H2 O)2 (BDP-X)6 ] (Ni-BDP-X; H2 BDP=1,4-bis(4-pyrazolyl)benzene, X=CHO, CN, COOH) with different functional groups, are designed, synthesized, and used in CO2 capture and proton conduction experiments. They possess face-centered cubic topological structures with functional nanoscale cavities. Importantly, these MOFs are fairly stable to maintain their structures in boiling water and 4 M sodium hydroxide solution at room temperature. Functionalization endows them with tunable properties. In gas adsorption studies, these MOFs exhibit selective adsorption of CO2 over CH4 and N2 , and in particular the introduction of COOH groups provides the highest selectivity. In addition, the COOH-functionalized Ni-BDP exhibits a high proton conductivity of 2.22×10-3 â S cm-1 at 80 °C and approximately 97 % relative humidity.
RESUMO
A mild and straightforward synthetic protocol for construction of a furan skeleton promoted by Yb(OTf)3 from ß-ketothioamides and arylglyoxals has been developed at room temperature. Importantly, this protocol involves a tandem sequence that includes aldol condensation, N-cyclization, ring opening, O-cyclization, S-cyclization, and Eschenmoser sulfide contraction.
RESUMO
We report a crystal-engineering study conducted upon a platform of three mixed-linker square lattice (sql) coordination networks of general formula [Zn(Ria)(bphy)] [bphy = 1,2-bis(pyridin-4-yl)hydrazine, H2Ria = 5-position-substituted isophthalic acid, and R = -Br, -NO2, and -OH; compounds 1-3]. Analysis of single-crystal X-ray diffraction data of 1-2 and the simulated crystal structure of 3 revealed that 1-3 are isomorphous and sustained by bilayers of sql networks linked by hydrogen bonds. Although similar pore shapes and sizes exist in 1-3, distinct isotherm shapes (linear and S shape) and uptakes (2.4, 11.6, and 13.3 wt %, respectively) were observed. Ab initio calculations indicated that the distinct water sorption properties can be attributed to the R groups, which offer a range of hydrophilicity. Calculations indicated that the significantly lower experimental uptake in compound 1 can be attributed to a constricted channel. The calculated water-binding sites provide insights into how adsorbed water molecules bond to the pore walls, with the strongest interactions, water-hydroxyl hydrogen bonding, observed for 3. Overall, this study reveals how pore engineering can result in large variations in water sorption properties in an isomorphous family of rigid porous coordination networks.
RESUMO
Benzene and SO2, coexisting as hazardous air pollutants in some cases, such as in coke oven emissions, have led to detrimental health and environmental effects. Physisorbents offer promise in capturing benzene and SO2, while their performance compromises at low concentration. Particularly, the simultaneous capture of trace benzene and SO2 under humid conditions is attractive but challenging. Here, we address this issue by constructing a robust pyrazolate metal-organic framework (MOF) sorbent featuring rich accessible Ni(II) sites with low affinity to water and good stability. This material achieves a high benzene uptake of 5.08 mmol g-1 at 10 Pa, surpassing previous benchmarks. More importantly, it exhibits an adsorption capacity of ~0.51 mmol g-1 for 10 ppm benzene and ~1.21 mmol g-1 for 250 ppm SO2 under 30% relative humidity. This work demonstrates that a pioneering MOF enables simultaneous capture of trace benzene and SO2, highlighting the potential of physisorbents for industrial effluent remediation, even in the presence of moisture.
RESUMO
Gas or vapor-induced phase transformations in flexible coordination networks (CNs) offer the potential to exceed the performance of their rigid counterparts for separation and storage applications. However, whereas ligand modification has been used to alter the properties of such stimulus-responsive materials, they remain understudied compared with their rigid counterparts. Here, we report that a family of Zn2+ CNs with square lattice (sql) topology, differing only through the substituents attached to a linker, exhibit variable flexibility. Structural and CO2 sorption studies on the sql networks, [Zn(5-Ria)(bphy)]n, ia = isophthalic acid, bphy = 1,2-bis(pyridin-4-yl)hydrazine, R = -CH3, -OCH3, -C(CH3)3, -N=N-Ph, and -N=N-Ph(CH3)2, 2-6, respectively, revealed that the substituent moieties influenced both structural and gas sorption properties. Whereas 2-3 exhibited rigidity, 4, 5, and 6 exhibited reversible transformation from small pore to large pore phases. Overall, the insight into the profound effect of pendent moieties of linkers upon phase transformations in this family of layered CNs should be transferable to other CN classes.
RESUMO
OBJECTIVES: This study aims to compare perceived family functioning between Chinese patients who had an acute ischaemic stroke (AIS) and family caregivers, and explore the association between family functioning and patients' depressive symptoms. DESIGN: This is a cross-sectional study design. SETTING: Stroke centres of two tertiary hospitals in Nanjing, China. PARTICIPANTS: One hundred and sixty-nine dyads of patients who had an AIS and family caregivers. PRIMARY AND SECONDARY OUTCOME MEASURES: Family functioning of patients who had an AIS and their primary family caregivers was assessed by the Family Assessment Device (FAD, Chinese version). Depressive symptoms of patients who had an AIS was assessed by the Centre for Epidemiological Studies Depression Scale. We test the agreement and differences in family functioning. Multivariate linear regression models were used to test the association of differences of family functioning within dyads with patients' depressive symptoms. RESULTS: AIS families demonstrated unhealthy family functioning. A total of 115 patients (76.9%) and 124 caregivers (73.4%) had a score of 2 or higher in FAD-general functioning (GF), indicating unhealthy family functioning. The intraclass correlation coefficient of FAD subdomain between patients who had an AIS and caregivers ranged from 0.15 to 0.55, which indicating the agreement of family functioning within dyads was poor to moderate. There was a significant difference between the FAD-GF scores of the patients and those of their caregivers (Z=-2.631, p=0.009), with caregivers reporting poorer general family functioning. Poor family functioning and greater difference of perceived family functioning within dyads were related to higher level of patients' depressive symptoms (ß=5.163, p<0.001, ß=5.534, p<0.001, respectively). CONCLUSIONS: These findings indicate that healthcare professionals should assess family functioning in both patients who had a stroke and caregivers. Improvement of family function and decreasing discrepancies within dyads may be helpful for relieving patients' depressive symptoms.
Assuntos
Isquemia Encefálica , AVC Isquêmico , Acidente Vascular Cerebral , Humanos , Depressão , Cuidadores , Estudos Transversais , FamíliaRESUMO
Herein, we report the crystal structure and guest binding properties of a new two-dimensional (2D) square lattice (sql) topology coordination network, sql-(azpy)(pdia)-Ni, which is comprised of two linker ligands with diazene (azo) moieties, (E)-1,2-di(pyridin-4-yl)diazene(azpy) and (E)-5-(phenyldiazenyl)isophthallate(pdia). sql-(azpy)(pdia)-Ni underwent guest-induced switching between a closed (nonporous) ß phase and several open (porous) α phases, but unlike the clay-like layer expansion to distinct phases previously reported in switching sql networks, a continuum of phases was formed. In effect, sql-(azpy)(pdia)-Ni exhibited elastic-like properties induced by adaptive guest binding. Single-crystal X-ray diffraction (SCXRD) studies of the α phases revealed that the structural transformations were enabled by the pendant phenyldiazenyl moiety on the pdia2- ligand. This moiety functioned as a type of hinge to enable parallel slippage of layers and interlayer expansion for the following guests: N,N-dimethylformamide, water, dichloromethane, para-xylene, and ethylbenzene. The slippage angle (interplanar distances) ranged from 54.133° (4.442 Å) in the ß phase to 69.497° (5.492 Å) in the ethylbenzene-included phase. Insight into the accompanying phase transformations was also gained from variable temperature powder XRD studies. Dynamic water vapor sorption studies revealed a stepped isotherm with little hysteresis that was reversible for at least 100 cycles. The isotherm step occurred at ca. 50% relative humidity (RH), the optimal RH value for humidity control.
RESUMO
Introduction: In November 2021, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant was identified as the variant of concern and has since spread globally, replacing other cocirculating variants. To better understand the dynamic changes in viral load over time and the natural history of the virus infection, we analyzed the expression of the open reading frames 1ab (ORF1ab) and nucleocapsid (N) genes in patients infected with Omicron. Methods: We included patients initially admitted to the hospital for SARS-CoV-2 infection between November 5 and December 25, 2022. We collected daily oropharyngeal swabs for quantitative reverse transcriptase-polymerase chain reaction tests using commercial kits. We depicted the cycle threshold (Ct) values for amplification of ORF1ab and N genes from individual patients in age-specific groups in a time series. Results: A total of 480 inpatients were included in the study, with a median age of 59 years (interquartile range, 42 to 78; range, 16 to 106). In the <45-year-old age group, the Ct values for ORF1ab and N gene amplification remained below 35 for 9.0 and 11.5 days, respectively. In the ≥80-year-old age group, the Ct values for ORF1ab and N genes stayed below 35 for 11.5 and 15.0 days, respectively, which was the longest among all age groups. The Ct values for N gene amplification took longer to rise above 35 than those for ORF1ab gene amplification. Conclusion: The time to test negative varied among different age groups, with viral nucleic acid shedding taking longer in older age groups compared to younger age groups. As a result, the time to resolution of Omicron infection increased with increasing age.
RESUMO
Metal-organic frameworks (MOFs) have been proven promising in addressing many critical issues related to gas separation and purification. However, it remains a great challenge to optimize the pore environment of MOFs for purification of specific gas mixtures. Herein, we report the rational construction of three isostructural microporous MOFs with the 4,4',4"-tricarboxyltriphenylamine (H3TCA) ligand, unusual hexaprismane Ni6O6 cluster, and functionalized pyrazine pillars [PYZ-x, x = -H (DZU-10), -NH2 (DZU-11), and -OH (DZU-12)], where the building blocks of Ni6O6 clusters and huddled pyrazine pillars are reported in porous MOFs for the first time. These building blocks have enabled the resulting materials to exhibit good chemical stability and variable pore chemistry, which thus contribute to distinct performances toward C2H2/CO2 separation. Both single-component isotherms and dynamic column breakthrough experiments demonstrate that DZU-11 with the PYZ-NH2 pillar outperforms its hydrogen and hydroxy analogues. Density functional theory calculations reveal that the higher C2H2 affinity of DZU-11 over CO2 is attributed to multiple electrostatic interactions between C2H2 and the framework, including strong C≡C···H-N (2.80 Å) interactions. This work highlights the potential of pore environment optimization to construct smart MOF adsorbents for some challenging gas separations.
RESUMO
Background: Recovery of cognitive function after stroke has inter-individual variability. The theory of cognitive reserve offers a potential explanation of the variability in cognitive function after stroke. Objective: This study aimed to investigate the moderating effect of cognitive reserve on the relationship between the stroke severity and cognitive function after stroke. Materials and methods: A total of 220 patients with Acute Ischemic Stroke (AIS) were recruited in 2021 from two stroke centers in Nanjing, China. The National Institutes of Health Stroke Scale (NIHSS) was used to assess stroke severity upon admission. Cognitive Reserve Index questionnaire (CRIq) and validated Montreal Cognitive Assessment, Changsha Version (MoCA-CS) were used to assess cognitive reserve and cognitive function within 7 days after stroke onset, respectively. A series of multivariate linear regression models were applied to test the moderating effect of cognitive reserve. Results: Patients with a higher level of cognitive reserve had better cognitive function after stroke compared with those with a lower level of cognitive reserve (ß = 0.074, p = 0.003). The interaction of NIHSS and cognitive reserve was statistically significant (ß = -0.010, p = 0.045) after adjusting for some key covariates [e.g., age, marital status, Oxfordshire Community Stroke Project (OCSP) classification, Trial of ORG 10172 in Acute Stroke Treatment (TOAST) classification, cerebral vascular stenosis, diabetes and atrial fibrillation]. Conclusion: Cognitive reserve may help to buffer the effect of stroke-related pathology on cognitive decline in Chinese acute stroke patients. Enhancing cognitive reserve in stroke patients may be one of the potential strategies for preventing vascular dementia.
RESUMO
INTRODUCTION: Urethral lengthening in phalloplasty could bring many postoperative complications, such as urethra fistula and stricture, which greatly affects the patient's mental health and quality of life. AIM: To describe a novel technique of vaginal mucosal graft for prelamination urethra (VMGPU) combined with modified urethral anastomosis (MUA) for the reconstruction of a neourethra. METHODS: A retrospective study of transgender men between January 2006 and March 2021 was conducted. Patients were divided into three groups according to the surgical methods : traditional groupï¼TGï¼VMGPU groupï¼VGï¼ and VMGPU+MUA group (VMG). MAIN OUTCOME MEASURE: The main outcomes measures were demographics, surgical characteristics, complications, International Prostate Symptom Scoreï¼IPSSï¼Quality of Lifeï¼QOLï¼ scoreï¼and voiding frequency conditions. RESULTS: Of 80 eligible transgender menï¼TG:n = 39ï¼VG:n = 31, VMG:n = 10), the urethral fistula developed in 19/39 (49%) patients in TG, 8/31 (26%) in VG, and 1/10 (10%) in VMG (P = 0.034). The urethral stricture formed in 15/39 (38%) patients in TG, 4/31 (13%) in VG, and 1/10 (10%) in VMG (P = 0.028). Compared with TG, the VG got more favorable IPSS. The QOL scores showed that patients in VG or VMG were more satisfied with their postoperative status. CLINICAL IMPLICATIONS: VMGPU combined with MUA may help reduce urethral complications for transgender men who wish to undergo phalloplasty with urethral lengthening. STRENGTH & LIMITATIONS: VMGPU combined with MUA focuses on reducing the urethra-related complications in the anastomotic stoma between the fixed and the penile urethra, which has not been noticed in the past. The limitations of this study are that the retrospective study design is prone to bias; the study using VMGPU+MUA technique is only in the preliminary stage, and more cases are needed to prove its effectiveness; the median follow-up in VMG was only 2 years, and longer-term follow-up results are inconclusive; the IPSS, QOL, and the voiding frequency chart were not validated in transgender men. CONCLUSION: Our pilot study suggests that VMGPU combined with MUA may reduce the urethra-related complications, especially the urethral fistula in the anastomosis stoma between the fixed and the penile urethra. Gao H, Wu D, Kong X, et al. A Novel Technique of Urethroplasty Could Reduce Urethra-Related Complications in Phalloplasty With Urethral Lengthening. Sex Med 2022;10:100571.
RESUMO
OBJECTIVES: The current study aims to explore person-centered communication between health care professionals and COVID-19-infected older patients in acute care settings. METHODS: The current qualitative study explored the communication between professionals and COVID-19-infected older adults in the acute care setting through 2 rounds of interviews with physicians and nurses who provided direct care and treatment for COVID-19-infected older patients in Wuhan, China. We explored the possibilities and significance of facilitating effective communication despite multiple challenges in the pandemic. Conventional content analysis was adopted to analyze the rich data collected from our participants. RESULTS: It is possible and necessary to initiate and sustain person-centered communication despite multiple challenges brought by the pandemic. The achievement of person-centered communication can play significant roles in addressing challenges, building mutual trust, improving quality of care and relationships, and promoting treatment adherence and patients' psychological well-being. DISCUSSION: It is challenging for health care professionals to provide care for COVID-19-infected older adults, especially for those with cognitive and sensory impairment, in acute care settings. Facilitating person-centered communication is a significant strategy in responding to the pandemic crisis and a core element of person-centered care.