Kinetic trapping of 2,4,6-tris(4-pyridyl)benzene and ZnI2 into M12L8 poly-[n]-catenanes using solution and solid-state processes

: Here, we show that in a supramolecular system with more than 20 building blocks forming large icosahedral M12L8 metal-organic cages (MOCs), using the instant synthesis method, it is possible to kinetically trap and control the formation of interlocking M12L8 nanocages, giving rare M12L8 TPB-ZnI2 poly-[n]-catenane. The catenanes are obtained in a one-pot reaction, selectively as amorphous (a1) or crystalline states, as demonstrated by powder X-ray diffraction (powder XRD), thermogravimetric (TG) analysis and 1H NMR. The 300 K M12L8 poly-[n]-catenane single crystal X-ray diffraction (SC-XRD) structure including nitrobenzene (1) indicates strong guest binding with the large M12L8 cage (i.e., internal volume ca. 2600 Å3), allowing its structural resolution. Conversely, slow self-assembly (5 days) leads to a mixture of the M12L8 poly-[n]-catenane and a new TPB-ZnI2 (2) coordination polymer (i.e., thermodynamic product), as revealed by SC-XRD. The neat grinding solid-state synthesis also yields amorphous M12L8 poly-[n]-catenane (a1'), but not coordination polymers, selectively in 15 min. The dynamic behavior of the M12L8 poly-[n]-catenanes demonstrated by the amorphous-to-crystalline transformation upon the uptake of ortho-, meta- and para-xylenes shows the potential of M12L8 poly-[n]-catenanes as functional materials in molecular separation. Finally, combining SC-XRD of 1 and DFT calculations specific for the solid-state, the role of the guests in the stability of the 1D chains of M12L8 nanocages is reported. Energy interactions such as interaction energies (E), lattice energies (E*), host-guest energies (Ehost-guest) and guest-guest energies (Eguest-guest) were analysed considering the X-ray structure with and without the nitrobenzene guest. Not only the synthetic control achieved in the synthesis of the M12L8 MOCs but also their dynamic behavior either in the crystalline or amorphous phase are sufficient to raise scientific interest in areas ranging from fundamental to applied sides of chemistry and material sciences

How to insert a PICC: practical tips for the intensive care physician

Peripherally inserted central catheters (PICCs) are central vascular access devices inserted via deep veins of the arm, also useful in critical care settings. The purpose of this article is to offer to a critical care clinician with good skills in central venous catheterization, but who has limited experience on PICC catheters, the basic information on how the procedure is performed and how to minimize the risks of complications or failure of the maneuver. The main technical steps and the main precautions to be taken during PICC placement will be analyzed, with reference to the differences compared to central catheterization. Specifically, the pre-procedural phase and the intraprocedural main steps of the maneuver will be analyzed. A dedicated Vascular Access Team is considered useful and desirable by the current literature, but when the use of the PICC proves useful or even mandatory, the intensive care physician skilled in central venous catheters can transfer skills from central to peripheral catheterization

Nuclear Magnetic Resonance and Molecular Dynamics Simulation of the Interaction between Recognition Protein H7 of the Novel Influenza Virus H7N9 and Glycan Cell Surface Receptors

Avian influenza A viruses, which can also propagate between humans, present serious pandemic threats, particularly in Asia. The specificity (selectivity) of interactions between the recognition protein hemagglutinin (HA) of the virus capsid and the glycoconjugates of host cells also contributes to the efficient spread of the virus by aerosol between humans. Some avian origin viruses, such as H1N1 (South Carolina 1918), have improved their selectivity for human receptors by mutation in the HA receptor binding site, to generate pandemic viruses. Molecular details and dynamics of glycan–HA interactions are of interest, both in predicting the pandemic potential of a new emerging strain and in searching for new antiviral drugs. Two complementary techniques, ¹H saturation transfer difference (¹H STD) nuclear magnetic resonance and molecular dynamics (MD) simulation, were applied to analyze the interaction of the new H7 (A/Anhui/1/13 H7N9) with LSTa [Neu5Ac α(2→3) Gal β(1→3) GlcNAc β(1→3) Gal β(1→4) Glc] and LSTc [Neu5Ac α(2→6) Gal β(1→4) GlcNAc β(1→3) Gal β(1→4) Glc] pentasaccharides, models of avian and human receptor glycans. Their interactions with H7 were analyzed for the first time using ¹H STD and MD, revealing structural and dynamic behavior that could not be obtained from crystal structures, and contributing to glycan–HA specificity. This highlighted aspects that could affect glycan–HA recognition, including the mutation H7 G228S, which increases H2 and H3 specificity for the human receptor. Finally, interactions between LSTc and H7 were compared with those between LSTc and H1 of H1N1 (South Carolina 1918), contributing to our understanding of the recognition ability of HAs

Applicazione delle nuove linee guida AARC per l'aspirazione endotracheale : impatto sui parametri vitali in pazienti sottoposti a rivascolarizzazione miocardica (BPAC)

RIASSUNTOIntroduzione : La manovra di bronco aspirazione è una procedura che espone il paziente critico a modificazioni dei parametri vitali. Le nuove linee guida AARC hanno enfatizzato sia l'importanza dell'identificazione corretta del momento in cui eseguire la procedura, sia l'utilizzo routinario del sistema chiuso. Obiettivo : Applicare le nuove linee guida AARC utilizzando un rilevatore sonoro per l'identificazione della presenza di secrezioni (TBA care©) e l'aspirazione a circuito chiuso ed analizzare l'andamento dei parametri vitali in una popolazione di pazienti cardiochirurgici. Materiali e metrodi: Lo studio è di tipo osservazionale. Sono stati investigati 15 pazienti sottoposti a BPAC, ricoverati in terapia intensiva cardiochirurgia. Sono stati registrati in continuo i seguenti parametri vitali HR, PAS, PAS*HR, ST varie derivazioni, SpO2, PEEP, RRv, TVc in quattro finestre temporali, 5 minuti prima della manovra di Broncoaspirazione, al momento della manovra (momento 0), a 5 minuti dalla stessa e 10 minuti dopo. Risultati : I parametri vitali rimangono sostanzialmente stabili nei quattro step investigati, con minime variazioni (Variazione percentuale durante la manovra rispetto al basale : HR +2,93%, PAS + 5,66%, SpO2 – 0,13%) . Non si sono registrate modificazioni del tratto ST. Si registra un aumento dell'indice di lavoro cardiaco, che però rientra a 5 minuti dall'esecuzione della manovra. Non si sono verificate desaturazioni arteriose. Conclusioni : Le alterazioni dei parametri vitali osservate, seppur minime, suggeriscono di mantenere il massimo monitoraggio emodinamico e respiratorio. Nella popolazione osservata, l'utilizzo di tecnologie per la diagnosi associate al sistema chiuso di broncoaspirazione ha evitato l'insorgenza di complicanze legate alla manovra.Parole chiave: aspirazione endotracheale, identificazione delle secrezioni, sistema chiuso, ventilazione meccanica, gestione delle secrezioniABSTRACT Introduction: Endotracheal suctioning is a procedure that exposes the patient to critical changes in vital signs. New AARC guidelines have emphasized both the importance of correct identification when to perform the procedure, and the routine use of closed system. Objective: To implement the new guidelines AARC using a sound detector for identifying the presence of secretions (TBA care ©) , closed suctioning circuit and analyze the performance of vital signs in a population of cardiac patients. Methods : The study is observational. Were investigated 15 patients undergoing CABG, cardiac surgery ICU. Were continuously recorded the following vital signs HR, SBP, SBP * HR, ST various leads, SpO2, PEEP, RRV, TVC in four time windows, 5 minutes before the suctioning maneuver at the time of operation (time 0), 5 minutes from the same and 10 minutes later. Results: Vital signs remain stable in the four steps investigated, with minor variations (percent change from baseline during the maneuver: HR +2.93% 5.66% PAS +, SpO2 - 0.13%). There were no ST segment changes. There is an increase in the cardiac work, but within 5 minutes from the execution of the maneuver. There were no arterial desaturation. Conclusions: The observed changes in vital signs, albeit small, suggest to keep the maximum hemodynamic and respiratory monitoring. The use of technologies for the diagnosis associated with the closed system of broncoaspiration has prevented the onset of complications related to the maneuver.Keywords: endotracheal suctioning, secretion detector, closed system, mechanical ventilation, secretion managemen

Human (α2→6) and Avian (α2→3) Sialylated Receptors of Influenza A Virus Show Distinct Conformations and Dynamics in Solution

Differential interactions between influenza A virus protein hemagglutinin (HA) and α2→3 (avian) or α2→6 (human) sialylated glycan receptors play an important role in governing host specificity and adaptation of the virus. Previous analysis of HA–glycan interactions with trisaccharides showed that, in addition to the terminal sialic acid linkage, the conformation and topology of the glycans, while they are bound to HA, are key factors in regulating these interactions. Here, the solution conformation and dynamics of two representative avian and human glycan pentasaccharide receptors [LSTa, Neu5Ac-α(2→3)-Gal-β(1→3)-GlcNAc-β(1→3)-Gal-β(1→4)-Glc; LSTc, (Neu5Ac-α(2→6)-Gal-β(1→4)-GlcNAc-β(1→3)-Gal-β(1→4)-Glc] have been explored using nuclear magnetic resonance and molecular dynamics simulation. Analyses demonstrate that, in solution, human and avian receptors sample distinct conformations, topologies, and dynamics. These unique features of avian and human receptors in solution could represent distinct molecular characteristics for recognition by HA, thereby providing the HA–glycan interaction specificity in influenza.Finlombardia SPAConselho Nacional de Pesquisas (Brazil)National Institutes of Health (U.S.) (R37 GM057073-13)Singapore. National Research Foundation (Singapore-MIT Alliance for Research and Technology

Structural and conformational studies of the heparan sulfate mimetic PI-88

The heparan sulfate mimetic PI-88 is a complex mixture of sulfated oligosaccharides with anti-metastatic and anti-angiogenic activity due to its potent inhibition of heparanase and heparan sulfate-dependent angiogenic growth factors. It was recently in Phase III clinical trials for post-resection hepatocellular carcinoma. The major oligosaccharide constituents of PI-88 were prepared for the first time by sulfonation of individually purified phosphorylated oligosaccharides isolated from the PI-88 precursor. PI-88 and its components were subjected to detailed 1D and 2D NMR spectroscopic analysis. The spectra of the individual components greatly assisted the assignment of minor resonances in the 1H NMR spectrum of PI-88. The data also showed that the majority of the oligosaccharides in PI-88 are fully sulfated and that undersulfated species present are largely due to anomeric desulfation. The solution conformation of the phosphomannopentaose sulfate (major component) of PI-88 was then determined by a combination of molecular dynamics simulations and NOE measurements which may provide insights into its binding interactions with target proteins

Enisamium Inhibits SARS-CoV-2 RNA Synthesis.

Pandemic SARS-CoV-2 causes a mild to severe respiratory disease called coronavirus disease 2019 (COVID-19). While control of the SARS-CoV-2 spread partly depends on vaccine-induced or naturally acquired protective herd immunity, antiviral strategies are still needed to manage COVID-19. Enisamium is an inhibitor of influenza A and B viruses in cell culture and clinically approved in countries of the Commonwealth of Independent States. In vitro, enisamium acts through metabolite VR17-04 and inhibits the activity of the influenza A virus RNA polymerase. Here we show that enisamium can inhibit coronavirus infections in NHBE and Caco-2 cells, and the activity of the SARS-CoV-2 RNA polymerase in vitro. Docking and molecular dynamics simulations provide insight into the mechanism of action and indicate that enisamium metabolite VR17-04 prevents GTP and UTP incorporation. Overall, these results suggest that enisamium is an inhibitor of SARS-CoV-2 RNA synthesis in vitro

Benefit-risk profile of cytoreductive drugs along with antiplatelet and antithrombotic therapy after transient ischemic attack or ischemic stroke in myeloproliferative neoplasms

We analyzed 597 patients with myeloproliferative neoplasms (MPN) who presented transient ischemic attacks (TIA, n = 270) or ischemic stroke (IS, n = 327). Treatment included aspirin, oral anticoagulants, and cytoreductive drugs. The composite incidence of recurrent TIA and IS, acute myocardial infarction (AMI), and cardiovascular (CV) death was 4.21 and 19.2%, respectively at one and five years after the index event, an estimate unexpectedly lower than reported in the general population. Patients tended to replicate the first clinical manifestation (hazard ratio, HR: 2.41 and 4.41 for recurrent TIA and IS, respectively); additional factors for recurrent TIA were previous TIA (HR: 3.40) and microvascular disturbances (HR: 2.30); for recurrent IS arterial hypertension (HR: 4.24) and IS occurrence after MPN diagnosis (HR: 4.47). CV mortality was predicted by age over 60 years (HR: 3.98), an index IS (HR: 3.61), and the occurrence of index events after MPN diagnosis (HR: 2.62). Cytoreductive therapy was a strong protective factor (HR: 0.24). The rate of major bleeding was similar to the general population (0.90 per 100 patient-years). In conclusion, the long-term clinical outcome after TIA and IS in MPN appears even more favorable than in the general population, suggesting an advantageous benefit-risk profile of antithrombotic and cytoreductive treatment

The 2019 coronavirus (SARS-CoV-2) surface protein (Spike) S1 Receptor Binding Domain undergoes conformational change upon heparin binding

Many pathogens take advantage of the dependence of the host on the interaction of hundreds of extracellular proteins with the glycosaminoglycans heparan sulphate to regulate homeostasis and use heparan sulphate as a means to adhere and gain access to cells. Moreover, mucosal epithelia such as that of the respiratory tract are protected by a layer of mucin polysaccharides, which are usually sulphated. Consequently, the polydisperse, natural products of heparan sulphate and the allied polysaccharide, heparin have been found to be involved and prevent infection by a range of viruses including S-associated coronavirus strain HSR1. Here we use surface plasmon resonance and circular dichroism to measure the interaction between the SARS-CoV-2 Spike S1 protein receptor binding domain (SARS-CoV-2 S1 RBD) and heparin. The data demonstrate an interaction between the recombinant surface receptor binding domain and the polysaccharide. This has implications for the rapid development of a first-line therapeutic by repurposing heparin and for next-generation, tailor-made, GAG-based antivirals

Pentosan Polysulfate Inhibits Attachment and Infection by SARS-CoV-2 In Vitro: Insights into Structural Requirements for Binding

Two years since the outbreak of the novel coronavirus SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) pandemic, there remain few clinically effective drugs to complement vaccines. One is the anticoagulant, heparin, which in 2004 was found able to inhibit invasion of SARS-CoV (CoV-1) and which has been employed during the current pandemic to prevent thromboembolic complications and moderate potentially damaging inflammation. Heparin has also been shown experimentally to inhibit SARS-CoV-2 attachment and infection in susceptible cells. At high therapeutic doses however, heparin increases the risk of bleeding and prolonged use can cause heparin-induced thrombocytopenia, a serious side effect. One alternative, with structural similarities to heparin, is the plant-derived, semi-synthetic polysaccharide, pentosan polysulfate (PPS). PPS is an established drug for the oral treatment of interstitial cystitis, is well-tolerated, and exhibits weaker anticoagulant effects than heparin. In an established Vero cell model, PPS and its fractions of varying molecular weights inhibited invasion by SARS-CoV-2. Intact PPS and its size-defined fractions were characterized by molecular weight distribution and chemical structure using nuclear magnetic resonance spectroscopy and liquid chromatography-mass spectrometry, then employed to explore the structural basis of interactions with SARS-CoV-2 spike protein receptor-binding domain (S1 RBD) and the inhibition of Vero cell invasion. PPS was as effective as unfractionated heparin, but more effective in inhibiting cell infection than low-molecular-weight heparin (on a weight/volume basis). Isothermal titration calorimetry and viral plaque-forming assays demonstrated size-dependent binding to S1 RBD and inhibition of Vero cell invasion, suggesting the potential application of PPS as a novel inhibitor of SARS-CoV-2 infection