Mechano-chemical synthesis and analysis of zinc and pyrogallol [4] arene complex under solvent-free and ambient conditions [abstract]

Faculty Mentor: Dr Jerry L. Atwood, ChemistryAbstract only availableHerein, we report a solvent-free approach for chemical synthesis which focuses on mechanochemically forming products from reactants under ambient conditions. With this protocol, several organo-metallic complexes or frameworks of zinc and pyrogallol[4]arenes were synthesized and analyzed with MALDI-TOF mass spectrometry combined with solid state carbon thirteen Nuclear Magnetic Resonance (13CNMR). This synthetic approach is in line with the synthetic methodology of green chemistry which focuses on eco-friendly chemical synthesis or synthetic routs

Training paid caregivers to improve their conversations with people with traumatic brain injury (TBI)

Paid caregivers are frequently involved in the lives of people with TBI with cognitive-communication disorders but no research has evaluated training to improve their interactions. This paper describes an RCT that evaluates a communication partner-training program for paid caregivers of people with TBI. Training was found to improve the skills of paid caregivers and have a significant impact on conversations that involved people with TBI. The long-term effectiveness of the intervention was demonstrated with skills maintained at 6-months follow-up. This research has implications for health professionals that work both with paid caregivers and people with severe TBI

David Maslanka’s Liberation: A Conductor’s Analysis

Abstract For more than forty years, David Maslanka (1943–2017) was a prolific composer for every musical medium. With significant contributions to chamber music, solo literature, vocal settings, and symphony orchestras, his works for wind band have garnered the most success. In addition to composing eight symphonies for band between 1985 and 2017, Maslanka's other significant works for band include, A Child’s Garden of Dreams (1981), Concerto for Alto Saxophone and Wind Ensemble (1999), Give Us This Day (2006), and Liberation (2010). His distinctive musical voice emerges in each of these works as he explores a wide gamut of emotions. Within his works for band, performers and audiences experience a composer with full control of the wind band’s range of forces and palette of colors. Through some of the most technically challenging literature written for wind band, Maslanka creates incredibly powerful moments comprised of surprisingly simple gestures. This document is an examination of David Maslanka’s piece for symphonic wind ensemble and chorus, Liberation. Included within this paper are sections covering: biographical information of the composer; Maslanka’s compositional approach; and information about the origin, inspiration, and source material, addressing formal structure, and performance considerations; in addition to appendices of errata, recommended program notes, and communication with the Maslanka Foundation

Design and Implementation of Mobile Educational Games: Networks for Innovation

Research networks foster creativity and break down institutional barriers, but introduce geographic barriers to communication and collaboration. In designing mobile educational games, our distributed team took advantage of diverse talent pools and differing perspectives to drive forward a core vision of our design targets. Our strategies included intense design workshops, use of online meeting rooms, group paper and software prototyping, and dissemination of prototypes to other teams for refinement and repurposing. Our group showed strong activity at the university-centered nodes with periods of highly effective dissemination between these nodes and to outside groups; we used workshop invitations to gather new ideas and perspectives, to refine the core vision, to forge inter-project links, and to stay current on what was happening in other networks. Important aspects of our final deliverables came from looselyassociated network members who engaged via collaborative design exercises in workshops, emphasizing the need to bring the network together and the importance of outside influences as ideas evolve. Our final deliverable, a mobile educational game and a series of parallel technology demonstrations, reflect the mix of influences and the focus on iterated development that our network maintained

Ureteric Injury During Transvaginal Ultrasound Guided Oocyte Retrieval

Background: Transvaginal ultrasound guided oocyte retrieval during in vitro fertilization is performed routinely around the world and has reduced the occurrence of intra-abdominal injury considerably over laparoscopic procedures. Despite this, injuries do occur. Case: We report a case of a 37-year-old patient who underwent IVF and encountered a ureteric injury during oocyte retrieval, which was recognized early and treated with ureteral stents with full resolution. During a subsequent IVF cycle, stenting of the ureters allowed better visualization, resulting in an uneventful retrieval and subsequent pregnancy. Conclusion: Ureteric injury can occur during transvaginal ultrasound guided egg retrieval. Prompt recognition is vital to successful treatment. Stenting of the ureters is the most common therapeutic modality and can be used in subsequent retrievals to identify the ureters

Late stage modification of receptors identified from dynamic combinatorial libraries

Approaches for the late-stage modification of receptors discovered from dynamic combinatorial libraries and the investigation of the effects of simple modifications on receptor binding and selectivity

Intensive care decision-making:Identifying the challenges and generating solutions to improve inter-specialty referrals to critical care

Introduction Decision-making regarding admission to UK intensive care units is challenging. Demand for beds exceeds capacity, yet the need to provide emergency cover creates pressure to build redundancy into the system. Guidelines to aid clinical decision-making are outdated, resulting in an over-reliance on professional judgement. Although clinicians are highly skilled, there is variability in intensive care unit decision-making, especially at the inter-specialty level wherein cognitive biases contribute to disagreement. Method This research is the first to explore intensive care unit referral and admission decision-making using the Critical Decision Method interviewing technique. We interviewed intensive care unit (n = 9) and non-intensive care unit (n = 6) consultants about a challenging referral they had dealt with in the past where there was disagreement about the patient’s suitability for intensive care unit. Results We present: (i) a description of the referral pathway; (ii) challenges that appear to derail referrals (i.e. process issues, decision biases, inherent stressors, post-decision consequences) and (iii) potential solutions to improve this process. Discussion This research provides a foundation upon which interventions to improve inter-specialty decision-making can be based

Supplementary data: Chemoradiotherapy in octogenarians as primary treatment for muscle-invasive bladder cancer

N/A</jats:p

Chemoradiotherapy in octogenarians as primary treatment for muscle-invasive bladder cancer

Introduction: While radical cystectomy is the gold standard for muscle-invasive bladder cancer (MIBC), in octogenarians cystectomy results in a higher perioperative mortality rate (6.8‒11.1%) than in younger patients (2.2%). Trimodality therapy is a bladder-sparing regimen composed of transurethral resection of bladder tumour (TURBT) and chemoradiotherapy, with intent for salvage cystectomy, and has a 62.5‒90% initial complete response rate. In this study, we evaluate TURBT and chemoradiotherapy without salvage cystectomy in medically inoperable octogenarian patients. Methods: We identified a retrospective cohort of patients aged 80‒89 years with invasive urothelial carcinoma who received combination chemoradiotherapy between 2008 and June 2014. Outcomes were evaluated by Kaplan-Meier (KM) and Cox regression. Results: In 40 patients, the mean age was 84.5 years (interquartile range [IQR] 83‒86). Seventeen patients received hypofractionated, low-dose radiotherapy (LD) (37.5‒40 Gy), while 23 received conventionally fractionated radiotherapy (high-dose [HD]) (50‒65 Gy). Mean overall survival (OS) was 20.7 months (IQR 12.75‒23.25), while mean recurrence-free survival (RFS) was 13.75 months (IQR 3.75‒16.5). Patients receiving HD radiotherapy showed improved OS and local RFS (LRFS) without significant differences in Grade 3‒4 toxicities. Univariate Cox regression identified hydronephrosis as a predictor of worse OS and local recurrence and HD radiotherapy as a predictor of improved OS and local recurrence rates. Multivariate Cox regression identified hydronephrosis to be a significant predictor of LRFS. Conclusions: Primary chemoradiotherapy for inoperable patients with MIBC resulted in a three-year OS of 54.9% (comparable to cystectomy) and three-year RFS of 42.3%. Superior outcomes were associated with more aggressive chemoradiotherapy treatment. The results of the local control subanalyses in this study are hypothesis-generating due to the limited patient numbers in the cohort