Publications by authors named "D P Keane"
A diastereoselective addition and rearrangement reaction has been developed for the synthesis of pyrrolidine-2-ylidenes from N-isoxazolines and electron-deficient allenes. This method proceeds via the rearrangement of a proposed -alkenylisoxazoline intermediate to generate densely functionalized pyrrolidine-2-ylidenes under simple catalyst-free conditions that tolerate ketone substituents and install relative stereochemistry at positions 3 and 4 of the heterocycle. Reaction optimization and the substrate scope are described in addition to studies evaluating the reactivity of the -dione and enaminone groups of the products.
View Article and Find Full Text PDFIntroduction: Fluid assessment and management is a key aspect of good dialysis care and is affected by patient-level characteristics and potentially centre-level practices. In this secondary analysis of the BISTRO trial we wished to establish whether centre-level practices with the potential to affect fluid status were stable over the course of the trial and explore if they had any residual associations with participant's fluid status.
Methods: Two surveys (S) of fluid management practices were conducted in 32 participating centres during the trial, (S1: 2017-18 and S2: 2021-22).
Background: Preservation of residual kidney function (RKF) in dialysis patients has been associated with improved survival. RKF in the BISTRO trial was relatively well preserved and here we describe its association with survival during the trial and extended follow-up.
Methods: RKF, measured as the average urea and creatinine clearance (GFR) or 24-hour urine volume was assessed at baseline, one, two and three months and three-monthly up to 2 years in incident haemodialysis patients.
Article Synopsis
- The study evaluated the economic benefits of using bioimpedance spectroscopy for fluid management in dialysis patients compared to standard methods, focusing on its impact on kidney function and risk of anuria.
- Conducted in 34 UK dialysis centers, the trial involved 439 adult patients with some residual kidney function, testing how bioimpedance data could optimize patient care.
- The primary goal was to assess the cost-effectiveness of this approach by calculating the cost per additional quality-adjusted life-year gained over 24 months.