Synthesis based on cyclohexadienes. Part 24. A new total synthesis of pupukean-2-one and a facile entry to copa and ylanga type sesquiterpene skeletons

A novel tandem 5-exo-trig allyl and 3-exo-trig radical cyclisation and rearrangement to copa and ylanga type sesquiterpene skeletons from easily prepared cyclohexadienes is reported. A new total synthesis of pupukean-2-one 8, which belongs to a novel class of sesquiterpenes, involving a 5-exo-trig allyl radical cyclisation as the key step is also reported

Synthesis based on cyclohexadienes. Part 23. Total synthesis of 5-epi-pupukean-2-one

A new strategy for the construction of the isotwistane skeleton is reported from easily available cyclohexadienes which involves stereoselective alkylation of a bicyclooctenone derivative and a decarboxylative 5-exo-trig radical cyclisation as the key steps in the total synthesis of 5-epi-pupukean-2-one

Synthesis based on cyclohexadienes. Part 22. Formal syntheses of patchouli alcohol and norpatchoulenol

The preparation of 6-endo-formyl-1,3,3-trimethylbicyclo[2.2.2]octan-2-one 7 and 6-endo-acetyl-1,3,3-trimethylbicyclo[2.2.2]octan-2-one 8, the two key intermediates for the synthesis of patchouli alcohol 1 and norpatchoulenol 2, is reported by a simple and short method from 2-methylbenzoic acid

Synthetic studies towards the nor-triterpene pfaffic acid: synthesis of DEF ring fragment via tandem radical cyclization rearrangement reactions

A tandem 5-exo-trig-vinyl-3-exo-radical cyclization-rearrangement reaction and its allylic radical version was developed (8 and 15 to 9 and 16 respectively) for the synthesis of DEF ring system of the nor-tritepene Pfaffic acid 1

Obstructive Sleep Apnea: A Pathophysiology and Pharmacotherapy Approach

Obstructive sleep apnea (OSA) is a common sleep disorder characterized by complete cessation of upper airflow during sleep, leading to repetitive episodes of desaturations and arousals. The symptoms include excessive daytime somnolence and are associated with a significant cardiovascular morbidity and mortality. The prevalence of OSA is higher in men with an approximate rate of 14 and 5% in women respectively. Typical risk factors for obstructive sleep apnea in the normal adult population are obesity, aging, gender, menopause, ethnicity, genetical predisposition, craniofacial anatomy, smoking, alcohol consumption and some other factors such as REM sleep, surface tension, and impaired sensory processing. Several screening questionnaires can be performed in outpatient settings to identify the patient symptoms. Polysomnography is considered as the gold standard for diagnosis of OSA. Different surgical treatments and devices are readily available for an effective management of this disease. Proper diagnosis and treatment improves not only the quality of life but also relatively decreases patient morbidity and mortality. A multifaceted approach is necessary for an accurate management of the OSA

New exact fronts for the nonlinear diffusion equation with quintic nonlinearities

We consider travelling wave solutions of the reaction diffusion equation with quintic nonlinearities $u_t = u_{xx} + \mu u (1 -u ) ( 1 +\alpha u + \beta u^2 +\gamma u^3)$. If the parameters $\alpha , \beta$ and $\gamma$ obey a special relation, then the criterion for the existence of a strong heteroclinic connection can be expressed in terms of two of these parameters. If an additional restriction is imposed, explicit front solutions can be obtained. The approach used can be extended to polynomials whose highest degree is odd.Comment: Revtex, 5 page

Costing interventions in the field: preliminary cost estimates and lessons learned from an evaluation of community-wide mass drug administration for elimination of soil-transmitted helminths in the DeWorm3 trial

OBJECTIVE: To present a costing study integrated within the DeWorm3 multi-country field trial of community-wide mass drug administration (cMDA) for elimination of soil-transmitted helminths. DESIGN: Tailored data collection instruments covering resource use, expenditure and operational details were developed for each site. These were populated alongside field activities by on-site staff. Data quality control and validation processes were established. Programmed routines were used to clean, standardise and analyse data to derive costs of cMDA and supportive activities. SETTING: Field site and collaborating research institutions. PRIMARY AND SECONDARY OUTCOME MEASURES: A strategy for costing interventions in parallel with field activities was discussed. Interim estimates of cMDA costs obtained with the strategy were presented for one of the trial sites. RESULTS: The study demonstrated that it was both feasible and advantageous to collect data alongside field activities. Practical decisions on implementing the strategy and the trade-offs involved varied by site; trialists and local partners were key to tailoring data collection to the technical and operational realities in the field. The strategy capitalised on the established processes for routine financial reporting at sites, benefitted from high recall and gathered operational insight that facilitated interpretation of the estimates derived. The methodology produced granular costs that aligned with the literature and allowed exploration of relevant scenarios. In the first year of the trial, net of drugs, the incremental financial cost of extending deworming of school-aged children to the whole community in India site averaged US$1.14 (USD, 2018) per person per round. A hypothesised at-scale routine implementation scenario yielded a much lower estimate of US$0.11 per person treated per round. CONCLUSIONS: We showed that costing interventions alongside field activities offers unique opportunities for collecting rich data to inform policy toward optimising health interventions and for facilitating transfer of economic evidence from the field to the programme. TRIAL REGISTRATION NUMBER: NCT03014167; Pre-results

Development and application of an electronic treatment register: a system for enumerating populations and monitoring treatment during mass drug administration.

We developed an electronic treatment register for the DeWorm3 Project, a cluster-randomised, controlled trial in Benin, India, and Malawi testing the feasibility of interrupting transmission of soil-transmitted helminths through community-wide mass drug administration. The electronic treatment register was designed in xlsform, deployed via the SurveyCTO mobile data collection platform, and implemented on smartphones running the Android operating system. The versatile system enables collection of census and treatment status information, facilitates data aggregation and visualisation, and permits real-time feedback loops during implementation of mass drug administration. Here we describe the system's design and use within the DeWorm3 Project and key features, and by sharing the register here, we hope our readers will further explore its use within their research and disease-control activities