ABSTRACT
A one-pot strategy for the synthesis of substituted isocoumarin, flavone, and isoquinolinedione derivatives through a switchable C-arylation/lactonization or SNAr reaction from a wide range of soft nucleophiles and o-quinol acetates has been developed. This base-mediated protocol proceeds under transition-metal-free conditions and selectively affords various heteroarenes in 13–98% yields from readily prepared or commercially available 1,3-dicarbonyl and α-EWG-substituted carbonyl compounds. The synthetic utility is further demonstrated in the synthesis of potential anti-HIV and anti-coronavirus derivatives and COX-2 inhibitors. In addition, detailed experimental and computational studies are performed to provide an intensive understanding and strong support of the reaction mechanism. © 2023 Wiley-VCH GmbH.
ABSTRACT
Background: Blood pressure (BP) management is imperative in reducing risk of adverse events in continuous flow (CF) left ventricular assist device (LVAD) patients. The gold standard for non-invasive blood pressure (BP) measurement in these patients is Doppler ultrasound, which requires training and dexterity and is not routinely used in the outpatient setting. In the current COVID-19 pandemic era, telehealth assessment has become mandatory to assess and monitor patients. At our institution, we have issued all CF-LVAD patients with a Doppler ultrasound device and an oscillometric BP monitor, and provided training to correctly use these devices. Accuracy of BP measurements in this setting has not been confirmed. Aim: We examined whether Doppler BP obtained by CF-LVAD patients (pts) correlates to Doppler BP obtained by health care workers (HCWs). Methods: CF-LVAD pts were recruited between November 2020 and January 2022. During these routine outpatient follow-up visits, Doppler BP measurements were obtained simultaneously and independently by pts and HCW. BP was taken in a comfortable seating position following 5 minutes rest. Results: A total 223 pairs of simultaneous patient Doppler BP readings and HCW Doppler BP readings were obtained from 38 CF-LVAD patients (87% male, mean age at implant 52 + 14 years, 15 HeartMate3 and 23 HeartWare HVAD, with support duration range 28 - 3492 days). Patient Doppler BP (average 85.9 + 9.8 mmHg) correlated closely with HCW Doppler BP (average 86.1 + 9.6 mmHg), r2=0.90, p<0.0001. There was no significant difference between BP taken by the patient and HCW (p=0.4). The mean difference between the two methods was -0.17 mmHg and the standard deviation was 0.22 mmHg (figure) using Bland-Altman analysis. Conclusions: These results demonstrate that in our patient-population, Doppler-derived blood pressure measurements in CF-LVAD patients were accurate and reliable. This supports the routine use of home Doppler BP measurement and monitoring by CF-LVAD patients, especially in the telehealth era. (Figure Presented).
ABSTRACT
INTRODUCTION: Although primarily a respiratory disorder, the coronavirus pandemic has paralyzed almost all aspects of healthcare delivery. Neurosurgeons provide critical care and their role in this pandemic is necessary and yet evolving. METHODS: Through professional registries and internet resources, we surveyed neurosurgeons from around the world. We looked at the national burden of illness, perception of preparedness, cancellation of clinics, surgeries and cessation of research and educational activities. Chisquare, Fisher's exact tests, and multivariate logistic regression model were used to analyze variables. RESULTS:Our survey was completed on April 3, 2020, and was wellreceived (661 completed, 60.7% response rate, 96 nations). Neurosurgeons in affluent nations still lacked adequate resources to combat this pandemic primarily due to lack of preparedness and insufficient medical equipment. The challenges to lower-income nations were similar but also included knowledge dissemination and inadequate resources. Hospital preparedness was central to effective healthcare delivery but also influenced the cancellation of surgeries and clinics. The impact on education, conferences and research was also significant. CONCLUSION: Neurosurgical disorders are significant casualties of the COVID-19 pandemic. Reduction of services, lack of preparedness, inadequate education, insufficient supplies and resources are important contributors. Improved preparedness requires careful planning, real-time surveillance and allocation of resources. This is more critical in poorer nations.
ABSTRACT
Under the COVID-19 pandemic, online/remote classroom teaching has become the new routine for schools to continue teaching and learning. This paper serves as a proposal for the development of a research model to measure the effectiveness of teaching in remote classes. Built on top of the Technological Pedagogical Content Knowledge (TPACK) framework, we developed the research model and a set of questionnaire to validate the associated hypotheses. A pilot test was conducted to initially ensure the validities of the questionnaire items. Findings from the pilot study are discussed. © AMCIS 2021.