Optimizing Home Oxygen Therapy. An Official American Thoracic Society Workshop Report.

More than 1.5 million adults in the United States use supplemental oxygen for a variety of respiratory disorders to improve their quality of life and prolong survival. This document describes recommendations from a multidisciplinary workshop convened at the ATS International Conference in 2017 with the goal of optimizing home oxygen therapy for adults. Ideal supplemental oxygen therapy is patient-specific, provided by a qualified clinician, includes an individualized prescription and therapeutic education program, and offers oxygen systems that are safe, promote mobility, and treat hypoxemia. Recently, patients and clinicians report a growing number of problems with home oxygen in the United States. Oxygen users experience significant functional, mechanical, and financial problems and a lack of education related to their oxygen equipment-problems that impact their quality of life. Health care providers report a lack of readily accessible resources needed to prescribe oxygen systems correctly and efficiently. Patients with certain lung diseases are affected more than others because of physically unmanageable or inadequate portable systems. Analysis is needed to quantify the unintended impact that the Centers for Medicare and Medicaid Services Competitive Bidding Program has had on patients receiving supplemental oxygen from durable medical equipment providers. Studies using effectiveness and implementation research designs are needed to develop and evaluate new models for patient education, identify effective ways for stakeholders to interface, determine the economic benefit of having respiratory therapists perform in-home education and follow-up testing, and collaborate with technology companies to improve portable oxygen devices. Generation of additional evidence of the benefit of supplemental oxygen across the spectrum of advanced lung diseases and the development of clinical practice guidelines should both be prioritized.

Classroom sound can be used to classify teaching practices in college science courses.

Active-learning pedagogies have been repeatedly demonstrated to produce superior learning gains with large effect sizes compared with lecture-based pedagogies. Shifting large numbers of college science, technology, engineering, and mathematics (STEM) faculty to include any active learning in their teaching may retain and more effectively educate far more students than having a few faculty completely transform their teaching, but the extent to which STEM faculty are changing their teaching methods is unclear. Here, we describe the development and application of the machine-learning-derived algorithm Decibel Analysis for Research in Teaching (DART), which can analyze thousands of hours of STEM course audio recordings quickly, with minimal costs, and without need for human observers. DART analyzes the volume and variance of classroom recordings to predict the quantity of time spent on single voice (e.g., lecture), multiple voice (e.g., pair discussion), and no voice (e.g., clicker question thinking) activities. Applying DART to 1,486 recordings of class sessions from 67 courses, a total of 1,720 h of audio, revealed varied patterns of lecture (single voice) and nonlecture activity (multiple and no voice) use. We also found that there was significantly more use of multiple and no voice strategies in courses for STEM majors compared with courses for non-STEM majors, indicating that DART can be used to compare teaching strategies in different types of courses. Therefore, DART has the potential to systematically inventory the presence of active learning with ∼90% accuracy across thousands of courses in diverse settings with minimal effort.

Carbanionic rearrangements of halomethylenecyclobutanes. Stereochemistry of the migrating group.

The unusual base-induced ring-enlargement of halomethylenecyclobutanes to 1-halocyclopentenes was examined with unsymmetrical and (13)C-labeled substrates to study regio- and stereochemical characteristics. Migration of a ring carbon atom (single migration) or simultaneous migration of a ring carbon atom and the halide (double migration) gives the ring-enlarged products. (13)C-labeling experiments established that both rearrangements occur with retention of configuration at the migrating center. These systems are suggested as models for the Fritsch-Buttenberg-Wiechell (FBW) rearrangement.

Synthesis and cytotoxicity of a salicylihalamide A analogue.

The synthesis of a simple analogue of salicylihalamide A with a truncated lactone ring (+/- 2) was achieved in 10 steps. Its cytotoxicity profile in the NCI 60-cell-line human tumor assay differed significantly from that of salicylihalamide A in both level and specificity.

Stylopeptide 2, a proline-rich cyclodecapeptide from the sponge Stylotella sp.

A new proline-rich cyclodecapeptide, designated stylopeptide 2, has been isolated from a cytotoxic extract of the Papua New Guinea marine sponge Stylotella sp. and found to correspond to structure 1. The structural assignment was based on HRMS collision-induced dissociation tandem mass spectrometry (CID MS/MS), NMR spectroscopic data, and amino acid analysis, which led to assignment of the absolute configuration.

New dimeric macrolide glycosides from the marine sponge Myriastra clavosa.

Clavosolides A-D (1-4), dimeric macrolides incorporating cyclopropyl, tetrahydropyranyl, and glycosidic ring systems, were isolated from the cytotoxic extract of a Philippines collection of the marine sponge Myriastra clavosa. The structures of the clavosolides, which occurred as only trace metabolites, were elucidated through extensive NMR spectroscopic analyses. Clavosolides A (1) and B (2) were recently reported metabolites from M. clavosa, while the unsymmetrical dimers clavosolides C (3) and D (4) had new structures.

Salicylihalamides A and B, Novel Cytotoxic Macrolides from the Marine Sponge Haliclona sp.

Two novel, highly potent, cytotoxic macrolides, salicylihalamides A (1) and B (2), were isolated from the sponge Haliclona sp. This new macrolide class incorporates salicylic acid, a 12-membered lactone ring, and an enamide side chain. COMPARE pattern-recognition analyses of the NCI 60-cell mean graph screening profiles of 1 did not reveal any significant correlations to the profiles of known antitumor compounds in the NCI's "standard agent database", thus supporting the conclusion that the salicylihalamides represent a potentially important new class for antitumor lead optimization and in vivo investigations.