Does diet quality matter? A secondary analysis of a randomized clinical trial.

This secondary analysis assessed the association of a plant-based index (PDI), healthful (hPDI), and unhealthful (uPDI), with weight loss in overweight adults. Participants (n = 244) were randomly assigned to a vegan (n = 122) or control group (n = 122) for 16 weeks. Three-day dietary records were analyzed and PDI indices were calculated. A repeated measure ANOVA was used for statistical analysis. All three scores increased in the vegan group; the effect sizes were: PDI +10.6 (95% CI +8.6 to +12.6; p < 0.001); hPDI +10.9 (95% CI +8.4 to +13.4; p < 0.001); and uPDI +5.4 (95% CI +3.4 to +7.4; p < 0.001). The change in all three scores significantly correlated with change in body weight: PDI (r = -0.40; p < 0.001); hPDI (r = -0.37; p < 0.001); and uPDI (r = -0.21; p = 0.002). These findings suggest that minimizing the consumption of animal products and oil may be an effective weight loss strategy in overweight adults. ClinicalTrials.gov number, NCT02939638.

Homo- and Heteronuclear Group 12 Metallothionein Type B Cluster Analogs: Synthesis, Structure, 1H NMR and ESI-MS.

Metallothioneins (MTs) are a ubiquitous class of small cysteine-rich metal-binding proteins involved in metal homeostasis and detoxification with highly versatile metal binding properties. Despite the long-standing association of MT with M3S3 and M4S5 metal clusters, synthetic complexes with these core architectures are exceptionally rare. Here, we demonstrate an approach to synthesizing and characterizing aggregates of group 12 metal ions with monocyclic M3S3 cores in acetonitrile solution without the protection of a protein. Multidentate monothiol ligand N,N-bis(2-pyridylmethyl)-2-aminoethanethiol (L1H) provided [Cd3(L1)3](ClO4)3 (1), the first structurally characterized nonproteinaceous aggregate with a metallothionein-like monocyclic Cd3S3 core. In addition, [Zn3(L1)3](ClO4)3·4CH3CN (2·4CH3CN) was characterized by X-ray crystallography. The complex cations of 1 and 2 had comparable structures despite being nonisomorphic. Variable temperature and concentration 1H NMR were used to investigate aggregation equilibria of 1, 2, and a precipitate with composition "Hg(L1)(ClO4)" (3). Cryogenic 1H NMR studies of 3 revealed a J(199Hg1H) coupling constant pattern consistent with an aggregate possessing a cyclic core. ESI-MS was used for gas-phase characterization of 1-3, as well as mixed-metal [M2M'(L1)3(ClO4)2]+ ions prepared in situ by pairwise acetonitrile solution combinations of the group 12 complexes of L1. Access to synthetic variants of metallothionein-like group 12 aggregates provides an additional approach to understanding their behavior.

Using sound pulses to solve the crystal-harvesting bottleneck.

Crystal harvesting has proven to be difficult to automate and remains the rate-limiting step for many structure-determination and high-throughput screening projects. This has resulted in crystals being prepared more rapidly than they can be harvested for X-ray data collection. Fourth-generation synchrotrons will support extraordinarily rapid rates of data acquisition, putting further pressure on the crystal-harvesting bottleneck. Here, a simple solution is reported in which crystals can be acoustically harvested from slightly modified MiTeGen In Situ-1 crystallization plates. This technique uses an acoustic pulse to eject each crystal out of its crystallization well, through a short air column and onto a micro-mesh (improving on previous work, which required separately grown crystals to be transferred before harvesting). Crystals can be individually harvested or can be serially combined with a chemical library such as a fragment library.

Reliability of Best Possible Medication Histories Completed by Non-admitted Patients in the Emergency Department.

BACKGROUND: Accreditation standards have outlined the need for staff in emergency departments to initiate the medication reconciliation process for patients who are at risk of adverse drug events. The authors hypothesized that a guided form could be used by non-admitted patients in the emergency department to assist with completion of a best possible medication history (BPMH). OBJECTIVE: To determine the percentage of patients in the non-acute care area of the emergency department who could complete a guided BPMH form with no clinically significant discrepancies (defined as no major discrepancies and no more than 1 moderate discrepancy). METHODS: This prospective exploratory study was conducted over 4 weeks in February and March 2016. Data were collected using the self-administered BPMH form, patient interviews, and a data collection form. After completion of the guided BPMH form, patients were randomly selected for interview by a pharmacy team member to ensure their self-completed BPMH forms were complete and accurate. Eligible patients were those with non-acute needs who had undergone triage to the waiting room. Patients who were already admitted and those with immediate triage to the acute care or trauma area of the emergency department were excluded. RESULTS: Of the 160 patients who were interviewed, 146 (91.3%) completed the form with no more than 1 moderate discrepancy (but some number of minor discrepancies). There were no discrepancies in 31 (19.4%) of the BPMH forms, and 101 (63.1%) of the forms had only minor discrepancies. CONCLUSIONS: Most of the patients interviewed by the pharmacy team were able to complete the BPMH form with no clinically significant discrepancies. The self-administered BPMH form would be a useful tool to initiate medication reconciliation in the emergency department for this patient population, but used on its own, it would not be a reliable source of BPMH information, given the relatively low number of patients who completed the form with no discrepancies.

CONTEXTE: Les normes d'agrément ont souligné la nécessité pour le personnel des services des urgences d'amorcer le processus de bilan comparatif des médicaments chez les patients à risque d'événements indésirables liés aux médicaments. Les auteurs ont avancé que des patients au service des urgences ne requérant pas une hospitalisation pourraient remplir un formulaire dirigé et ainsi aider à établir leur meilleur schéma thérapeutique possible (MSTP). OBJECTIF: Déterminer le pourcentage de patients dans l'aire de soins non urgents du service des urgences qui sont en mesure de remplir un formulaire dirigé de MSTP sans divergence cliniquement significative (c'est-à-dire aucune divergence majeure et pas plus d'une divergence modérée). MÉTHODES: La présente étude préliminaire prospective a été menée sur une période de quatre semaines en février et en mars 2016. Les données ont été recueillies à l'aide d'un formulaire autoadministré de MSTP, d'entrevue avec les patients et d'un formulaire de collecte de données. Une fois les formulaires dirigés de MSTP remplis, des patients ont été sélectionnés aléatoirement et interrogés par un des membres de l'équipe de pharmacie afin de s'assurer de l'exhaustivité et de l'exactitude des renseignements fournis de soi-même. Les patients admissibles à l'étude étaient ceux ne nécessitant pas de soins urgents et ayant passé au triage dans la salle d'attente. Les patients déjà hospitalisés et ceux dirigés immédiatement après le triage dans l'aire de soins urgents ou de trauma du service des urgences ont été exclus. RÉSULTATS: Parmi les 160 patients interrogés, 146 (91,3 %) avaient rempli le formulaire avec au plus une divergence modérée (mais un certain nombre de divergences mineures). Dans 31 (19,4 %) des formulaires de MSTP, il n'y avait aucune divergence et, dans 101 (63,1 %) des formulaires, il n'y avait que des divergences mineures. CONCLUSIONS: La plupart des patients interrogés par l'équipe de pharmacie étaient en mesure de remplir le formulaire de MSTP sans qu'apparaisse de divergence cliniquement significative. Le formulaire autoadministré de MSTP serait un outil pratique pour établir un bilan comparatif des médicaments dans le service des urgences pour cette population de patients, mais employé seul, il ne représenterait pas une source fiable d'information sur le MSTP, compte tenu du nombre relativement restreint de patients ayant rempli le formulaire sans qu'apparaisse de divergence.