Endoscopy during the COVID-19 pandemic: simple construction of a single-use, disposable face shield using inexpensive and readily available materials.
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ABSTRACT:
SUBMITTER: Skamnelos A
PROVIDER: S-EPMC7224167 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:The motivation for research on 3D printing of protective face shields was the urgent societal demand for healthcare in the fight against the spread of COVID19 pandemic. Research is based on a literature review that shows that objects produced by additive technologies do not always have consistent quality suitable for the given purpose of use. Besides, they have different effects on the environment and leave different footprints. The overall goal of the research was to find out the most suitable thermoplastic material for printing shield frames in terms of mechanical properties, geometric accuracy, weight, printing time, filament price, and environmental sustainability. Fused deposition modeling (FDM) technology was used for 3D printing, and three different filaments were investigated: polylactic acid (PLA), polyethylene terephthalate (PETG), and polyhydroxyalkanoate (PHA). The weighted sum method for multi-objective optimization was used. Finally, PHA material was chosen, mainly due to its environmental sustainability, as it has the most negligible impact on the environment.
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Project description:In the quest for new catalysts that can deliver single enantiomer pharmaceuticals and agricultural chemicals, chemists have extensively mined the "chiral pool", with little in the way of inexpensive, readily available building blocks now remaining. It is found that Werner complexes based upon the D3 symmetric chiral trication [Co(en)3](3+) (en = 1,2-ethylenediamine), which features an earth abundant metal and cheap ligand type, and was among the first inorganic compounds resolved into enantiomers 103 years ago, catalyze a valuable carbon-carbon bond forming reaction, the Michael addition of malonate esters to nitroalkenes, in high enantioselectivities and without requiring inert atmosphere conditions. The title catalysts, [Co((S,S)-dpen)3](3+) ((S,S)-3 (3+)) 3X(-), employ a commercially available chiral ligand, (S,S)-1,2-diphenylethylenediamine. The rates and ee values are functions of the configuration of the cobalt center (Λ/Δ) and the counteranions, which must be lipophilic to solubilize the trication in nonaqueous media. The highest enantioselectivities are obtained with Λ and 2Cl(-)BArf (-), 2BF4 (-)BArf (-), or 3BF4 (-) salts (BArf (-) = B(3,5-C6H3(CF3)2)4 (-)). The substrates are not activated by metal coordination, but rather by second coordination sphere hydrogen bonding involving the ligating NH2 groups. Crystal structures and NMR data indicate enthalpically stronger interactions with the NH moieties related by the C3 symmetry axis, as opposed to those related by the C2 symmetry axes; rate trends and other observations suggest this to be the catalytically active site. Both Λ- and Δ-(S,S)-3 (3+) 2Cl(-)BArf (-) are effective catalysts for additions of β-ketoesters to RO2CN=NCO2R species (99-86% yields, 81-76% ee), which provide carbon-nitrogen bonds and valuable precursors to α-amino acids.
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Project description:Background and aimDuring the Coronavirus Disease 2019 pandemic, esophagogastroduodenoscopy (EGD) has been recognized as an aerosol-generating procedure. This study aimed to systematically compare the degree of face shield contamination between endoscopists who performed EGD on patients lying in the left lateral decubitus (LL) and prone positions.MethodsThis is a randomized trial in patients scheduled for EGD between April and June 2020. Eligible 212 patients were randomized with 1:1 allocation. Rapid adenosine triphosphate test was used to determine contamination level using relative light units of greater than 200 as a cutoff value. All eligible patients were randomized to lie in either the LL or prone position during EGD. The primary outcome was the rate of contamination on the endoscopist's face shield.ResultsThe majority of patients were female (63%), with a mean age of 60 ± 13 years. Baseline characteristics were comparable between the two groups. There was no face shield contamination after EGD in either group. The number of coughs in the LL group was higher than the prone group (1.38 ± 1.8 vs 0.89 ± 1.4, P = 0.03). The mean differences in relative light units on the face shield before and after EGD in the LL and prone groups were 9.9 ± 20.9 and 4.1 ± 6 (P = 0.008), respectively.ConclusionAs measured by the adenosine triphosphate test, performing diagnostic EGD does not lead to contamination on the face shield of the endoscopist. However, placing patients in the prone position may further mitigate the risk.
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Project description:Pseudo-natural products (PNPs) combine fragments derived from NPs in ways that are not found in nature, and may lead to the discovery of novel chemotypes for unexpected targets or the identification of unprecedented bioactivities. PNPs have increasingly been explored in recent drug discovery programs, and are strongly enriched in clinical compounds. We describe how a large number of structurally different PNPs can be accessed readily and without the need to execute labor- and time intensive synthesis programs. We employed an improved version of the previously reported natural product fragment combination (NPFC) tool to analyze the full library of 3.5 M synthetic small molecules and screening libraries from Enamine for PNP content, assessed the spatial complexity of Enamine-PNPs using the recently developed normalized spatial score (nSPS) and evaluated the bioactivity of a selected subset of Enamine-PNPs in the unbiased morphological cell painting assay. A major fraction (32%; 1.1 million compounds) of the Enamine library are PNPs which contain a significant number of compounds with unexpected and probably new bioactivity.
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| S-EPMC7273030 | biostudies-literature
Project description:BackgroundA portable disposable ultrathin endoscope (DUE) with high visual quality and maneuverability would reduce the need for expensive facilities and emergency endoscopy could be available anywhere. It would increase patient satisfaction, prevent unnecessary sedation, and reduce infection. Our aim was to evaluate the usefulness of portable DUE in performing percutaneous endoscopic gastrostomy (PEG).MethodsWe prospectively enrolled patients who underwent PEG under DUE guidance and compared them with historical controls who underwent PEG under conventional ultrathin endoscopy (CUE) guidance. The primary outcomes were successful stomach visualization and PEG tube insertion.ResultsTwenty-five patients (19 male) were enrolled and compared with 25 gender and indication-matched controls. The most common indications for PEG were aspiration due to stroke or brain injury, dementia, and head and neck cancer. Entrance into the stomach was achieved in 92.0% (23/25) and 96% (24/25) in the DUE and CUE groups, and PEG was performed in 91.3% (21/23) and 95.8% (23/24), respectively. The mean insertion time for the DUE and CUE groups were 22.7 ± 9.3 minutes and 17.1 ± 5.7 minutes (P = 0.044). The 3 cases of failure to reach the stomach in both groups were caused by esophageal blockage. The 3 cases of failed PEG tube insertion were caused by poor visualization of the insertion site. Bleeding and pneumoperitoneum occurred in 1 and 2 patients in the DUE group. One case of fever was noted in the CUE group. All adverse events were conservatively managed.ConclusionsOur study shows that portable DUE in facilities without endoscopy equipment may be clinically feasible.
| S-EPMC5134776 | biostudies-literature
Project description:BackgroundMalignant hyperthermia is a rare but life-threatening pharmacogenetic muscle disorder characterized by abnormal hypermetabolic reactions and commonly triggered in susceptible individuals by volatile anesthetics or succinylcholine, or both. Unfortunately, the specific medicine dantrolene is not readily available in many countries including China. The aim of this study was to find the characteristics of malignant hyperthermia under the situation that dantrolene is not readily available.MethodsThe cases of malignant hyperthermia reported on the most commonly used databases in China from 1985 to 2020 were analyzed. The inclusion criteria were the MH episodes only related to anesthesia. The exclusion criteria were dubious MH episodes only caused by Ketamine administration or MH episodes irrelevant to anesthesia. Independent samples t-test and Pearson's chi-squared test were applied to assess the difference between the survived and death cases.ResultsNinety-two cases of malignant hyperthermia reported on the most commonly used databases in China from 1985 to 2020 were analyzed. Median (IQR [range]) age was 18.5 (11.8-37.0 [0-70.0]) years. Compared with the survived cases, the death cases had higher maximum end-tidal partial pressure of CO2 (P = 0.033), the maximum arterial partial pressure of CO2 (P = 0.006), temperature first measured when the patient was first discovered abnormal (P = 0.012), and maximum temperature (P < 0.001). Besides, the death cases had less minimum pH (P < 0.001) and higher potassium (P < 0.001) and were more likely to have coagulation disorders (p = 0.018). Concerning treatment, cases used furosemide (P = 0.024), mannitol (P = 0.029), blood purification treatment (P = 0.017) had the advantage on the outcome. Creatine phosphokinase, myoglobin, and MB isoenzyme of creatine phosphokinase differed greatly among cases during the first week. 43 (46.7%) cases had congenital diseases. 12 (13.0%) cases were reported with abnormal laboratory test results or abnormal signs that are possibly relevant before anesthesia.ConclusionsIn countries that dantrolene is not readily available, early warning, diagnosis, and prompt effective therapies are crucial for MH patients to survive.
| S-EPMC8051048 | biostudies-literature
Project description:Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Till now, the total number of affected patients are 9,073,969 with 471,199 deaths and 3,747,128 currently infected active cases. Major concern is due to the droplets and aerosols of SARS CoV 2 causing the rapid spread and transmission. Since last 3 months we are using the indigenous face shields for our health care workers which costs only 0.13 USD per shield. Now we propose the use of this same shield for the general public to reduce the transmission of SARS CoV2.
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