The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J-SSCG 2016)

Background and purposeThe Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J-SSCG 2016), a Japanese-specific set of clinical practice guidelines for sepsis and septic shock created jointly by the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine, was first released in February 2017 and published in the Journal of JSICM, [2017; Volume 24 (supplement 2)] https://doi.org/10.3918/jsicm.24S0001 and Journal of Japanese Association for Acute Medicine [2017; Volume 28, (supplement 1)] http://onlinelibrary.wiley.com/doi/10.1002/jja2.2017.28.issue-S1/issuetoc.This abridged English edition of the J-SSCG 2016 was produced with permission from the Japanese Association of Acute Medicine and the Japanese Society for Intensive Care Medicine.MethodsMembers of the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine were selected and organized into 19 committee members and 52 working group members. The guidelines were prepared in accordance with the Medical Information Network Distribution Service (Minds) creation procedures. The Academic Guidelines Promotion Team was organized to oversee and provide academic support to the respective activities allocated to each Guideline Creation Team. To improve quality assurance and workflow transparency, a mutual peer review system was established, and discussions within each team were open to the public. Public comments were collected once after the initial formulation of a clinical question (CQ) and twice during the review of the final draft. Recommendations were determined to have been adopted after obtaining support from a two-thirds (> 66.6%) majority vote of each of the 19 committee members.ResultsA total of 87 CQs were selected among 19 clinical areas, including pediatric topics and several other important areas not covered in the first edition of the Japanese guidelines (J-SSCG 2012). The approval rate obtained through committee voting, in addition to ratings of the strengths of the recommendation, and its supporting evidence were also added to each recommendation statement. We conducted meta-analyses for 29 CQs. Thirty-seven CQs contained recommendations in the form of an expert consensus due to insufficient evidence. No recommendations were provided for five CQs.ConclusionsBased on the evidence gathered, we were able to formulate Japanese-specific clinical practice guidelines that are tailored to the Japanese context in a highly transparent manner. These guidelines can easily be used not only by specialists, but also by non-specialists, general clinicians, nurses, pharmacists, clinical engineers, and other healthcare professionals

Tris-Azo Triangular Paraphenylenes: Synthesis and Reversible Interconversion into Radial π-Conjugated Macrocycles

We report the synthesis of cycloparaphenylene derivatives featuring tris-azo groups. The smaller derivative, [3]cycloazobenzene ([3]CAB-0), adopts a triangular all-cis form and exhibits thermally and photochemically stable characteristics due to significant ring strain, as well as symmetric Kagome-patterned crystal packing. In contrast, the as-synthesized [3]cycloazobenzene with three biphenylene bridges ([3]CAB-1) adopts a similar triangular all-cis form; however, it undergoes photoinduced isomerization, leading to a mixture of cis and trans forms at a photostationary state. Interestingly, the addition of an excess of acid selectively leads to the formation of the all-trans form. DFT calculations reveal that the interconversion from a triangular to a circular shape correlates with an increase in HOMO and a decrease in LUMO, characteristics intrinsic to radial π-conjugated systems

A Dodecamethoxy [6]Cycloparaphenylene Consisting Entirely of Hydoroquinone Ether Units: Redox Properties and Host-Guest Complexation

[6]Cycloparaphenylene derivative with twelve methoxy groups at the 2,5-positions of all benzene rings was synthesized via a macrocyclic gold complex. The compound adopts a cylindrical molecular structure with a planar chirality due to multiple introductions of methoxy groups, thereby including electron-deficient guest molecules, and is easily oxidized to give a dicationic compound that exhibits in-plane aromaticity

Cationic Hydridotriplatinum Complex with Bridging Germylene Ligands

Triplatinum complexes with bridging secondary germylene ligands, [{Pt­(PMe₃)}₃(μ-GeR₂)₃] (R = Ph, ^<i>n</i>Bu), were prepared from the reaction of H₂GeR₂ with [Pt­(PMe₃)₄] in a 1:1 ratio. Protonation of the triplatinum complexes with HBF₄ led to formation of the cationic hydride complexes [{Pt­(PMe₃)}₃(μ-GeR₂)₃(μ₃-H)]­BF₄ (R = Ph, ^<i>n</i>Bu). The results of multinuclear NMR spectra and DFT calculations of the cationic complexes revealed that the Pt₃H core has a trigonal-pyramidal structure with rapid exchange of the μ₃-hydride ligand position between the two possible positions on the opposite side of the Pt₃ plane

A Water-Soluble Cycloparaphenylene: Synthesis and Application as a Supramolecular Receptor with Visible Fluorescence

We report the first synthesis of water-soluble [9]cycloparaphenylene derivative containing three hydrindacene (1,2,3,5,6,7-hexahydro-s-indacene) units with four carboxylates at the 2,6-positions via a macrocyclic gold complex. This crown-shaped macrocyclic compound exhibits remarkable water solubility, with a maximum solubility of 16 mmol L-1 (2.6 g/100 mL), as well as strong visible fluorescence in water (λem = 447 nm, φF = 0.64, brightness (ε×φF) = 5.1×104). This molecule effectively encapsulates cationic guest compounds, such as methyl viologen dichloride, as indicated by a change in visible fluorescence

Aromatic Macrocycle Containing Amine and Imine Groups: Intramolecular Charge-Transfer and Multiple Redox Behavior

A cyclic compound that has alternating diphenylamine and quinodiimine units was obtained by condensation of anthraquinone with bis­(4-aminophenyl)­amine (aniline dimer) in 20% yield. The resulting macrocycle has an absorption of 462 nm, which is assigned to charge transfer transitions between electron-rich diphenylamine units and electron-poor anthraquinone diimine units. Cyclic voltammetry in acidic MeCN shows redox of anthraquinone diimine units (<i>E</i>_1/2 = 0.03 V vs Ag/Ag⁺) and of oxidation of amino groups of higher potentials (0.60 and 0.77 V)

Aromatic Macrocycle Containing Amine and Imine Groups: Intramolecular Charge-Transfer and Multiple Redox Behavior

A cyclic compound that has alternating diphenylamine and quinodiimine units was obtained by condensation of anthraquinone with bis­(4-aminophenyl)­amine (aniline dimer) in 20% yield. The resulting macrocycle has an absorption of 462 nm, which is assigned to charge transfer transitions between electron-rich diphenylamine units and electron-poor anthraquinone diimine units. Cyclic voltammetry in acidic MeCN shows redox of anthraquinone diimine units (<i>E</i>_1/2 = 0.03 V vs Ag/Ag⁺) and of oxidation of amino groups of higher potentials (0.60 and 0.77 V)

Strained and Unstrained Macrocycles Composed of Carbazole and Butadiyne Units: Electronic State and Optical Properties

Cu­(OAc)₂ catalyzes dehydrogenative condensation of 3,6-bis­(2-ethynylphenyl)­carbazole in the presence of O₂ to afford the cyclization product <b>1</b> and cyclodimer <b>2</b>. Compound <b>1</b> contains bent carbazole and butadiyne groups, while <b>2</b> has a less strained structure with Z shape around the two parallel butadiyne groups. Optical properties of the compounds are discussed based on the electronic states estimated from electrochemical measurement and density functional theory calculation