Here we describe a new class of CPL switches based on oxophilic interactions between chiral sulfoxide-containing ortho-phenylene ethynylene (o-OPE) foldamers and cationic metals. These systems ...represent a unique case combining high glum values (up to 0.7 × 10-2) and high quantum yields in both folded ON and unfolded OFF CPL states.
Background
Antibiotic resistance is a global threat and burden on healthcare systems. One major factor contributing to this problem is inappropriate use of antibiotics, which comprises suboptimal ...use, misuse, abuse, and dispensing errors. Another important factor is dispensing antibiotics without medical prescription. Many studies considered pharmacists as healthcare providers accountable for this malpractice.
Objectives
To investigate community pharmacists’ knowledge, attitudes, and practices in relation to antibiotic dispensing, antibiotic resistance and antibiotic stewardship.
Setting
Community pharmacists selected from different areas in Amman/Jordan. Subjects were selected based on their availability and accessibility.
Methods
A descriptive cross-sectional survey of community pharmacists was conducted between May to October 2019, using a structured, validated, and pilot-tested questionnaire. A four-part systematic survey consisting of biography, knowledge, practice and attitude domains was used
. Main outcome measure
community pharmacist knowledge, practices and attitudes regarding antibiotic use and resistance
. Results
Of 150 community pharmacists approached, 114 completed and returned the questionnaire (response rate 76%). More than 83.3% perceived antimicrobial resistance as a global problem. A substantial percentage (59.7%) educate patients about issues of inappropriate antibiotics use. Almost half the participants (44.7%) agreed that implementing antimicrobial stewardship would result in better outcomes.
Conclusion
It is crucial to improve the curriculum in schools of pharmacy, emphasizing on interprofessional education and developing customized interventions. Regulations on dispensing antibiotics without prescription should be enforced. Policy makers need to implement antimicrobial stewardship and encourage the use of public educational interventions in community pharmacy.
To describe the relationship between longevity and local access to preventive healthcare at the county level.
We used Medicare outpatient reimbursement data from the 2010 Dartmouth Health Atlas and ...longevity data from Chetty et al. (2016) to identify the cross-sectional associations between county longevity, access to outpatient care, and the quality of primary care.
We find that the cost of outpatient care is inversely correlated with area life expectancy for individuals in the bottom income quartile. Much of this correlation is driven by men in the bottom income quartile. We also find that disaggregating a preventive care index produces significant relationships between components of the index and longevity where none were previously found.
These results counter prior assertions that local health costs are not associated with life expectancy. Additionally, the results also suggest that the local cost of outpatient care and the quality of that care may influence the longevity of low-income populations, especially for low-income men.
Plaques in the carotid artery result in stenosis, which is one of the main causes for stroke. Patients have to be carefully selected for stenosis treatments as they carry some risk. Since patients ...with symptomatic plaques have greater risk for strokes, an objective classification technique that classifies the plaques into symptomatic and asymptomatic classes is needed. We present a computer aided diagnostic (CAD) based ultrasound characterization methodology (a class of Atheromatic systems) that classifies the patient into symptomatic and asymptomatic classes using two kinds of datasets: (1) plaque regions in ultrasound carotids segmented semi-automatically and (2) far wall gray-scale intima-media thickness (IMT) regions along the common carotid artery segmented automatically. For both kinds of datasets, the protocol consists of estimating texture-based features in frameworks of local binary patterns (LBP) and Law's texture energy (LTE) and applying these features for obtaining the training parameters, which are then used for classification. Our database consists of 150 asymptomatic and 196 symptomatic plaque regions and 342 IMT wall regions. When using the Atheromatic-based system on semiautomatically determined plaque regions, support vector machine (SVM) classifier was adapted with highest accuracy of 83%. The accuracy registered was 89.5% on the far wall gray-scale IMT regions when using SVM, K-nearest neighbor (KNN) or radial basis probabilistic neural network (RBPNN) classifiers. LBP/LTE-based techniques on both kinds of carotid datasets are noninvasive, fast, objective and cost-effective for plaque characterization and, hence, will add more value to the existing carotid plaque diagnostics protocol. We have also proposed an index for each type of datasets: AtheromaticPi, for carotid plaque region, and AtheromaticWi, for IMT carotid wall region, based on the combination of the respective significant features. These indices show a separation between symptomatic and asymptomatic by 4.53 units and 4.42 units, respectively, thereby supporting the texture hypothesis classification.
Logistics is the transfer of goods from one place to another, mostly from the production house to the customers. A logistics network is a set of operations that involve designing, production, and ...marketing the goods. Cold-chain logistics are those that needed to be transported in a cold refrigeration right from the production house to the customer. A secured networking model is essential to handle the logistics networks. In this article, we are going to see an intelligent secured networking model to identify the optimal path for cold-chain logistics to hospitals. The optimal pathfinder is used to find the path between point A to point B, which is short and best. It also considers the road traffic and cost of transport. The cold-chain logistics to the hospitals include medicines and vaccines, which are to be stored at a particular temperature. Thus, path optimization is more essential in cold-chain logistics to hospitals than other types of logistics. In this research, the bee-ant optimization algorithm (BAOA) is proposed to perform the intelligent transportation to the hospitals. The proposed algorithm is compared with the existing ant colony optimization (ACO), bee colony optimization (BCO), and neural network model. From the results, it can be observed that the proposed algorithm shows 98.83% for the accurate delivery of logistics to the hospitals.
► In this study we have developed automatic, real-time on-line CAD-based paradigm for thyroid nodule classification. ► We proposed novel grayscale feature design and extraction system for the ...off-line training process. ► The proposed system provides 100% accuracy for HRUS and 98.1% accuracy for CEUS acquisition protocols.
Ultrasound-based thyroid nodule characterization into benign and malignant types is limited by subjective interpretations. This paper presents a Computer Aided Diagnostic (CAD) technique that would present more objective and accurate classification and further would offer the physician a valuable second opinion. In this paradigm, we first extracted the features that quantify the local changes in the texture characteristics of the ultrasound off-line training images from both benign and malignant nodules. These features include: Fractal Dimension (FD), Local Binary Pattern (LBP), Fourier Spectrum Descriptor (FS), and Laws Texture Energy (LTE). The resulting feature vectors were used to build seven different classifiers: Support Vector Machine (SVM), Decision Tree (DT), Sugeno Fuzzy, Gaussian Mixture Model (GMM), K-Nearest Neighbor (KNN), Radial Basis Probabilistic Neural Network (RBPNN), and Naive Bayes Classifier (NBC). Subsequently, the feature vector-classifier combination that results in the maximum classification accuracy was used to predict the class of a new on-line test thyroid ultrasound image. Two data sets with 3D Contrast-Enhanced Ultrasound (CEUS) and 3D High Resolution Ultrasound (HRUS) images of 20 nodules (10 benign and 10 malignant) were used. Fine needle aspiration biopsy and histology results were used to confirm malignancy. Our results show that a combination of texture features coupled with SVM or Fuzzy classifiers resulted in 100% accuracy for the HRUS dataset, while GMM classifier resulted in 98.1% accuracy for the CEUS dataset. Finally, for each dataset, we have proposed a novel integrated index called Thyroid Malignancy Index (TMI) using the combination of FD, LBP, LTE texture features, to diagnose benign or malignant nodules. This index can help clinicians to make a more objective differentiation of benign/malignant thyroid lesions. We have compared and benchmarked the system with existing methods.
Non-covalent interactions (NCIs) can play a major role in the stereoselective ring-opening polymerization (ROP) of racemic β-lactones mediated by achiral metal catalysts, towards the formation of the ...corresponding polyhydroxyalkanoates (PHAs) with a specific microstructure. Our longstanding endeavor to better understand the factors governing the stereoselective ROP of 4-substituted β-propiolactone monomers
rac
-BPL
FG
s (resulting in PBPL
FG
s; FG = (non)functional group), from catalyst systems based on diamino- or amino-alkoxy-bis(
ortho
,
para
-substituted)phenolate rare earth complexes associated with an exogenous alcohol as an initiator, indicated that the formation of iso-enriched polyesters requires the use of
ortho
-halogen-substituted phenolate ligands (halogen = F, Cl, and Br) along with a methylene alkoxide pending substituent (FG = -CH
2
OCH
2
R*) on the lactone. Any other ligand/β-lactone combination resulted in either syndiotactic or atactic PBPL
FG
s. We report herein the controlled ROP of 4-methylene-alkoxy-fluorinated substituted β-propiolactone,
rac
-BPL
CH
2
OCF
2
CHF
2
, catalyzed by diamino-bis(
ortho
,
para
-R,R-substituted)phenolate yttrium catalyst systems Y{ONNO
R2
}/
i
PrOH (with R = Me, Cl,
t
Bu, cumyl; namely
1a-d
/
i
PrOH, respectively). This monomer does not feature any outer methylene hydrogen in the alkoxide moiety (-CH
2
OC&cmb.b.line;F&cmb.b.line;
2
CHF
2
vs
. -CH
2
OC&cmb.b.line;H&cmb.b.line;
2
R*), thus enabling the evaluation of the role of outer CH
2
O(R*)C&cmb.b.line;
H&cmb.b.line;
2
R
NCIs in the stereocontrol. The
t
Bu catalyst
1c
showed the highest ROP activity (TOF up to 4650 h
−1
) out of the four catalyst systems investigated. The fluoroalkyl PHAs were recovered with molar mass values up to
M
n,NMR
= 106 000 g mol
−1
and narrow dispersity (
M
= 1.02-1.24). Detailed NMR and mass spectrometry characterization studies supported the formation of α-isopropoxy,ω-hydroxy telechelic PBPL
CH
2
OCF
2
CHF
2
chains. Catalysts
1c
and
1d
flanked with bulky phenolate substituents (R =
t
Bu, cumyl) and the chloro-substituted one
1b
all returned syndio-enriched PBPL
CH
2
OCF
2
CHF
2
s with
P
r
up to 0.87, as assessed by
13
C NMR spectroscopy. Only the methyl substituted catalyst
1a
gave atactic PHAs. Eventually, these findings support the hypothesis that both inner and outer methylene hydrogens within an alkoxymethylene exocyclic group on the
rac
-β-lactone monomer (C&cmb.b.line;H&cmb.b.line;
2
OC&cmb.b.line;H&cmb.b.line;
2
R*) are required, along with an
ortho
-chloro-substituted yttrium bisphenolate catalyst (Y{ONNO
Cl
2
}), to induce NCIs (
Cl
H&cmb.b.line;
2
C&cmb.b.line;-O-C&cmb.b.line;(R*)
H&cmb.b.line;
2
Cl
), ultimately resulting in unique isotactic synthetic PHAs.
Non-covalent interactions (NCIs) can guide stereoselective ring-opening polymerization (ROP) of racemic β-lactones mediated by achiral complexes, towards stereoregular polyhydroxyalkanoates (PHAs).
Water‐soluble, biocompatible, and photoluminescent carbon nanodots have been obtained from the rationalized carbonization of vitamin C, a well‐known antioxidant molecule in the presence of an amine ...co‐reactant. Herein, we describe the positive influence of N‐doping to induce a unique pH‐dependent lifetime decay response that would be potentially attractive in biological backgrounds with intrinsic fluorescence fluctuations. In addition, the selectivity and sensitivity of the N‐containing carbon nanoprobes towards the detection of copper ions at ppm levels is critically enhanced in comparison with the un‐doped counterpart, especially in the near‐infrared (NIR) range. Finally, the up‐converting properties have been also successfully applied to image tumor cells in the visible range and remarkably, in the NIR region in which minimal tissue or water absorption and maximum penetration depth are expected.
Multi‐use vitamin: N‐doped carbon dots are successfully tested as promising lifetime decay pH‐dependent sensors, highly selective copper ionic probes even in the presence of interference ions and as biocompatible labels in the visible and NIR windows.
Within bioplastics, natural poly(3-hydroxybutyrate) (PHB) stands out as fully biocompatible and biodegradable, even in marine environments; however, its high isotacticity and crystallinity limits its ...mechanical properties and hence its applications. PHB can also be synthesized with different tacticities via a catalytic ring-opening polymerization (ROP) of rac-β-butyrolactone (BBL), paving the way to PHB with better thermomechanical and processability properties. In this work, the catalyst family is extended based on aluminum phenoxy-imine methyl catalyst AlMeL
, that reveals efficient in the ROP of BBL, to the halogeno analogous complex AlClL
. As well, the impact on the ROP mechanism of different initiators is further explored with a particular focus in dimethylaminopyridine (DMAP), a hardly studied initiator for the ROP of BBL. A thorough mechanistic study is performed that evidences the presence of two concomitant DMAP-mediated mechanisms, that lead to either a DMAP or a crotonate end-capping group. Besides, in order to increase the possibilities of PHB post-polymerization functionalization, the introduction of a side-chain functionality is explored, establishing the copolymerization of BBL with β-allyloxymethylene propiolactone (BPL
), resulting in well-defined P(BBL-co-BPL
) copolymers.
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