Cocrystallization integrates the merits of high energy and insensitivity between energetic molecules to obtain energetics with satisfying performance.However,how to obtain supramolecular synthons accurately and rapidl...Cocrystallization integrates the merits of high energy and insensitivity between energetic molecules to obtain energetics with satisfying performance.However,how to obtain supramolecular synthons accurately and rapidly for predicting the structure and property of cocrystal remains a challenging problem.In this research,an efficient systematic search approach to predict CL-20/2,4-DNI cocrystal has been proposed that 2,4-DNI revolves around CL-20 with a stoichiometric ratio of 1:1 in accordance with the specified rules(hydrogen bond length:2.2-3.0 Å;search radius:6.5 Å;the number of hydrogen bond:1-3).Eight possible supramolecular synthons were obtained by combining quantum chemistry with molecular mechanics.Crystal structure prediction indicated that there are four structures in cocrystal,namely P21/c,P212121,Pbca and Pna21,and CL-20/2,4-DNI cocrystal is likely to be P21/c and the corresponding cell parameters are Z=4,a=8.28 Å,b=12.17 Å,c=20.42 Å,α=90°,β=96.94°,γ=90°,and ρ=1.9353 g/cm^(3).To further study the intermolecular interaction of CL-20/2,4-DNI cocrystal,a series of theoretical analyses were employed including intermolecular interaction energy,electrostatic potential(ESP),Density of State(DOS),Hirshfeld surface analysis.The C-H…O hydrogen bonds are demonstrated as the predominant driving forces in the cocrystal formation.The mechanical properties and detonation properties of CL-20/2,4-DNI cocrystal implies that the cocrystal shows better ductility and excellent detonation performances(9257 m/s,39.27 GPa)and can serve as a promising energetic material.Cocrystal structure predicted was compared with the experimental one to verify the accuracy of systematic search approach.There is a less than 8.8%error between experiment and predict results,indicating the systematic search approach has extremely high reliability and accuracy.The systematic search approach can be a new strategy to search supramolecular synthons and identify structures effectively and does have the potential to promote the development of energetic cocrystal by theoretical design.展开更多
Objectives:This study employed evidence mapping to systematically evaluate clinical practice guidelines(CPGs)for neurogenic bladder(NB)care.We aimed to identify research trends,evidence gaps,and consensus patterns to ...Objectives:This study employed evidence mapping to systematically evaluate clinical practice guidelines(CPGs)for neurogenic bladder(NB)care.We aimed to identify research trends,evidence gaps,and consensus patterns to inform evidence-based nursing practices and support the formulation of highquality CPGs.Methods:A systematic search of electronic databases and guideline repositories was conducted,included PubMed,Web of Science,Embase,Guidelines International Network(GIN),ect.Eligible NB guidelines underwent dual-researcher screening and extraction,and methodological and recommendation quality were assessed using the Appraisal of Guidelines for Research and Evaluation II(AGREE II)and Evaluation-Recommendations Excellence(AGREE-REX)instruments.Five researchers independently evaluated recommendation specificity,evidence grading systems,and implementation consistency.Discrepancies were resolved through consensus discussion or third-party arbitration.Results:Analysis of 19 CPGs(2006–2023)from 11 countries/regions revealed that 78.95%(15/19)incorporated evidence grading systems and 68.42%(13/19)specifiedrecommendation strength.The AGREE II evaluation identifiedcritical methodological deficiencies,with three domains scoring below the acceptable thresholds:Rigor of Development(41.70%),Editorial Independence(43.30%),and Applicability(30.00%).The AGREE-REX results showed moderate performance in Clinical Applicability(55.56%)and implantability(41.67%)but severe gaps in Values and Preferences(25.00%).A systematic synthesis identified40 recommendations:90%(36/40)demonstrated consensus and 10%(4/40)contradictions.These studies addressed the following six clinical themes:1)nursing assessment,2)manipulation-assisted voiding,3)behavioral therapy,4)intermittent catheterization,5)indwelling catheterization,and 6)other therapies.Conclusions:The methodologies and recommendations of the CPGs for NB in nursing demonstrated substantial variability.Therefore,there is an urgent need to improve the quality of the NB-related CPGs.More in-depth research and timely updates are required to enhance the practical utility of CPGs and narrow the gap between CPGs and clinical practice.展开更多
Background Previous studies have shown contradictory results between early application of antiplatelet therapy and intravenous thrombolysis(IVT)for mild acute ischaemic stroke(AIS),with National Institutes of Health S...Background Previous studies have shown contradictory results between early application of antiplatelet therapy and intravenous thrombolysis(IVT)for mild acute ischaemic stroke(AIS),with National Institutes of Health Stroke Scale score 0-5.Objective To compare the benefits and risks of antiplatelet therapy and IVT in patients with mild AIS.Methods A systematic search of MEDLINE,Embase and Cochrane Library was conducted from database inception until July 2023,without language restriction.Randomised clinical trials(RCTs)or observational studies were selected.The primary outcomes were 90-day functional outcomes,measured by the modified Rankin Scale(mRS)score.The protocol has been registered before data collection.Results Two RCTs and four observational studies with relatively low risk of bias that enrolled 3975 patients were analysed(2454 in antiplatelet therapy and 1521 in IVT therapy).There were no significant differences between antiplatelet therapy and IVT in 90-day functional outcomes(mRS 0-1,OR 1.08(95%CI 0.73 to 1.58);mRS 0-2,OR,1.04(95%CI 0.63 to 1.73)),death(OR,0.64(95%CI 0.19 to 2.13))and stroke recurrence(OR,0.71(95%CI 0.28 to 1.79)).Antiplatelet therapy was associated with a reduced risk of symptomatic intracranial haemorrhage(sICH)compared with IVT(OR,0.20(95%CI 0.06 to 0.69)).Conclusions Among patients with mild AIS,compared with IVT,early application of antiplatelet therapy was not significantly associated with improved functional outcomes,reduced death or stroke recurrence,but was significantly associated with a reduced risk of sICH.展开更多
基金the support of the National Natural Science Foundation of China(No.22005090)Beijing Institute of Technology Research Fund Program for Young Scholars+2 种基金the National Natural Science Foundation of China(No.11672040 and No.21801016)Open Research Fund Program of Science and Technology on Aerospace Chemical Power Laboratory(STACPL120201B02)the State Key Laboratory of Explosion Science and Technology(No.YB2016-17)。
文摘Cocrystallization integrates the merits of high energy and insensitivity between energetic molecules to obtain energetics with satisfying performance.However,how to obtain supramolecular synthons accurately and rapidly for predicting the structure and property of cocrystal remains a challenging problem.In this research,an efficient systematic search approach to predict CL-20/2,4-DNI cocrystal has been proposed that 2,4-DNI revolves around CL-20 with a stoichiometric ratio of 1:1 in accordance with the specified rules(hydrogen bond length:2.2-3.0 Å;search radius:6.5 Å;the number of hydrogen bond:1-3).Eight possible supramolecular synthons were obtained by combining quantum chemistry with molecular mechanics.Crystal structure prediction indicated that there are four structures in cocrystal,namely P21/c,P212121,Pbca and Pna21,and CL-20/2,4-DNI cocrystal is likely to be P21/c and the corresponding cell parameters are Z=4,a=8.28 Å,b=12.17 Å,c=20.42 Å,α=90°,β=96.94°,γ=90°,and ρ=1.9353 g/cm^(3).To further study the intermolecular interaction of CL-20/2,4-DNI cocrystal,a series of theoretical analyses were employed including intermolecular interaction energy,electrostatic potential(ESP),Density of State(DOS),Hirshfeld surface analysis.The C-H…O hydrogen bonds are demonstrated as the predominant driving forces in the cocrystal formation.The mechanical properties and detonation properties of CL-20/2,4-DNI cocrystal implies that the cocrystal shows better ductility and excellent detonation performances(9257 m/s,39.27 GPa)and can serve as a promising energetic material.Cocrystal structure predicted was compared with the experimental one to verify the accuracy of systematic search approach.There is a less than 8.8%error between experiment and predict results,indicating the systematic search approach has extremely high reliability and accuracy.The systematic search approach can be a new strategy to search supramolecular synthons and identify structures effectively and does have the potential to promote the development of energetic cocrystal by theoretical design.
文摘Objectives:This study employed evidence mapping to systematically evaluate clinical practice guidelines(CPGs)for neurogenic bladder(NB)care.We aimed to identify research trends,evidence gaps,and consensus patterns to inform evidence-based nursing practices and support the formulation of highquality CPGs.Methods:A systematic search of electronic databases and guideline repositories was conducted,included PubMed,Web of Science,Embase,Guidelines International Network(GIN),ect.Eligible NB guidelines underwent dual-researcher screening and extraction,and methodological and recommendation quality were assessed using the Appraisal of Guidelines for Research and Evaluation II(AGREE II)and Evaluation-Recommendations Excellence(AGREE-REX)instruments.Five researchers independently evaluated recommendation specificity,evidence grading systems,and implementation consistency.Discrepancies were resolved through consensus discussion or third-party arbitration.Results:Analysis of 19 CPGs(2006–2023)from 11 countries/regions revealed that 78.95%(15/19)incorporated evidence grading systems and 68.42%(13/19)specifiedrecommendation strength.The AGREE II evaluation identifiedcritical methodological deficiencies,with three domains scoring below the acceptable thresholds:Rigor of Development(41.70%),Editorial Independence(43.30%),and Applicability(30.00%).The AGREE-REX results showed moderate performance in Clinical Applicability(55.56%)and implantability(41.67%)but severe gaps in Values and Preferences(25.00%).A systematic synthesis identified40 recommendations:90%(36/40)demonstrated consensus and 10%(4/40)contradictions.These studies addressed the following six clinical themes:1)nursing assessment,2)manipulation-assisted voiding,3)behavioral therapy,4)intermittent catheterization,5)indwelling catheterization,and 6)other therapies.Conclusions:The methodologies and recommendations of the CPGs for NB in nursing demonstrated substantial variability.Therefore,there is an urgent need to improve the quality of the NB-related CPGs.More in-depth research and timely updates are required to enhance the practical utility of CPGs and narrow the gap between CPGs and clinical practice.
基金funded by the National Key R&D Program of China(2022YFC3501100).
文摘Background Previous studies have shown contradictory results between early application of antiplatelet therapy and intravenous thrombolysis(IVT)for mild acute ischaemic stroke(AIS),with National Institutes of Health Stroke Scale score 0-5.Objective To compare the benefits and risks of antiplatelet therapy and IVT in patients with mild AIS.Methods A systematic search of MEDLINE,Embase and Cochrane Library was conducted from database inception until July 2023,without language restriction.Randomised clinical trials(RCTs)or observational studies were selected.The primary outcomes were 90-day functional outcomes,measured by the modified Rankin Scale(mRS)score.The protocol has been registered before data collection.Results Two RCTs and four observational studies with relatively low risk of bias that enrolled 3975 patients were analysed(2454 in antiplatelet therapy and 1521 in IVT therapy).There were no significant differences between antiplatelet therapy and IVT in 90-day functional outcomes(mRS 0-1,OR 1.08(95%CI 0.73 to 1.58);mRS 0-2,OR,1.04(95%CI 0.63 to 1.73)),death(OR,0.64(95%CI 0.19 to 2.13))and stroke recurrence(OR,0.71(95%CI 0.28 to 1.79)).Antiplatelet therapy was associated with a reduced risk of symptomatic intracranial haemorrhage(sICH)compared with IVT(OR,0.20(95%CI 0.06 to 0.69)).Conclusions Among patients with mild AIS,compared with IVT,early application of antiplatelet therapy was not significantly associated with improved functional outcomes,reduced death or stroke recurrence,but was significantly associated with a reduced risk of sICH.
