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1.
J Am Chem Soc ; 143(34): 13710-13720, 2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34410114

RESUMO

PCM-102 is a new organophosphine metal-organic framework (MOF) featuring diphosphine pockets that consist of pairs of offset trans-oriented P(III) donors. Postsynthetic addition of M(I) salts (M = Cu, Ag, Au) to PCM-102 induces single-crystal to single-crystal transformations and the formation of trans-[P2M]+ solid-state complexes (where P = framework-based triarylphosphines). While the unmetalated PCM-102 has low porosity, the addition of secondary Lewis acids to install rigid P-M-P pillars is shown to dramatically increase both stability and selective gas uptake properties, with N2 Brunauer-Emmett-Teller surface areas >1500 m2 g-1. The Ag(I) analogue can also be obtained via a simple, one-pot peri-synthetic route and is an ideal sacrificial precursor for materials with mixed bimetallic MA/MB pillars via postsynthetic, solvent-assisted metal exchange. Notably, the M-PCM-102 family of MOFs contain periodic trans-[P2M]+ sites that are free of counter anions, unlike traditional analogous molecular complexes, since the precursor PCM-102 MOF is monoanionic, enabling access to charge-neutral metal-pillared materials. Four M-PCM-102 materials were evaluated for the separation of C2 hydrocarbons. The separation performance was found to be tunable based on the metal(s) incorporated, and density functional theory was employed to elucidate the nature of the unusual observed sorption preference, C2H2 > C2H6 > C2H4.

2.
J Korean Med Sci ; 35(24): e185, 2020 Jun 22.
Artigo em Inglês | MEDLINE | ID: mdl-32567256

RESUMO

BACKGROUND: Little is known regarding the safe fixed dose of mycophenolic acid (MPA) for preventing biopsy-proven acute rejection (BPAR) in kidney transplant recipients (KTRs). We investigated the correlation of MPA trough concentration (MPA C0) and dose with renal transplant outcomes and adverse events. METHODS: This study included 79 consecutive KTRs who received MPA with tacrolimus (TAC) and corticosteroids. The MPA C0 of all the enrolled KTRs was measured, which was determined monthly by using particle-enhanced turbidimetric inhibition immunoassay for 12 months, and clinical data were collected at each time point. The clinical endpoints included BPAR, any cytopenia, and BK or cytomegalovirus infections. RESULTS: No differences in MPA C0 and dose were observed between KTRs with or without BPAR or viral infections under statistically comparable TAC concentrations. MPA C0 was significantly higher in patients with leukopenia (P = 0.021) and anemia (P = 0.002) compared with those without cytopenia. The MPA dose was significantly higher in patients with thrombocytopenia (P = 0.002) compared with those without thrombocytopenia. MPA C0 ≥ 3.5 µg/mL was an independent risk factor for leukopenia (adjusted odds ratio [AOR], 3.80; 95% confidence interval [CI], 1.24-11.64; P = 0.019) and anemia (AOR, 5.90; 95% CI, 1.27-27.51; P = 0.024). An MPA dose greater than the mean value of 1,188.8 mg/day was an independent risk factor for thrombocytopenia (AOR, 3.83; 95% CI, 1.15-12.78; P = 0.029). However, an MPA dose less than the mean value of 1,137.3 mg/day did not increase the risk of BPAR. CONCLUSION: Either a higher MPA C0 or dose is associated with an increased risk of cytopenia, but neither a lower MPA C0 nor dose is associated with BPAR within the first year of transplantation. Hence, a reduced MPA dose with TAC and corticosteroids might be safe in terms of reducing hematologic abnormalities without causing rejection.


Assuntos
Rejeição de Enxerto/prevenção & controle , Doenças Hematológicas/etiologia , Imunossupressores/efeitos adversos , Transplante de Rim/efeitos adversos , Ácido Micofenólico/uso terapêutico , Corticosteroides/uso terapêutico , Adulto , Anemia/etiologia , Relação Dose-Resposta a Droga , Quimioterapia Combinada , Feminino , Rejeição de Enxerto/etiologia , Humanos , Imunossupressores/uso terapêutico , Leucopenia/etiologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Ácido Micofenólico/efeitos adversos , Razão de Chances , Fatores de Risco , Tacrolimo/uso terapêutico , Trombocitopenia/etiologia
3.
BMC Med Educ ; 20(1): 476, 2020 Nov 26.
Artigo em Inglês | MEDLINE | ID: mdl-33243233

RESUMO

BACKGROUND: Effective collaboration and communication among health care team members are critical for providing safe medical care. Interprofessional education aims to instruct healthcare students how to learn with, from, and about healthcare professionals from different occupations to encourage effective collaboration to provide safe and high-quality patient care. The purpose of this study is to confirm the effectiveness of Interprofessional education by comparing students' attitudes toward interprofessional learning before and after simulation-based interprofessional education, the perception of teamwork and collaboration between physicians and nurses, and the self-reported competency differences among students in interprofessional practice. METHODS: The survey responses from 37 5th-year medical students and 38 4th-year nursing students who participated in an interprofessional education program were analyzed. The Attitude Towards Teamwork in Training Undergoing Designed Educational Simulation scale, the Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration, and the Interprofessional Education Collaborative competency scale were used for this study. The demographic distribution of the study participants was obtained, and the perception differences before and after participation in interprofessional education between medical and nursing students were analyzed. RESULTS: After interprofessional education, student awareness of interprofessional learning and self-competency in interprofessional practice improved. Total scores for the Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration did not change significantly among medical students but increased significantly among nursing students. Additionally, there was no significant change in the perception of the role of other professions among either medical or nursing students. CONCLUSIONS: We observed an effect of interprofessional education on cultivating self-confidence and recognizing the importance of interprofessional collaboration between medical professions. It can be inferred that exposure to collaboration situations through Interprofessional education leads to a positive perception of interprofessional learning. However, even after their interprofessional education experience, existing perceptions of the role of other professional groups in the collaboration situation did not change, which shows the limitations of a one-time short-term program. This suggests that efforts should be made to ensure continuous exposure to social interaction experiences with other professions.


Assuntos
Estudantes de Medicina , Estudantes de Enfermagem , Atitude do Pessoal de Saúde , Comportamento Cooperativo , Humanos , Educação Interprofissional , Relações Interprofissionais , Equipe de Assistência ao Paciente , República da Coreia
4.
Acad Psychiatry ; 44(3): 316-319, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31873921

RESUMO

OBJECTIVE: The aim of this study was to ascertain the relationships between perspective-taking, empathic concern, and self-rating of empathy as a physician among medical students. METHODS: This study analyzed the questionnaire responses of 152 medical students enrolled in Ajou University School of Medicine, Suwon, Republic of Korea, in 2018. As measurement instruments, the authors applied the Interpersonal Reactivity Index (IRI) and Korean Student Version of the Jefferson Scale of Physician Empathy (Korean JSPE-S), and then examined participant characteristic variables based on the obtained data and conducted subsequent correlation analyses of subscales, one-way ANOVA, and regression analyses. RESULTS: Medical students with clinical clerkship experience demonstrated higher levels of perspective-taking and empathy as physicians than did students without experience. Moreover, perspective-taking and empathic concern were significant predictors of medical students' empathy as physicians in the regression model. CONCLUSIONS: Medical students with higher scores in perspective-taking and empathic concern demonstrated higher levels of perception regarding the necessity and importance of empathy as a physician in patient-physician relationships. Therefore, in actual medical situations with patient-centered therapy, to enhance the levels of physician empathy, medical education should focus on the understanding of other persons' opinions and interpersonal interactions accompanied by empathic concern.


Assuntos
Empatia , Relações Médico-Paciente , Médicos/psicologia , Estudantes de Medicina/psicologia , Adulto , Fatores Etários , Estágio Clínico , Educação Médica , Feminino , Humanos , Masculino , República da Coreia , Fatores Sexuais , Inquéritos e Questionários/estatística & dados numéricos
5.
Acad Psychiatry ; 44(3): 272-276, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31863413

RESUMO

OBJECTIVE: In this study, the authors aimed to analyze the effects of clinical practice and Standardized Patient (SP) feedback on medical students' self-assessments of their clinical communication skills (CCS). METHODS: The authors analyzed questionnaire responses from 43 fifth-year medical students enrolled in the Ajou University School of Medicine, Suwon, Republic of Korea, in 2019, and used the Communication Assessment Tool (CAT) scale to measure the study's variables. A descriptive statistical analysis and paired t test focused on the distribution of and changes in CCS before and after clinical practice and after receiving SP feedback. RESULTS: After clinical practice, the students' perceptions of their own CCS were positively increased, but after the receipt of SP feedback, they significantly decreased. Scores for the item on interpersonal relationships with the patient from the perspective of the patient were significantly lower after the SP feedback was obtained. CONCLUSIONS: SP feedback emerged as an important educational method, allowing students to assess their CCS more objectively and view their CCS as physicians from the patient's perspective. SP feedback is necessary, as is providing students with the experience of receiving direct SP feedback, on clinical performance to increase patient-centered care competencies.


Assuntos
Competência Clínica/normas , Comunicação , Retroalimentação , Simulação de Paciente , Autoavaliação (Psicologia) , Estudantes de Medicina/estatística & dados numéricos , Estágio Clínico , Educação de Graduação em Medicina , Feminino , Humanos , Medicina Interna , República da Coreia , Inquéritos e Questionários
6.
Chemistry ; 25(56): 12889-12894, 2019 Oct 08.
Artigo em Inglês | MEDLINE | ID: mdl-31161642

RESUMO

Oxo-bridged trimeric chromium acetate clusters [Cr3 O(OOCCH3 )6 (H2 O)3 ]NO3 have been encapsulated for the first time in the mesoporous cages of the chromium terephthalate MIL-101(Cr). The isolated clusters in MIL-101(Cr) have increased affinity towards propylene compared to propane, due to generation of a new kind of pocket-based propylene-binding site, as supported by DFT calculations.

7.
Ann Clin Microbiol Antimicrob ; 18(1): 2, 2019 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-30606210

RESUMO

BACKGROUND: Drug resistance in Mycobacterium tuberculosis (MTB) is a major health issue worldwide. Recently, next-generation sequencing (NGS) technology has begun to be used to detect resistance genes of MTB. We aimed to assess the clinical usefulness of Ion S5 NGS TB research panel for detecting MTB resistance in Korean tuberculosis patients. METHODS: Mycobacterium tuberculosis with various drug resistance profiles including susceptible strains (N = 36) were isolated from clinical specimens. Nucleic acids were extracted from inactivated culture medium and underwent amplicon-based NGS to detect resistance variants in eight genes (gyrA, rpoB, pncA, katG, eis, rpsL, embB, and inhA). Data from previous studies using the same panel were merged to yield pooled sensitivity and specificity values for detecting drug resistance compared to phenotype-based methods. RESULTS: The sequencing reactions were successful for all samples. A total of 24 variants were considered to be related to resistance, and 6 of them were novel. Agreement between the phenotypic and genotypic results was excellent for isoniazid, rifampicin, and ethambutol, and was poor for streptomycin, amikacin, and kanamycin. The negative predictive values were greater than 97% for all drug classes, while the positive predictive values varied (44% to 100%). There was a possibility that common mutations could not be detected owing to the low coverage. CONCLUSIONS: We successfully applied NGS for genetic analysis of drug resistances in MTB, as well as for susceptible strains. We obtained lists of polymorphisms and possible polymorphisms, which could be used as a guide for future tests applying NGS in mycobacteriology laboratories. When analyzing the results of NGS, coverage analysis of each samples for each gene and benign polymorphisms not related to drug resistance should be considered.


Assuntos
Proteínas de Bactérias/genética , Farmacorresistência Bacteriana Múltipla/genética , Estudos de Associação Genética/métodos , Sequenciamento de Nucleotídeos em Larga Escala/métodos , Mycobacterium tuberculosis/genética , Tuberculose Resistente a Múltiplos Medicamentos/genética , Acetiltransferases/genética , Amidoidrolases/genética , Antituberculosos/farmacologia , Catalase/genética , DNA Girase/genética , DNA Bacteriano/isolamento & purificação , RNA Polimerases Dirigidas por DNA/genética , Genótipo , Humanos , Testes de Sensibilidade Microbiana , Mutação , Mycobacterium tuberculosis/efeitos dos fármacos , Oxirredutases/genética , Pentosiltransferases/genética , Fenótipo , Reação em Cadeia da Polimerase/métodos , Polimorfismo Genético , República da Coreia , Sensibilidade e Especificidade , Análise de Sequência de DNA , Tuberculose Resistente a Múltiplos Medicamentos/diagnóstico , Tuberculose Resistente a Múltiplos Medicamentos/microbiologia
8.
World J Surg ; 43(12): 3128-3137, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31502003

RESUMO

BACKGROUND: Fibrin sealants and topical glue have been studied to reduce the incidence of postoperative pancreatic fistulas (POPF) after pancreatico-enteric anastomosis, but a definitive innovation is still needed. We aim to evaluate the effectiveness of fibrin sealant patch applied to pancreatico-enteric anastomosis to reduce postoperative complications, including POPF. METHODS: This study was a single-center, prospective, randomized, phase IV trial involving three pancreaticobiliary surgeons. The primary outcome was POPF; secondary outcomes included complications, drain removal days, hospital stay, readmission rate, and cost. Risk factors for POPF were identified by logistic regression analysis. RESULTS: A total of 124 patients were enrolled. Biochemical leakage (BL) or POPF occurred in 16 patients (25.8%) in the intervention group and 23 patients (37.1%) in the control group (no statistical significance). Clinically relevant POPF occurred in 4 patients (6.5%) in both the intervention and control groups (p = 1.000). Hospital stay (11.6 days vs. 12.1 days, p = 0.585) and drain removal days (5.7 days vs. 5.3 days, p = 0.281) were not statistically different between two groups. Complication rates were not different between the two groups (p = 0.506); nor were readmission rates (12.9% vs. 11.3%, p = 1.000) or cost ($13,549 vs. $15,038, p = 0.103). In multivariable analysis, age and soft pancreas texture were independent risk factors for BL or POPF in this study. Applying fibrin sealant patch is not a negative risk factor, but the p value may indicate a likelihood of reducing the incidence of BL (p = 0.084). CONCLUSIONS: Fibrin sealant patches after pancreaticojejunostomy did not reduce the incidence of POPF or other postoperative complications. This study was registered at clinicaltrials.gov (NCT03269955).


Assuntos
Fibrinogênio/administração & dosagem , Fístula Pancreática/prevenção & controle , Pancreaticoduodenectomia/efeitos adversos , Pancreaticojejunostomia/métodos , Complicações Pós-Operatórias/prevenção & controle , Trombina/administração & dosagem , Idoso , Combinação de Medicamentos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
9.
BMC Med Educ ; 19(1): 248, 2019 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-31277637

RESUMO

BACKGROUND: Medical school faculty members have been reported to be highly likely to suffer burnout. Research is being conducted on professional self-concepts as a factor that relieves burnout in many professions. However, there is a paucity of data on the relationship between professional self-concept and burnout among medical school faculty. Professional self-concept means a perception of oneself as a member of the profession. It influences an individual's thoughts, actions, and emotions. The more positive the professional self-concept, the higher is the self-esteem in the profession, which can contribute to reducing burnout. This study aimed to investigate the professional self-concept and incidence of burnout among medical school clinical faculty members, and to ascertain the factors that affect professional self-concept with respect to burnout. METHODS: A total of 68 clinical faculty members at the Ajou University School of Medicine completed a modified form of the professional self-concept scale and the Maslach Burnout Inventory. We undertook the following statistical analyses: a descriptive analysis to understand the distribution of participants, correlation analysis to indicate associations between variables and a multiple regression analysis to examine the influence of gender, position, and specialty on professional self-concept and burnout, and the effect of each subscale of professional self-concept on burnout. RESULTS: As professional self-concept increases, burnout decreases. There was no significant difference between professional self-concept and burnout with respect to gender or field of medical specialty, while a significant difference was observed across faculty position levels. Additionally, the professional self-concept subscale, which included satisfaction and communication skill, was found to significantly affect burnout. CONCLUSIONS: This study shows that professional self-concept affects burnout. Through these results, we can infer that professional self-concept functioned to protect medical school faculty from burnout. This may be a strategy that fortifies the professional identity of medical school faculty, and it is suggested that educational programs that are directed toward this goal be established.


Assuntos
Esgotamento Profissional/epidemiologia , Faculdades de Medicina , Autoimagem , Estresse Psicológico/epidemiologia , Carga de Trabalho/psicologia , Adulto , Estudos Transversais , Feminino , Humanos , Satisfação no Emprego , Masculino , República da Coreia/epidemiologia , Carga de Trabalho/estatística & dados numéricos , Adulto Jovem
10.
Nat Mater ; 16(5): 526-531, 2017 05.
Artigo em Inglês | MEDLINE | ID: mdl-27992421

RESUMO

Selective dinitrogen binding to transition metal ions mainly covers two strategic domains: biological nitrogen fixation catalysed by metalloenzyme nitrogenases, and adsorptive purification of natural gas and air. Many transition metal-dinitrogen complexes have been envisaged for biomimetic nitrogen fixation to produce ammonia. Inspired by this concept, here we report mesoporous metal-organic framework materials containing accessible Cr(III) sites, able to thermodynamically capture N2 over CH4 and O2. This fundamental study integrating advanced experimental and computational tools confirmed that the separation mechanism for both N2/CH4 and N2/O2 gas mixtures is driven by the presence of these unsaturated Cr(III) sites that allows a much stronger binding of N2 over the two other gases. Besides the potential breakthrough in adsorption-based technologies, this proof of concept could open new horizons to address several challenges in chemistry, including the design of heterogeneous biomimetic catalysts through nitrogen fixation.

11.
Kidney Blood Press Res ; 42(6): 1119-1127, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29224021

RESUMO

BACKGROUND/AIMS: Our study aims to evaluate the association between thigh muscle cross-sectional area (TMA) using computed tomography (CT), or appendicular skeletal muscle mass (ASM) using dual energy X-ray absorptiometry (DEXA), and physical performance levels in hemodialysis (HD) patients. METHODS: Patients were included if they were on HD for ≥6 months (n = 84). ASM and TMA were adjusted to body weight (BW, kg) or height2 (Ht2, m2). Each participant performed a short physical performance battery test (SPPB), a sit-to-stand for 30 second test (STS30), a 6-minute walk test (6-MWT), a timed up and go test (TUG), and hand grip strength (HGS) test. RESULTS: Correlation coefficients for SPPB, GS, 5STS, STS30, 6-MWT, and TUG were highest in TMA/BW. Results from partial correlation or linear regression analyses displayed similar trends to those derived from Pearson's correlation analyses. An increase in TMA/BW or TMA/Ht2 was associated with a decreased odds ratio of low SPPB, GS, or HGS in multivariate analyses. Indices using DEXA were associated with a decreased odds ratio of a low HGS only in multivariate analysis. CONCLUSION: TMA indices using CT may be more valuable in predicting physical performance or strength in HD patients.


Assuntos
Absorciometria de Fóton/métodos , Músculo Esquelético/fisiologia , Aptidão Física , Insuficiência Renal Crônica/fisiopatologia , Tomografia Computadorizada por Raios X/métodos , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tamanho do Órgão , Prognóstico , Diálise Renal , Coxa da Perna/fisiologia
12.
Inorg Chem ; 55(15): 7219-28, 2016 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-27030923

RESUMO

([Sc2(OH)2(BPTC)]) (H4BPTC = biphenyl-3,3',5,5'-tetracarboxylic acid), MFM-400 (MFM = Manchester Framework Material, previously designated NOTT), and ([Sc(OH)(TDA)]) (H2TDA = thiophene-2,5-dicarboxylic acid), MFM-401, both show selective and reversible capture of CO2. In particular, MFM-400 exhibits a reasonably high CO2 uptake at low pressures and competitive CO2/N2 selectivity coupled to a moderate isosteric heat of adsorption (Qst) for CO2 (29.5 kJ mol(-1)) at zero coverage, thus affording a facile uptake-release process. Grand canonical Monte Carlo (GCMC) and density functional theory (DFT) computational analyses of CO2 uptake in both materials confirmed preferential adsorption sites consistent with the higher CO2 uptake observed experimentally for MFM-400 over MFM-401 at low pressures. For MFM-400, the Sc-OH group participates in moderate interactions with CO2 (Qst = 33.5 kJ mol(-1)), and these are complemented by weak hydrogen-bonding interactions (O···H-C = 3.10-3.22 Å) from four surrounding aromatic -CH groups. In the case of MFM-401, adsorption is provided by cooperative interactions of CO2 with the Sc-OH group and one C-H group. The binding energies obtained by DFT analysis for the adsorption sites for both materials correlate well with the observed moderate isosteric heats of adsorption for CO2. GCMC simulations for both materials confirmed higher uptake of EtOH compared with nonpolar vapors of toluene and cyclohexane. This is in good correlation with the experimental data, and DFT analysis confirmed the formation of a strong hydrogen bond between EtOH and the hydrogen atom of the hydroxyl group of the MFM-400 and MFM-401 framework (FW) with H-OEtOH···H-OFW distances of 1.77 and 1.75 Å, respectively. In addition, the accessible regeneration of MFM-400 and MFM-401 and release of CO2 potentially provide minimal economic and environmental penalties.

13.
Int J Med Sci ; 13(3): 235-9, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26941584

RESUMO

BACKGROUND: Intraoperative blood transfusion increases the risk for perioperative mortality and morbidity in liver transplant recipients. A high stroke volume variation (SVV) method has been proposed to reduce blood loss during living donor hepatectomy. Herein, we investigated whether maintaining high SVV could reduce the need for blood transfusion and also evaluated the effect of the high SVV method on postoperative outcomes in liver transplant recipients. METHODS: We retrospectively analyzed 332 patients who underwent liver transplantation, divided into control (maintaining <10% of SVV during surgery) and high SVV (maintaining 10-20% of SVV during surgery) groups. We evaluated the blood transfusion requirement and hemodynamic parameters, including SVV, as well as postoperative outcomes, such as incidences of acute kidney injury, durations of postoperative intensive care unit and hospital stay, and rates of 1-year mortality. RESULTS: Mean SVV values were 7.0% ± 1.3% in the control group (n = 288) and 11.2% ± 1.8% in the high SVV group (n = 44). The median numbers of transfused packed red blood cells and fresh frozen plasmas in the high SVV group were significantly lower than those in control group (0 vs. 2 units, P = 0.003; and 0 vs. 3 units, P = 0.033, respectively). No significant between-group differences were observed for postoperative outcomes. CONCLUSIONS: Maintaining high SVV can reduce the blood transfusion requirement during liver transplantation without worsening postoperative outcomes. These findings provide insights into improving perioperative management in liver transplant recipients.


Assuntos
Transfusão de Sangue/métodos , Transplante de Fígado/métodos , Volume Sistólico/fisiologia , Injúria Renal Aguda/etiologia , Adulto , Feminino , Hepatectomia , Humanos , Cuidados Intraoperatórios , Tempo de Internação , Transplante de Fígado/mortalidade , Doadores Vivos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , Resultado do Tratamento
14.
Eur Spine J ; 25(1): 74-79, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26394857

RESUMO

PURPOSE: To verify the clinical applicability of a modified classification system in distractive-extension cervical spine injury that reflects the degrees of soft tissue damage and spinal cord injury while complementing previous Allen classification and subaxial cervical spine injury classification (SLIC) system. METHODS: A total of 195 patients with cervical spine distraction-extension (DE) injury were retrospectively classified. We added stages IIIA (with concomitant spinal cord injury without bony abnormalities) and IIIB (with concomitant additional soft tissue swelling) to the existing stages I and II of the Allen classification. We also supplemented the SLIC system by refining and assigning scores to bony morphology and soft tissue damage. The previous and proposed classification systems were compared by analyzing their scoring performances in terms of clinical features and prognosis. RESULTS: The Allen classification yielded 153 and 42 patients with stage 1 and 42 stage 2 injuries, respectively. Patients classified according to the proposed system were stratified as follows: stage I, 58; stage II, 27; stage IIIA, 33; and stage IIIB, 77. Regarding neurological symptoms and prognosis, stages IIIA and IIIB were poorer than stage I but significantly better than stage II (P < 0.05). On the SLIC system, 146 patients scored ≥5; and 37 and 12 patients scored 4 and ≤3 points, respectively, whereas the numbers of patients who scored ≥5, 4, and ≤3 points on the modified SLIC system were 170, 21, and 4, respectively. CONCLUSIONS: The proposed classification and scoring system to complement the Allen classification and SLIC system with respect to the degrees of soft tissue damage and spinal cord injury is considered effective for diagnosing and determining therapeutic directions and prognosis in cases of cervical spine extension injury.


Assuntos
Vértebras Cervicais/lesões , Traumatismos da Coluna Vertebral/classificação , Adulto , Idoso , Edema/classificação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Lesões dos Tecidos Moles/classificação , Adulto Jovem
15.
J Anesth ; 30(4): 591-5, 2016 08.
Artigo em Inglês | MEDLINE | ID: mdl-27193185

RESUMO

PURPOSE: Confirming the epidural space during epidural anesthesia relies mainly on feel and experience, which are difficult techniques for a trainee to learn. We designed an epidural simulator for trainees to experience loss of resistance (LOR) and various degrees of pressure resistance. METHODS: The simulator consists of a Perifix(®) LOR syringe and 1-, 5-, 10- and 50-mL syringes assembled by three-way stopcocks. A total of 89 anesthesiologists evaluated the simulator, given the choice of either the intermittent technique with air or continuous technique with saline. Sudden LOR and applicability of the simulator for training purposes were assessed using the numerical rating score (NRS). Pressure resistance at each lumbar structure was evaluated by the anesthesiologists using the intermittent technique with air. RESULTS: Seventy-four anesthesiologists used the intermittent technique with air and 15 used the continuous technique with saline. The NRSs for sudden LOR and the applicability for training purposes were 8 and 9 (median), respectively. The pressure resistance to a 50-mL syringe was regarded as the epidural space (odds ratio 602.3 for 5-mL syringe and 144.4 for 10-mL syringe) by 89 % of anesthesiologists using air for LOR. Resistance to the 10-mL syringe was most frequently considered as muscle, subcutaneous fat, or the interspinous ligament, while resistance to the 1-mL syringe was considered as the ligamentum flavum (odds ratio 2.3 for 5-mL syringe and 18.6 for 10-mL syringe). CONCLUSIONS: Our epidural simulator is a simple, low-cost device that can be easily constructed. It was shown to provide valid haptic feedback as a promising tool for training novice anesthesiologists.


Assuntos
Anestesia Epidural/métodos , Anestesiologistas/educação , Espaço Epidural , Adulto , Feminino , Humanos , Aprendizagem , Região Lombossacral , Masculino , Pessoa de Meia-Idade , Pressão , Seringas
16.
Chemistry ; 21(50): 18431-8, 2015 Dec 07.
Artigo em Inglês | MEDLINE | ID: mdl-26515022

RESUMO

A reducible metal-organic framework (MOF), iron(III) trimesate, denoted as MIL-100(Fe), was investigated for the separation and purification of methane/ethane/ethylene/acetylene and an acetylene/CO2 mixtures by using sorption isotherms, breakthrough experiments, ideal adsorbed solution theory (IAST) calculations, and IR spectroscopic analysis. The MIL-100(Fe) showed high adsorption selectivity not only for acetylene and ethylene over methane and ethane, but also for acetylene over CO2 . The separation and purification of acetylene over ethylene was also possible for MIL-100(Fe) activated at 423 K. According to the data obtained from operando IR spectroscopy, the unsaturated Fe(III) sites and surface OH groups are mainly responsible for the successful separation of the acetylene/ethylene mixture, whereas the unsaturated Fe(II) sites have a detrimental effect on both separation and purification. The potential of MIL-100(Fe) for the separation of a mixture of C2 H2 /CO2 was also examined by using the IAST calculations and transient breakthrough simulations. Comparing the IAST selectivity calculations of C2 H2 /CO2 for four MOFs selected from the literature, the selectivity with MIL-100(Fe) was higher than those of CuBTC, ZJU-60a, and PCP-33, but lower than that of HOF-3.

17.
Chempluschem ; : e202400096, 2024 Mar 24.
Artigo em Inglês | MEDLINE | ID: mdl-38523300

RESUMO

A newly designed heterogenized catalyst that incorporates silver(I) ions with 2-(dicyclohexylphosphaneyl)acetaldehyde (PCy2 aldehyde) into amino-functionalized chromium(III) terephthalate is developed. Silver(I) ions were robustly immobilized on the amino-functionalized chromium(III) terephthalate, which contains an imine bond formed by the reaction with PCy2 aldehyde. The Ag(I) ion is coordinated with the phosphine in the imine group to create MIL-101-AP(Ag). Characterizations were carefully carried out according to the synthetic steps. The catalytic performance of MIL-101-AP(Ag) was evaluated through the C-H carboxylation of thiophene-2-carbonitrile, achieving a 10 % yield with a turnover number of 1.0. The recyclability of the MIL-101-AP(Ag) catalyst was successfully demonstrated with five cycle, with no loss in activity and selectivity observed. This approach, which involves the formation of an imine bond to facilitate silver loading with phosphine on amino-functionalized MIL-101(Cr), exhibits significant potential for both CO2 fixation and C-H carboxylation, thereby highlighting the modified material's promise as a sustainable catalyst.

18.
ACS Appl Mater Interfaces ; 16(1): 1342-1350, 2024 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-38116929

RESUMO

In this study, three nitrogen-containing aluminum-based metal-organic frameworks (Al-MOFs), namely, CAU-10pydc, MOF-303, and KMF-1, were investigated for the efficient separation of a C2H2/CO2 gas mixture. Among these three Al-MOFs, KMF-1 demonstrated the highest selectivity for C2H2/CO2 separation (6.31), primarily owing to its superior C2H2 uptake (7.90 mmol g-1) and lower CO2 uptake (2.82 mmol g-1) compared to that of the other two Al-MOFs. Dynamic breakthrough experiments, using an equimolar binary C2H2/CO2 gas mixture, demonstrated that KMF-1 achieved the highest separation performance. It yielded 3.42 mmol g-1 of high-purity C2H2 (>99.95%) through a straightforward desorption process under He purging at 298 K and 1 bar. To gain insights into the distinctive characteristics of the pore surfaces of structurally similar CAU-10pydc and KMF-1, we conducted computational simulations using canonical Monte Carlo and dispersion-corrected density functional theory methods. These simulations revealed that the secondary amine (C2N-H) groups in KMF-1 played a more significant role in differentiating between C2H2 and CO2 compared to that of the N atoms in CAU-10pydc and MOF-303. Consequently, KMF-1 emerged as a promising adsorbent for the separation of high-purity C2H2 from binary C2H2/CO2 gas mixtures.

19.
Sci Rep ; 14(1): 8878, 2024 04 17.
Artigo em Inglês | MEDLINE | ID: mdl-38632261

RESUMO

This prospective single-arm study aimed to evaluate the clinical efficacy and safety of a refractive multifocal contact lens for the correction of presbyopia in 22 patients. The participants underwent clinical examinations before and 1 week after wearing a refractive multifocal contact lens (OptaCon ZOOM). The primary endpoints were the corrected distance visual acuity (CDVA) and distance-corrected near visual acuity (DCNVA). Defocus curve, contrast sensitivity, and ocular surface disease index (OSDI) were analyzed. A slit-lamp examination was performed for safety analysis. Contact lens comfort and patient satisfaction were assessed using a questionnaire. No significant difference in CDVA was observed before and 1 week after refractive multifocal contact lens use (p = 0.127), whereas DCNVA was significantly improved after 1 week (p < 0.001). The contrast sensitivity was not significantly affected at any spatial frequency under mesopic or photopic conditions. OSDI was significantly increased (p = 0.023). The patient-reported satisfaction scores were 96.2, 91.9, and 85.0 out of 100 at far, intermediate, and near distances, respectively. No significant adverse events were observed. Refractive multifocal contact lenses improved near vision while maintaining distance vision in presbyopic patients, without compromising contrast sensitivity. The study results suggest that OptaCon ZOOM can be considered safe and effective for the correction of presbyopia.


Assuntos
Lentes de Contato , Presbiopia , Humanos , Estudos Prospectivos , Refração Ocular , Acuidade Visual
20.
Bioorg Med Chem Lett ; 23(13): 3769-74, 2013 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-23726031

RESUMO

PRL-3, phosphatase of regenerating liver-3, plays a role in cancer progression through its involvement in invasion, migration, metastasis, and angiogenesis. We synthesized rhodanine derivatives, CG-707 and BR-1, which inhibited PRL-3 enzymatic activity with IC50 values of 0.8 µM and 1.1 µM, respectively. CG-707 and BR-1 strongly inhibited the migration and invasion of PRL-3 overexpressing colon cancer cells without exhibiting cytotoxicity. The specificity of the inhibitors on PRL-3 phosphatase activity was confirmed by the phosphorylation recovery of known PRL-3 substrates such as ezrin and cytokeratin 8. The compounds selectively inhibited PRL-3 in comparison with other phosphatases, and CG-707 regulated epithelial-to-mesenchymal transition (EMT) marker proteins. The results of the present study reveal that rhodanine is a specific PRL-3 inhibitor and a good lead molecule for obtaining a selective PRL-3 inhibitor.


Assuntos
Antineoplásicos/farmacologia , Inibidores Enzimáticos/farmacologia , Proteínas de Neoplasias/antagonistas & inibidores , Proteínas Tirosina Fosfatases/antagonistas & inibidores , Rodanina/química , Antineoplásicos/síntese química , Antineoplásicos/química , Linhagem Celular Tumoral , Movimento Celular/efeitos dos fármacos , Proliferação de Células/efeitos dos fármacos , Sobrevivência Celular/efeitos dos fármacos , Relação Dose-Resposta a Droga , Ensaios de Seleção de Medicamentos Antitumorais , Inibidores Enzimáticos/síntese química , Inibidores Enzimáticos/química , Humanos , Estrutura Molecular , Proteínas de Neoplasias/metabolismo , Proteínas Tirosina Fosfatases/metabolismo , Relação Estrutura-Atividade
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