Syntheses of Azaborine Polymers and Optimisation of Precursor Syntheses

On the route to 1,2-azaborines, secondary allylamines were needed as starting materials. For the syntheses of these allylamines, the reduction of allylamides by lithium aluminium hydride is a common method. However, the application of reported procedures led to an unexpected attack of the unactivated nonpolar double bond and, consequently, to a separation problem of product and by-product. Therefore, an in-depth investigation of the mechanism and an optimisation of the reaction conditions were performed. Towards the synthesis of monomers for conjugated 1,2-azaborine polymers, the aromatisation (oxidative dehydrogenation) to 1,2-azaborines emerged to be the bottleneck reaction with only moderate conversion. Consequently, an optimisation of the reaction conditions was performed which led to an improvement, but also revealed inherent limitations due to a fast catalyst deactivation by the aryl bromide substituent. Since the aromatisation to the N-methylated azaborine led to nearly full conversion and a feasible isolation, N-methyl-B-vinylazaborine was successfully synthesised. A following free radical polymerisation resulted in a novel poly(vinylazaborine) – a new B-N analogue of polystyrene. Furthermore, a copolymerisation with the C-C analogue (2-methylstyrene) led to the first copolymer of its type. A thorough comparison of the polymers by NMR spectroscopy, thermogravimetry, differential scanning calorimetry, gel permeations chromatography, UV-Vis spectroscopy and infrared spectroscopy showed significant differences of their physical and chemical properties.Eine essentielle Komponente für die Synthese von 1,2-Azaborinen ist sekundäres Allylamin. Um dieses herzustellen, ist die Reduktion von Allylamiden mit Hilfe von Lithiumaluminiumhydrid eine gängige Methode. Die Anwendung von literaturbekannten Vorschriften führte allerdings zu einem Angriff auf die nicht aktivierte, unpolare Doppelbindung. Daraus resultierte ein Problem in der Separation von Produkt und Nebenprodukt. In Folge dessen wurden eine detaillierte Untersuchung des Mechanismus und eine Optimierung der Reaktionsbedingungen für die Synthese von Allylaminen durchgeführt. Bei der Synthese der Monomere für konjugierte 1,2-Azaborin-Polymere stellte sich die Aromatisierung (oxidative Dehydrogenierung) zu 1,2-Azaborinen als Nadelöhr-Reaktion mit mä-ßiger Umsetzung heraus. Eine Optimierung der Reaktionsbedingungen führte zwar zur Verbesserung der Umsetzung, aber durch die schnelle Desaktivierung durch den Arylbromid-Substitutent auch zur Limitierung von Palladium als Katalysator dieser Reaktion. Da allerdings die Aromatisierung zum N-methylierten Azaborin zu einer nahezu vollständigen Umsetzung führte und eine erfolgreiche Isolierung ermöglichte, konnte das N-Methyl-B-vinylazaborin synthetisiert werden. Eine anschließende freie radikalische Polymerisation ergab ein neuartiges Poly(vinylazaborin) – ein neues B-N-Analogon von Polystyrol. Darüber hinaus wurde das erste Copolymer seiner Art durch die Copolymerisation mit dem C-C-Analogon (2-Methylstyrol) erfolgreich hergestellt. Ein sorgfältiger Vergleich der Polymere mit Hilfe von NMR-Spektroskopie, Thermogravimetrie, dynamischer Differenzkalorimetrie, Gel-Permeations-Chromatographie, UV/Vis-Spektroskopie und IR-Spektroskopie zeigte signifikante Unterschiede der Eigenschaften

Necessity of Immediate MRI Imaging in the Acute Care of Severely Injured Patients

Background and Objectives: The standard diagnostic procedure for a patient with a suspected polytrauma injury is computed tomography (CT). In individual cases, however, extended acute imaging using magnetic resonance imaging (MRI) can provide valuable and therapy-relevant information. The aim of our cohort study was to find such cases and to describe their characteristics in order to be able to give possible recommendations for MRI application in acute trauma situations. Materials and Methods: In the study period from 2015–2019, an evaluation of the imaging performed on polytrauma patients was carried out. The specific diagnostic and therapeutic criteria of the MRI group were further defined. Results: In total, 580 patients with an ISS ≥16 (injury severity score) were included in the study. Of these 580 patients, 568 patients received a CT scan and 12 patients an MRI scan as part of the initial diagnostic. Altogether, 66.67% of the MRIs took place outside of regular service hours. The main findings for MRI indications were neurological abnormalities with a focus on myelon injuries. Further MRI examinations were performed to rule out vascular injuries. All in all, 58.3% of the MRIs performed resulted in modified therapeutic strategies afterward. Conclusions: MRI in the context of acute diagnostic of a severely injured patient will likely remain reserved for special indications in the future. However, maximum care hospitals with a high flow of severely injured patients should provide 24/7 MR imaging to ensure the best possible care, especially in neurological and blunt vascular injuries

Investigation to the prevalence of sleep disorders and its effect on the rehabilitation-outcome during a neurological and geriatric rehabiliation : a prospective study

Sleep disorders, especially Insomnia, sleep apnea syndrome and sleep related movement disorders are relevant in the elderly and are often correlated to somatic and psychiatric disorders (Happe 2011). Aim of this prospective study was Primary to investigate the effect of restful/ restless sleep to the rehabilitation-outcome during a geriatric or neurological rehabilitation and secondary to identify other parameters having an effect on the rehabilitation-outcome. Overall 678 geriatric subjects and geriatric subjects with a neurological principal diagnosis participated successfully. Subjects were interviewed 1-3 days (visit 1) and 3 weeks (visit 2) after entering the rehabilitation clinic to sleep disorders, sleep quality as well as to physical and psychic conditions by using several questionnaires. Additionally objective parameters from the medical report were used. Results reveal that sleep quality (questionnaire: PSQI) does not have an effect on the rehabilitation-outcome of geriatric subjects directly. But this study featured other parameters like daytime sleepiness (EES) as well as mental and psychical parameters (age, sub items of the IADL and SF-36) do have an significant effect. Interpretation of these results could be that other parameters like age, daytime sleepiness as well as mental and physical conditions have more effect on the rehabilitation-outcome than sleep quality itself. But the fact that these parameters are linked to sleep quality can be a hint that sleep quality can have a more indirect effect on the rehabilitation-outcome

Patienteneinwilligungen für das TraumaRegister DGU® aufgrund der EU-Datenschutz-Grundverordnung (EU-DSGVO) – Eine Herausforderung für die Kliniken: Status quo und Lösungsstrategien

According to the General Data Protection Regulation (GDPR 05/2018), anonymized data sets with a sufficiently high data density are classified as traceable and require a declaration of consent if they are evaluated centrally for research or quality control purposes. Quality assurance and further increases in the quality of care are, however, only possible with a nearly complete survey of seriously injured persons in the sense of health services research. The more than 600 German clinics that take part in the TraumaRegistry DGU® try to obtain the declarations of consent from this special patient population. The study clinic evaluated the rate of consent and the reasons for rejection or failure to obtain consent over a 12-month period. While using a resource-intensive workflow especially for patient education and obtaining the consent, a patient consent rate of 64.5% and an error rate of 35.5% were recorded. Of the 276 potential TraumaRegistry DGU® data records 98 could not be entered and were therefore neither available for quality control nor for multiple trauma research. In order to guarantee the quality control and the further improvement of the quality of care, an approximate total recording of the patient population is necessary; however, this cannot be achieved by requiring a declaration of consent. We therefore advocate creating the possibility of collecting the TraumaRegistry data set without consent, as this ultimately represents a standard data set, comparable to the Hospital Remuneration Act (§21-KHEntgG) data set but pseudonymised