Oral Health and nutritional status in nursing home residents-results of an explorative cross-sectional pilot study.

BACKGROUND: This study was performed to assess oral and nutritional status of nursing home residents in a region of Lower Saxony, Germany. The aim was to show potential associations between oral status (dentate or edentulous), further anamnestic factors (dementia, age, smoking) and the risk for malnutrition in this population. METHODS: In this observational cross-sectional pilot study of residents from four nursing homes Mini Nutritional Assessment (MNA), Body-Mass-Index (BMI), dental status (DMF-T) and periodontal situation (PSR®/PSI) were recorded. Associations of recorded factors with oral health and nutritional status were examined in univariate and multivariate analysis. RESULTS: Eighty-seven residents participated in the study (mean age: 84.1 years; female: 72%, demented: 47%). Average BMI was 26.2 kg/m2; according MNA 52% were at risk for malnutrition. 48% of the residents were edentulous, and the average DMF-T of dentulous was 25.0 (3.7) (D-T: 2.0 [3.1], M-T: 15.0 [8.3], F-T: 8.0 [7.4]); PSR®/PSI 3 and 4 (need for periodontal treatment) showed 79% of residents. In univariate analysis dementia (OR 2.5 CI95 1.1-5.6) but not being edentulous (OR 2.0 CI95 0.8-5.8) were associated with being at risk for malnutrition. Dementia remained associated in multivariate analysis adjusting for age and sex, (OR 3.1 CI95 1.2-8.2) and additionally being edentulous (OR 2.8 CI95 1.1-7.3) became associated significantly. Furthermore, nursing home residents with dementia had more remaining teeth (OR 2.5 CI95 1.1-5.9). CONCLUSION: Dementia was a stronger predictor for risk of malnutrition in nursing home residents than being edentulous. Further studies to elucidate the possible role of oral health as cofactor for malnutrition in dementia are needed.

What Do Physician Assistant Students Know About Nutrition? A Survey of Attitudes, Self-Perceived Proficiency, and Knowledge During Three Stages of Physician Assistant Education.

PURPOSE: This study applied a cross-sectional design and analyzed the nutrition knowledge and attitudes of physician assistant (PA) students during 3 stages of PA education. METHODS: The PA students from the class of 2014, 2015, and 2016 attending a midwestern university were surveyed using Qualtrics. Descriptive statistics and analysis of variance tests were performed to determine the difference between the 3 cohorts on "previous nutrition knowledge," "attitudes," and "knowledge" subscores and total scores. A post hoc analysis was performed to determine the differences between groups. RESULTS: A statistically significant difference was found in the mean total score between classes, with the class of 2014 scoring 17 points higher on average than the class of 2016. CONCLUSION: These results suggest that positive nutrition attitudes and knowledge among PA students from this sample were lacking. This study suggests a possible need for revision of nutrition education provided by PA programs.

Interactions of Isonitriles with Metal-Boron Bonds: Insertions, Coupling, Ring Formation, and Liberation of Monovalent Boron.

Boryl, borylene, and base-stabilized borylene complexes of manganese and iron undergo a range of different reactions when treated with isonitriles including single, double, and partial isonitrile insertions into metal-boron bonds, ring formation, isonitrile coupling, and the liberation of new monovalent boron species. Two of the resulting cyclic species have also been found to react selectively with anhydrous HCl to form ring-opened products. The diverse isonitrile-promoted reactivity of transition-metal-boron compounds has been explored computationally.

Trimetallaborides as starting points for the syntheses of large metal-rich molecular borides and clusters.

Treatment of an anionic dimanganaborylene complex ([{Cp(CO)2Mn}2B]-) with coinage metal cations stabilized by a very weakly coordinating Lewis base (SMe2) led to the coordination of the incoming metal and subsequent displacement of dimethylsulfide in the formation of hexametalladiborides featuring planar four-membered M2B2 cores (M = Cu, Au) comparable to transition metal clusters constructed around four-membered rings composed solely of coinage metals. The analogies between compounds consisting of B2M2 units and M4 (M = Cu, Au) units speak to the often overlooked metalloid nature of boron. Treatment of one of these compounds (M = Cu) with a Lewis-basic metal fragment (Pt(PCy3)2) led to the formation of a tetrametallaboride featuring two manganese, one copper and one platinum atom, all bound to boron in a geometry not yet seen for this kind of compound. Computational examination suggests that this geometry is the result of d10-d10 dispersion interactions between the copper and platinum fragments.

Activation of boryl-, borylene and metalloborylene complexes by isonitriles.

The reactions of isonitriles with a variety of metalloboryl and metalloborylene species are shown to yield a range of products, none of which display the typical Lewis acid-base reactivity previously observed between such metal complexes and other Lewis bases. Insertions of one, or several, isonitriles into the metal-boron bond give cyclic and spiro compounds with bonding controlled by the electron count at the metal and in the ring.

Organometallic Probe for the Electronics of Base-Stabilized Group†11 Metal Cations.

A number of trimetalloborides have been synthesized through the reactions of base-stabilized coinage metal chlorides with a dimanganaborylene lithium salt in the hope of using this organometallic platform to compare and evaluate the electronics of these popular coinage metal fragments. The adducts of Cu(I), Ag(I), and Au(I) ions, stabilized by tricyclohexylphosphine (PCy3), N-1,3-bis(4-methylphenyl)imidazol-2-ylidene (ITol), or 1-(2,6-diisopropylphenyl)-3,3,5,5-tetramethylpyrrolidin-2-ylidene (CAAC), with [{Cp(CO)2Mn}2B](-) were studied spectroscopically, structurally, and computationally. The geometries of the adducts fall into two classes, one symmetric and one asymmetric, each relying on the combined characteristics of both the metal and ligand. The energetic factors proposed as the causes of the structural differences were investigated by ETS-NOCV (extended transition state-natural orbitals for chemical valence) analysis, which showed the final geometry to be controlled by the competition between the tendency of the coinage metal to adopt a higher or lower coordination number and the willingness of the cationic fragment to participate in back-bonding interactions.

Synthesis and characterization of a mercury-containing trimetalloboride.

The reaction of phenylmercuric chloride with an anionic dimanganese borylene (Li(+)[Cp2(CO)4Mn2B](-)) led to the formation of a trimetalloboride featuring the first reported bond between mercury and a non-cluster boron atom. Examination by (199)Hg NMR indicated (11)B-(199)Hg scalar coupling. Theoretical calculations indicated the nature of bonding to be σ-donation from a B-Mn π-orbital to Hg, in conjunction with weak Hgd→π* back-donation.

Current concepts on integrative safety assessment of active substances of botanical, mineral or chemical origin in homeopathic medicinal products within the European regulatory framework.

For active substances of botanical, mineral or chemical origin processed in homeopathic medicinal products for human use, the adequate safety principles as with other human medicinal products are applied in line with the European regulatory framework. In homeopathy, nonclinical safety assessment is facing a particular challenge because of a multitude and diversity of source materials used and due to rarely available toxicological data. Thus, current concepts applied by the national regulatory authority in Germany (BfArM) on integrative safety assessment of raw materials used in homeopathic medicinal products involve several evaluation approaches like the use of the Lowest Human Recommended Dose (LHRD), toxicological limit values, Threshold of Toxicological Concern (TTC), data from food regulation or the consideration of unavoidable environmental or dietary background exposure. This publication is intended to further develop and clarify the practical use of these assessment routes by exemplary application on selected homeopathic preparations. In conclusion, the different approaches are considered a very useful scientific and simultaneously pragmatic procedure in differentiated risk assessment of homeopathic medicinal products. Overall, this paper aims to increase the visibility of the safety issues in homeopathy and to stimulate scientific discussion of worldwide existing regulatory concepts on homeopathic medicinal products.

Quaternizing diboranes(4): highly divergent outcomes and an inorganic Wagner-Meerwein rearrangement.

Apart from a few compounds under heavy use in organic chemistry, diboranes are relatively exotic and poorly understood. Recently, interest in these molecules has intensified with the advent of so-called "sp(2)-sp(3)" diboranes which exhibit useful reactivity toward organic substrates. In our hands, addition of Lewis bases to dihalodiorganyl diboranes(4) has previously shown some very surprising reactivity, including a substituent exchange between the boron atoms, and diboranes in which halide atoms bridge the B-B bond. Herein we have expanded the range of diborane(4) and Lewis base reaction partners, in the process uncovering three new reactivity patterns as well as some cases where mixtures are obtained. Trends are established for the preferential formation of certain products which rationalize the results based on electronic and steric effects. The substituent exchange, clearly based on an inorganic version of the well-known Wagner-Meerwein rearrangement, was also found to be an equilibrium reaction with the halide-bridged Lewis adducts on the other side.