Notes

Lamarckian Illusions.
3% vs 77.5%; P = 0.781). PP analysis reached a similar result (81.5% vs 85%; P = 0.278). Difference in the eradication rate achieved by BA quadruple regimen was greater than the preestablished margin of noninferiority, at -10% (the lower bounds of the 95% CI were - 7.66% and - 9.43%, respectively). The rate of adverse events was lower for BA than TF therapy (18.5% vs 26.1%, P = 0.024). The rates of compliance and symptom improvement were similar for the two therapies. CONCLUSION The efficacies of the two regimens in rescue treatment were both not satisfactory, and two groups showed no significant difference. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.OBJECTIVES The aim of this anatomical study is to make quantitative comparison among three endoscopic approaches, encompassing contralateral endonasal transseptal transmaxillary transpterygoid approach (contralateral EEA), endoscopic sublabial transmaxillary transalisphenoid (Caldwell-Luc) approach, and endoscopic transorbital transmaxillary approach through inferior orbital fissure (ETOA), to the anterolateral skull base for assisting preoperative planning. DESIGN & PARTICIPANTS Anatomical dissections were performed in four adult cadaveric heads bilaterally using three endoscopic transmaxillary approaches described above. SETTING Skull Base Laboratory at the National Defense Medical Center. MAIN OUTCOME MEASURES The area of exposure, angles of attack, and depth of surgical corridor of each approach were measured and obtained for statistical comparison. RESULTS The ETOA had significantly larger exposure over middle cranial fossa (731.40 ± 80.08 mm2 ) than contralateral EEA (266.60 ± 46.74 mm2 ) and Caldwell-Luc approach (468.40 ± 59.67 mm2 ). In comparison with contralateral EEA and Caldwell-Luc approach, the ETOA offered significantly greater angles of attack and shorter depth of surgical corridor (P less then 0.05 for all comparisons). CONCLUSIONS The ETOA is the superior choice for target lesion occupying multiple compartments with its epicenter located in the middle cranial fossa or superior portion of infratemporal fossa. This article is protected by copyright. All rights reserved.The neighboring effect of two adjacent heteroatoms influences the structures and properties of heterocyclic compounds. Herein, we demonstrated that the introduction of two adjacent sp2 nitrogen atoms into a porphyrinic skeleton significantly enhanced its Brønsted basicity due to the repulsive interaction between two lone pairs on the nitrogen atoms. Palladium-and copper-templated ring closure of dichlorobis(dipyrrin) with hydrazine hydrate provided meso-diazacorrphycene palladium and copper complexes in good yields. The structural, magnetic, and electrochemical properties of the diazacorrphycene complexes were investigated experimentally and theoretically to elucidate the effect of the meso-nitrogen atoms. © 2020 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.Typical surgical treatment for invasive thyroid carcinoma at the level of the cricoid substantially reduces surrounding cartilaginous support and risks damage to the recurrent laryngeal nerve (RLN). We present a novel tracheal reconstructive technique that minimizes this injury risk. A 72-year-old man with recurrent invasive thyroid carcinoma underwent cricotracheal resection and reconstruction using a stair-step approach. Diseased cartilage was removed by a left hemitracheal and hemicricoid resection. A portion of normal trachea was also resected on the contralateral right side, removing the third and fourth hemitracheal rings, to close the defect with a sliding tracheoplasty and avoid dissection near the right cricothyroid joint on the side of the functioning RLN. The trachea was elevated superiorly and reanastomosed to the cut margin of the cricoid. This novel stair-step approach to tracheal reconstruction offers reduced risk of injury to the contralateral RLN while still establishing a patent airway. © 2020 Wiley Periodicals, Inc.Worldwide Coronavirus Disease 2019 (COVID-19) epidemic makes the management of acute myocardial infarction (AMI) more complicated, effective treatment without further dissemination is thus quite challenging. Recently, we successfully treated three representative AMI cases, by sharing these detailed procedures, we summarized some important issues including patient screening, reperfusion strategy selecting, personnel/catheter lab protection principle, as well as operation tactics, which may lend precious experience on AMI treating during the ongoing COVID-19 pandemic situation. © 2020 The Authors. Catheterization and Cardiovascular Interventions published by Wiley Periodicals, Inc.IMPORTANCE This is the largest Gram-negative endophthalmitis specific series and provides important evidence to guide management. BACKGROUND Endophthalmitis is a sight-threatening emergency. Gram-negative infections are associated with poorer visual outcomes; however, there is limited literature pertaining to this uncommon condition. β-Estradiol in vitro DESIGN Prospective case series. PARTICIPANTS All patients presenting with endophthalmitis to a tertiary institution over a 20-year period. METHODS Data were collected prospectively and entered into a registry. Patients with microbiological evidence of Gram-negative infection were included in the analysis. MAIN OUTCOMES MEASURES Final visual acuity (VA), precipitating events, causative organisms, antibiotic sensitivity profiles and risk factors for poor visual outcomes were reported. RESULTS One hundred Gram-negative organisms were isolated in 97 eyes. Final VA was worse than 6/60 in 65 (67.0%) eyes at follow-up and 29 (29.9%) eyes were eviscerated or enucleated. Microbial keratitis (26.8%, n = 26) and Pseudomonas aeruginosa (34.0%, n = 34) were the most common precipitating event and causative organism, respectively. Eight (8.0%) isolates were third-generation cephalosporin resistant; of which, 7 (88.0%) were sensitive to ciprofloxacin. Preceding microbial keratitis (OR = 13.16, P = .015) or P. aeruginosa infections (OR = 3.40, P = .045) were strongly associated with poorer visual outcomes (worse than 6/60). CONCLUSIONS AND RELEVANCE Visual outcomes following Gram-negative endophthalmitis are extremely poor, with almost 30% of patients being eviscerated or enucleated. A majority of ceftazidime resistant organisms are sensitive to ciprofloxacin, providing evidence to support the empirical use of quinolones. Clinicians should be mindful that infections secondary to P. aeruginosa or microbial keratitis carry a particularly poor prognosis. © 2020 Royal Australian and New Zealand College of Ophthalmologists.Boronic acid catalysis has emerged as a mild method for promoting a wide variety of reactions. It has been proposed that the mode of catalysis involves Lewis acid or covalent activation of hydroxyl groups by boron, but limited mechanistic evidence exists. Here, we reinvestigate representative boronic acid-catalyzed reactions of alcohols and oximes. We interpret a series of control experiments with boronic and Brønsted acids along with correlations between their reactivity and their acidity measured by the Gutmann-Beckett method. Overall, we conclude that the major modes of catalysis involve either dual H-bond catalysis or Brønsted acid catalysis. We show that strong Brønsted acids are generated in situ from covalent assembly of the boronic acids with hexafluoroisopropanol, explaining why the solvent had such a major impact on the reactivity. This new insight should guide the future development of boronic acid catalysis, where the diverse and solvent-specific nature of catalytic modes has been overlooked. © 2020 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.In the search for highly reactive oxidants we have identified high-valent metal-fluorides as a potential potent oxidant. The high-valent Ni-F complex [NiIII(F)(L)] (2, L = N,N'-(2,6-dimethylphenyl)-2,6-pyridinedicarboxamidate) was prepared from [NiII(F)(L)]- (1) by oxidation with selectfluor. 1 and 2 were characterized using 1H/19F NMR, UV-vis, and EPR spectroscopies, mass spectrometry, and X-ray crystallography. 2 was found to be a highly reactive oxidant in the oxidation of hydrocarbons. Kinetic data and products analysis demonstrate a hydrogen atom transfer mechanism of oxidation. The rate constant determined for the oxidation of 9,10-dihydroanthracene (k2 = 29 M-1s-1) compared favourably with the most reactive high-valent metallo-oxidants. 2 displayed reactions rates 2000-4500-fold enhanced with respect to [NiIII(Cl)(L)]. 2 also displayed high kinetic isotope effect values. Oxidative hydrocarbon and phosphine fluorination was achieved. Our results provide an interesting direction in designing catalysts for hydrocarbon oxidation and fluorination. © 2020 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.Here, we report a simple and green quasi-solid-phase (QSP) method for facile synthesis of proton-type ZSM-5 avoiding use of excessive water, dry gel, Na + cation and fluoride. Crystallization using the stoichiometric amount of TPAOH at 180 °C for only 12 h yields well-structured HZSM-5 crystals having high specific surface area of 429 m 2 /g and high thermal stability. 5MRs is observed to closely relate the formation of MFI structure and QSP method exhibits shorter induction period ( t 0 ), higher nucleation rate ( V n ), and faster growth rate ( V g ). Moreover, HZ-12-180 shows extremely better and rather stable catalytic activity for methanol-to-propylene reaction by comparison with commercial HZSM-5. © 2020 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.The Matching Assessment using Photographs with Scars assessment tool, published in 2005, enables accurate relocation and reassessment of scars. While used in Australia, uptake has been hampered by its paper manual format. With electronic records and increasing use of smart devices in health, here we report the development of the Matching Assessment using Photographs with Scars manual into a mobile application format ClinMAPSTM Pro. At the time of development, no other digital scar assessment applications were available. link2 For clinical validation, the digitized Matching Assessment using Photographs with Scars module within ClinMAPSTM Pro was used for intra- and inter-rater reliability testing. Convenience sampling was utilized to recruit burns patients representing 44 scars, based on predetermined power calculations. Three therapists, one experienced and two novice, acted as the assessors. link3 Each therapist assessed preselected scars with the digitized Matching Assessment using Photographs with Scars. Re-assessments within the ClinMAPSTM Pro application is now readily available for clinicians and researchers internationally. © 2020 by the Wound Healing Society.BACKGROUND Telehealth postoperative visits are an attractive strategy to minimize exposure, especially during the SARS-CoV-2 (COVID-19) pandemic. The use of a surgical drain often prevents this minimal-exposure approach in that patients return to the outpatient clinic for drain removal. METHODS AND RESULTS Following unilateral neck dissection, the customary closed-suction drain was replaced with a self-removing, passive drain dressing to facilitate same-day discharge and telehealth postoperative follow-up. The patient removed the dressing and drain at home during a telehealth visit on postoperative day 4 and she healed favorably without any signs of infection or seroma. CONCLUSIONS When thoughtfully applied in the appropriate clinical context, small practice adaptations like this can facilitate telehealth solutions that diminish unnecessary exposure for patients, their caregivers, and health care staff. © 2020 Wiley Periodicals, Inc.
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