3,6-Diacetyl-1,4-diphenyl-1,4-dihydro-1,2,4,5-tetra­zine

In the title compound, C18H16N4O2, the central six-membered ring has a boat conformation

Bis­(2-amino-6-methyl­pyridinium) tetra­bromido­cuprate(II)

In the crystal structure of the title compound, (C6H9N2)2[CuBr4], the geometry around the Cu atom is inter­mediate between tetra­hedral (Td) and square planar (D4h). Each [CuBr4]2− anion is connected non-symmetrically to four surrounding cations through N—H⋯X (pyridine and amine proton) hydrogen bonds, forming chains of the ladder-type running parallel to the crystallographic b axis. These layers are further connected by means of offset face-to-face inter­actions (parallel to the a axis), giving a three-dimensional network. Cation π–π stacking [centroid separations of 3.69 (9) and 3.71 (1) Å] and Br⋯aryl inter­actions [3.72 (2) and 4.04 (6) Å] are present in the crystal structure. There are no inter­molecular Br⋯Br inter­actions

Bis(2,6-dimethyl­pyridinium) tetra­bromido­cobaltate(II)

In the crystal structure of the title compound, (C7H10N)2[CoBr4], the [CoBr4]2− anion is connected to two cations through N—H⋯Br and H2C—H⋯Br hydrogen bonds to form two-dimensional cation–anion–cation layers normal to the crystallographic b axis. Inter­actions of the π–π type are absent between cations in the stacks [centroid–centroid separation = 5.01 (5) Å]. Significant inter­molecular Br–aryl inter­actions are present in the structure, especially an unusually short Br–ring centroid inter­action of 3.78 (1) Å. The coordination geometry of the anion is approximately tetrahedral and a twofold rotation axis passes through the Co atom

Bis(2,6-diamino-3,5-dibromo­pyridinium) hexa­bromidostannate(IV)

The asymmetric unit of the title compound, (C5H6Br2N3)2[SnBr6], contains one cation and one half-anion in which the Sn atom is located on a crystallographic centre of inversion and is in a quasi-octa­hedral geometry. The crystal structure is assembled via hydrogen-bonding inter­actions of two kinds, N(pyridine/amine)—H⋯Br—Sn, along with C—Br⋯Br—Sn interactions [3.4925 (19) Å]. The cations are involved in π–π stacking, which adds an extra supra­molecularity as it presents a strong case of offset-face-to-face motifs [centroid–centroid distance = 3.577 (3) Å]. The inter­molecular hydrogen bonds, short Br⋯Br inter­actions and π–π stacking result in the formation of a three-dimensional supra­molecular architecture

Bis(2-bromo­pyridinium) hexa­chlorido­stannate(IV)

The asymmetric unit of the title compound, (C5H5BrN)2[SnCl6], contains one cation and one half-anion. The [SnCl6]2− anion is located on an inversion center and forms a quasi-regular octa­hedral arrangement. Hydrogen-bonding inter­actions of two kinds, viz. N—H⋯Cl—Sn and C—H⋯Cl—Sn, along with Cl⋯Br inter­actions [3.4393 (15) Å], connect the ions in the crystal structure into two-dimensional supra­molecular arrays. These supra­molecular arrays are arranged in layers approximately parallel to (110) built up from anions inter­acting with six symmetry-related surrounding cations

External validation of prognostic models to predict stillbirth using the International Prediction of Pregnancy Complications (IPPIC) Network database: an individual participant data meta-analysis

Objective Stillbirth is a potentially preventable complication of pregnancy. Identifying women at high risk of stillbirth can guide decisions on the need for closer surveillance and timing of delivery in order to prevent fetal death. Prognostic models have been developed to predict the risk of stillbirth, but none has yet been validated externally. In this study, we externally validated published prediction models for stillbirth using individual participant data (IPD) meta-analysis to assess their predictive performance. Methods MEDLINE, EMBASE, DH-DATA and AMED databases were searched from inception to December 2020 to identify studies reporting stillbirth prediction models. Studies that developed or updated prediction models for stillbirth for use at any time during pregnancy were included. IPD from cohorts within the International Prediction of Pregnancy Complications (IPPIC) Network were used to validate externally the identified prediction models whose individual variables were available in the IPD. The risk of bias of the models and cohorts was assessed using the Prediction study Risk Of Bias ASsessment Tool (PROBAST). The discriminative performance of the models was evaluated using the C-statistic, and calibration was assessed using calibration plots, calibration slope and calibration-in-the-large. Performance measures were estimated separately in each cohort, as well as summarized across cohorts using random-effects meta-analysis. Clinical utility was assessed using net benefit. Results Seventeen studies reporting the development of 40 prognostic models for stillbirth were identified. None of the models had been previously validated externally, and the full model equation was reported for only one-fifth (20%, 8/40) of the models. External validation was possible for three of these models, using IPD from 19 cohorts (491 201 pregnant women) within the IPPIC Network database. Based on evaluation of the model development studies, all three models had an overall high risk of bias, according to PROBAST. In the IPD meta-analysis, the models had summary C-statistics ranging from 0.53 to 0.65 and summary calibration slopes ranging from 0.40 to 0.88, with risk predictions that were generally too extreme compared with the observed risks. The models had little to no clinical utility, as assessed by net benefit. However, there remained uncertainty in the performance of some models due to small available sample sizes. Conclusions The three validated stillbirth prediction models showed generally poor and uncertain predictive performance in new data, with limited evidence to support their clinical application. The findings suggest methodological shortcomings in their development, including overfitting. Further research is needed to further validate these and other models, identify stronger prognostic factors and develop more robust prediction models. (c) 2021 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.Peer reviewe