44 research outputs found
Surgical site infection prevention through bundled interventions in hip replacement surgery: A systematic review
3D printable acrylate polydimethylsiloxane resins for cell culture and drug testing
Nowadays, most of the microfluidic devices for biological applications are fabricated with only few well-established materials. Among these, polydimethylsiloxane (PDMS) is the most used and known. However, it has many limitations, like the operator dependent and time-consuming manufacturing technique and the high molecule retention. TEGORad or Acrylate PDMS is an acrylate polydimethylsiloxane copolymer that can be 3D printed through Digital Light Processing (DLP), a technology that can boast reduction of waste products and the possibility of low cost and rapid manufacturing of complex components. Here, we developed 3D printed Acrylate PDMS-based devices for cell culture and drug testing. Our in vitro study shows that Acrylate PDMS can sustain cell growth of lung and skin epithelium, both of great interest for in vitro drug testing, without causing any genotoxic effect. Moreover, flow experiments with a drug-like solution (Rhodamine 6G) show that Acrylate PDMS drug retention is negligible unlike the high signal shown by PDMS. In conclusion, the study demonstrates that this acrylate resin can be an excellent alternative to PDMS to design stretchable platforms for cell culture and drug testing
Clinical autonomic nervous system laboratories in Europe. A joint survey of the European Academy of Neurology and the European Federation of Autonomic Societies
Background and purpose: Disorders of the autonomic nervous system (ANS) are common conditions, but it is unclear whether access to ANS healthcare provision is homogeneous across European countries. The aim of this study was to identify neurology-driven or interdisciplinary clinical ANS laboratories in Europe, describe their characteristics and explore regional differences. Methods: We contacted the European national ANS and neurological societies, as well as members of our professional network, to identify clinical ANS laboratories in each country and invite them to answer a web-based survey. Results: We identified 84 laboratories in 22 countries and 46 (55%) answered the survey. All laboratories perform cardiovascular autonomic function tests, and 83% also perform sweat tests. Testing for catecholamines and autoantibodies are performed in 63% and 56% of laboratories, and epidermal nerve fiber density analysis in 63%. Each laboratory is staffed by a median of two consultants, one resident, one technician and one nurse. The median (interquartile range [IQR]) number of head-up tilt tests/laboratory/year is 105 (49–251). Reflex syncope and neurogenic orthostatic hypotension are the most frequently diagnosed cardiovascular ANS disorders. Thirty-five centers (76%) have an ANS outpatient clinic, with a median (IQR) of 200 (100–360) outpatient visits/year; 42 centers (91%) also offer inpatient care (median 20 [IQR 4–110] inpatient stays/year). Forty-one laboratories (89%) are involved in research activities. We observed a significant difference in the geographical distribution of ANS services among European regions: 11 out of 12 countries from North/West Europe have at least one ANS laboratory versus 11 out of 21 from South/East/Greater Europe (p = 0.021). Conclusions: This survey highlights disparities in the availability of healthcare services for people with ANS disorders across European countries, stressing the need for improved access to specialized care in South, East and Greater Europe
Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy
Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe
Development of highly structured non-heme iron catalysts for selective C-H group oxidations
Catalytic oxidation reactions of hydrocarbons that occur in the active site of metalloenzymes exhibit high efficiency and exquisite regio- and stereoselectivity under mild experimental conditions. We describe the efficient and selective oxidation of alkanes using a family of highly structured non-heme iron catalysts that introduce sterically bulky pinene groups. In this way, it is possible to modulate the selectivity, which depends on the combination of the chirality of the catalyst, the nature of the diamine backbone and the presence of a cavity-like site surrounding the metal center. We present an optimized reaction protocol for efficient oxidation of alkanes with the readily available [Fe(CF3SO3)2(mcp)] catalyst, which shows enhanced selectivity toward methylenic sites. Finally, we describe a new family of iron catalysts to systematically study the steric influence of the ligand in regioselectivity. We observe a strong relationship between the bulk of the silyl substituent and the regioselectivity offered by the catalyst.Les reaccions catalítiques d’oxidació d’hidrocarburs que ocorren al centre actiu dels metal•loenzims són eficients, regio- i estereoselectives en condicions experimentals molt suaus. Es descriu l’oxidació eficient i selectiva d’alcans utilitzant una família de catalitzadors de ferro no-hemo altament estructurats que incorporen grups pinè voluminosos. D’aquesta manera és possible modular la selectivitat, que depèn de la combinació de la quiralitat del catalitzador, la natura de la diamina pont i la presència d’una cavitat al voltat del centre metàl•lic. Es presenta un protocol de reacció optimitzat per l’oxidació eficient d’alcans amb el catalitzador disponible [Fe(CF3SO3)2(mcp)], que mostra una millor selectivitat per posicions metilèniques. Finalment, es descriu una nova família de catalitzadors de ferro per estudiar sistemàticament la influencia estèrica del lligand en la regioselectivitat. S’observa una forta relació entre l’impediment imposat pel substituent silil i la regioselectivitat mostrada pel catalitzador
The phobic applying for a job: Differential efficacy of reappraising or faking on subjective states, physiological reactions and performance
Background: It is known that social anxiety disorder (SAD) interferes in a great deal of life areas, ranging from social and private relationships to work related environments. We aimed to investigate the comparative efficacy of three emotion-regulation strategies in a job interview task for individuals with SAD. We considered both different categories of emotion-regulation strategies (reappraisal vs. suppression) but also different types of the same strategy (functional vs. positive reappraisal). Methods: 92 participants diagnosed with SAD were randomly assigned to one of the three experimental groups and a no strategy control group. Participants were required to present themselves in front of external observers who would rate their performance and decide if they are suited for the job. We measured subjective mood, rated performance, EEG asymmetries, and autonomic flexibility at three different phases: while anticipating the discourse, after the statement (when emotion regulation strategy was offered), and when recovering. Results: The functional reappraisal strategy was found to be superior to no strategy for anxiety, confidence, and coded performance. We found a higher level of left side PFC activity for the functional reappraisal group at the statement phase, with a moderation effect for PFC asymmetry of SAD severity
Group Counseling as Methodology to Prevent Homophobic Bullying in an Action-Research Project.
Group counseling as methodology to prevent homophobic bullying in an action-research project
This scientific work is represented by an action-research project that has been thought with the aim to prevent the homophobic bullying. This project arises from the necessity to train and to sensitize on this problem teachers, parents and other education agency that bear on the development of sexuality social representation.
One of the techniques that has been used on this type of project is group counselling with subjects that belong to the same age. This technique is a short term intervention realized in a group with subject that don’t present any psychopathological problems.
Group counselling is articulated in two cycles of three sessions each; sessions take place weekly and last for one hour and fifteen minutes. The discussions are conducted by two psychologists, one of whom has the role of conductor and the other that has a non-participant observer role. At the end of each session the task of the second psychologist is to write down the principal topics that have been carried by during the group session. The aim of these group sessions are to think about the topic of the gender identity and try to deal with the problem of homophobic bullying.
In the poster the whole project, with a particular focus on the main topics that have came to light during group sessions will be discussed
Long-term costs to Medicare associated with endovascular and open repairs of infrarenal and complex abdominal aortic aneurysms
Objective: The vast majority of patients with abdominal aortic aneurysms (AAAs) undergoing repairs receive endovascular interventions (EVARs) instead of open operations (OARs). Although EVARs have better short-term outcomes, OARs have improved longer-term durability and require less radiographic follow-up and monitoring, which may have significant implications on health care economics surrounding provision of AAA care nationally. Herein, we compared costs associated with EVAR and OAR of both infrarenal and complex AAAs. Methods: We examined patients undergoing index elective EVARs or OARs of infrarenal and complex AAAs in the 2014-2019 Vascular Quality Initiative-Vascular Implant Surveillance and Interventional Outcomes Network (VQI-VISION) dataset. We defined overall costs as the aggregated longitudinal costs associated with: (1) the index surgery; (2) reinterventions; and (3) imaging tests. We evaluated overall costs up to 5 years after infrarenal AAA repair and 3 years for complex AAA repair. Multivariable regressions adjusted for case-mix when evaluating cost differences between EVARs vs OARs. Results: We identified 23,746 infrarenal AAA repairs (8.7% OAR, 91% EVAR) and 2279 complex AAA repairs (69% OAR, 31% EVAR). In both cohorts, patients undergoing EVARs were more likely to be older and have more comorbidities. The cost for the index procedure for EVARs relative to OARs was lower for infrarenal AAAs (37,488; P < .01) but higher among complex AAAs (44,530; P < .01). EVARs had higher annual imaging and reintervention costs during each of the 5 postoperative years for infrarenal aneurysms and the 3 postoperative years for complex aneurysms. Among patients undergoing infrarenal AAA repairs who survived 5 years, the total 5-year cost of EVARs was similar to that of OARs (34,212; −3042 to 64,492 vs 9860 [95% CI, 13,885]). For patients receiving EVARs for complex aneurysms, physician-modified endovascular grafts had higher index procedure costs (47,064; P < .01) although similar total costs on adjusted analyses (+7997 to $11,710]; P = .70) relative to Zenith fenestrated endovascular grafts among those that were alive at 3 years. Conclusions: Longer-term costs associated with EVARs are lower for infrarenal AAAs but higher for complex AAAs relative to OARs, driven by reintervention and imaging costs. Further analyses to characterize the financial viability of EVARs for both infrarenal and complex AAAs should evaluate hospital margins and anticipated changes in costs of devices.</p
Experimental epothilone B neurotoxicity: results of in vitro and in vivo studies.
Epothilones are a novel class of microtubule-targeting anticancer agents that are neurotoxic. In this study, we investigated the epothilone B toxic effect in vitro and we characterized in vivo the general and neurological side effects of epothilone B administration in Wistar and Fischer rats. The in vitro experiments made it possible to explore a wide concentration range (0.1 nM-1 muM) and evidenced a dose-dependent effect of epothilone B exposure on neuron neurite elongation. This dose-dependent neurotoxic effect was confirmed in both in vivo studies performed on two different rat strains at the neurophysiological, behavioral and pathological levels in the dose range 0.25-1.5 mg/kg iv weekly x 4 weeks and tubulin hyper-polymerization was demonstrated in sciatic nerve specimens. These are the first studies of the neurological effects of epothilone B and they can provide a basis for extending pre-clinical investigation to other members of the epothilone family