Synthesis and reactivity of chiral hypervalent iodine compounds

Hypervalent iodine compounds are molecules of increasing interest to the synthetic chemist. Their low toxicity when compared to heavy metal reagents and their ease of use in the laboratory are helping to establish them into the armoury of the synthetic chemist. More recently, research into chiral hypervalent iodine compounds has been the main focus. The work performed during this research tenure is based upon the development of new chiral hypervalent iodine reagents for use in stereoselective synthesis and this research can be summarised into three main sections: Synthesis of novel chiral iodine(III) compounds; Reactivity of chiral iodine(III) compounds; Novel oxididative procedure. The synthesis of new chiral iodine(III) compounds and their use in asymmetric oxidative functionalisations are described herein. The use of stoichiometric quantities of these iodine(III) reagents with 1 eq of pTsOHO in the a-oxytosylation of ketones and 2 eq of /7TSOH H2 O in the dioxytosylation of alkenes, have given the corresponding products in good yields, 57-76% (3-12% ee) and 48-75% (9-16% ee) respectively. Additionally, a new catalytic method is described in which the presence of a stoichiometric oxidant, 1 eq of /7TSOH H2O and only catalytic quantities of the chiral iodine(I) reagent is necessary to afford a-oxytosylated ketones. The final aspect of the research has dealt with the problems associated with oxidizing iodine(I) compounds to iodine(III) compounds. The development of a new method to oxidise iodine(I) compounds to bis(trifluoroacetoxy)iodo arenes through the use of urea-hydrogen peroxide adduct and trifluoroacetic anhydride is also described.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Synthesis and reactivity of chiral hypervalent iodine compounds

Hypervalent iodine compounds are molecules of increasing interest to the synthetic chemist. Their low toxicity when compared to heavy metal reagents and their ease of use in the laboratory are helping to establish them into the armoury of the synthetic chemist. More recently, research into chiral hypervalent iodine compounds has been the main focus. The work performed during this research tenure is based upon the development of new chiral hypervalent iodine reagents for use in stereoselective synthesis and this research can be summarised into three main sections: Synthesis of novel chiral iodine(III) compounds; Reactivity of chiral iodine(III) compounds; Novel oxididative procedure. The synthesis of new chiral iodine(III) compounds and their use in asymmetric oxidative functionalisations are described herein. The use of stoichiometric quantities of these iodine(III) reagents with 1 eq of pTsOHO in the a-oxytosylation of ketones and 2 eq of /7TSOH H2 O in the dioxytosylation of alkenes, have given the corresponding products in good yields, 57-76% (3-12% ee) and 48-75% (9-16% ee) respectively. Additionally, a new catalytic method is described in which the presence of a stoichiometric oxidant, 1 eq of /7TSOH H2O and only catalytic quantities of the chiral iodine(I) reagent is necessary to afford a-oxytosylated ketones. The final aspect of the research has dealt with the problems associated with oxidizing iodine(I) compounds to iodine(III) compounds. The development of a new method to oxidise iodine(I) compounds to bis(trifluoroacetoxy)iodo arenes through the use of urea-hydrogen peroxide adduct and trifluoroacetic anhydride is also described

Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19: The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial.

Importance: Evidence regarding corticosteroid use for severe coronavirus disease 2019 (COVID-19) is limited. Objective: To determine whether hydrocortisone improves outcome for patients with severe COVID-19. Design, Setting, and Participants: An ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin. Between March 9 and June 17, 2020, 614 adult patients with suspected or confirmed COVID-19 were enrolled and randomized within at least 1 domain following admission to an intensive care unit (ICU) for respiratory or cardiovascular organ support at 121 sites in 8 countries. Of these, 403 were randomized to open-label interventions within the corticosteroid domain. The domain was halted after results from another trial were released. Follow-up ended August 12, 2020. Interventions: The corticosteroid domain randomized participants to a fixed 7-day course of intravenous hydrocortisone (50 mg or 100 mg every 6 hours) (n = 143), a shock-dependent course (50 mg every 6 hours when shock was clinically evident) (n = 152), or no hydrocortisone (n = 108). Main Outcomes and Measures: The primary end point was organ support-free days (days alive and free of ICU-based respiratory or cardiovascular support) within 21 days, where patients who died were assigned -1 day. The primary analysis was a bayesian cumulative logistic model that included all patients enrolled with severe COVID-19, adjusting for age, sex, site, region, time, assignment to interventions within other domains, and domain and intervention eligibility. Superiority was defined as the posterior probability of an odds ratio greater than 1 (threshold for trial conclusion of superiority >99%). Results: After excluding 19 participants who withdrew consent, there were 384 patients (mean age, 60 years; 29% female) randomized to the fixed-dose (n = 137), shock-dependent (n = 146), and no (n = 101) hydrocortisone groups; 379 (99%) completed the study and were included in the analysis. The mean age for the 3 groups ranged between 59.5 and 60.4 years; most patients were male (range, 70.6%-71.5%); mean body mass index ranged between 29.7 and 30.9; and patients receiving mechanical ventilation ranged between 50.0% and 63.5%. For the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively, the median organ support-free days were 0 (IQR, -1 to 15), 0 (IQR, -1 to 13), and 0 (-1 to 11) days (composed of 30%, 26%, and 33% mortality rates and 11.5, 9.5, and 6 median organ support-free days among survivors). The median adjusted odds ratio and bayesian probability of superiority were 1.43 (95% credible interval, 0.91-2.27) and 93% for fixed-dose hydrocortisone, respectively, and were 1.22 (95% credible interval, 0.76-1.94) and 80% for shock-dependent hydrocortisone compared with no hydrocortisone. Serious adverse events were reported in 4 (3%), 5 (3%), and 1 (1%) patients in the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively. Conclusions and Relevance: Among patients with severe COVID-19, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority with regard to the odds of improvement in organ support-free days within 21 days. However, the trial was stopped early and no treatment strategy met prespecified criteria for statistical superiority, precluding definitive conclusions. Trial Registration: ClinicalTrials.gov Identifier: NCT02735707

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Catalytic enantioselective alpha-oxytosylation of propiophenone using chiral hypervalent iodine reagents

We report herein our initial results of the catalytic enantioselective alpha-oxytosylation of propiophenone using chiral hypervalent iodine reagents. Low to moderate enantioselectivities of the alpha-oxytosylate are seen using a variety of ortho substituted chiral aryl iodides as catalysts. We also report our efforts using a variety of co-oxidants and reaction conditions in order to optimize this reaction. To our knowledge, this represents the first example of enantioselective organocatalysis using hypervalent iodine reagents

Catalytic Enantioselective alpha-Oxysulfonylation of Ketones Mediated by Iodoarenes

The alpha-oxysulfonylation of ketones catalysed by enantioenriched iodoarenes using mCPBA as stoichiometric oxidant is reported to give useful synthetic intermediates in good yield and modest enantioselectivity. We believe this to be the first report of an enantioselective organocatalytic reaction involving hypervalent iodine reagents which should open up a new field for enantioselective organocatalysis of oxidation reactions

The gene expression landscape of the human locus coeruleus revealed by single-nucleus and spatially-resolved transcriptomics

Norepinephrine (NE) neurons in the locus coeruleus (LC) make long-range projections throughout the central nervous system, playing critical roles in arousal and mood, as well as various components of cognition including attention, learning, and memory. The LC-NE system is also implicated in multiple neurological and neuropsychiatric disorders. Importantly, LC-NE neurons are highly sensitive to degeneration in both Alzheimer’s and Parkinson’s disease. Despite the clinical importance of the brain region and the prominent role of LC-NE neurons in a variety of brain and behavioral functions, a detailed molecular characterization of the LC is lacking. Here, we used a combination of spatially-resolved transcriptomics and single-nucleus RNA-sequencing to characterize the molecular landscape of the LC region and the transcriptomic profile of LC-NE neurons in the human brain. We provide a freely accessible resource of these data in web-accessible and downloadable formats