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The acute myocardial infarction (AMI) present high mortality rate that may be reduced with cardiac rehabilitation. Despite its good establishment in outpatient care, few studies analyzed cardiac rehabilitation during hospitalization. Thus, this study aims to clarify the safety and efficacy of early cardiac rehabilitation after AMI. This will be a clinical, controlled, randomized trial with blind outcome evaluation and a superiority hypothesis. Twenty-four patients with AMI will be divided into two groups (1:1 allocation ratio). The intervention group will receive an individualized exercise-based cardiac rehabilitation protocol during hospitalization and a semi-supervised protocol after hospital discharge; the control group will receive conventional care. The primary outcomes will be the cardiac remodeling assessed by cardiac magnetic resonance imaging, functional capacity assessed by maximal oxygen consumption, and cardiac autonomic balance examined via heart rate variability. Secondary outcomes will include safety and the total exercise dose provided during the protocol. Statistical analysis will consider the intent-to-treat analysis. Trial registration. Trial registration number: Brazilian Registry of Clinical Trials (ReBEC) (RBR- 9nyx8hb)., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Schon et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Introduction: The SARS-CoV-2 pandemic has affected global public healthcare for several years. Numerous medical professionals have been infected since the outbreak in 2019, resulting in a shortage of healthcare providers. Since traditional personal protective wear was insufficient to eliminate the virus transmission reliably, new strategies to avoid cross-infection were imperative while enabling high-quality medical care. In the project ProteCT, we investigated the potential of robotic-assisted examination in providing medical examination via a telemedical approach., Material and Methods: We constructed a fully functional examination cabin equipped with cameras, microphones, screens and robotic arms to evaluate usability and perception. Therefore, we conducted a preliminary study with 10 healthy volunteers and 10 physicians to gain first insights and optimize the setup. In a second step, we performed telemedical examinations of actual patients from the local emergency department to compare the robotic approach with the classical method of measuring vital signs, auscultation, palpation and percussion., Results: The preliminary study identified basic requirements, such as the need for force-feedback and telemedical training for physicians. In the main study, acceptance was high and most patients indicated they would use a telemedical system again. Our setup enabled the physician to make the same diagnoses as by classic examination in the emergency department in most cases., Discussion: The potential acceptance of a telemedical system such as ProteCT is high. Robotic telemedical approaches could complement future healthcare beyond the Corona pandemic to reach rural areas or even war zones. Moreover, the daily clinical use of robotic telemedicine could improve patients' safety, the quality of perioperative management and the workflow in any medical facility., Conclusion: The development of telemedical and telerobotic systems is a multidisciplinary and complex challenge. However, acceptance of the proposed system was high among patients and physicians, indicating the potential use of similar systems for future healthcare., Competing Interests: The authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: SH is a shareholder in Franka Emika GmbH (Munich, Germany) but declares no non-financial competing interests., (© The Author(s) 2024.)

Patients suffering from hypoventilation and pulmonary expansion deficit are at increased risk of developing pulmonary complications such as atelectasis, pneumonia or pleural effusion. These complications can increase the length of stay and spending on health, and generate long-term functional impairment. This study aims to produce a therapeutic alternative to the traditional method of lung re-expansion through incentive spirometry (IS) using the game therapy to build an innovative system. This system makes use of infrared and Bluetooth communication technology to associate the game therapy to EI. At the end of the system implementation, we expect to obtain good adhesion of the patient and the physiotherapists.

We report a synthetic, spectroscopic and computational study of the polycyclic aromatic molecule pyracene, which contains aliphatic five-membered rings annealed to a naphthalene chromophore. An improved route to synthesize the compound is described. Gas-phase IR and solid-state Raman spectra agree with a ground-state D2h structure. The electronically excited S1 A(1)B3u state has been studied by resonance-enhanced multiphoton ionisation. An adiabatic excitation energy T0 = 30,798 cm(-1) (3.818 eV) was determined. SCS-ADC(2) calculations found a D2h minimum energy structure of the S1 state and yielded an excitation energy of +3.98 eV, including correction for zero point vibrational energy. The spectrum shows a rich low-frequency vibrational structure that can be assigned to the overtones of out-of-plane deformation modes of the five-membered rings by comparison with computations. The appearance of these modes as well as the frequency reduction in the excited state indicate that the potential in the S1 state is very flat. At higher excess energies most bands can be assigned to fundamentals, overtones and combination bands of either totally symmetric ag modes or of b2g modes that appear due to vibronic coupling. Lifetimes between 43 ns and 76 ns were measured for a number of vibronic bands. For the S2 state an equilibrium geometry with a non-planar carbon framework was computed. In addition a signal from the pyracene dimer was present. The spectrum shows several broad and structureless transitions. The origin band has a maximum at around 329 nm (30,400 cm(-1)). Again lifetimes between 60 ns and 70 ns were found. The dimer ion signal rises within less than 10 ps. Computations show that a crossed geometry with the long axis of one unit aligned with the short axis of the second constitutes the most stable structure. The broadening of the bands is most likely caused by excimer formation.

The vacuum ultraviolet (VUV) photoionization and dissociative photoionization of three hydroxy-substituted [2.2]paracyclophane derivatives were studied yielding adiabatic ionization energies and dissociative photoionization energies (appearance energies). The simplest dissociation pathway is the breaking of both CH(2)-CH(2) bridge units and fragmenting the molecular ion in half to yield xylylene neutral and cationic fragments. The experimental data show that this process is outcompeted by a faster, higher energy channel, possibly yielding cyclooctatetraene derivatives. The role of the reaction coordinate, the effect of large amplitude motions on the density of states function at low and high energies and the temperature dependent 'population gap' in the internal energy distribution in large molecules are discussed in the context of applying statistical models to the dissociation. Computational approaches to the binding energy of paracyclophanes are marred with pitfalls. Noncovalent interactions play a major role in keeping paracyclophanes bound by some 200 kJ mol(-1) with respect to the two xylylene motifs, and the covalent CH(2)-CH(2) bonds are mostly counteracted by the geometric strain. The stabilizing effects are twofold: first, paracyclophanes are aromatic compounds, whereas xylylenes are not. Thus, the aromaticity of the molecule is induced by dimerization. Second, dispersive π-π interactions also stabilize the molecule. We evaluated 23 different computational chemistry approaches, and found that very few of the favorably scaling ones give an adequate description of this system. Among the DFT functionals tested, only PBE-D3 and perhaps M06-2X yielded consistently accurate results, comparable with MP3 and CCSD, or the G4 and CBS-QB3 composite methods. MP2 results in general suffer from significant overbonding.

The structure of the electronic ground- and first excited state of mono-hydroxy [2.2]paracyclophane (MHPC) and the S(1)← S(0) electronic transition have been investigated by resonance-enhanced multiphoton ionisation (REMPI) and by quantum chemical spin-component-scaled-approximate coupled cluster second order (SCS-CC2) computations. The origin of the S(1)← S(0) transition was located at 30,772 cm(-1) (3.815 eV) in the REMPI spectrum. The value has to be compared with a computed excitation energy of 3.79 eV. The vibrational structure of the spectrum confirms a significant geometry change upon excitation along the coordinates corresponding to twist- and shift-motions in the molecule. It gives rise to an experimentally observed progression with a fundamental of +30 cm(-1) and an inverse anharmonicity. From the experimental data a shallow potential along the twist coordinate was derived for the S(1) state. For the shift vibration a wavenumber of +91 cm(-1) was observed, while +85 cm(-1) was computed. The ionisation energy of MHPC was determined to be 7.63 ± 0.05 eV using synchrotron radiation. When compared to earlier results on the parent compound [2.2]paracyclophane and pseudo-ortho-dihydroxy[2.2]paracyclophane it can be seen that already small variations in the substitution pattern have a significant impact on the shapes of the involved potential energy surfaces leading to strong variations in ground and excited state geometries and opto-electronic properties governing the exciton transfer processes.

The structures and energetics of the ground and first excited states of [2.2]paracyclophane (PC) and its pseudo-para- (p-DHPC) and pseudo-ortho-dihydroxy (o-DHPC) as well as monohydroxy derivates (MHPC) are investigated by quantum chemical calculations, X-ray crystallography, and resonance-enhanced multiphoton ionization spectroscopy (REMPI) in a free jet. We show that substitution of the aromatic hydrogens in PC causes significant changes of the structure and in particular its change between the ground and the excited state. The structural changes include a breathing mode as well as shift and rotation of the benzene moieties and are rationalized by the electronic structure changes upon excitation. Spin-component-scaled second-order Møller-Plesset perturbation method (SCS-MP2) reproduces the experimental X-ray structure correctly and performs significantly better than ordinary MP2 and the B3LYP methods. The parent propagation method, SCS-approximate coupled cluster second order (SCS-CC2), yields adiabatic excitation energies within 0.1 eV of the experimental values for PC and the investigated hydroxyl derivates as well as the related aromatic molecules benzene and phenol. It is shown that zero-point vibration energy corrections at the time dependent density functional (B3LYP) level are no more accurate enough for that level of theory and have to be substituted by SCS-CC2 values. While the structures of PC and o-DHPC are only slightly modified upon excitation, p-DHPC changes its structural parameters substantially. This is in line with [1 + 1] REMPI-spectra of these substances, which are interpreted with the help of Franck-Condon simulations.

In this work we describe a study of the ground and first excited state structures and energetics of a dihydroxy-derivative of [2.2]paracyclophane (PC), the pseudo-ortho-dihydroxy[2.2]paracyclophane (o-DHPC), also termed 4,12-dihydroxy[2.2]paracyclophane. In order to understand the electronic interactions between the two pi-systems, the molecule is investigated by REMPI spectroscopy in a free jet and by quantum chemical calculations. REMPI-spectra of the cluster with one water molecule were also obtained and aid in the interpretation. The origin of the S(1) <-- S(0) transition lies at 31,483 cm(-1) (3.903 eV) for o-DHPC and 31,263 cm(-1) (3.876 eV) for the o-DHPC x H(2)O cluster. An adiabatic excitation energy of 3.87 eV was computed for the S(1) <-- S(0) transition in o-DHPC. The SCS-CC2 calculations deviate by less than 0.1 eV for the adiabatic excitation energies of PC, o-DHPC and the related aromatic molecules benzene and phenol. Considerable activity in a breathing vibration of 190 cm(-1) is found in the S(1) state of o-DHPC and o-DHPC x H(2)O, in agreement with the computed SCS-CC2 value of 185 cm(-1). Further vibrations appear at +11 cm(-1) and +54 cm(-1) in o-DHPC. The computations and the available experimental data of the parent PC show that both PC and o-DHPC are rather flexible with respect to motions of the benzene moieties.While PC has a double minimum potential energy with respect to the torsional motion, a single-minimum structure is found for the ground state of o-DHPC. The geometry change upon excitation is less pronounced in o-DHPC as compared to PC. Two of the three possible rotational conformers of the OH groups were found to have similar energies, but spectral hole burning shows that the spectra are dominated by a single rotamer.

We investigate the photochemistry and photodissociation dynamics of uracil by two-colour photofragment Doppler spectroscopy and by two-colour slice imaging at excitation wavelengths between 268 and 235 nm. We observe the loss of a hydrogen atom upon excitation into the pipi* state. The angular distribution indicates a statistical process, while the translational energy distribution agrees with a dissociation that takes place on the electronic ground state. The pipi* state most likely deactivates via the lower-lying npi* state. In addition there is evidence for a second pathway: direct decay of the pipi* state to the electronic ground state with subsequent dissociation. Experiments on uracil-1,3-D(2) show that there is no site selectivity in the dissociation process. No evidence was found for the direct dissociation via a pisigma* excited state that seems to be relevant in the photochemistry of adenine and many other heterocyclic molecules. Overall, the photochemistry of uracil is similar to that of thymine.