Variation in postoperative outcomes of patients with intracranial tumors: insights from a prospective international cohort study during the COVID-19 pandemic

Background: This study assessed the international variation in surgical neuro-oncology practice and 30-day outcomes of patients who had surgery for an intracranial tumor during the COVID-19 pandemic. Methods: We prospectively included adults aged ≥18 years who underwent surgery for a malignant or benign intracranial tumor across 55 international hospitals from 26 countries. Each participating hospital recorded cases for 3 consecutive months from the start of the pandemic. We categorized patients’ location by World Bank income groups (high [HIC], upper-middle [UMIC], and low- and lower-middle [LLMIC]). Main outcomes were a change from routine management, SARS-CoV-2 infection, and 30-day mortality. We used a Bayesian multilevel logistic regression stratified by hospitals and adjusted for key confounders to estimate the association between income groups and mortality. Results: Among 1016 patients, the number of patients in each income group was 765 (75.3%) in HIC, 142 (14.0%) in UMIC, and 109 (10.7%) in LLMIC. The management of 200 (19.8%) patients changed from usual care, most commonly delayed surgery. Within 30 days after surgery, 14 (1.4%) patients had a COVID-19 diagnosis and 39 (3.8%) patients died. In the multivariable model, LLMIC was associated with increased mortality (odds ratio 2.83, 95% credible interval 1.37–5.74) compared to HIC. Conclusions: The first wave of the pandemic had a significant impact on surgical decision-making. While the incidence of SARS-CoV-2 infection within 30 days after surgery was low, there was a disparity in mortality between countries and this warrants further examination to identify any modifiable factors

Metal- and Oxidant-Free Modular Approach To Access <i>N</i>‑Alkoxy Oxindoles via Aryne Annulation

An unprecedented metal- and oxidant-free (intermolecular) approach to access <i>N</i>-alkoxy oxindoles via [3 + 2] cycloadition of <i>in situ</i> generated electrophilic species <i>viz</i>. aryne and (putative) aza-oxyallyl cation is reported. This approach is amenable to both C3-unsubstituted as well as C3-substituted oxindoles. A one-pot manipulation further makes this reaction highly practical. The versatility of this approach was demonstrated through valuable synthetic transformations

Phosphane-catalyzed Knoevenagel condensation: a facile synthesis of α-cyanoacrylates and α-cyanoacrylonitriles

Triphenylphosphane (TPP) has been utilized as a novel and efficient catalyst for the Knoevenagel condensation of aldehydes with acidic methylene compounds such as ethyl cyanoacetate and malononitrile to afford substituted olefins. The reaction proceeds smoothly under mild and solvent-free conditions and the products are obtained in excellent yields with an E-geometry. This method is applicable for a wide range of aldehydes including aromatic, aliphatic and heterocyclic substrates. Microwave irradiation has been used to achieve enhanced reaction rates and improved yields

Utilization of maternal health services by the migrant population living in the non-notified slums of Hyderabad city, India

Background: Despite increase in accessibility and utilization of maternal health services in the state of Telangana, penetration of these services in vulnerable communities is inadequate. Aims & Objectives: To understand the determinants of utilization of reproductive health services by migrant population living in non-notified slums of Hyderabad city in the Indian state of Telangana. Material & Methods: It is a community based cross sectional study of 761 rural to urban internal migrant mothers with a child of less than 2 years of age residing for a period minimum of 30 days and not more than 10 years. Information was collected for socio demographic details, antenatal care and child delivery. Results: Mothers receiving at least 4 antenatal care visits and institutional deliveries in migrants was 69.6% and 69% respectively, compared to 85.8% and 97% in general population of Hyderabad city. The likelihood of mothers receiving adequate care is 6.7 times higher in mothers with secondary education compared to formal education. The likelihood of institutional delivery is 7.8 times higher in mothers availing adequate antenatal care versus inadequate care and 2.2 times higher in mothers with secondary education versus formal education. Conclusion: Utilization of antenatal care services and promotion of institutional deliveries can be improved by acting on the supply side barriers such as health care infrastructure and demand side barriers such as indirect consumer costs, financial constraints and community engagemen

Operational and Instrumentation Aspects of XRD

X-ray Diffraction (XRD) is an important tool to determine the crystallographic properties of materials. The instrumental and operational aspects has been dealt in this communication while XRD of Al  and TiO2 powder with focus on scan speed, Δ2, dwell second, Kβ filter and mode of operation: coupled and decoupled -2 mode

Green protocol for the Biginelli three-component reaction: Ag<SUB>3</SUB>PW<SUB>12</SUB>O<SUB>40</SUB> as a novel, water-tolerant heteropolyacid for the synthesis of 3,4-dihydropyrimidinones

Biginelli three-component condensation of an aldehyde, β-keto ester, and urea proceeds smoothly on the surface of the silver salt of heteropolyacid (HPA), i.e. Ag<SUB>3</SUB>PW<SUB>12</SUB>O<SUB>40</SUB>, in water to afford the corresponding 3,4-dihydropyrimidinones in high-to-quantitative yields under mild conditions. The heterogeneous solid acid provides ease of separation of the catalyst and isolation of the products. The recovered catalyst can be recycled in subsequent reactions with consistent activity. Compared to the classical Biginelli reaction conditions, this new method has the advantages of improved yields, reusability of the catalyst, an eco-friendly solvent, ease of isolation of products, and simplicity in the experimental procedure