NMR Chemical Shifts of Trace Impurities: Common Laboratory Solvents, Organics, and Gases in Deuterated Solvents Relevant to the Organometallic Chemist

Tables of ^1H and ^(13)C NMR chemical shifts have been compiled for common organic compounds often used as reagents or found as products or contaminants in deuterated organic solvents. Building upon the work of Gottlieb, Kotlyar, and Nudelman in the Journal of Organic Chemistry, signals for common impurities are now reported in additional NMR solvents (tetrahydrofuran-d_8, toluene-d_8, dichloromethane-d_2, chlorobenzene-d_5, and 2,2,2-trifluoroethanol-d_3) which are frequently used in organometallic laboratories. Chemical shifts for other organics which are often used as reagents or internal standards or are found as products in organometallic chemistry are also reported for all the listed solvents

The impact of ozone depleting substances on the circulation, temperature, and salinity of the Southern Ocean: An attribution study with CESM1(WACCM)

Observations show robust changes in the circulation, temperature, and salinity of the Southern Ocean in recent decades. To what extent these changes are related to the formation of the ozone hole in the late twentieth century is an open question. Using a comprehensive chemistry-climate Earth system model, we contrast model runs with varying and with fixed surface concentrations of ozone depleting substances (ODS) from 1955 to 2005. In our model, ODS cause the majority of the summertime changes in surface wind stress which, in turn, induce a clear poleward shift of the ocean's meridional overturning circulation. In addition, more than 30% of the model changes in the temperature and salinity of the Southern Ocean are caused by ODS. These findings offer unambiguous evidence that increased concentrations of ODS in the late twentieth century are likely to have been been an important driver of changes in the Southern Ocean

Palbociclib with Letrozole in Postmenopausal Women with ER+/HER2- Advanced Breast Cancer: Hematologic Safety Analysis of the Randomized PALOMA-2 Trial.

BackgroundPALOMA-2 confirmed that first-line palbociclib + letrozole improved progression-free survival (hazard ratio, 0.58; 95% confidence interval, 0.46-0.72) in postmenopausal women with estrogen receptor-positive (ER+)/human epidermal growth factor receptor 2-negative (HER2-) advanced breast cancer (ABC). This analysis evaluated palbociclib-associated hematologic adverse events (AEs) and provides insight on managing these AEs.Materials and methodsPostmenopausal women with ER+/HER2- ABC were randomly assigned 2:1 to letrozole (2.5 mg daily continuously) plus oral palbociclib (125 mg daily; 3 weeks on/1 week off) or placebo. Safety assessments were performed at baseline, days 1 and 15 (first two cycles) and day 1 of subsequent cycles, and included white blood cell, platelet, and absolute neutrophil count (ANC).ResultsPALOMA-2 randomized 666 women to palbociclib + letrozole (n = 444) or placebo + letrozole (n = 222). Neutropenia was the most common AE (95.3%) with palbociclib (grade 3, 55.6%; grade 4, 11.5%) and was managed by dose modifications; progression-free survival was similar between patients who experienced grade ≥ 3 neutropenia versus those who did not. Median (range) time to onset of neutropenia with palbociclib + letrozole was 15 (12-700) days (grade ≥ 3, 28.0 [12-854] days); median duration of each neutropenia episode grade ≥ 3 was 7.0 days. Asian ethnicity and low baseline ANC were associated with increased risk of grade 3/4 neutropenia with palbociclib (p < .001).ConclusionPalbociclib + letrozole was generally well tolerated. Neutropenia, the most frequently reported AE in women with ER+/HER2- ABC, was mostly transient and manageable by dose modifications in patients who experienced grade ≥ 3 neutropenia, without appearing to compromise efficacy. (Pfizer; NCT01740427) IMPLICATIONS FOR PRACTICE: Palbociclib demonstrated an acceptable safety profile in PALOMA-2 in women with estrogen receptor-positive (ER+)/human epidermal growth factor receptor 2-negative (HER2-) advanced breast cancer (ABC) receiving first-line palbociclib + letrozole. Although hematologic adverse events (AEs) are typically expected with anticancer therapies and are often clinically significant, palbociclib-related hematologic AEs, particularly neutropenia (most frequent AE), were transient/manageable by dose reduction, interruption, or cycle delay, which is in contrast to the more profound neutropenia associated with chemotherapy. Palbociclib dose adjustments decreased hematologic AE severity without appearing to compromise efficacy, supporting palbociclib + letrozole as a first-line treatment for ER+/HER2- ABC

Asociación del nivel de afrontamiento y las prácticas de autocuidado del adulto con pie diabético del Hospital Belén de Trujillo 2018

La presente investigación de tipo descriptivo- correlacional de corte transversal, se realizó con la finalidad de determinar la asociación del nivel de afrontamiento y las prácticas de autocuidado del adulto con pie diabético del Hospital Belén de Trujillo 2018. La muestra estuvo conformada por 20 pacientes con pie diabético a quienes se les aplicó un instrumento que estuvo conformado por 3 partes : la primera con datos generales, la segunda para identificar el nivel de afrontamiento del adulto con pie diabético y la tercera para identificar el nivel de prácticas de autocuidado, encontrándose que el 75% de pacientes corresponden a la categoría de adulto intermedio y el 65% de pacientes corresponden al género masculino. Asi mismo, el nivel de afrontamiento del adulto con pie diabético fue bajo en un 55 %. medio en un 40 % y alto en sólo el 5 %. En relación a las prácticas de autocuidado del adulto con pie diabético, el 75 % tuvo nivel bajo de autocuidado , el 25% medio y 0% bajo. En conclusión se aprecia que la prueba estadística de Chi-cuadrado tiene un valor de 9.633. Con un p-valor de significancia de 0.000 (p<0.05), por lo tanto existe asociación del nivel de afrontamiento y las prácticas de autocuidado del adulto con pie diabético.The present descriptive-correlational cross-sectional investigation was carried out with the purpose of determining the association of the level of coping and the self-care practices of the adult with diabetic foot of the Bethlehem Hospital of Trujillo 2018. The sample consisted of 20 patients with diabetic foot to whom an instrument was applied that consisted of 3 parts: the first with general data, the second to identify the level of coping with the adult with diabetic foot and the third to identify the level of self-care practices, finding that the 75% of patients correspond to the intermediate adult category and 65% of patients correspond to the male gender. It was also found that the level of coping of the adult with diabetic foot was low by 55%. medium by 40% and high by only 5%. In relation to self-care practices of the adult with diabetic foot, 75% had low level of self-care, 25% medium and 0% low. In conclusion, it can be seen that the Chi-square statistical test has a value of 9,633. With a p-value of significance of 0.000 (p <0.05), therefore, there is an association between the level of coping and the self-care practices of the adult with diabetic foot.Tesi

Property Rights and Social Norms for Managing the Commons

In many of the developing countries, dependency on natural resources is significantly high. From peasants to fishermen and farmers, all of them earn their living from the utility of renewable natural resources such as water, air, farming land, forest, plants, animals and grazing areas (Heltberg, 2002). Given the importance of natural resources for many of the developing countries, it is important to address the issues like the tragedy of the commons, climatic change, pollution, and unsustainable usage of natural resources which might lead to rural poverty, food insecurity, and high rural-urban migration (Heltberg, 2002). Among the major factors mentioned above, this essay will focus on tragedy of the commons, property rights, and natural resource management in developing countries

Long-Term Ranibizumab Treatment in Neovascular Age-Related Macular Degeneration: A Belgian Subanalysis from the Global Real-World LUMINOUS TM Study

To evaluate long-term, real-world treatment patterns and outcomes of ranibizumab 0.5 mg for neovascular age-related macular degeneration (nAMD) in a Belgian cohort.; This Belgian (BE) cohort of the 5-year global observational LUMINOUS study included 229 patients with nAMD. Outcomes included visual acuity (VA), central retinal thickness (CRT) and safety.; The mean age was 79.5±7.7 years. The majority of patients (67.7%) were female and all patients were Caucasian. Most patients previously received ranibizumab with only 17.5% of patients being treatment-naïve. The injection frequency declined over time irrespective of prior treatment status (p<0.0001), with treatment-naïve eyes receiving a mean of 4.2±2.9 yearly injections and prior-ranibizumab eyes 3.6±2.7. Regression analysis confirmed first-year VA increases for treatment-naïve eyes (p=0.002) followed by a slight decrease of -1.8 letters per year. For prior-ranibizumab eyes, the visual changes over 1 year were statistically non-significant (p=0.90) but declined slightly after year one (p<0.0001). Anatomically, the CRT of treatment-naïve eyes decreased over time from baseline (p<0.0001), whereas the CRT of prior-ranibizumab eyes remained stable (p=0.43). No new safety findings were identified.; LUMINOUS-BE reconfirms the well-characterized benefit-risk profile of ranibizumab for nAMD treatment. The observed low injection frequency reflects a need for more rigorous treatment in real-world settings.; NCT01318941

Species richness, vegetation structure, and floristic composition of woody plants along the elevation gradient of Mt. Meru, Tanzania

Understanding the change in vegetation composition along elevational gradients is critical for species conservation in a changing world. We studied the species richness, tree height, and floristic composition of woody plants along an elevation gradient of protected habitats on the eastern slope of Mount Meru and analyzed how these vegetation variables are influenced by the interplay of temperature and precipitation. Vegetation data were collected on 44 plots systematically placed along five transects spanning an elevational gradient of 1600 to 3400 m a.s.l. We used ordinary linear models and multivariate analyses to test the effect of mean annual temperature and precipitation on woody plant species richness, tree height, and floristic composition. We found that species richness, mean tree height, and maximum tree height declined monotonically with elevation. Models that included only mean annual temperature as an explanatory variable were generally best supported to predict changes in species richness and tree height along the elevation gradient. We found significant changes in woody plant floristic composition with elevation, which were shaped by an interaction of mean annual temperature and precipitation. While plant communities consistently changed with temperature along the elevation gradient, levels of precipitation were more important for plant communities at lower than for those at higher elevations. Our study suggests that changes in temperature and precipitation regimes in the course of climate change will reshape elevational gradients of diversity, tree height, and correlated carbon storage in ecosystems, and the sequence of tree communities on East African mountains.publishedVersio

Teamwork and Collaboration: Integration of Interprofessional Education across Pharmacy and Nursing Curricula

In this 30 minute presentation, presenters articulated the evidence and need for interprofessional education supporting teamwork and collaboration. Strategies for integrating Interprofessional Education in curricula were discussed. Finally, challenges and lessons learned in implementing IPE across the curricula were described by presenting faculty