Intensive care unit adaptations in the COVID-19 pandemic: Lessons learned.

The coronavirus disease 2019 pandemic had deleterious effects on the healthcare systems around the world. To increase intensive care units (ICUs) bed capacities, multiple adaptations had to be made to increase surge capacity. In this editorial, we demonstrate the changes made by an ICU of a midwest community hospital in the United States.

infection reduction in the ICU: a successful multidisciplinary quality improvement project.

infection causes high morbidity and mortality, especially in immunocompromised patients. can develop multidrug resistance. As a result, it can cause serious outbreaks in hospital and intensive care unit (ICU) settings, increasing both length of stay and costs.

Gold-Catalyzed Regioselective Synthesis of Crowded Cyclopentadienes by Migratory Cycloisomerization of Vinylallenes.

We report the regioselective synthesis of silyl-substituted cyclopentadienyl esters through gold-catalyzed migratory cycloisomerization of silyl-substituted vinylallenes. This transformation is proposed to proceed through a perfectly orchestrated sequence of events including Nazarov-like cyclization and several silyl and hydrogen rearrangements. Furthermore, exploiting the multifaceted nature of the gold catalyst, we have also identified suitable conditions for the synthesis of these cyclopentadienes in a more straightforward manner through gold-catalyzed reaction of propargyl esters and alkynylsilanes.

Ambiphilic boryl groups in a neutral Ni(ii) complex: a new activation mode of H.

The concept of metal-ligand cooperation opens new avenues for the design of catalytic systems that may offer alternative reactivity patterns to the existing ones. Investigations of this concept with ligands bearing a boron center in their skeleton established mechanistic pathways for the activation of small molecules in which the boron atom usually performs as an electrophile. Here, we show how this electrophilic behavior can be modified by the ligand to the boron center, evincing its ambiphilic nature.

Gold-Catalyzed [3+2] Carbocycloaddition Reaction of Pinacol Alkenylboronates: Stereospecific Synthesis of Boryl-Functionalized Cyclopentene Derivatives.

Gold-catalysis has enabled new synthetic opportunities in the chemistry of vinyldiazo compounds. Herein, we report the gold-catalyzed reaction of stabilized vinyldiazo compounds with pinacol alkenylboronates to provide boryl-functionalized cyclopentene derivatives through a formal [3+2] carbocycloaddition reaction, a very unusual pathway in alkenylboronate chemistry. This reaction proceeds with high regio- and stereoselectivity.

Trapping -Quinone Methide Intermediates with Ferrocene: Synthesis and Preliminary Biological Evaluation of New Phenol-Ferrocene Conjugates.

The reaction of -hydroxybenzyl alcohols with ferrocene in the presence of a catalytic amount of InCl₃ provided ferrocenyl phenol derivatives, an interesting class of organometallic compounds with potential applications in medicinal chemistry. This transformation exhibited a reasonable substrate scope delivering the desired products in synthetically useful yields. Evidence of involvement of a -quinone methide intermediate in this coupling process was also provided.

A Definition of the Magnetic Transition Temperature Using Valence Bond Theory.

Macroscopic magnetic properties are analyzed using Valence Bond theory. Commonly the critical temperature T for magnetic systems is associated with a maximum in the energy-based heat capacity C(T). Here a more broadly applicable definition of the magnetic transition temperature T is described using the spin moment expectation value (i.

Selective catalytic synthesis of amino-silanes at part-per million catalyst loadings.

Platinum(ii) complex [Pt(IBu')(IBu)][BAr] (1a) is a highly active and selective catalyst in the dehydrocoupling of amines and silanes at part-per-million catalyst loadings (up to 10 ppm, 0.001 mol%), achieving the highest TON and TOF numbers reported in the literature (up to 1 mmol scale). NMR studies suggest a process taking place through electrophilic activation of the silane by the platinum species, assisted by an amine.

Gold-Catalyzed Intermolecular Formal Insertion of Aryldiazo Esters into Cp-H Bonds of Iron and Ruthenium Metallocenes.

The reaction of ferrocene and ruthenocene with aryldiazo acetates in the presence of gold catalysts produced new functionalized metallocenes resulting from a C-H bond functionalization process. This process is believed to proceed through initial decomposition of the diazo component and formation of an electrophilic gold-carbene intermediate, which is subsequently involved in an electrophilic aromatic substitution. The gold-catalyzed functionalization of ruthenocene exhibited a broad scope and a notable functional-group tolerance.

Au Iminophosphorane Complexes as Efficient Catalysts for the Cycloisomerization of Alkynyl Amides under Air, at Room Temperature, and in Aqueous or Eutectic-Mixture Solutions.

New iminophosphorane-phosphine Au complexes [AuCl(κ -P-Ph PCH P{=NP(=S)(OR) }Ph )] (3 a,b) and [Au Cl (μ -P,S-Ph PCH P{=NP(=S)(OR) }Ph )] (4 a,b) proved to be general, very efficient, and recyclable (up to four consecutive runs) catalysts for the cycloisomerization of alkynyl amides in water or choline chloride-based eutectic mixtures as green solvents. Remarkably, this cycloisomerization reaction took place under mild conditions (low catalyst loading, at room temperature, and in the absence of cocatalysts or protecting atmosphere) to give the corresponding alkylidene lactams by employing an efficient and sustainable methodology.

Bis(allyl)-ruthenium(iv) complexes with phosphinous acid ligands as catalysts for nitrile hydration reactions.

Several mononuclear ruthenium(iv) complexes with phosphinous acid ligands [RuCl2(η(3):η(3)-C10H16)(PR2OH)] have been synthesized (78-86% yield) by treatment of the dimeric precursor [{RuCl(μ-Cl)(η(3):η(3)-C10H16)}2] (C10H16 = 2,7-dimethylocta-2,6-diene-1,8-diyl) with 2 equivalents of different aromatic, heteroaromatic and aliphatic secondary phosphine oxides R2P([double bond, length as m-dash]O)H. The compounds [RuCl2(η(3):η(3)-C10H16)(PR2OH)] could also be prepared, in similar yields, by hydrolysis of the P-Cl bond in the corresponding chlorophosphine-Ru(iv) derivatives [RuCl2(η(3):η(3)-C10H16)(PR2Cl)]. In addition to NMR and IR data, the X-ray crystal structures of representative examples are discussed.

Reliability of diagnostic ultrasound in measuring the multifidus muscle.

Background: Ultrasound is frequently used to measure activity in the lumbar multifidus muscle (LMM). However previous reliability studies on diagnostic ultrasound and LMM have included a limited number of subjects and few have used Bland-Altman's Limits of Agreement (LOA). Further one does not know if activity affects the subjects' ability to contract the LMM.

Bathymetry determination via X-band radar data: a new strategy and numerical results.

This work deals with the question of sea state monitoring using marine X-band radar images and focuses its attention on the problem of sea depth estimation. We present and discuss a technique to estimate bathymetry by exploiting the dispersion relation for surface gravity waves. This estimation technique is based on the correlation between the measured and the theoretical sea wave spectra and a simple analysis of the approach is performed through test cases with synthetic data.

Specific synthesis of 1,2- and 1,3-dialkylidenecycloheptanes by [3+2+2] cyclization of alkenyl Fischer carbene complexes and allenes.

The 1,2- and 1,3-dialkylidenecycloheptane rings are specifically assembled from chromium alkenyl Fischer carbene complexes and allenes via [3+2+2] cyclization reactions. The former cycloadducts are obtained when the cyclization is performed in the presence of 1 equiv of [Ni(cod)2], while the [Rh(cod)Cl]2-catalyzed cyclization leads to the latter cycloadducts.

The nordic back pain subpopulation program: demographic and clinical predictors for outcome in patients receiving chiropractic treatment for persistent low back pain.

Objective: To identify demographic and clinic-related predictors for successful outcome in patients with persistent low-back pain who received chiropractic treatment.

Design: Prospective uncontrolled multicenter study with internal control groups.

Subjects: Each of 115 Norwegian chiropractors, out of 205 invited, were asked to recruit 10 consecutive patients who had low-back pain for at least 2 weeks at the time of consultation and a minimum of 30 days altogether within the preceding year.

On the fitting of model electron densities into EM reconstructions: a reciprocal-space formulation.

A fast method for fitting model electron densities into EM reconstructions is presented. The methodology was inspired by the molecular-replacement technique, adapted to take into account phase information and the symmetry imposed during the EM reconstruction. Calculations are performed in reciprocal space, which enables the selection of large volumes of the EM maps, thus avoiding the bias introduced when defining the boundaries of the target density.

Cryo-negative staining reduces electron-beam sensitivity of vitrified biological particles.

Beam damage is the main resolution-limiting factor when biological particles are observed by cryoelectron microscopy in a thin vitrified solution film. Furthermore, the low contrast of the specimen frequently makes observation difficult and limits the possibility of image processing. Cryo-negative staining, in which the particles are vitrified in a thin layer of concentrated ammonium molybdate solution, makes it possible to visualize the particles with a much better signal-to-noise ratio (SNR) while keeping the specimen in a good state of preservation.

Combining image-seeking functions and a subtraction strategy: a vector-space procedure to improve many-body searches in molecular replacement.

Many-body searches in molecular replacement are usually carried out sequentially and each step benefits from the structural information obtained in previous rotational and translational stages. In this context, the incorporation of known structural information has proved to enhance the discrimination of a rotation function in Patterson space when many independent molecules have to be located in the asymmetric unit of the crystal cell. This improvement is achieved by subtraction of the contributions of already positioned molecules from the observed Patterson map, which makes the determination of the correct orientation of the remaining molecules easier.

Prognostic values of physical examination findings in patients with chronic low back pain treated conservatively: a systematic literature review.

Background: Most patients undergo physical examination. However, low back pain can only rarely be clearly diagnosed as having an irrefutable pathoanatomic cause on the basis of the classical battery of noninvasive physical examination procedures. However, physical examination findings are also used to predict the prognosis of treatment of chronic low back pain.

A new vector-search rotation function: image-seeking functions revisited in macromolecular crystallography.

A new rotation function in Patterson space is described. An image-seeking function can be defined as a criterion of fit between the observed Patterson map and a suitable vector set extracted from a specially calculated Patterson map of the search model. The behaviour of image-seeking functions has appeared to be heavily dependent on certain relations between some statistical parameters of both maps.

Tourniquet control of liver bleeding.

Many methods have been described for control of bleeding from the liver. We have found that the technique of simply securing a 2 1/2 cm (1-in) Penrose drain as a tourniquet around the left or right lobe of the liver is a rapid and effective method of obtaining hemostasis. The tourniquet can be used to temporaily control bleeding so individual points can be secured, or tied down onto the liver and removed later.