Synthesis of Leiodolide A Macrolactone.

A convergent route toward the synthesis of leiodolide A () is described. Our studies explored reactions of the indium chloride-induced transmetalation of allylic stannane for nucleophilic addition with nonracemic aldehyde . The stereoselective formation of the all- stereotriad was rationalized by an isomerization to produce the -allylindium reagent for subsequent -Felkin addition.

Studies Toward the Synthesis of Leiodolide A.

Studies have described a highly convergent plan toward the synthesis of leiodolide A (), a potent cytotoxic sponge metabolite. The enantiocontrolled preparation of aldehyde is achieved with the application of several advances in methodology for the synthesis of substituted 1,3-oxazoles. Efforts have examined the halogen dance reaction, the selectivity of Stille cross coupling reactions of 4-bromo-1,3-oxazoles, and nucleophilic displacement of the 2-phenylsulfonyl substituent with organolithium reagents as preparatively useful reactions.

A Randomized Controlled Trial of Instillation Protocols Prior to Intradetrusor OnabotulinumtoxinA.

Introduction And Hypothesis: Achieving adequate pain relief is crucial for intradetrusor onabotulinumtoxinA treatments for idiopathic overactive bladder in office settings. The objective of this study was to determine whether buffered lidocaine bladder instillation provides better pain control than standard lidocaine prior to intradetrusor onabotulinumtoxinA injections.

Methods: We conducted a prospective, double-blind, randomized controlled trial comparing two protocols.

Use of Harms trabeculotome to assist failed microcatheter advancement during trabeculotomy in primary congenital glaucoma.

We report the use of the Harms trabeculotome to facilitate 360° microcatheter advancement during illuminated microcatheter-assisted circumferential trabeculotomy (IMCT) ab externo in a 3-month-old infant with bilateral primary congenital glaucoma who required repeat surgery. The illuminated microcatheter was advanced 270°, from 9 to 6 o'clock; however, a focal blockage occurred, and, despite viscodilation, further advancement was not possible. The surgeon introduced a right Harms trabeculotome in the opposite direction, counterclockwise through the same scleral flap.

Characterization of population connectivity for enhanced cross-border surveillance of yellow fever at Mutukula and Namanga borders in Tanzania.

Objectives: Yellow fever (YF) remains a public health threat in Sub-Saharan Africa and South America, with an estimated 200,000 cases and 30,000 deaths annually. Although the World Health Organization considers Tanzania to be at low risk for YF because no YF cases have been reported, the country remains at alert to importation of the virus due to ecological factors and high connectivity to high-risk YF areas in other countries. This study aimed to identify points of interest with connectivity to high-risk YF areas to guide preparedness efforts in Tanzania.

Evaluating Criteria for Symptoms Suggestive of Early Osteoarthritis Over Two Years Post-Anterior Cruciate Ligament Reconstruction: Data From the New Zealand Anterior Cruciate Ligament Registry.

Objective: The objectives were to determine the prevalence of meeting criteria for symptoms suggestive of early osteoarthritis (OA) after anterior cruciate ligament reconstruction (ACLR) and to characterize the longitudinal changes in these symptoms during the first two years post-ACLR.

Methods: We analyzed data from 10,231 patients aged 14 to 40 years in the New Zealand ACL Registry who completed the Knee Injury and Osteoarthritis Outcome Score (KOOS) at 6, 12, and 24 months post-ACLR. Symptoms suggestive of early OA were defined as scoring ≤85% on at least two of four KOOS subscales.

Perinatal mortality among term births: Informing decisions about singleton early term births in Western Australia.

Background: To minimise the risk of perinatal mortality, clinicians and expectant mothers must understand the risks and benefits associated with continuing the pregnancy.

Objectives: Report the gestation-specific risk of perinatal mortality at term.

Methods: Population-based cohort study using linked health data to identify all singleton births at gestations 37-41 weeks, in Western Australia (WA) from 2009 to 2019.

Changes in fatigue symptoms following an exercise-based rehabilitation programme for patients with long COVID.

Background: There is evidence to support COVID-19 rehabilitation programmes improving persistent COVID-19 symptoms; however, there is concern that therapies that include an exercise component may increase fatigue and post-exertional symptom exacerbation (PESE). The objectives of the present study were to determine the effect of a 6-week COVID-19 rehabilitation programme on fatigue and PESE in individuals with ongoing COVID-19 symptoms.

Methods: After a routine medical assessment, individuals with persistent COVID-19 symptoms were enrolled on a 6-week COVID-19 specific rehabilitation programme.

Capturing the ghost in the machine: a process for development and validation of measures of phenomenal consciousness in delirium.

Background: Delirium has conventionally been considered a disorder of consciousness. Alertness and arousal are used as surrogates in clinical practice but are insufficient for the purposes of a more dimensional assessment of consciousness. We present a process of development and validation of candidate measures of phenomenal consciousness that could be applied to the diagnosis of delirium.

Maturation and biomechanical risk factors associated with anterior cruciate ligament injury: Is there a link? A systematic review.

Objective: To establish the potential link between sex-specific maturation and biomechanical factors associated with ACL injury during dynamic tasks.

Design: Systematic review.

Literature Search: Five databases (CINHAL®, Cochrane Library, PubMed®, Scopus®, and SPORTDiscus) were searched and monitored until 27 May 2024.

Ascertainment of Aboriginal and Torres Strait Islander status for assessment of perinatal health outcomes: Reported versus derived maternal ethnicity in Western Australian pregnancy data.

Background: Under-identification of Aboriginal and Torres Strait Islander (hereafter referred to as Aboriginal) people can result in inaccurate estimation of health outcomes. Data linkage has improved identification of Aboriginal people in administrative datasets.

Aim: To compare three methods of ascertainment of Aboriginal status using only pregnancy data from the Western Australian Midwives Notification System (MNS), to the linked Indigenous Status Flag (ISF) derived by the Department of Health.

Toward Personalized Orthopedic Care: Validation of a Smart Knee Brace.

Introduction: Wearable technology offers a promising solution to advance current rehabilitation strategies for post-operative orthopedic care. The aim of this study was to determine the level of agreement and concurrent validity of a smart knee brace compared to the gold standard measurement system GAITRite for assessing lower limb gait parameters.

Methods: Thirty-four healthy participants were fitted with the smart knee brace (Digital Knee) on their dominant limb.

Evaluation of the awareness of Western Australian SunSmart campaigns between 2008 and 2022.

Issue Addressed: It is unknown whether SunSmart health promotion campaigns in Western Australia are still effectively reaching their target audience of young people (under 45 years). This study examined trends over time in awareness, relevancy and believability of SunSmart advertisements and identified socio-demographic characteristics and risk factors associated with campaign awareness.

Method: Linear regression and log-binomial modelling were undertaken using data from the annual SunSmart post-campaign evaluation surveys between 2008/2009 and 2021/2022.

Does-dual mobility still offer improved stability in smaller cup sizes? A computer modelling comparison of stability with 22-mm versus 28-mm inner heads in dual-mobility versus single-bearing constructs.

Purpose: Dislocation remains 1 of the leading causes of revision after primary total hip arthroplasty (THA) and there is clear evidence the dual-mobility (DM) is used more frequently to minimise this. But in smaller cups, whether the use of DM with smaller 22-mm heads imparts any increased stability compared to standard bearing is unknown; especially when those smaller cups now allow for large single-bearing (SB) heads.

Methods: 3 primary cup sizes (48 mm, 50 mm, 52 mm) were chosen for modelling.

Education in Female Sexual Function and Dysfunction among American Urogynecologic Society Members: An Unmet Need.

Objectives: Sexual function is an important component of women's health that has not been traditionally emphasized during medical training, suggesting that further education is needed to provide comprehensive patient care. The purpose of this study was to describe education and interest in female sexual function among urogynecology providers.

Methods: Conducted in 2020, this was a cross-sectional survey of American Urogynecologic Society members assessing educational and clinical experience with female sexual function.

Successful implementation of a quality improvement bundle to reduce opioid overprescribing following total hip and knee arthroplasty.

Background: Opioid overprescribing is commonplace after total hip (THA) and total knee arthroplasty (TKA). Preliminary data demonstrated that approximately 32% of the opioids prescribed at discharge from our hospital following THA and TKA remain unused. This is a concern given that unused prescribed opioids are available for diversion and may result in misuse and abuse.

Association of functional, inherited vitamin D-binding protein variants with melanoma-specific death.

Background: It is unclear whether genetic variants affecting vitamin D metabolism are associated with melanoma prognosis. Two functional missense variants in the vitamin D-binding protein gene (GC), rs7041 and rs4588, determine 3 common haplotypes, Gc1s, Gc1f, and Gc2, of which Gc1f may be associated with decreased all-cause death among melanoma patients based on results of a prior study, but the association of Gc1f with melanoma-specific death is unclear.

Methods: We investigated the association of the Gc1s, Gc1f, and Gc2 haplotypes with melanoma-specific and all-cause death among 4490 individuals with incident, invasive primary melanoma in 2 population-based studies using multivariable Cox-proportional hazards regression.

Sex-Specific Associations of and Variants with Risk of Multiple Primary Melanomas and Melanoma Survival in Non-Hispanic Whites.

-SNP309 (rs2279744), a common genetic modifier of cancer incidence in Li-Fraumeni syndrome, modifies risk, age of onset, or prognosis in a variety of cancers. Melanoma incidence and outcomes vary by sex, and although SNP309 exerts an effect on the estrogen receptor, no consensus exists on its effect on melanoma. MDM2 and MDM4 restrain p53-mediated tumor suppression, independently or together.

Choosing Money Over Meaningful Work: Examining Relative Job Preferences for High Compensation Versus Meaningful Work.

People sometimes must choose between prioritizing meaningful work or high compensation. Eight studies ( = 4,177; 7 preregistered) examined the relative importance of meaningful work and salary in evaluations of actual and hypothetical jobs. Although meaningful work and high salaries are both perceived as highly important job attributes when evaluated independently, when presented with tradeoffs between these job attributes, participants consistently preferred high-salary jobs with low meaningfulness over low-salary jobs with high meaningfulness (Studies 1-5).

Virtual Fracture Care in Long-Term Care Homes Avoiding Emergency Department Visits.

Long-term care residents with suspected fractures as a result of a fall typically transfer to the emergency department (ED) for diagnostic imaging and care. During the COVID-19 pandemic, transfer to the hospital increased the risk of COVID-19 exposure and resulted in extended isolation days for the resident. A fracture care pathway was developed and implemented to provide rapid diagnostic imaging results and stabilization in the care home, reducing transportation and exposure risk to COVID-19.

The MC1R r allele does not increase melanoma risk in MITF E318K carriers.

Background: Population-wide screening for melanoma is not cost-effective, but genetic characterization could facilitate risk stratification and targeted screening. Common Melanocortin-1 receptor (MC1R) red hair colour (RHC) variants and Microphthalmia-associated transcription factor (MITF) E318K separately confer moderate melanoma susceptibility, but their interactive effects are relatively unexplored.

Objectives: To evaluate whether MC1R genotypes differentially affect melanoma risk in MITF E318K+ vs.

Capacity building at points of entry during COVID-19 pandemic: harmonising training curriculum for Economic Community of West African States.

This paper describes the process for developing, validating and disseminating through a train-the-trainer (TOT) event a standardised curriculum for public health capacity building for points of entry (POE) staff across the 15-member state Economic Community of West African States (ECOWAS) that reflects both international standards and national guidelines.A five-phase process was used in developing the curriculum: phase (1) assessment of existing materials developed by the US Centers for Disease Control and Prevention (CDC), Africa CDC and the West African Economic and Monetary Union, (2) design of retained and new, harmonised content, (3) validation by the national leadership to produce final content, (4) implementation of the harmonised curriculum during a regional TOT, and (5) evaluation of the curriculum.Of the nine modules assessed in English and French, the technical team agreed to retain six harmonised modules providing materials for 10 days of intensive training.