Unexpected nucleophilic participation and rearrangement of DBU in reactions with saccharin derivatives

DBU attacks saccharin derivatives with subsequent rearrangement to give rise to 3-[3'-(1"-azepin-2"-onyl)propylamino]-1,2-benzisothiazole-1,1-dioxide 2 after work-up

Barrett's oesophagus and oesophageal cancer following oesophageal atresia repair: a systematic review

BACKGROUND: Concern exists that patients born with oesophageal atresia (OA) may be at high risk for Barrett's oesophagus (BO), a known malignant precursor to the development of oesophageal adenocarcinoma. Screening endoscopy has a role in early BO identification but is not universal in this population. This study aimed to determine prevalence of BO after OA repair surgery, to quantify the magnitude of this association and inform the need for screening and surveillance. METHODS: A systematic review, undertaken according to PRISMA guidelines, was preregistered on PROSPERO (CRD42017081001). PubMed and EMBASE were interrogated using a standardized search strategy on 31 July 2020. Included papers, published in English, reported either: one or more patients with either BO (gastric/intestinal metaplasia) or oesophageal cancer in patients born with OA; or long-term (greater than 2 years) follow-up after OA surgery with or without endoscopic screening or surveillance. RESULTS: Some 134 studies were identified, including 19 case reports or series and 115 single- or multi-centre cohort studies. There were 13 cases of oesophageal cancer (9 squamous cell carcinoma, 4 adenocarcinoma) with a mean age at diagnosis of 40.5 (range 20-47) years. From 6282 patients under long-term follow-up, 317 patients with BO were reported. Overall prevalence of BO was 5.0 (95 per cent c.i. 4.5 to 5.6) per cent, with a mean age at detection of 13.8 years (range 8 months to 56 years). Prevalence of BO in series reporting endoscopic screening or surveillance was 12.8 (95 per cent c.i. 11.3 to 14.5) per cent. CONCLUSION: Despite a limited number of cancers, the prevalence of BO in patients born with OA is relatively high. While limited by the quality of available evidence, this review suggests endoscopic screening and surveillance may be warranted, but uncertainties remain over the design and effectiveness of any putative programme

Evaluating Mood Changes in Response to Anthropogenic Noise with a Response-Slowing Task in Three Species of Zoo-housed Primates

In the zoo environment, anthropogenic noise is common as sound levels fluctuate due to visitors, construction, habitat design, and special events. In this study, changes in the mood of three species of zoo-housed primates in response to a loud annual event were evaluated with the response-slowing paradigm. In this paradigm, animals experiencing anxiety slow responses on simple cognitive tasks when emotional content is displayed. Following a previously validated approach, we measured latencies to touch potentially threatening (conspecific faces with directed gaze) and non-threatening (conspecific faces with averted gaze) images overlaid on a grey square, relative to neutral control images (grey squares only) on a touchscreen. In Experiment 1, four Japanese macaques (Macaca fuscata) were tested in two conditions: during a baseline (non-stressful) period and opportunistically during three days during which loud jets frequently flew overhead. Results indicated a significant effect of condition, with an increase in latency to touch images of conspecific faces relative to control images during the days of the loud event. In Experiment 2, chimpanzees (Pan troglodytes, n = 4) and western lowland gorillas (Gorilla gorilla gorilla, n = 2) were tested during the same loud event following a similar methodology. The results revealed subtle changes across conditions; however, this was likely driven by the apes increasing their response speed to face stimuli relative to control stimuli over time (habituation). These findings suggest that the macaques, but not the apes, underwent detectable affective changes during the loud event. With additional development, this relatively simple paradigm may be an effective and feasible way to evaluate real-time changes in the mood of zoo-housed animals

Physical Distancing With Social Connectedness

Recognizing and supporting the many ways of investing in relationship has great potential to create a positive sea change in a health care system that currently feels fragmented and depersonalized to both patients and health care providers. The current COVID-19 pandemic is full of opportunity to use remote communication to develop healing human relationships. What we need in a pandemic is not social distancing, but physical distancing with social connectedness.In light of concerns over the potential detrimental effects of declining care continuity, and the need for connection between patients and health care providers, our multidisciplinary group considered the possible ways that relationships might be developed in different kinds of health care encounters. We were surprised to discover many avenues to invest in relationships, even in non-continuity consultations, and how meaningful human connections might be developed even in telehealth visits.Opportunities range from the quality of attention or the structure of the time during the visit, to supporting relationship development in how care is organized at the local or system level and in the use of digital encounters. These ways of investing in relationships can exhibit different manifestations and emphases during different kinds of visits, but most are available during all kinds of encounters. Recognizing and supporting the many ways of investing in relationships has great potential to create a positive sea change in a health care system that currently feels fragmented and depersonalized to both patients and health care clinicians. The current COVID-19 pandemic is full of opportunity to use remote communication to develop healing human relationships. What we need in a pandemic is not social distancing, but physical distancing with social connectedness.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/154577/1/StangeAFM-674-19 ms.pdfDescription of StangeAFM-674-19 ms.pdf : Final pdf for DeepBlue deposi