Reakcija β-amino-α,γ-dicianokrotononitrila s acetofenonom: sinteza derivata piridina, piridazina i tiofena s antimikrobnim djelovanjem

Condensation of β-amino-α,γ-dicyanocrotononitrile (1) with acetophenone gave the 2-amino-4-phenylpenta-1,3-diene-1,1,3-tricarbonitrile (2). The latter product was used in a series of heterocyclization reactions when react with different reagents like diazonium salts, hydrazines, hydroxylamine and elemental sulfur to give pyridazine, pyrazole, isoxazole and thiophene derivatives, respectively. On the other hand, it gave pyridine derivatives with aromatic aldehydes followed by reaction with cyanomethylene reagents. The MIC values for the newly synthesized product were measured against E. coli, B. cereus, B. subtilis and C. albicansKondenzacijom β-amino-α,γ-dicijanokrotononitrila 1 s acetofenonom dobiven je 2-amino-4-fenilpenta-1,3-dien-1,1,3-trikarbonitril (2) koji je upotrebljen u reakcijama heterociklizacije s različitim reagensima poput diazonijevih soli, hidrazina, hidroksilamina i elementarnog sumpora pri čemu su nastali derivati piridazina, pirazola, izoksazola, odnosno tiofena. Spoj 2 je u reakciji s aromatskim aldehidima te naknadno sa cijanometilenima dao derivate piridina. Određene su MIC vrijednosti za novosintetizirane spojeve protiv E. coli, B. cereus, B. subtilis i C. albicans

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

Synthesis, Characterization, and Reactivity of PCN Pincer Nickel Complexes

New diamagnetic nickel(II) complexes based on an unsymmetrical (1-(3-((ditert-butylphosphino)methyl)phenyl)-N,N-dimethyl-methanamine) (PCN) pincer ligand were synthesized and characterized by 1H, 31P{1H}, and 13C{1H} NMR spectroscopy. Their molecular structures were confirmed by X-ray diffraction. Oxidation to high-valent paramagnetic Ni(III) dihalide complexes was achieved through straightforward reaction of the corresponding diamagnetic halide complexes with anhydrous CuX2 (X = Cl, Br). In agreement with this, the complexes are active in Kharasch addition of CCl4 to olefins. The reaction of the hydroxo complex (8) and the amido complex (11) with CO2 produced the hydrogen carbonate and carbamate complexes, respectively. The hydrogen carbonate complex was converted to the dinuclear nickel carbonate complex (10). The methyl (13), phenyl (14), and p-tolylacetylide (15) complexes are also described in the current study providing the first example of the hydrocarbyl nickel complexes based on an unsymmetric aromatic pincer ligand. Furthermore, the reactivity of the methyl complex toward different electrophiles has been investigated, showing that C-C bond formation is possible with aryl halides, whereas the reaction with CO2 is sluggish

Does the Use of a Checklist Help Medical Students in the Detection of Abnormalities on a Chest Radiograph?

The interpretation of chest radiographs is a complex task that is prone to diagnostic error, especially for medical students. The aim of this study is to investigate the extent to which medical students benefit from the use of a checklist regarding the detection of abnormalities on a chest radiograph. We developed a checklist based on literature and interviews with experienced thorax radiologists. Forty medical students in the clinical phase assessed 18 chest radiographs during a computer test, either with (n = 20) or without (n = 20) the checklist. We measured performance and asked participants for feedback using a survey. Participants that used a checklist detected more abnormalities on images with multiple abnormalities (M = 50.1%) than participants that could not use a checklist (M = 41.9%), p = 0.04. The post-experimental survey shows that on average, participants considered the checklist helpful (M = 3.25 on a five-point scale), but also time consuming (M = 3.30 on a five-point scale). In conclusion, a checklist can help medical students to detect abnormalities in chest radiographs. Moreover, students tend to appreciate the use of a checklist as a helpful tool during the interpretation of a chest radiograph. Therefore, a checklist is a potentially important tool to improve radiology education in the medical curriculum

Synthesis and characterisation of POCsp3OP supported Ni(II) hydroxo, hydroxycarbonyl and carbonate complexes

A nickel(II) hydroxo complex (3) supported by a cyclohexyl based POCsp3OP pincer ligand (POCsp3OP = cis-1,3-Bis-(di-tert-butylphosphinito)cyclohexyl) is reported. Complex 3 reacts with CO to form the corresponding hydroxycarbonyl complex, (POCsp3OP)NiCOOH (4). Complex 3 is also reactive towards CO2, forming a bicarbonate species (5) that under reduced pressure loses 1/2 eq. of H2O and CO2 to give a binuclear, bridged carbonate complex (6). All compounds were characterized in the solid state by X-ray diffraction