Evaluating the impact of the community-based health planning and services initiative on uptake of skilled birth care in Ghana

Background: the Community-based Health Planning and Services (CHPS) initiative is a major government policy to improve maternal and child health and accelerate progress in the reduction of maternal mortality in Ghana. However, strategic intelligence on the impact of the initiative is lacking, given the persistent ?problems of patchy geographical access to care for rural women. This study investigates the impact of proximity to CHPS on facilitating uptake of skilled ?birth care in rural areas.Methods and findings: data from the ?2003 and 2008 Demographic and Health Survey, ? on 4,349 births from 463 rural communities were linked to georeferenced data on health facilities, CHPS and topographic data on national road-networks. Distance to nearest health facility and CHPS was computed using the closest facility functionality in ArcGIS 10.1. Multilevel logistic regression was used to examine the effect of proximity to health facilities and CHPS on use of skilled care at birth, adjusting for relevant predictors and clustering within ?communities.? The results show that a substantial proportion of births continue to occur in communities more than 8 km from both ?health facilities and CHPS. Increases in uptake of skilled birth care are more pronounced where both health ?facilities and CHPS compounds are within 8 km, but not in communities within 8 km of CHPS but lack access to health facilities. Where both health facilities and CHPS are within 8 km, the odds of skilled ?birth care is 16% higher than ?where there is only a health facility within 8km. Conclusion: where CHPS compounds are set up near health facilities, there is improved access to care, demonstrating the facilitatory role of CHPS in stimulating access to better care at birth, in areas where health facilities are accessible. <br/

Autonomic dysfunction in progressive supranuclear palsy

Background: The degree of involvement of the autonomic nervous system in progressive supranuclear palsy (PSP) has been investigated in several studies, often providing conflicting results. There is a need for a better characterization of autonomic dysfunction in PSP, to enhance our understanding of this highly disabling neurodegenerative disease including patients’ needs and possibly be of value for clinicians in the differential diagnosis among Parkinsonian syndromes. Methods: We applied a systematic methodology to review existing literature on Pubmed regarding autonomic nervous system involvement in PSP. Results: PSP reported quite frequently symptoms suggestive of autonomic dysfunction in all domains. Cardiovascular autonomic testing showed in some cases a certain degree of impairment (never severe). There was some evidence suggesting bladder dysfunction particularly in the storage phase. Dysphagia and constipation were the most common gastrointestinal symptoms. Instrumental tests seemed to confirm sudomotor and pupillomotor disturbances. Conclusions: PSP patients frequently reported visceral symptoms, however objective testing showed that not always these reflected actual autonomic impairment. Further studies are needed to better delineate autonomic profile and its prognostic role in PSP

Organocatalysis and beyond: Activating reactions with two catalytic species

Since the beginning of the millennium, organocatalysis has been gaining a predominant role in asymmetric synthesis and it is, nowadays, a foundation of catalysis. Synergistic catalysis, combining two or more different catalytic cycles acting in concert, exploits the vast knowledge acquired in organocatalysis and other fields to perform reactions that would be otherwise impossible. Merging organocatalysis with photo-, metallo- and organocatalysis itself, researchers have ingeniously devised a range of activations. This feature review, focusing on selected synergistic catalytic approaches, aims to provide a flavor of the creativity and innovation in the area, showing ground-breaking examples of organocatalysts, such as proline derivatives, hydrogen bond-mediated, Cinchona alkaloids or phosphoric acids catalysts, which work cooperatively with different catalytic partners

Asymmetric Organocatalysis Accelerated via Self-Assembled Minimal Structures

Self-assembling minimalistic peptides embedded with an organocatalytic moiety were designed. By controlling the formation of fibrils via external intervention, it was shown that the activation is accelerated when the organocatalyst is in its supramolecular state. The effect of the accelerated catalysis was demonstrated in a Michael benchmark reaction

Stereoisomeric Homo- and Hetero-Binuclear Iridium(III) Complexes with 3-Oxidopicolinate Bridging Ligand and Their Application in OLEDs

The small and simple 3-hydroxypyridine-2-carboxylic acid (Hpic-OH) is explored as asymmetric bridging ligand for the synthesis of neutral binuclear cyclometalated iridium(III) complexes. Once fully deprotonated the picO2– ligand can act as ancillary ligand toward two iridium centers adopting both the N^O– and O^O– chelation modes. To tune the energy of the excited states within such binuclear complexes, the 2-(2,4-difluorophenyl)pyridine (Hdfppy) and the 2-phenylbenzothiazole (Hpbtz) are used as cyclometalating ligands to respectively obtain both blue- or orange-emissive homo-cyclometalated complexes (BB and YY, with formula [Ir(dfppy)2]2(picO) and [Ir(pbtz)2]2(picO), respectively). Moreover, for the first time, short-bridged hetero-cyclometalated binuclear complexes are also obtained (BY and YB, with formula [Ir(dfppy)2](picO)[Ir(pbtz)2] and [Ir(pbtz)2](picO)[Ir(dfppy)2]). Depending on the reciprocal arrangement of the cyclometalating ligands on the two sides of the small picolinate bridge, two couples of diastereoisomers are obtained and efficiently separated, as proved by combined NMR and DFT studies. The reported binuclear complexes are highly emissive with photoluminescence quantum yields (PLQYs) up to 67%, which are comparable to those of their mononuclear analogues (B and Y). Due to the full reversibility of their redox processes, all the complexes are also tested in solution-processed organic light-emitting diodes, providing unique OLEDs based on hetero-binuclear cyclometalated iridium(III) complexe

Unexpected reactivity of cyclometalated iridium(iii) dimers. Direct synthesis of a mononuclear luminescent complex

A new synthetic method has been developed for the preparation of unexpected emissive iridium(III) complexes (A and B), directly obtained from the established [Ir(ppy)2(μ-Cl)]2 dimer, under reaction conditions in which such compounds are usually considered stable. Complex A ([Ir(ppy)2(Oppy)], where Hppy = 2-phenylpyridine and HOppy = 2-(o-hydroxyphenyl)pyridine) was obtained from the dimer without the addition of further ancillary ligands in the reaction environment, but in the presence of a basic water environment in 2-ethoxyethanol as solvent at 165 °C. The complex evidences the unexpected insertion of an oxygen atom between the iridium(III) center and the carbon atom of one ppy moiety. Under specific reaction conditions, the mer-[Ir(ppy)3] complex (B) was obtained. The presence of the right amount of water is important to maximize the formation of A relative to B. Both compounds were fully characterized by NMR spectroscopy and mass spectrometry (MS), and the X-ray structure of A was also determined. DFT calculations were used to shed light on the reaction mechanism leading to the unexpected formation of A, suggesting that the Oppy ligand is generated intramolecularly once the [Ir(ppy)2(μ-OH)]2 dimer is formed. The process is probably assisted by a redox reaction involving the second iridium(III) center in the dimer. The electrochemical and photophysical properties of complexes A and B were investigated in comparison with the well-known fac-[Ir(ppy)3] analogue (C). Complex A displays a green emission (λmax = 545 nm) with a photoluminescence quantum yield (PLQY) of nearly 40%, whereas the oxygen-free counterpart B is poorly emissive, exhibiting an orange emission (λmax = 605 nm) with a PLQY below 10%. These findings may pave the way for the direct synthesis of neutral luminescent complexes with the general formula [Ir(C^N)2(OC^N)], even using dimers with non-commercial or highly substituted C^N ligands, without the need for synthesizing the corresponding hydroxyl-substituted ancillary ligand, which may be hardly obtainable

4-Phenyl-1,2,3-triazoles as Versatile Ligands for Cationic Cyclometalated Iridium(III) Complexes

Five cationic iridium(III) complexes (1-5) were synthesized exploiting two triazole-based cyclometalating ligands, namely, 1-methyl-4-phenyl-1H-1,2,3-triazole (A) and the corresponding mesoionic carbene 1,3-dimethyl-4-phenyl-1H-1,2,3-triazol-5-yliclene (B). From the combination of these two ligands and the ancillary one, i.e., 4,4'-di-tert-butyl-2,2'-bipyridine (for 1-3) or tert-butyl isocyanide (for 4 and 5), not only the typical bis-heteroleptic complexes but also the much less explored tris-heteroleptic analogues (2 and 5) could be synthesized. The redox and emission properties of all of the complexes are effectively fine-tuned by the different ligands: (i) cyclometalating ligand A induces a stronger highest occupied molecular orbital (HOMO) stabilization compared to B and leads to complexes with progressively narrower HOMO-lowest unoccupied molecular orbital (LUMO) and redox gaps, and lower emission energy; (ii) complexes 1-3, equipped with the bipyridine ancillary ligand, display fully reversible redox processes and emit from predominantly metal-to-ligand charge transfer (MLCT) states with high emission quantum yields, up to 60% in polymeric matrix; (iii) complexes 4 and 5, equipped with high-field isocyanide ligands, display irreversible redox processes and high-energy emission from strongly ligand-centered triplets with long emission lifetimes but relatively low quantum yields (below 6%, both in room-temperature solution and in solid state). This work demonstrates the versatility of phenyl-triazole derivatives as cyclometalating ligands with different chelation modes (i.e., C&lt;^&gt;N and C&lt;^&gt;C:) for the synthesis of photoactive iridium(III) complexes with highly tunable properties

Autonomic dysfunction in progressive supranuclear palsy.

BACKGROUND: The degree of involvement of the autonomic nervous system in progressive supranuclear palsy (PSP) has been investigated in several studies, often providing conflicting results. There is a need for a better characterization of autonomic dysfunction in PSP, to enhance our understanding of this highly disabling neurodegenerative disease including patients' needs and possibly be of value for clinicians in the differential diagnosis among Parkinsonian syndromes. METHODS: We applied a systematic methodology to review existing literature on Pubmed regarding autonomic nervous system involvement in PSP. RESULTS: PSP reported quite frequently symptoms suggestive of autonomic dysfunction in all domains. Cardiovascular autonomic testing showed in some cases a certain degree of impairment (never severe). There was some evidence suggesting bladder dysfunction particularly in the storage phase. Dysphagia and constipation were the most common gastrointestinal symptoms. Instrumental tests seemed to confirm sudomotor and pupillomotor disturbances. CONCLUSIONS: PSP patients frequently reported visceral symptoms, however objective testing showed that not always these reflected actual autonomic impairment. Further studies are needed to better delineate autonomic profile and its prognostic role in PSP

Processing and structural properties of random oriented lead lanthanum zirconate titanate thin films

Polycrystalline lead lanthanum zirconate titanate (PLZT) thin films have been prepared by a polymeric chemical route to understand the mechanisms of phase transformations and map the microstructure and elastic properties at the nanoscale in these films. X-ray diffraction, atomic force microscopy (AFM) and ultrasonic force microscopy (UFM) have been used as investigative tools. On one side, PLZT films with mixed-phase show that the pyrochlore phase crystallizes predominantly in the bottom film-electrode interface while a pure perovskite phase crystallizes in top film surface. On the contrary, pyrochlore-free PLZT films show a non-uniform microstrain and crystallite size along the film thickness with a heterogeneous complex grainy structure leading to different elastic properties at nanoscale

Pro-aromatic Natural Terpenes as Unusual “Slingshot” Antioxidants with Promising Ferroptosis Inhibition Activity

Ferroptosis is a cell death mechanism based on extensive cellular membrane peroxidation, implicated in neurodegenerative and other diseases. The essential oil component gamma-terpinene, a natural monoterpene with a unique highly oxidizable pro-aromatic 1,4-cyclohexadiene skeleton, inhibits peroxidation of polyunsaturated lipid in model heterogeneous systems (micelles and liposomes). Upon H-atom abstraction, an unstable gamma-terpinene-derived peroxyl radical is formed, that aromatizes to p-cymene generating HOO &amp; sdot; radicals. As HOO &amp; sdot; are small and hydrophilic radicals, they quickly diffuse outside the lipid core, blocking the radical chain propagation of polyunsaturated lipids. This unprecedented antioxidant "slingshot" mechanism explains why gamma-terpinene shows a protective activity against ferroptosis, being effective at submicromolar concentrations in human neuroblastoma (SH-SY5Y) cells