Benzimidazole-diamide (bida) Pincer Chromium Complexes: Structures and Reactivity.

Serendipitous discovery of bida (i.e., N1-Ar-N2-((1-Ar-1-benzo[d]imidazol-2-yl)methyl)benzene-1,2-diamide; Ar = 2,6-iPr-C6H3), a potentially redox noninnocent, hemilabile pincer ligand with a methylene group that may facilitate proton/H atom reactivity, prompted its investigation. Chromium was chosen for study due to its multiple stable oxidation states. Disodium salt (bida)Na2(THF)n was prepared by thermal rearrangement of (dadi)Na2(THF)4 (i.e., (N,N'-di-2-(2,6-diisopropylphenylamine)phenylglyoxaldiimine)-Na2(THF)4). Salt metathesis of (bida)Na2(THF)n (generated in situ) with CrCl3(THF)3 or Cl3V═NAr (Ar = 2,6-iPr2C6H3) afforded (bida)CrCl(THF) (1-THF) and (bida)ClV═NAr, respectively. Substitutions provided (bida)CrCl(PMe2Ph) (1-PMe2Ph) and (bida)CrR(THF) (2-R, where R = Me, CH2CMe2Ph (Nph)). Oxidation of 1-THF with ArN3 (Ar = 2,6-iPr2C6H3) or AdN3 (Ad = 1-adamantyl) generated (bida)ClCr═NAr (3═NAr) and (bida)ClCr═NAd (3═NAd) and subsequent alkylation converted these to (bida)R'Cr═NR (R' = Me, R = Ad, Ar, 5═NR; R' = CH2CMe2Ph (Nph), R = Ad, Ar, 6═NR). In contrast, the addition of AdN3 to 2-Nph gave the insertion product (bida)Cr(κ2-N,N-ArN3Nph) (7). Addition of N-chlorosuccinimide to 1-THF produced (bia)CrCl2(THF) (8), where bia is the pincer derived via hydrogen atom loss from bida methylene. A similar HAT afforded (bia)ClCr(CNAr')2 (9, Ar' = 2,6-Me2C6H3) when 3═NAd was exposed to Ar'NC. An empirical equation of charge was applied to each bida species, whose metric parameters are unchanging despite formal oxidation state conversions from Cr(III) to Cr(V). Calculations and Mulliken spin density assessments reveal several situations in which antiferromagnetic (AF) coupling and admixtures of integer ground states (GSs) describe a complicated electronic structure.

TEMPO coordination and reactivity in group 6; pseudo-pentagonal planar (η2-TEMPO)2CrX (X = Cl, TEMPO).

The exposure of CrCl2(THF)2 to 1 equiv. of TEMPO and 1 equiv. [TEMPO]Na afforded (η2-O,N-TEMPO)2CrCl (1, 67%); addition of [TEMPO]Na to 1 yielded (η2-O,N-TEMPO)2Cr(TEMPO) (2). Both 1 and 2 exhibit pseudo-pentagonal planar (PPP) geometry, instead of myriad alternatives. Calculations and spectral studies suggest the solid-state geometry persists in solution.

Electronic case reporting (eCR) of COVID-19 to public health: implementation perspectives from the Minnesota Department of Health.

Electronic case reporting (eCR) is the automated generation and transmission of case reports from electronic health records to public health for review and action. These reports (electronic initial case reports: eICRs) adhere to recommended exchange and terminology standards. eCR is a partnership of the Centers for Disease Control and Prevention (CDC), Association of Public Health Laboratories (APHL) and Council of State and Territorial Epidemiologists (CSTE). The Minnesota Department of Health (MDH) received eICRs for COVID-19 from April 2020 (3 sites, manual process), automated eCR implementation in August 2020 (7 sites), and on-boarded ∼1780 clinical units in 460 sites across 6 integrated healthcare systems (through March 2022). Approximately 20 000 eICRs/month were reported to MDH during high-volume timeframes. With increasing provider/health system implementation, the proportion of COVID-19 cases with an eICR increased to 30% (March 2022). Evaluation of data quality for select demographic variables (gender, race, ethnicity, email, phone, language) across the 6 reporting health systems revealed a high proportion of completeness (>80%) for half of variables and less complete data for rest (ethnicity, email, language) along with low ethnicity data (<50%) for one health system. Presently eCR implementation at MDH includes only one EHR vendor. Next steps will focus on onboarding other EHRs, additional eICR data extraction/utilization, detailed analysis, outreach to address data quality issues, and expanding to other reportable conditions.

Evaluation of Data Exchange Process for Interoperability and Impact on Electronic Laboratory Reporting Quality to a State Public Health Agency.

BACKGROUND: Past and present national initiatives advocate for electronic exchange of health data and emphasize interoperability. The critical role of public health in the context of disease surveillance was recognized with recommendations for electronic laboratory reporting (ELR). Many public health agencies have seen a trend towards centralization of information technology services which adds another layer of complexity to interoperability efforts. OBJECTIVES: The study objective was to understand the process of data exchange and its impact on the quality of data being transmitted in the context of electronic laboratory reporting to public health. This was conducted in context of Minnesota Electronic Disease Surveillance System (MEDSS), the public health information system for supporting infectious disease surveillance in Minnesota. Data Quality (DQ) dimensions by Strong et al., was chosen as the guiding framework for evaluation. METHODS: The process of assessing data exchange for electronic lab reporting and its impact was a mixed methods approach with qualitative data obtained through expert discussions and quantitative data obtained from queries of the MEDSS system. Interviews were conducted in an open-ended format from November 2017 through February 2018. Based on these discussions, two high level categories of data exchange process which could impact data quality were identified: onboarding for electronic lab reporting and internal data exchange routing. This in turn comprised of ten critical steps and its impact on quality of data was identified through expert input. This was followed by analysis of data in MEDSS by various criteria identified by the informatics team. RESULTS: All DQ metrics (Intrinsic DQ, Contextual DQ, Representational DQ, and Accessibility DQ) were impacted in the data exchange process with varying influence on DQ dimensions. Some errors such as improper mapping in electronic health records (EHRs) and laboratory information systems had a cascading effect and can pass through technical filters and go undetected till use of data by epidemiologists. Some DQ dimensions such as accuracy, relevancy, value-added data and interpretability are more dependent on users at either end of the data exchange spectrum, the relevant clinical groups and the public health program professionals. The study revealed that data quality is dynamic and on-going oversight is a combined effort by MEDSS Informatics team and review by technical and public health program professionals. CONCLUSION: With increasing electronic reporting to public health, there is a need to understand the current processes for electronic exchange and their impact on quality of data. This study focused on electronic laboratory reporting to public health and analyzed both onboarding and internal data exchange processes. Insights gathered from this research can be applied to other public health reporting currently (e.g. immunizations) and will be valuable in planning for electronic case reporting in near future.

Does an AHEC-Sponsored Clerkship Experience Strengthen Medical Students' Intent to Provide Care for Medically Underserved Patients?

The mission of Area Health Education Centers (AHECs) is to recruit and educate students to serve as practicing health care professionals in rural, primary care, and medically underserved communities. We sought to determine if participation in an AHEC-sponsored family medicine clerkship experiences during medical school are significantly associated with a self-reported intent to practice primary care in a medically underserved environment upon graduation. The study was a prospective cohort study comparing third-year family medicine students with the Indiana University School of Medicine who participated in either an AHEC-sponsored family medicine clerkship to those who completed their required family medicine clerkship outside of the AHEC setting. Following the 160-h clinical clerkship, all students completed a mandatory, electronic survey and were asked to self-report their intent to the following question: "Which of the following statements best describes the impact of the family medicine clerkship on your intention to provide care to underserved patients when you complete residency training?" The question was integrated into a mandatory post-clerkship evaluation form required by the Indiana University School of Medicine, Department of Family Medicine. A Chi square test of independence as well as a multivariate logistic regression analysis was used to determine the independent association of AHEC clerkship participation and reported intent. A total of 1138 students completed the survey. There were not significant differences in age, gender, race, and ethnicity between students that completed an AHEC clerkship and those that did not. After adjusting for gender, race, and ethnicity, AHEC participants were significantly more likely to report an intention to practice primary care in a medically underserved setting upon graduation. Female students were found to be 1.2-3.4 times as likely to report increased intent compared to male students (95 % CI 1.241-3.394). Participation in an AHEC-supported clerkship was associated with a significant increase in self-reported intent to practice primary care in a medically underserved setting. Additional research is required to determine if participation and/or reported intent are predictive of practice selection after graduation.