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- BookBenjamin James Sadock, Virginia Alcott Sadock, Pedro Ruiz.Summary: "This study guide is an excellent aid in preparing for boards and other psychiatry exams and in reinforcing your knowledge. It offers chapter overviews of Synopsis, Tenth Edition and over 1,600 multiple-choice questions with discussions of correct and incorrect answers"--Provided by publisher.
- ArticleRocha D, Lobato CT, Melo Pinto D, Marques F, Marques T, Guedes C.Cureus. 2023 Nov;15(11):e49444.INTRODUCTION: Venous thromboembolism (VTE) includes pulmonary embolism (PE), deep vein thrombosis (DVT) in lower limbs, and thrombosis in rare locations. VTE is a common cardiovascular disease, being the leading preventable cause of in-hospital death. Both surgical and acute medical patients have an elevated risk of developing VTE. VTE risk assessment is essential to identify patients who might benefit from VTE prophylaxis accurately. Clinical data on risk factors and prophylaxis in Portugal are scarce. We aimed to determine the proportion of at-risk patients who received prophylaxis and the incidence of bleeding events. We also intended to study the rate of VTE in a cohort of medical and surgical patients during the hospitalization period and three months after discharge.
METHODS: During one week in 2020, adults admitted for more than 72hr to a medical or surgical ward were included. The study excluded patients with a diagnosis of VTE three months before hospitalization and who were either chronically receiving anticoagulation therapy or had started it 48 hours after admission. Risk assessments were based on the Padua Prediction Score (PPS) for medical patients and the Caprini Risk Assessment Model (CRAM) for surgical patients. We used CHEST guidelines, 9th edition, to determine the adequacy of the prophylactic method.
RESULTS: A total of 123 patients were analyzed, 18.7% of which tested positive for SARS-CoV-2. VTE risk in surgical patients was categorized as very low or low (16.6%), moderate (37.5%), and high (43.8%), according to the CRAM. Risk in medical patients was categorized as low (60.0%) or high (40.0%) according to the PPS. We estimated that VTE chemoprophylaxis was overused in about 30.0% of patients vs. 7.0% who were at risk and did not receive appropriate chemoprophylaxis. The rate of thromboembolic events was 4.1% (n=5), 2 of which happened after discharge. Two of these patients were under VTE prophylaxis during hospitalization. Major bleeding occurred in 2.4% of patients (n=3).
DISCUSSION: A significant number of hospitalized patients are deemed to be at risk for VTE, making appropriate prophylaxis essential. The results emphasize the insufficient management of VTE prophylaxis. - ArticleNordmann S, Biard L, Ravaud P, Esposito-Farèse M, Tubach F.PLoS One. 2012;7(11):e49444.BACKGROUND: Case-only designs have been used since late 1980's. In these, as opposed to case-control or cohort studies for instance, only cases are required and are self-controlled, eliminating selection biases and confounding related to control subjects, and time-invariant characteristics. The objectives of this systematic review were to analyze how the two main case-only designs - case-crossover (CC) and self-controlled case series (SCCS) - have been applied and reported in pharmacoepidemiology literature, in terms of applicability assumptions and specificities of these designs.
METHODOLOGY/PRINCIPAL FINDINGS: We systematically selected all reports in this field involving case-only designs from MEDLINE and EMBASE up to September 15, 2010. Data were extracted using a standardized form. The analysis included 93 reports 50 (54%) of CC and 45 (48%) SCCS, 2 reports combined both designs. In 12 (24%) CC and 18 (40%) SCCS articles, all applicable validity assumptions of the designs were fulfilled, respectively. Fifty (54%) articles (15 CC (30%) and 35 (78%) SCCS) adequately addressed the specificities of the case-only analyses in the way they reported results.
CONCLUSIONS/SIGNIFICANCE: Our systematic review underlines that implementation of CC and SCCS designs needs to be more rigorous with regard to validity assumptions, as well as improvement in results reporting. - ArticleHan J, Liu Z, Yang H, Zhu M, Lv J.ACS Omega. 2023 Dec 26;8(51):49444-49459.To investigate the nonstationary diffusion and transport law of gas in coal, an innovative fractal diffusion model based on fractal theory and a treelike bifurcation network under different diffusion modes were built. In addition, the quantitative relationships among the diffusion coefficient, temperature, pressure, and structural parameters were determined. The model considers the effect of pore tortuosity and connectivity on gas diffusion, which renders it more realistic than the previously presented single-pore diffusion models. Moreover, each parameter in the model has a definite physical meaning and does not contain any empirical constants. The applicability of the new model was verified by experimental data and other model. Subsequently, a sensitivity analysis of the gas diffusion coefficient was performed to study the effect of the microstructural parameters on gas diffusion. Finally, the dispersion degree of the diffusion coefficients at different temperatures and pressures was analyzed to determine the main influencing factors of gas diffusion at different diffusion stages in coal and study their evolution. The results show that the gas diffusion state is more sensitive to pressure variations. The diffusion behavior of gases in coal-based porous media is more influenced by the temperature and pressure at the beginning of the diffusion process.
- ArticleObst F, Mertz M, Mehner PJ, Beck A, Castiglione K, Richter A, Voit B, Appelhans D.ACS Appl Mater Interfaces. 2021 Oct 20;13(41):49433-49444.Multienzymatic cascade reactions are a powerful strategy for straightforward and highly specific synthesis of complex materials, such as active substances in drugs. Cross-inhibitions and incompatible reaction steps, however, often limit enzymatic activity and thus the conversion. Such limitations occur, e.g., in the enzymatic synthesis of the biologically active sialic acid cytidine monophosphate N-acetylneuraminic acid (CMP-Neu5Ac). We addressed this challenge by developing a confinement and compartmentalization concept of hydrogel-immobilized enzymes for improving the efficiency of the enzyme cascade reaction. The three enzymes required for the synthesis of CMP-Neu5Ac, namely, N-acyl-d-glucosamine 2-epimerase (AGE), N-acetylneuraminate lyase (NAL), and CMP-sialic acid synthetase (CSS), were immobilized into bulk hydrogels and microstructured hydrogel-enzyme-dot arrays, which were then integrated into microfluidic devices. To overcome the cytidine triphosphate (CTP) cross-inhibition of AGE and NAL, only a low CTP concentration was applied and continuously conveyed through the device. In a second approach, the enzymes were compartmentalized in separate reaction chambers of the microfluidic device to completely avoid cross-inhibitions and enable the use of higher substrate concentrations. Immobilization efficiencies of up to 25% and pronounced long-term activity of the immobilized enzymes for several weeks were realized. Moreover, immobilized enzymes were less sensitive to inhibition and the substrate-channeling effect between immobilized enzymes promoted the overall conversion in the trienzymatic cascade reaction. Based on this, CMP-Neu5Ac was successfully synthesized by immobilized enzymes in noncompartmentalized and compartmentalized microfluidic devices. This study demonstrates the high potential of immobilizing enzymes in (compartmentalized) microfluidic devices to perform multienzymatic cascade reactions despite cross-inhibitions under continuous flow conditions. Due to the ease of enzyme immobilization in hydrogels, this concept is likely applicable for many cascade reactions with or without cross-inhibition characteristics.