(2RS,4′RS)-3′-(3-Chloro-4-meth­oxy­phen­yl)-4′-phenyl-4′H-spiro­[indene-2,5′-isoxazol]-1(3H)-one ethanol monosolvate

The title compound, C23H17ClN2O3·C2H6O, is the stoichiometric 1:1 ethanol solvate of a racemic reaction product, which forms a conglomerate. The refined Flack parameter of 0.36 (3) indicates racemic twinning. In the structure, mol­ecules are linked into zigzag chains by a series of inter­molecular N—H⋯O and O—H⋯O hydrogen bonds

3′-(4-Meth­oxy­phen­yl)-4′-phenyl-3H,4′H-spiro­[1-benzothio­phene-2,5′-isoxazol]-3-one

In the title compound, C23H17NO3S, the thio­phene and isoxazole rings each have an envelope conformation with the spiro C atom linking them forming the flap of the envelope in each case. The dihedral angle between the mean planes of the benzothio­phene ring and isoxazole rings is 81.35 (7)°. In the crystal, an inter­molecular C—H⋯O hydrogen bond links the mol­ecules into a chain running parallel to the a axis

Ethyl 2-amino-4-(3-nitrophenyl)-4H-1-benzothieno[3,2-b]pyran-3-carboxylate

The molecule of the title compound, C20H16N2O5S, is built up by one fused five-membered and two fused six-membered rings linked to ethoxycarbonyl and 3-nitrophenyl groups. The benzothienopyran ring system is nearly planar (r.m.s deviation = 0.0392 Å) and forms a dihedral angle of 86.90 (6)° with the aromatic ring of the nitrobenzene group. In the crystal, molecules are linked by N—H...O hydrogen bonds and by π–π interactions between the phenyl ring and the six-membered heterocyle [intercentroid distance = 3.5819 (8) Å], forming a three-dimensional network

3′-(4-Chlorophenyl)-4′-phenyl-3H,4′H-spiro[benzo[b]thiophene-2,5′-isoxazol]-3-one

The molecule of the title compound, C22H14ClNO2S, is built up from an isoxazole ring linked to a benzothiophene ring system with additional phenyl and 4-chlorophenyl substituents. The benzothiophene system is virtually planar with the largest deviation from the mean plane being 0.041 (2) Å, while the isoxazole ring adopts an envelope conformation. The plane of the benzothiophene ring system is almost perpendicular to those of the phenyl and the 4-chlorophenyl rings, with dihedral angles of 64.76 (10) and 82.81 (10)°, respectively, between them. The phenyl ring is inclined by 85.76 (12)° to the plane of the 4-chlorophenyl ring, which in turn lies close to the plane of the isoxazole ring. In the crystal, molecules are linked by weak C—H...O hydrogen bonds and offset π–π interactions between the aromatic rings of adjacent benzothiophene ring systems. These combine to form a three-dimensional network structure

3′,4′-Diphenyl-3H,4′H-spiro[benzo[b]thiophene-2,5′-isoxazol]-3-one

The molecule of the title compound, C22H15NO2S, is built up from a benzothiophene system linked to an isoxazoline ring which is connected to two phenyl rings. The benzothiophene system is essentially planar, while the isoxazoline ring displays an envelope conformation with the spiro C atom as the flap. The mean plane through the isoxazoline ring is slightly inclined to one phenyl ring by 5.74 (13)° and is approximately perpendicular [86.10 (10)°] to the fused ring system and to the other phenyl ring [84.31 (12)°]. In the crystal, molecules are linked together by C—H...O hydrogen bonds and by π–π interactions between the fused ring systems [intercentroid distance = 3.702 (2) Å], forming a three-dimensional network

Crystal structure of 3,4′-diphenyl-3′-p-tolyl-4′H-spiro[indan-2,5′-[1,2]oxazol]-1-one

In the title compound, C30H23NO2, the five-membered rings are both in envelope conformations with the same spiro C atom as the flap. The benzene ring and the two phenyl rings are inclined to the mean plane of the indene ring system by 83.98 (8), 81.46 (8) and 72.31 (7)°. In the crystal, molecules are linked by pairs of C—H...O hydrogen bonds into inversion dimers. The dimers are further connected by C—H...N interactions, forming layers parallel to (10-1)

2-Methyl-3′-(4-methylphenyl)-4′-(2-nitrophenyl)-4′H-spiro[chroman-3,5′-isoxazol]-4-one

The title compound, C25H20N2O5, crystallizes with two molecules (A and B) in the asymmetric unit with similar conformations. The five-membered rings are both in envelope conformations with the spiro C atom as the flap. The six-membered heterocycles display half-chair conformations. The mean plane through the isoxazole ring is nearly perpendicular to those through the spiro-chroman system and the 4-nitrophenyl moieties, as indicated by the dihedral angles of 81.42 (9) and 87.58 (8)°, respectively, between them in molecule A. Equivalent data for molecule B are 75.58 (9) and 84.15 (8)°, respectively. The p-tolyl plane makes a dihedral angles of 24.10 (9) and 28.78 (8)° with the isoxazole ring in molecules A and B, respectively. In the crystal, molecules are linked by C—H...O and C—H...N hydrogen bonds and C—H...π interaction, forming a three-dimensional network

Trauma care in Oman: A call for action

© 2017 Elsevier Inc. Many Arab countries have undergone the epidemiologic transition of diseases with increasing economic development and a proportionately decreasing prevalence of communicable diseases. With this transition, injuries have emerged as a major cause of mortality and morbidity in the Gulf Cooperation Council countries in addition to diseases of affluence. Injuries are the number one cause of years of life lost and disability-adjusted life-years in the Sultanate of Oman. The burden of injuries, which affects mostly young Omani males, has a unique geographic distribution that is in contrast to the trauma care capabilities of the country. The concentration of health care resources in the northern part of the country makes it difficult for the majority of Omanis who live elsewhere to access high-quality and time-sensitive care. A broader multisectorial national injury prevention strategy should be evidence based and must strengthen human resources, service delivery, and information systems to improve care of the injured and loss of life. This paper provides a unique overview of the Omani health system with the goal of examining its trauma care capabilities and injury control policies

Development of an mHealth trauma registry in the Middle East using an implementation science framework

Background: Trauma registries (TRs) play a vital role in the assessment of trauma care, but are often underutilized in countries with a high burden of injuries. Objectives: We investigated whether information and communications technology (ICT) such as mobile health (mHealth) could enable the design of a tablet-based application for healthcare professionals. This would be used to inform trauma care and acquire surveillance data for injury control and prevention in Oman. This paper focuses on documenting the implementation process in a healthcare setting. Methods: The study was conducted using an ICT implementation framework consisting of multistep assessment, development and pilot testing of an electronic tablet-based TR. The pilot study was conducted at two large hospitals in Oman, followed by detailed evaluation of the process, system and impact of implementation. Results: The registry was designed to provide comprehensive information on each trauma case from the location of injury until hospital discharge, with variables organized to cover 11 domains of demographic and clinical information. The pilot study demonstrated that the registry was user friendly and reliable, and the implementation framework was useful in planning for the Omani hospital setting. Data collection by trained and dedicated nurses proved to be more feasible, efficient and reliable than real-time data entry by care providers. Conclusions: The initial results show the promising potential of a user-friendly, comprehensive electronic TR through the use of mHealth tools. The pilot test in two hospitals indicates that the registry can be used to create a multicenter trauma database