Rapid Guest Exchange and Ultraâ Low Surface Tension Solvents Optimize Metalâ Organic Framework Activation

Exploratory research into the critical steps in metalâ organic framework (MOF) activation involving solvent exchange and solvent evacuation are reported. It is discovered that solvent exchange kinetics are extremely fast, and minutes rather days are appropriate for solvent exchange in many MOFs. It is also demonstrated that choice of a very low surface tension solvent is critical in successfully activating challenging MOFs. MOFs that have failed to be activated previously can achieve predicted surface areas provided that lower surface tension solvents, such as nâ hexane and perfluoropentane, are applied. The insights herein aid in the efficient activation of MOFs in both laboratory and industrial settings and provide best practices for avoiding structural collapse.An exchange for the better: Activation involving solvent exchange and evacuation is crucial to achieve maximum surface area and gasâ storage properties in metalâ organic frameworks (MOFs). Porosity is preserved when fast solvent exchange kinetics and ultraâ low surface tension solvents are exploited yielding MOFs without structural collapse.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140054/1/anie201709187_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/140054/2/anie201709187-sup-0001-misc_information.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/140054/3/anie201709187.pd

Rapid Guest Exchange and Ultraâ Low Surface Tension Solvents Optimize Metalâ Organic Framework Activation

Exploratory research into the critical steps in metalâ organic framework (MOF) activation involving solvent exchange and solvent evacuation are reported. It is discovered that solvent exchange kinetics are extremely fast, and minutes rather days are appropriate for solvent exchange in many MOFs. It is also demonstrated that choice of a very low surface tension solvent is critical in successfully activating challenging MOFs. MOFs that have failed to be activated previously can achieve predicted surface areas provided that lower surface tension solvents, such as nâ hexane and perfluoropentane, are applied. The insights herein aid in the efficient activation of MOFs in both laboratory and industrial settings and provide best practices for avoiding structural collapse.Ein Wechsel des Lösungsmittels mit anschlieà ender Evakuierung aktiviert Metallâ organische Gerüste (MOFs), maximiert ihre Oberflächen und verbessert ihre Eigenschaften bei der Gasspeicherung. Wenn der Austausch schnell erfolgt und Lösungsmittel mit sehr niedriger Oberflächenspannung verwendet werden, bleibt die Porosität erhalten, und die MOFâ Struktur fällt nicht in sich zusammen.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/139930/1/ange201709187.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/139930/2/ange201709187_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/139930/3/ange201709187-sup-0001-misc_information.pd

Designing theoretically-informed implementation interventions

Clinical and health services research is continually producing new findings that may contribute to effective and efficient patient care. However, the transfer of research findings into practice is unpredictable and can be a slow and haphazard process. Ideally, the choice of implementation strategies would be based upon evidence from randomised controlled trials or systematic reviews of a given implementation strategy. Unfortunately, reviews of implementation strategies consistently report effectiveness some, but not all of the time; possible causes of this variation are seldom reported or measured by the investigators in the original studies. Thus, any attempts to extrapolate from study settings to the real world are hampered by a lack of understanding of the effects of key elements of individuals, interventions, and the settings in which they were trialled. The explicit use of theory offers a way of addressing these issues and has a number of advantages, such as providing: a generalisable framework within which to represent the dimensions that implementation studies address, a process by which to inform the development and delivery of interventions, a guide when evaluating, and a way to allow for an exploration of potential causal mechanisms. However, the use of theory in designing implementation interventions is methodologically challenging for a number of reasons, including choosing between theories and faithfully translating theoretical constructs into interventions. The explicit use of theory offers potential advantages in terms of facilitating a better understanding of the generalisability and replicability of implementation interventions. However, this is a relatively unexplored methodological area

Adjusting a cancer mortality-prediction model for disease status-related eligibility criteria

<p>Abstract</p> <p>Background</p> <p>Volunteering participants in disease studies tend to be healthier than the general population partially due to specific enrollment criteria. Using modeling to accurately predict outcomes of cohort studies enrolling volunteers requires adjusting for the bias introduced in this way. Here we propose a new method to account for the effect of a specific form of healthy volunteer bias resulting from imposing disease status-related eligibility criteria, on disease-specific mortality, by explicitly modeling the length of the time interval between the moment when the subject becomes ineligible for the study, and the outcome.</p> <p>Methods</p> <p>Using survival time data from 1190 newly diagnosed lung cancer patients at MD Anderson Cancer Center, we model the time from clinical lung cancer diagnosis to death using an exponential distribution to approximate the length of this interval for a study where lung cancer death serves as the outcome. Incorporating this interval into our previously developed lung cancer risk model, we adjust for the effect of disease status-related eligibility criteria in predicting the number of lung cancer deaths in the control arm of CARET. The effect of the adjustment using the MD Anderson-derived approximation is compared to that based on SEER data.</p> <p>Results</p> <p>Using the adjustment developed in conjunction with our existing lung cancer model, we are able to accurately predict the number of lung cancer deaths observed in the control arm of CARET.</p> <p>Conclusions</p> <p>The resulting adjustment was accurate in predicting the lower rates of disease observed in the early years while still maintaining reasonable prediction ability in the later years of the trial. This method could be used to adjust for, or predict the duration and relative effect of any possible biases related to disease-specific eligibility criteria in modeling studies of volunteer-based cohorts.</p

Appropriate disclosure of a diagnosis of dementia : identifying the key behaviours of 'best practice'

Background: Despite growing evidence that many people with dementia want to know their diagnosis, there is wide variation in attitudes of professionals towards disclosure. The disclosure of the diagnosis of dementia is increasingly recognised as being a process rather than a one-off behaviour. However, the different behaviours that contribute to this process have not been comprehensively defined. No intervention studies to improve diagnostic disclosure in dementia have been reported to date. As part of a larger study to develop an intervention to promote appropriate disclosure, we sought to identify important disclosure behaviours and explore whether supplementing a literature review with other methods would result in the identification of new behaviours. Methods: To identify a comprehensive list of behaviours in disclosure we conducted a literature review, interviewed people with dementia and informal carers, and used a consensus process involving health and social care professionals. Content analysis of the full list of behaviours was carried out. Results: Interviews were conducted with four people with dementia and six informal carers. Eight health and social care professionals took part in the consensus panel. From the interviews, consensus panel and literature review 220 behaviours were elicited, with 109 behaviours over-lapping. The interviews and consensus panel elicited 27 behaviours supplementary to the review. Those from the interviews appeared to be self-evident but highlighted deficiencies in current practice and from the panel focused largely on balancing the needs of people with dementia and family members. Behaviours were grouped into eight categories: preparing for disclosure; integrating family members; exploring the patient's perspective; disclosing the diagnosis; responding to patient reactions; focusing on quality of life and well-being; planning for the future; and communicating effectively. Conclusion: This exercise has highlighted the complexity of the process of disclosing a diagnosis of dementia in an appropriate manner. It confirms that many of the behaviours identified in the literature (often based on professional opinion rather than empirical evidence) also resonate with people with dementia and informal carers. The presence of contradictory behaviours emphasises the need to tailor the process of disclosure to individual patients and carers. Our combined methods may be relevant to other efforts to identify and define complex clinical practices for further study.This project is funded by UK Medical Research Council, Grant reference number G0300999

Improving the delivery of care for patients with diabetes through understanding optimised team work and organisation in primary care

Peer reviewedPublisher PD

Using the Theoretical Domains Framework (TDF) to understand adherence to multiple evidence-based indicators in primary care : a qualitative study

BACKGROUND: There are recognised gaps between evidence and practice in general practice, a setting posing particular implementation challenges. We earlier screened clinical guideline recommendations to derive a set of 'high-impact' indicators based upon criteria including potential for significant patient benefit, scope for improved practice and amenability to measurement using routinely collected data. Here, we explore health professionals' perceived determinants of adherence to these indicators, examining the degree to which determinants were indicator-specific or potentially generalisable across indicators. METHODS: We interviewed 60 general practitioners, practice nurses and practice managers in West Yorkshire, the UK, about adherence to four indicators: avoidance of risky prescribing; treatment targets in type 2 diabetes; blood pressure targets in treated hypertension; and anticoagulation in atrial fibrillation. Interview questions drew upon the Theoretical Domains Framework (TDF). Data were analysed using framework analysis. RESULTS: Professional role and identity and environmental context and resources featured prominently across all indicators whilst the importance of other domains, for example, beliefs about consequences, social influences and knowledge varied across indicators. We identified five meta-themes representing more general organisational and contextual factors common to all indicators. CONCLUSIONS: The TDF helped elicit a wide range of reported determinants of adherence to 'high-impact' indicators in primary care. It was more difficult to pinpoint which determinants, if targeted by an implementation strategy, would maximise change. The meta-themes broadly underline the need to align the design of interventions targeting general practices with higher level supports and broader contextual considerations. However, our findings suggest that it is feasible to develop interventions to promote the uptake of different evidence-based indicators which share common features whilst also including content-specific adaptations

“Breathing” in Adsorbate-Responsive Metal Tetraphosphonate Hybrid Materials

The structures of various layered calcium tetraphosphonates (CaH6DTMP; H8DTMP=hexamethyl- tetrakis(methylenephosphonic acid)), have been determined. Starting from CaH6DTMP·2H2O, thermal treatment and subsequent exposure to NH3 and/or H2O vapors led to four new compounds that showed high storage capacity of guest species between the layers (up to ten H2O/NH3 molecules) and a maximum volume increase of 55%. The basic building block for these phosphonates consists of an eight-membered ring chelating Ca2+ through two phoshonate groups, and the organic ligand is located within the layers, which are held together by hydrogen bonds. The structural analysis revealed that the uptake/removal of guest species (H2O and NH3) induces significant changes in the framework not only by changing the interlayer distances but also through important conformational changes of the organic ligand. An anisotropic breathing motion could be quantified by the changes of the unit-cell dimensions and ligand arrangements in four crystalline derivatives. Complete characterization revealed the existence of interconversion reactions between the different phases upon gas uptake and release. The observed behavior represents, to the best of our knowledge, the first example of a breathing-like mechanism in metal phosphonates that possess a 2D topology

Lipid-lowering drugs in ischaemic heart disease : a quasi-experimental uncontrolled before-and-after study of the effectiveness of clinical practice guidelines

Background: Cardiovascular diseases(CVD), specifically ischaemic heart disease(IHD), are the main causes of death in industrialized countries. Statins are not usually prescribed in the most appropriate way. To ensure the correct prescription of these drugs, it is necessary to develop, disseminate and implement clinical practice guidelines(CPGs), and subsequently evaluate them. The main objective of this study is to evaluate the effectiveness of the implementation of consensual Lipid-lowering drugs (LLD) prescription guidelines in hospital and primary care settings, to improve the control of Low-Density Lipoprotein Cholesterol (LDL-C) levels in patients with IHD in the Terres de l'Ebre region covered by the Catalonian Health Institute. Secondary bjectives are to assess the improvement of the prescription profile of these LLDs, to assess cardiovascular morbimortality and the professional profile and participant centre characteristics that govern the control of LDL-C. Methods/Design Design: Quasi-experimental uncontrolled before and after study. The intervention consists of the delivery of training strategies for guideline implementation (classroom clinical sessions and on-line courses) aimed at primary care and hospital physicians. The improvement in the control of LDL-C levels in the 3,402 patients with IHD in our territory is then assessed. Scope: Primary care physicians from 11 basic health areas(BHAs) and two hospital services (internal medicine and cardiology). Sample: 3,402 patients registered with IHD in the database of the Catalan Institute of Health(E-cap) before December 2008 and patients newly diagnosed during 2009-2010. Variables: Percentage of patients achieving good control of LDL-C, measured in milligrams per decilitre. The aim of the intervention is to achieve levels of LDL-C < 100 mg/dl in patients with IHD. Secondary variables measure type and time of diagnosis of IHD, type and dose of prescribed cholesterol-lowering drugs, level of physician participation in training activities and their professional profile. Discussion: The development of prescription guidelines previously agreed by various medical specialists involved in treating IHD patients have usually improved drug prescription. The guideline presented in this study aims to improve the control of LDL-C by training physicians through presential and on-line courses on the dissemination of this guideline, and by providing feedback on their personal results a year after this training intervention