Using an online journal club to improve Asian speakers' comfort in using English to discuss and understand research papers written in English.

INTRODUCTION: This study aimed to evaluate the participants' comfort in understanding research papers written in English and discussing such research in English via an Asian online journal club. METHODS: A self-administered online survey was delivered to seven journal club meeting attendees from July 2020 to July 2021. A customer satisfaction analysis was performed to assess the association between the participants' perspectives on program logistics and satisfaction. RESULTS: The recovery rate was 37.0% (44/119). After participating in the journal club, the median scores of critical appraisal skills, knowledge and/or pharmaceutical care skills in clinical practice, and discussion skills in English (assessed using a seven-point Likert scale) improved significantly (compared to pre-participation median scores) from 4 (interquartile range [IQR]: 3-5) to 5 (IQR: 4-6), 5 (IQR: 4-5) to 5 (IQR: 5-6), and 4 (IQR: 2-5) to 5 (IQR: 3-5), respectively (P < 0.0001). The respondents also expressed great appreciation for the benefits and overall qualities of the journal club. Additionally, regarding patient care behavior after participation in the journal club, 34 (77.3%), 17 (38.6%), 16 (36.4%), and 14 (31.8%) respondents reported improvement in "drug information services," "patient assessments," "patient counseling," and "multidisciplinary rounds," respectively. Customer satisfaction analysis revealed that sharing information, mutual discussion, a shift system of presenters and co-chairs, and session duration should be improved as a matter of highest priority. CONCLUSION: The findings suggest that our program could be helpful for Asian pharmacists, pharmacy students, and faculty members of the department of pharmacy.

Blinatumomab: Bridging the Gap in Adult Relapsed/Refractory B-Cell Acute Lymphoblastic Leukemia.

Adult patients with acute lymphoblastic leukemia who relapse after frontline therapy have extremely poor outcomes despite advances in chemotherapy and hematopoietic stem cell transplantation. Blinatumomab is a first-in-class bispecific T-cell engager that links T cells to tumor cells leading to T-cell activation and tumor cell lysis. In December 2014, the Food and Drug Administration approved blinatumomab for treatment of relapsed or refractory Philadelphia chromosome-negative precursor B-cell acute lymphoblastic leukemia. In a phase II trial, blinatumomab produced response rates of 43%, and 40% of patients achieving a complete remission proceeded to hematopoietic stem cell transplantation. Early use of blinatumomab was complicated with adverse effects, including cytokine release syndrome and neurotoxicity. Management strategies, including dexamethasone premedication and 2-step dose escalation during the first cycle of blinatumomab, have decreased the incidence and severity of these adverse effects. Blinatumomab currently is being studied for other B-cell malignancies and has the potential to benefit many patients with CD19+ malignancies in the future.

Overcoming treatment challenges in myelofibrosis and polycythemia vera: the role of ruxolitinib.

Myelofibrosis (MF) and polycythemia vera (PV) are BCR-ABL1-negative myeloproliferative neoplasms associated with somatic hematopoietic stem cell mutations leading to over activation of JAK-STAT signaling. MF and PV are pathogenically related and share specific clinical features such as splenomegaly and constitutional symptoms. The MF phenotype is dominated by the effects of progressive bone marrow fibrosis resulting in shortened survival. In contrast, elevated thrombosis risk due to erythrocytosis is the primary clinical concern in PV. Ruxolitinib, an oral JAK1/JAK2 inhibitor, is approved in the USA for the treatment of patients with intermediate- or high-risk MF and patients with PV who have had an inadequate response to or are intolerant of hydroxyurea. For MF, results of two phase III studies demonstrated that ruxolitinib therapy reduced spleen volume and MF-related symptom burden, improved quality-of-life measures, and was associated with prolonged overall survival. Treatment benefits were generally sustained with continued therapy. Dose-dependent cytopenias were common but generally manageable with transfusions (for anemia), dose reduction, or treatment interruption. Optimal dosing management is critical to maintain long-term treatment benefit, because cessation of therapy resulted in rapid return of symptoms to baseline levels. Results of the phase III PV trial showed that ruxolitinib was significantly more effective than standard therapy in controlling hematocrit levels and improving splenomegaly and PV-related symptoms. Only 1 of 110 patients in the ruxolitinib arm compared with 6 of 112 patients in the control arm experienced a thromboembolic event through week 32. Grade ≥3 cytopenias were uncommon.

Management of Relapsed/Refractory Acute Myeloid Leukemia in the Elderly: Current Strategies and Developments.

Elderly patients with acute myeloid leukemia (AML) who are refractory to or relapse following frontline treatment constitute a poor-risk group with a poor long-term outcome. Host-related factors and unfavorable disease-related features contribute to early treatment failures following frontline therapy, thus making attainment of remission and long-term survival with salvage therapy particularly challenging for elderly patients. Currently, no optimal salvage strategy exists for responding patients, and allogeneic hematopoietic stem cell transplant is the only curative option in this setting; however, the vast majority of elderly patients are not candidates for this procedure due to poor functional status secondary to age and age-related comorbidities. Furthermore, the lack of effective salvage programs available for elderly patients with recurrent AML underscores the need for therapies that consistently yield durable remissions or durable control of their disease. The purpose of this review was to highlight the currently available strategies, as well as future strategies under development, for treating older patients with recurrent AML.

Structural insights into the coordination and extraction of Pb(II) by disulfonamide ligands derived from o-phenylenediamine.

The o-phenylenediamine-derived disulfonamide ligands 1 and 2 complex and efficiently extract Pb(II) from water into 1,2-dichloroethane via ion-exchange, in combination with 2,2'-bipyridine (97.5% and 95.0%, respectively, for 1:1 ligand-to-Pb ratios). The corresponding Pb(II)-sulfonamido binary complexes of ligands 1 and 2 (3 and 4, respectively), and ternary complexes with 2,2'-bipyridine (5 and 6, respectively), were isolated and characterized. (1)H NMR spectra of the organic phases after extraction show the formation of ternary Pb-sulfonamido-bipy complexes. X-ray characterization of 3, 4, and the ternary complex 5 consistently demonstrates four primary coordination sites and a stereochemically active lone pair on Pb. The X-ray structure of 3 shows a pseudo trigonal bipyramidal configuration on Pb, with the lone pair occupying one of the equatorial sites, and the formation of an unusual "hemidirected" coordination polymer via axial S=O-Pb coordination. The same axial S=O-Pb coordination pattern with two DMSO molecules is observed in the structure of 4.[2(CH(3))(2)SO)], thus rationalizing the high solubility of the binary complexes in strongly coordinating solvents. In contrast, the X-ray structure of the ternary complex 5 reveals a distorted four-coordinate configuration with only weak S=O-Pb coordination leading to dimer formation, thus explaining its higher solubility in weakly coordinating solvents. FT-IR spectroscopy confirms the X-ray data, since the ligand nu(S)(=)(O) stretching frequencies shift to lower values in the binary Pb(II)-sulfonamido complexes and are again altered upon formation of the ternary Pb(II)-sulfonamido-bipy complexes, as would be expected for 2,2'-bipy complexation and hindered S=O-Pb coordination.

Pb(II) coordination and synergistic ion-exchange extraction by combinations of sulfonamide chelates and 2,2'-bipyridine.

The disulfonamide ligands 1,2-C(6)H(4)(NH(2)SO(2)C(6)H(5))(2) (1) and 1,2-C(6)H(4)(NH(2)SO(2)C(6)H(4)-p-Bu(t))(2) (2), which are readily available in good yields from o-phenylenediamine and the corresponding sulfonyl chlorides, efficiently extract Pb(II) from water into 1,2-dichloroethane when used in synergistic combinations with 2,2'-bipyridine via an ion-exchange mechanism. The extraction was shown to proceed via the formation of a ternary Pb-sulfamido-2,2'-bipyridine complex. The X-ray crystal structure of the binary Pb-sulfamido complex 3 shows a coordination polymer with a stereochemically active lone pair on Pb formed by S=O-Pb axial coordination.

Crystallographic evidence for oxygen acceptor directionality in oxyanion hydrogen bonds.

A survey of 2632 D-H...O-A hydrogen bonds in crystal structures (where D is any atom and A is the central atom of a trigonal planar (A = C, N) or tetrahedral (A = P, S, Cl, As, Se, Cr, Mo) oxyanion, has established the existence of a distinct directionalities at the oxygen atom acceptors. The directionality depends primarily on the geometry of the oxyanion. With the trigonal planar oxyanions NO3-, HCO3-, and CO32-, the average H...O-A angle is 115 +/- 12 degrees and there is a clear preference for the hydrogen to lie within the plane of the anion. With the tetrahedral oxyanions H2PO4-, HPO42-, HSO4-, SO42-, ClO4-, H2AsO4-, HAsO42-, AsO43-, HSeO4-, SeO42-, CrO42-, and MoO42-, the average H...O-A angle is 122 +/- 12 degrees , and there is a weak preference for eclipsed H...O-X-O dihedral angles. The observed directionality closely coincides with minima on electrostatic potential surfaces calculated for the anions.

Structural Aspects of Rubidium Ion Selectivity by Tribenzo-21-crown-7(1)(a).

The structural origins of the selectivity of rubidium ion over other alkali metal ions by tribenzo-21-crown-7 is investigated from single-crystal X-ray diffraction: data for Cs(tribenzo-21-crown-7)(NO(3)), monoclinic, P2(1)/c, a = 9.598(2) Å, b = 23.466(3) Å, c = 23.973(5) Å, beta = 93.31(1) degrees, V = 5390(2) Å(3), Z = 8; data for [Rb(4,4'-bis-tert-butylbenzo,benzo-21-crown-7)(dioxane)(1.5)(H(2)O)(0.18)][Cl].(dioxane)1.82(H(2)O), triclinic, P&onemacr;, a = 11.687(3) Å, b = 12.800(4) Å, c = 17.680(3) Å, alpha = 75.31(2) degrees, beta = 80.01(2) degrees, gamma = 69.09(2) degrees, V = 2379.8(10) Å(3), Z = 2; data for Na(4,4'-bis-tert-butylbenzo,benzo-21-crown-7)ReO(4).0.5(i-PrOH), monoclinic, P2(1)/c, a = 24.300(5) Å, b = 14.066(3) Å, c = 22.676(5) Å, beta = 108.06(3) degrees, V = 7369(3) Å(3), Z = 8; data for and 4,4'-bis-tert-butylbenzo,benzo-21-crown-7, monoclinic, P2(1)/n, a = 16.427(2) Å, b = 11.3675(9) Å, c = 33.137(3) Å, beta = 94.469(8) degrees, V = 6169.0(10) Å(3), Z = 8. The structures reported here are the first reported for a tribenzo-21-crown-7, and the alkali metal ion complexes are the first reported structures of these ions with any 21-crown-7 ether. Different crown conformations are observed for each structure. Molecular mechanics calculations were performed on all conformers, and the results are related to the observed extraction selectivity for rubidium.

Comparison of H-H versus Si-H sigma-Bond Coordination and Activation on 16e Metal Fragments. Organosilane, N(2), and Ethylene Addition to the Agostic Complex W(CO)(3)(PR(3))(2) and Dynamic NMR Behavior of the Latter.

Variable-temperature (31)P{(1)H} NMR spectroscopy of the agostic complexes M(CO)(3)(PCy(3))(2) (M = Mo, W) indicates dynamic behavior as evidenced by collapse below -20 degrees C of a singlet to an AB signal plus a shifted singlet. The inequivalency of the phosphines is possibly due to the presence of conformational isomers resulting from hindered rotation of the M-P bond or, less likely, a geometric isomer with pseudo-cis PCy(3) ligands. Further studies on the coordination chemistry of W(CO)(3)(PR(3))(2) (R = iPr, Cy) were performed. The bridging dinitrogen complex [W(CO)(3)(PiPr(3))(2)](2)(&mgr;-N(2)) (1) was cleanly formed in the reaction of W(CO)(3)(PiPr(3))(2) with N(2). Complex 1 was structurally characterized and compared with other bridging dinitrogen compounds of tungsten. The ethylene complex W(CO)(3)(PCy(3))(2)(eta(2)-C(2)H(4)) (2) was synthesized and characterized by X-ray crystallography in order to compare the binding mode of ethylene with that of H(2). Phenylsilane reacted with W(CO)(3)(PR(3))(2) (R = iPr, Cy) to form the thermally unstable oxidative addition (OA) products WH(SiH(2)Ph)(CO)(3)(PR(3))(2) (3, R = Cy; 4, R = iPr). Diphenylsilane reacted with W(CO)(3)(PiPr(3))(2) at 60 degrees C to form the bridging silyl species [W(CO)(3)(PiPr(3))(&mgr;-SiHPh(2))](2) (5), which was confirmed by spectroscopic techniques and X-ray crystallography to have two 3-center 2-electron W.H.Si interactions. Detailed comparisons of the binding and activation of silanes versus H(2) on various 16e metal centers suggest a high degree of similarity, but relative ease of OA depends on the electrophilicity of the metal-ligand fragment and other factors such as bond energetics. Increasing the electrophilicity of the metal center (e.g., adding positive charge) may aid in stabilizing alkane coordination.

Technetium(III), Technetium(II), and Technetium(I) Complexes with Pyridine Ligands. Can Pyridine Coordination Stabilize the Low Oxidation States of Technetium?

The substitution chemistry of TcCl(3)(PPh(3))(2)(CH(3)CN) is rather facile relative to the analogous rhenium complex, since both the chloride and phosphine ligands are easily substituted for various pyridine ligands. Consequently a series of Tc(III) complexes with amine, pyridine, and polypyridyl ligands were prepared and characterized by (1)H NMR and cyclic voltammetry. In addition, the zinc reduction of TcCl(4)(py)(2) in the presence of pyridine results in TcCl(2)(py)(4). Structural and spectroscopic data indicate that this Tc(II) complex exhibits strong metal-pyridine interactions characteristic of low-valent amine complexes of Re(II) and Os(II). For example, a decrease of 0.04 and 0.06 Å is observed for the trans-Tc-N bond length in TcCl(2)(py)(4 )relative to mer-TcCl(3)(pic)(3) and [TcCl(2)(py)(3)(PPh(3))](+), respectively. This ability of pyridine to function both as a strong sigma-donor and moderate pi-acid ligand has resulted in the isolation of technetium complexes in various oxidation states with similar ligand environments. As a result, a structural comparison of [TcCl(2)(py)(3)(PPh(3))](+), TcCl(2)(py)(4), TcCl(tpy)(py)(2), and other known Tc(III) and Tc(II) pyridine complexes is presented. Crystals of [TcCl(2)(py)(3)(PPh(3))]PF(6) are triclinic, with space group P&onemacr;, Z = 2, and lattice parameters a = 12.677(4) Å, b = 13.064(4) Å, c = 13.103(5) Å, alpha = 110.14(3) degrees, beta = 101.12(3) degrees, gamma = 96.61 degrees, V = 1959 Å(3), and R = 0.0615 (R(w) = 0.1148). Crystals of TcCl(2)(py)(4) are tetragonal, with space group I4(1)/acd, Z = 8, and lattice parameters a = 15.641(4) Å, c = 16.845(6) Å, V = 4121 Å(3), and R = 0.0373 (R(w) = 0.0290). Crystals of TcCl(tpy)(py)(2) are orthorhombic, with space group C222(1), Z = 4, and lattice parameters a = 9.359(3) Å, b = 16.088(6) Å, c = 18.367(4) Å, V = 2765 Å(3), and R = 0.0499 (R(w) = 0.0599).