Catch and release’ cascades: a resin-mediated three-component cascade approach to small molecules

The application of a ‘catch and release’ approach to palladium-catalysed multi-component cascade reactions leads to diverse libraries of pharmacologically interesting small molecules in high yield and with excellent purity

Descripción de un modelo de gestión de enfermedad en una población en diálisis en Colombia

Introduction: Management Models of Disease (MMD) allows one to identify risks and prioritize interven-tions to achieve better clinical outcomes. This work aims to describe a MMD designed for a population on dialysis and identify the cardiovascular risk factors and metabolic diseases in this population.Methods: MMD described. We included patients older than 18 years, receiving dialysis between March 1stand  August 31st2013; demographic variables were assessed and baseline clinical and risk factors werei-dentified according to the presence of diabetes. For the analysisdescriptive statistics in Stata® 12 was used.Results: 2219 patients were analyzed, 1004 (45.24%) of them were diabetic, 624 (28.1%) had a history of cardiovascular disease, 990 (94.37%) reported some alteration in the echocardiogram, being the most frequent the hypertensive cardiopathy in the 58.63%. As a result, the total number of patients on hemodialy-sis was 271 (13%), and on peritoneal dialysis112 (5%) had poor control of blood volume, high CRP in the 64.4% and TSH >10 IU/ml in 12.1% of the subjects. The ankle-brachial index (ITB) was found altered in 37.5% of diabetics, versus 21.8% in non-diabetics (p<0.001); differences were observed for the overweight population; 40.03% vs. 26.91%, in diabetics and non-diabetics, respectively.Conclusions: This disease management model is based on agency of cases and integration of networks of services may be a high impact response to populations in dialysis with important comorbidity.Introducción: Los Modelos de Gestión de Enfermedad (MGE) permiten identificar riesgos y priorizar intervenciones para lograr mejores desenlaces clínicos. Este trabajo tiene por objetivo describir un MGE diseñado para una población en diálisis e identificar los factores de riesgo cardiovascular y metabólico en dicha población.Métodos: Se describe el MGE. Se incluyeron pacientes mayores de 18 años, prevalentes en diálisis entre el 1º de marzo y el 31 de agosto de 2013; se evaluaron variables demográficas y clínicas basales, y se identificaron factores de riesgo según la presencia de diabetes. Para el análisis se usó estadística descriptiva en Stata® 12.Resultados: Se analizaron 2219 pacientes, 1004 (45.24%) de ellos eran diabéticos, 624 (28.1%) tuvieron antecedentes de enfermedad cardiovascular, en 990 (94.37%) se reportó alguna alteración en el ecocardiograma, siendo la más frecuente la cardiopatía hipertensiva en el 58.63%. Se observó que del total de los pacientes en hemodiálisis, 271 (13%), y en diálisis peritoneal 112 (5%) tuvieron mal control de la volemia, PCR elevada en el 64.4% y TSH > 10 UI/ml en el 12.1% de los sujetos. El índice tobillo-brazo (ITB) se encontró alterado en el 37.5% de los diabéticos, versus 21.8% en los no diabéticos (p<0.001); se observaron diferencias significativas en cuanto a sobrepeso, 40.03% versus 26.91%, en diabéticos y no diabéticos, respectivamente.Conclusiones: Este modelo de gestión de enfermedad basado en gestoría de casos e integración de redes de servicios puede ser una respuesta de alto impacto para poblaciones en diálisis con importante comorbilidad

A first generation compact microbeam radiation therapy system based on carbon nanotube X-ray technology

We have developed a compact microbeam radiation therapy device using carbon nanotube cathodes to create a linear array of narrow focal line segments on a tungsten anode and a custom collimator assembly to select a slice of the resulting wedge-shaped radiation pattern. Effective focal line width was measured to be 131 μm, resulting in a microbeam width of ∼300 μm. The instantaneous dose rate was projected to be 2 Gy/s at full-power. Peak to valley dose ratio was measured to be >17 when a 1.4 mm microbeam separation was employed. Finally, multiple microbeams were delivered to a mouse with beam paths verified through histology

Second generation stationary digital breast tomosynthesis system with faster scan time and wider angular span

Purpose: The aim of this study was to characterize a new generation stationary digital breast tomosynthesis system with higher tube flux and increased angular span over a first generation system. Methods: The linear CNT x-ray source was designed, built, and evaluated to determine its performance parameters. The second generation system was then constructed using the CNT x-ray source and a Hologic gantry. Upon construction, test objects and phantoms were used to characterize system resolution as measured by the modulation transfer function (MTF), and artifact spread function (ASF). Results: The results indicated that the linear CNT x-ray source was capable of stable operation at a tube potential of 49 kVp, and measured focal spot sizes showed source-to-source consistency with a nominal focal spot size of 1.1 mm. After construction, the second generation (Gen 2) system exhibited entrance surface air kerma rates two times greater the previous s-DBT system. System in-plane resolution as measured by the MTF is 7.7 cycles/mm, compared to 6.7 cycles/mm for the Gen 1 system. As expected, an increase in the z-axis depth resolution was observed, with a decrease in the ASF from 4.30 mm to 2.35 mm moving from the Gen 1 system to the Gen 2 system as result of an increased angular span. Conclusions: The results indicate that the Gen 2 stationary digital breast tomosynthesis system, which has a larger angular span, increased entrance surface air kerma, and faster image acquisition time over the Gen 1 s-DBT system, results in higher resolution images. With the detector operating at full resolution, the Gen 2 s-DBT system can achieve an in-plane resolution of 7.7 cycles per mm, which is better than the current commercial DBT systems today, and may potentially result in better patient diagnosis

Impacto de un modelo de gestión de enfermedad en una población con tratamiento de diálisis en Colombia

Introducción. La implementación de modelos de gestión de enfermedad (MGE) ha demostrado mejores desenlaces en salud.Objetivo. Describir la tasa de hospitalización y mortalidad en una cohorte de pacientes con tratamiento de diálisis en la que se implementó un MGE.Materiales y métodos. Estudio de cohorte prospectivo en el que se incluyeron pacientes prevalentes en diálisis, mayores de 18 años, pertenecientes a la entidad promotora de salud del régimen contributivo Nueva EPS y con al menos tres meses de intervención con MGE en la red Renal Therapy Services (RTS) entre el 1 de enero y el 31 de diciembre de 2014. Para el análisis se usaron modelos multivariables de supervivencia y estadística descriptiva.Resultados. Se evaluaron 2 525 pacientes; la mediana de edad fue 64.5 años (RIC=19), el 56.9% (n=1 437) estaban en hemodiálisis, el 59.5% (n=1 503) fueron hombres y se encontró una tasa de hospitalización de 1.15 eventos por paciente/año (IC95%: 1.10- 1.19) con 9.6 días hospitalarios paciente/año. La tasa de mortalidad fue de 146 muertes por 1 000 pacientes/año (IC95%: 130.3-163.6).Conclusión. A pesar de la alta comorbilidad observada en esta población en diálisis intervenida con un MGE, se encontraron desenlaces clínicos favorables.Introduction: The implementation of disease management models (DMM) has shown better health outcomes.Objective: To describe hospitalization and mortality rates in a cohort of patients on dialysis in which a DMM was implemented.Materials and methods: Prospective cohort study in which prevalent dialysis patients, older than 18 years of age, belonging to the health promoter of the contributory scheme (Nueva EPS), and with at least three months of intervention with DMM, were included in the Renal Therapy Services Network (RTS) between January 1 and December 31, 2014.To conduct the multivariate analysis, survival models and descriptive statistics were used.Results: 2 525 patients were evaluated; median age was 64.5 years (IR=19); 56.9% (n=1 437) were on hemodialysis; 59.5% (n=1,503) were male, and a hospitalization rate of 1.15 events per patient/year was found (95% CI: 1.10-1.19) with 9.6 hospital patient days/year. The mortality rate was 146 deaths per 1 000 patients/year (95% CI: 130.3-163.6).Conclusion: Despite the high comorbidity observed in the population undergoing dialysis managed with DMM, favorable clinical outcomes were found

THE AUTHORITY OF THE MANAGEMENT BOARD TO REPRESENT THE JOINT STOCK COMPANY AND THE LIMITED LIABILITY COMPANY

U radu se obrađuje položaj uprave u dioničkom društvu i društvu s ograničenom odgovornošću s posebnim osvrtom na ovlast članova uprave na zastupanje društva. Autorica obrađuje pitanja sastava uprave, imenovanja i opoziva članova uprave, pravnu regulaciju odnosa između članova društva i članova uprave, gdje naglašava da se radi o kompleksnom odnosu na dvije razine, ugovornopravnoj i statusnopravnoj. U posebnom poglavlju rada analizira ovlast članova uprave kao i ograničenja njihovih ovlasti, gdje detaljno razrađuje pitanje ovlasti članova uprave zastupati trgovačko društvo. Naime, bez zastupanja društvo ne može sudjelovati u pravnim odnosima s drugim fizičkim i pravnim osobama. Zasebno obrađuje i uspoređuje položaj člana uprave u dioničkom društvu i društvu s ograničenom odgovornošću, iznoseći sličnosti i razlike normativnih rješenja obaju društava. Rad potkrijepljuje sudskom praksom te na temelju provedenog istraživanja iznosi relevantne zaključke

THE AUTHORITY OF THE MANAGEMENT BOARD TO REPRESENT THE JOINT STOCK COMPANY AND THE LIMITED LIABILITY COMPANY

U radu se obrađuje položaj uprave u dioničkom društvu i društvu s ograničenom odgovornošću s posebnim osvrtom na ovlast članova uprave na zastupanje društva. Autorica obrađuje pitanja sastava uprave, imenovanja i opoziva članova uprave, pravnu regulaciju odnosa između članova društva i članova uprave, gdje naglašava da se radi o kompleksnom odnosu na dvije razine, ugovornopravnoj i statusnopravnoj. U posebnom poglavlju rada analizira ovlast članova uprave kao i ograničenja njihovih ovlasti, gdje detaljno razrađuje pitanje ovlasti članova uprave zastupati trgovačko društvo. Naime, bez zastupanja društvo ne može sudjelovati u pravnim odnosima s drugim fizičkim i pravnim osobama. Zasebno obrađuje i uspoređuje položaj člana uprave u dioničkom društvu i društvu s ograničenom odgovornošću, iznoseći sličnosti i razlike normativnih rješenja obaju društava. Rad potkrijepljuje sudskom praksom te na temelju provedenog istraživanja iznosi relevantne zaključke