The cost of a single concussion in American high school football: a retrospective cohort study.

AIM: The potential financial burden of American football-related concussions (FRC) is unknown. Our objective was to describe the healthcare costs associated with an FRC and determine factors associated with increased costs. METHODOLOGY/RESULTS: A retrospective cohort study of concussed high school football players presenting between November 2017 and March 2020 was undertaken; 144 male high school football players were included. Total costs were about $115,000, for an average direct healthcare cost of $800.10/concussion. Visiting the emergency department (ß = 502.29, 95% CI: 105.79-898.61; p = 0.01), the initial post-concussion symptom scale score (ß = 0.39, 95% CI: 0.11-0.66; p = 0.01) and a post-concussion syndrome diagnosis (ß = 670.37, 95% CI: 98.96-1241.79; p = 0.02) were each independently associated with total costs. CONCLUSION: A granular understanding of cost-driving factors associated with FRC is the first step in understanding the cost-effectiveness of prevention and treatment methods.

Synthesis and Photophysical Properties of T-Shaped Coinage-Metal Complexes.

The photophysical properties of a series of T-shaped coinage d10 metal complexes, supported by a bis(mesoionic carbene)carbazolide (CNC) pincer ligand, are explored. The series includes a rare new example of a tridentate T-shaped AgI complex. Post-complexation modification of the AuI complex provides access to a linear cationic AuI complex following ligand alkylation, or the first example of a cationic square planar AuIII -F complex from electrophilic attack on the metal centre. Emissions ranging from blue (CuI ) to orange (AgI ) are obtained, with variable contributions of thermally-dependent fluorescence and phosphorescence to the observed photoluminescence. Green emissions are observed for all three gold complexes (neutral T-shaped AuI , cationic linear AuI and square planar cationic AuIII ). The higher quantum yield and longer decay lifetime of the linear gold(I) complex are indicative of increased phosphorescence contribution.

Synthesis of heterobimetallic gold(i) ferrocenyl-substituted 1,2,3-triazol-5-ylidene complexes as potential anticancer agents.

1,2,3-Triazol-5-ylidene (trz) complexes of gold(i) containing a ferrocenyl substituent on the C4-position of the trz ring were synthesized to yield the neutral heterobimetallic gold(i) trz chlorido (2), gold(i) trz phenyl (3), and the cationic gold(i) trz triphenylphospine (5) complexes. In order to compare the effect of silver(i) as central metal vs. gold(i), [Ag(trz)2]+ (4) was also prepared, while variation of the C4-1,2,3-triazol-5-ylidene substituent from a ferrocenyl to a phenyl group was done to prepare the monometallic analogue of 5, namely the cationic Au(i) trz triphenylphosphine complex 6. The complexes were characterised with spectroscopic and electrochemical methods, and the single crystal X-ray structures of 2-6 were determined. NMR stability studies of 5 as a representative example of the series of complexes were performed to confirm the stability of the complexes in the solvent dimethylsulfoxide and in aqueous solution. The anti-cancer potential of 5 was evaluated against the lung cancer cell lines A549 and H1975, and the human embryonic kidney cell line (HEK-293) was used as a non-cancer model. IC50 values of 0.89, 0.23 and 5.43 µM, respectively, were obtained for A549, H1975 and HEK-293, respectively, indicating the activity and selectivity of 5 for cancer cells. Fluorescence microscopy experiments as a preliminary mode-of-action study evidenced an apoptotic cell death mechanism rather than necrotic cell death.

Mono-, di- and tetrarhenium Fischer carbene complexes with thienothiophene substituents.

The oxidative cleaving of a rhenium-rhenium bond by bromine in binuclear Fischer carbene complexes proves to be an effective method to prepare mononuclear bromido-carbene complexes. The reaction of mono- and dilithiated thieno[2,3-b]thiophene (2,3-b-TTH2) and thieno[3,2-b]thiophene (3,2-b-TTH2) with [Re2(CO)10] affords dirhenium nonacarbonyl ethoxycarbene complexes, [Re2(CO)9{C(OEt)2,3-b-TTH}] (1a) and [Re2(CO)9{C(OEt)3,2-b-TTH}] (1b), and the tetrarhenium bis(ethoxycarbene) complexes from the dilithiated thiophene substrates, [Re2(CO)9-µ-{C(OEt)-2,3-b-TT-C(OEt)}Re2(CO)9] (2a) and [Re2(CO)9-µ-{C(OEt)-3,2-b-TT-C(OEt)}Re2(CO)9] (2b) featuring bridging thiophene linkers. Rhenium-rhenium bond cleavage by bromine of the monocarbene complexes yielded the scarce class of monorhenium bromido-carbene complexes, cis-[Re(CO)4{C(OEt)2,3-b-TTH}Br] (3a) and cis-[Re(CO)4{C(OEt)3,2-b-TTH}Br] (3b), while the corresponding reaction of the biscarbene tetrarhenium carbonyl complex of thieno[2,3-b]thiophene afforded the cleaving of both metal-metal bonds to give the novel dirhenium biscarbene dibromido complex with a thienothiophene spacer, [Re(CO)4Br-µ-{C(OEt)-2,3-b-TT-C(OEt)}Re(CO)4Br] (4a). A new indirect aminolysis route is described to prepare the chlorido dimethylaminocarbene complex 5acis-[Re(CO)4{C(NMe2)2,3-b-TTH}Cl], with unexpected cleavage of the Re-Re bond. Single crystal X-ray diffraction studies were performed on 1a, 2a, 3a, 5a, 1b and 3b. Spectroscopic and electrochemical methods are employed to investigate the electronic effect of the different conjugation pathways in the different thienothiophenyl carbene substituents, and the replacement of the rhenium pentacarbonyl fragment with a bromido ligand.

A Hemilabile and Cooperative N-Donor-Functionalized 1,2,3-Triazol-5-Ylidene Ligand for Alkyne Hydrothiolation Reactions.

A series of novel cationic and neutral Rh complexes with an N-donor-functionalized 1,2,3-triazol-5-ylidene (TRZ) ligand (in which the pendant N donor is NHBoc, NH2 , or NMe2 ) is described. The catalytic activity of these complexes was evaluated in the hydrothiolation of alkynes. Among the catalysts, a neutral dicarbonyl complex featuring the tethered-NBoc amido-TRZ ligand proved very selective for alkyne hydrothiolation with an aryl thiol. Remarkably, the reaction could be carried out in the absence of pyridine or base additive. In addition, during the reaction, no evidence for oxidative addition of the thiol S-H bond was observed, strongly suggesting a reaction pathway in which a bifunctional ligand is involved. Experimental and theoretical mechanistic investigations suggest a ligand-assisted deprotonation of thiol, hemilabile dissociation of amine from the metal, and thiolate coordination, which is indicative of a different reaction mechanism to those previously reported for related alkyne hydrothiolation reactions.

Nucleophilic T-Shaped (LXL)Au(I)-Pincer Complexes: Protonation and Alkylation.

We report the synthesis and reactivity of unusual T-shaped (LXL)Au(I)-pincer complexes, based on a carbazole framework flanked by two mesoionic carbenes (MICs). In contrast to other Au(I) complexes, these complexes react with electrophiles. Protonation and alkylation occur either at the metal or the ligand, depending on steric factors. Of particular interest, protonation at gold leads to an unprecedented cationic Au(III) hydride, which gives a 1H NMR resonance at δ -8.34 ppm. The reactivity of this "hydride", however, shows protic and not hydridic behavior.

A rhodium(I)-oxygen adduct as a selective catalyst for one-pot sequential alkyne dimerization-hydrothiolation tandem reactions.

An air-stable rhodium(I)-oxygen adduct featuring a CNC-pincer ligand, based on 1,2,3-triazol-5-ylidenes, catalyzes the homo-dimerization and hydrothiolation of alkynes, affording the gem-enyne and α-vinyl sulfide isomers, respectively, with excellent selectivity. A one-pot stepwise strategy allows the selective catalytic preparation of non-symmetric bis-vinyl sulfides, as well as the alkyne dimerization-hydrothiolation tandem reactions.

Synthesis and properties of mono- and dimetal Fischer multicarbene complexes derived from thiophene and thieno[2,3-b]thiophene.

Access to multicarbene complexes of a fused thienothiophene substrate was obtained by the use of the tetrabrominated thieno[2,3-b]thiophene precursor in a lithium-bromide exchange reaction, followed by nucleophilic attack on metal hexacarbonyls (M = Cr, W). Subsequent alkylation afforded unique triscarbene complexes [M(CO)4{{C(OEt)}2C6H1S2C(OEt)}M(CO)5] (M = Cr 12, W 13) featuring three non-equivalent carbene ligands on a single thiophene linker, as well as the bischelated tetracarbene complexes [M(CO)4{{C(OEt)}2C6S2{C(OEt)}2}M(CO)4] (M = Cr 14, W 15). The triscarbene complexes 12 and 13 are the first examples of multi-alkoxycarbene complexes featuring three non-equivalent carbene ligands. The reaction also afforded the chelated mononuclear biscarbene complexes [M(CO)4{C(OEt)}2C6H2S2] (M = Cr 10, W 11) in low yields. Similarly, employing tetrabromothiophene as precursor yielded the mononuclear chelate biscarbene complexes [M(CO)4{C(OEt)}2C4H2S] (M = Cr 6, W 7) and the dinuclear tetracarbene complexes [M(CO)4{{C(OEt)}2C4S{C(OEt)}2}M(CO)4] (M = Cr 8, W 9). Modification of the classic Fischer carbene synthetic methodology to a process of stepwise additions of lithiating agent and metal carbonyls to thieno[2,3-b]thiophene, facilitates the formation of the mixed metal biscarbene complex [W(CO)5C(OEt){C6H2S2}C(OEt)Cr(CO)5] 5, as analogue of the homonuclear biscarbene complexes [M(CO)5C(OEt){C6H2S2}C(OEt)M(CO)5], (M = Cr 3, W 4). The monocarbene complexes [M(CO)5{C(OEt)C6H3S2}], (M = Cr 1, W 2) were also obtained in high yields, and the molecular structures of the tungsten complexes, with the exception of 9 and 11, were confirmed by single crystal X-ray diffraction studies.

Isolation of a potassium bis(1,2,3-triazol-5-ylidene)carbazolide: a stabilizing pincer ligand for reactive late transition metal complexes.

The synthesis and X-ray crystal structure of a potassium adduct of a monoanionic CNC-pincer ligand featuring two mesoionic carbenes is reported. Owing to the peculiar electronic and steric properties of this ligand, the first neutral stable Ni(II)-hydride, and an unusual Cu(II) complex displaying a seesaw geometry, have been isolated.

Fischer-type gold(I) carbene complexes stabilized by aurophilic interactions.

The synthesis and structure of rare acyclic alkoxy- and aminocarbene complexes of gold(i) are reported, including a novel ferrocenophane dinuclear biscarbene complex. X-Ray diffraction analyses and DFT calculations reveal that these complexes are stabilized by genuine aurophilic interactions.

Substituent effects on the electrochemical, spectroscopic, and structural properties of Fischer mono- and biscarbene complexes of chromium(0).

A series of ten ferrocenyl, furyl, and thienyl mono- and biscarbene chromium(0) complexes were synthesized and characterized spectroscopically and electrochemically. The single crystal structure of the biscarbene complex [(CO)5Cr═C(OEt)-Fu'-(OEt)C═Cr(CO)5] (4a) was determined: C20H12Cr2O13; triclinic; P1; a = 6.2838(5), b = 12.6526(9), c = 29.1888(19) Å, α = 89.575(2), ß = 88.030(2), γ = 87.423(2)°; Z = 4. Results from an electrochemical study in CH2Cl2 were mutually consistent with a computational study in showing that the carbene double bond of 1-6 is reduced to an anion radical, (-)Cr-C• at formal reduction potentials < -1.7 V vs FcH/FcH(+). The Cr centers are oxidized in two successive one electron transfer steps to Cr(II) via the Cr(I) intermediate. Only Cr(I) oxidation is electrochemically irreversible. Dicationic Cr(II) species formed upon two consecutive one-electron oxidation processes are characterized by a peculiar bonding situation as they are stabilized by genuine CH···Cr agostic interactions. With respect to aryl substituents, carbene redox processes occurred at the lowest potentials for ferrocene derivatives followed by furan complexes. Redox process in the thiophene derivatives occurred at the highest potentials. This result is mutually consistent with a (13)C NMR study that showed the Cr═C functionality of furyl complexes were more shielded than thienyl complexes. The NHBu carbene substituent resulted in carbene complexes showing redox processes at substantially lower redox potentials than carbenes having OEt substituents.

Electrochemical illumination of thienyl and ferrocenyl chromium(0) Fischer carbene complexes.

A series of ferrocenyl and thienyl mono- and biscarbene chromium(0) complexes 1-6 were synthesised. The complexes were characterised both spectroscopically and electrochemically, and the single crystal X-ray structure of 3 was determined. Electrochemical measurements in CH2Cl2 revealed that the carbene double bond of 1-6 is reduced to an anion radical, (-)Cr-C˙ at formal reduction potentials <-1.7 V vs. FcH/FcH(+). A computational study on 1, 3 and 4 (B3LYP/def2-SVP level) is consistent with electrochemical results in showing that electrochemically generated chromium(I) species may be further electrochemically irreversibly oxidised to chromium(II) at Epa > 0.95 V. The reactivity towards follow-up chemical reactions of the anodically produced Cr(II) species is much higher than the reactivity of the cathodically produced radical anions as the latter was still observably reoxidised to the parent Cr=C species at fast scan rates. The ferrocenyl group is oxidised electrochemically reversibly to ferrocenium at larger potentials than the electrochemically reversible oxidation of the Cr(0) centre to Cr(I). That all redox centres in 1-6 are involved in one-electron transfer steps was confirmed by comparing the ferrocenyl voltammetric wave with those of the other redox centres in linear sweep voltammetric experiments. The ferrocenyl group was electrochemically shown to stabilise the Cr=C centre almost as much as the NHBu, and much more than the ethoxy and thienyl groups.

3,6-Diaza-octane-1,8-diaminium diiodide.

The asymmetric unit of the title salt, C(6)H(20)N(4) (2+)·2I(-), comprises half a 3,6-diaza-octane-1,8-diaminium dication plus an I(-) anion. The dications are symmetrical and lie across crystallographic centres of inversion. In the crystal, the ions form a network involving mainly weak N-H⋯I inter-molecular inter-actions: two H atoms of the ammonium group form inter-actions with two I(-) anions and the H atom of the secondary amine forms a weak inter-action with a third I(-) cation. The third ammonium H atom is hydrogen bonded to a secondary amine of an adjacent cation. The backbone of the cation does not form a uniformly trans chain, but is 'kinked' [C-N-C-C torsion angle = 71.5 (2)°], probably to accommodate the direct hydrogen bond between the ammonium group and the secondary amine in an adjacent cation.

2,2'-(Piperazine-1,4-di-yl)diethanaminium bis-(2-hy-droxy-benzoate).

The asymmetric unit of the title salt, C(8)H(22)N(4) (2+)·2C(7)H(5)O(3) (-), comprises half a 2,2'-(piperazine-1,4-di-yl)diethan-aminium dication plus a 2-hy-droxy-benzoate anion. In the crystal, the anions and cations are linked by N-H⋯O and O-H⋯O hydrogen bonds to form infinite two-dimensional networks parallel with the a unit-cell face. The conformation adopted by the cation in the crystal is very similar to that adopted by the same cation in the structures of the nitrate and tetra-hydrogen penta-borate salts.

2,2'-(Piperazine-1,4-di-yl)diethanaminium dibenzoate.

The asymmetric unit of the title salt C(8)H(22)N(4) (2+)·2C(7)H(5)O(2) (-), comprises two independent pairs of half a 2,2'-(piperazine-1,4-di-yl)diethanaminium dication plus a benzoate anion. The dications are symmetrical and lie across crystallographic centres of inversion. The crystal structure was refined as a two-component pseudo-merohedral twin using the twin law 001 0-10 100 [he domain fractions are 0.8645 (8) and 0.1355 (8)]. The anions and cations are linked by N-H⋯O hydrogen bonds and weak N-H⋯O inter-molecular inter-actions to form infinite two-dimensional networks parallel to [101]. The conformation adopted by the cation in the crystal structure is very similar to that adopted by the same cation in the structures of the 2-hy-droxy-benzoate [Cukrowski et al. (2012 ▶). Acta Cryst, E68, o2387], the nitrate and the tetra-hydrogen penta-borate salts.

[N,N'-Bis(2,4,6-trimethyl-phen-yl)ethane-1,2-diimine-κ(2)N,N']tetra-carbonyl-chromium(0).

The octa-hedral coordination of the Cr(0) atom in the title compound, [Cr(C(20)H(24)N(2))(CO)(4)], displays some distortion. This is manifested by an exocyclic torsion angle C(mesitylene)-N-Cr-C(carbon-yl) that deviates by more than 20° from planarity. Another structural feature is the significant distortion from linearity of the Cr-C-O angles of the two carbonyl groups that inter-act with both ortho-methyl groups of the two mesitylene rings. The remaining two carbonyl groups overlap with the centres of the mesitylene rings themselves and are linear within <3°.

{µ-5-[1,3-Bis(2,4,6-trimethyl-phen-yl)-3H-imidazolium-2-yl]-2-(2-oxoethenyl-1κC)furan-3-yl-2κC}-µ-hydrido-bis(tetra-carbonyl-rhenium) tetra-hydro-furan 0.67-solvate.

The title complex, [Re(2)(C(27)H(25)N(2)O(2))H(CO)(8)]·0.67C(4)H(8)O, was formed as a product in the reaction of a rhenium(I)-Fischer carbene complex with a free NHC carbene. The coordination environment about the two Re atoms is slightly distorted octahedral, including a bridging H atom. The imidazolium and furan groups are almost coplanar, whereas the mesityl substituents show an almost perpendicular arrangement with respect to both heterocyclic units. Mol-ecules of the complex pack in such a way as to form channels parallel with the bc unit-cell face diagonal running through the unit face diagonal. These channels are partially occupied by tetra-hydro-furan solvent mol-ecules.

2-(Biphenyl-4-yl)propan-2-ol.

The title compound, C(15)H(16)O, crystallizes with two independent mol-ecules in the asymmetric unit. Due to the space-group symmetry, this results in the formation of a tetra-mer where the four mol-ecules are connected by O-H⋯O hydrogen bonds. The mol-ecules pack parallel to the c axis. Both mol-ecules in the asymmetric unit are nonplanar and the dihedral angles between connected aromatic rings in each mol-ecule are 7.96 (12) and 9.75 (13)°. This contrasts with the gas phase density functional theory (DFT) optimized conformation, where this dihedral angle is 39.33°.

1,3-Bis(2,4,6-trimethyl-phen-yl)-3H-imidazol-1-ium tetra-oxidorhenate(VII).

The title compound, (C(21)H(25)N(2))[ReO(4)], was formed as the unexpected product in an attempted synthesis of a rhenium(I)-N-heterocyclic carbene (NHC) complex. The compound has crystallographic mirror symmetry with both the cation and the tetrahedral anion located across a mirror plane. The cation and anion are linked by a C-H⋯O hydrogen bond.

Rhenium ethoxy- and hydroxycarbene complexes with thiophene substituents.

Reaction of mono- and dilithiated thiophene (a), bithiophene (b) and 2,5-dibromothiophene (c) with [Re(2)(CO)(10)] afforded, after subsequent alkylation with triethyloxonium tetrafluoroborate, tetra- and binuclear Fischer carbene complexes, [Re(2)(CO)(9){C(OEt){C(4)H(2)S}(n)X}], n = 1, X = H (1a); n = 2, X = H (1b); n = 1, X = Br (1c); n = 1, X = C(OEt)Re(2)(CO)(9), (2a); n = 2, X = C(OEt)Re(2)(CO)(9) (2b), as major products. The dirhenium acylate intermediates from this reaction not only gave the expected novel ethoxycarbene complexes with alkylation but after rhenium-rhenium bond breaking afforded a number of minor products. The (1)H NMR spectrum of the crude reaction mixture revealed the formation of four metal hydride complexes and aldehydes. Protonation with HBF(4) instead of alkylation with Et(3)OBF(4) significantly increased the yields of the hydride complexes, which enabled the positive identification of three of these complexes. In addition to the known compounds [Re(CO)(5)H] and [Re(3)(CO)(14)H] (3), a unique complex displaying a hydroxycarbene fragment connected to an acyl fragment via an O-H···O hydrogen bond and a Re···H···Re bond linking the two Re centers, [(µ-H){Re(CO)(4)C(OH){C(4)H(2)S}(n)H}{Re(CO)(4)C(O){C(4)H(2)S}(n)H}], n = 1 (4a) or n = 2 (4b), were isolated. The formation of thiophene aldehydes, H{C(O)}(m){C(4)H(2)S}(n)C(O)H (m = 0 or 1 and n = 1 or 2), were observed and the novel monocarbene complexes with terminal aldehyde groups, [Re(2)(CO)(9){C(OEt){C(4)H(2)S}(n)C(O)H}], n = 1 (5a) and n = 2 (5b) could be isolated. A higher yield of 5b was obtained after stirring crystals of 2b in wet THF. The crystal structures of 1a, 2a, 4a and 5b are reported.