A robust heterogeneous chiral phosphoric acid enables multi decagram scale production of optically active N,S-ketals

Asymmetric organocatalysis has been recognized as one of the "top 10 emerging technologies" in chemistry by IUPAC in 2019. Its potential to make chemical processes more sustainable is promising, but there are still challenges that need to be addressed. Developing new and reliable enantioselective processes for reproducing batch reactions on a large scale requires a combination of chemical and technical solutions. In this manuscript, we combine a robust immobilized chiral phosphoric acid with a new packed-bed reactor design. This combination allows scaling up of the enantioselective addition of thiols to imines from a few milligrams to a multi-decagram scale in a continuous flow process without physical or chemical degradation of the catalyst.

A Telescoped Continuous Flow Enantioselective Process for Accessing Intermediates of 1-Aryl-1,3-diols as Chiral Building Blocks

A telescoped continuous flow process is reported for the enantioselective synthesis of chiral precursors of 1-aryl-1,3-diols, intermediates in the synthesis of ezetimibe, dapoxetine, duloxetine, and atomoxetine. The two-step sequence consists of an asymmetric allylboration of readily available aldehydes using a polymer-supported chiral phosphoric acid catalyst to introduce asymmetry, followed by selective epoxidation of the resulting alkene. The process is highly stable for at least 7 h and represents a transition-metal free enantioselective approach to valuable 1-aryl-1,3-diols.

Phosphine-catalysed transformations of ortho- and para-quinone methides

Organocatalytic methodologies for the derivatization of o-QM, p-QM and the analogous aza-QM have been recently developed and involve different catalytic systems such as phosphoric acids, thioureas, squaramides, NHC carbenes or chiral ammonium salts. Besides, phosphines, commonly used as ligands in metal-catalysed reactions, can be also used as organocatalysts. In this case, they are mainly involved as nucleophilic catalysts in reactions such as the Rauhut-Currier (RC) reaction. In this review, an analysis of the recent developments in racemic and enantioselective phosphine-catalysed transformations of o-QM, p-QM and aza-o-QM has been carried out.

Cu(I)-Catalyzed Alkynylation of Quinolones

Herein we report the first alkynylation of quinolones with terminal alkynes under mild reaction conditions. The reaction is catalyzed by Cu(I) salts in the presence of a Lewis acid, which is essential for the reactivity of the system. The enantioselective version of this transformation has also been explored, and the methodology has been applied in the synthesis of the enantioenriched tetrahydroquinoline alkaloid cuspareine.

An overview of the applications of chiral phosphoric acid organocatalysts in enantioselective additions to CO and CN bonds

Since 2004, chiral phosphoric acids (CPAs) have emerged as highyl efficient organocatalysts, providing excellent results in a wide reaction scope. In this review, the applications of CPA for enantioselective additions to CO and CN bonds are covered.

Asymmetric Synthesis of Tetrasubstituted α-Aminophosphonic Acid Derivatives

Due to their structural similarity with natural α-amino acids, α-aminophosphonic acid derivatives are known biologically active molecules. In view of the relevance of tetrasubstituted carbons in nature and medicine and the strong dependence of the biological activity of chiral molecules into their absolute configuration, the synthesis of α-aminophosphonates bearing tetrasubstituted carbons in an asymmetric fashion has grown in interest in the past few decades. In the following lines, the existing literatures for the synthesis of optically active tetrasubstituted α-aminophosphonates are summarized, comprising diastereoselective and enantioselective approaches.

ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION NUMERIC AND EXPERIMENTAL ANALYSES: INFLUENCE OF TRABECULAR BONE CONSTITUTIVE MODEL

INTRODUCTION

The number of variables that influence the success of an ACL reconstruction is such that, the use of numerical tools becomes increasingly necessary. In this work, a finite element model is developed to simulate the ACL reconstruction in its tibial insertion.

MATERIAL AND METHODS

Tibiae and ligaments porcine samples were used in this work. As the tibial fixation, an interference screw with a nominal diameter of 7mm and a length of 25mm is used.

The plasty which replace the injured ligament was characterize using tensile tests. Uniaxial and confined compression tests, as well as indentation tests, were used for characterizing trabecular bone. Finite element methods were used for the implementation of the ACL reconstruction simulation, which studies the effect in the knee joint of all the elements involved (plasty, bone and interference screw).

RESULTS

None of the models available for the description of the trabecular bone behavior (von Mises, Hill and Crushable Foam), is capable of doing it in a completely proper manner. The use of one or the other constitutive model does not greatly influence the numerical simulation results.

CONCLUSIONS

As trabecular bone has a strongly anisotropic and non-symmetric mechanical behavior, none of the constitutive models available in the finite element code used is capable of fully describing it. Thus, the use of von Mises criterion is recommended, as it is the easiest to define and the one that requires the least numerical resources (lower computational cost).

Enantioselective Aza-Reformatsky Reaction with Ketimines

Here, an enantioselective aza-Reformatsky reaction using acyclic ketimine substrates is presented. Using α-phosphorated ketimines as electrophilic substrates and a simple BINOL-derived ligand, phosphorated analogues of aspartic acid holding chiral tetrasubstituted carbons are efficiently obtained with excellent enantioselectivity through an asymmetric organocatalytic Reformatsky-type reaction. The phosphorated analogues of aspartic acid have been used for the synthesis of phosphorus-containing enantiopure tetrasubstituted β-lactams.

Synthesis of novel antiproliferative hybrid bis-(3-indolyl)methane phosphonate derivatives

An efficient synthetic methodology for the preparation of phosphorus substituted bis-(3-indolyl)methane through a double nucleophilic addition of indole derivatives to an in situ generated α-iminophosphonate is reported. In addition, bis-(3-indolyl)methane substrates showed in vitro cytotoxicity, inhibiting the growth of carcinoma human tumor cell lines A549 (carcinomic human alveolar basal epithelial cell) and SKOV03 (human ovarian carcinoma).

Amorphous freezing in two dimensions: from soft coils to rigid particles

The topic of the gel transition in two dimensions is revisited by considering data on the shear elasticity of Langmuir monolayers of different spherical objects. Amorphous freezing can be associated to structural percolation in a lattice able to resist shear stresses. The shear modulus and its dependence on the packing fraction are found to strongly depend on the details of the interaction potential and largely differ from expectations for entropic networks. This behaviour can be interpreted in terms of more elaborated percolation theories including central forces and bond-bending forces.

Molecular weight dependence of the shear rheology of poly(methyl methacrylate) Langmuir films: a comparison between two different rheometry techniques

The surface shear rheology of Langmuir monolayers of poly(methyl methacrylate) (PMMA) has been studied as a function of polymer concentration (Gamma) and molecular weight (N). Two different rheology techniques were used, one based on free damped oscillations of a ring with a sharp edge and the other based on a forced oscillation of a biconical disk. Both instruments were used in the oscillatory mode at comparable oscillation frequency and amplitude, which gave access to the viscoelastic shear modulus (S). The two instruments, working in different viscosity ranges, provide complementary and mutually compatible data. The results obtained for four PMMA samples of molecular weight between 8x10(3) and 2.7x10(5) g.mol(-1) show powerlike behavior as S approximately Gamma10 and S approximately N4. These strong dependences suggest a structural scenario based on the 2D percolation of the polymer pancakes.

Filling of segmental bone defects in revision knee arthroplasty using morsellized bone grafts contained within a metal mesh

For revision knee surgery with uncontained tibial bone defects, the authors report the containment of compacted morsellized allograft using metal-wire mesh, followed by implantation of a cemented total knee prosthesis. This method is comparable to the "impaction grafting technique" described for revision hip surgery and could be an alternative to metal wedges, augmented components, custom-made implants, polymethyl-methacrylate or structural bone grafts to solve some problems of cavitary and segmental bone defects in revision total knee arthroplasty.

[Socio-economic model and the quality of life: an approximation to the concept of social health]

After a brief analysis of the principal contradictions in the model of the National Health Service in the industrialised, capitalist countries which, after the second world war, acceded to the Welfare State, we shall study, within the framework of the so-called "epidemiological revolution", the way in which a degradation of the medical model of Social Security and the configuration of an ideological view directed at the individualisation of health problems, is recorded following a crisis in the Welfare State. Finally the concept of Social Health shall be expounded as a category of analysis which may permit the understanding of the methodological inexactitude which involves creating the characteristics and possibilities of a health service outside the socio-economic model.

The midvastus surgical approach in total knee arthroplasty

We report a study of 2 surgical approaches to the knee in 42 consecutive patients undergoing a total arthroplasty. They were divided into 2 groups. In Group 1 (n=17) the knee was exposed through classic medial parapatellar arthrotomy and in Group 2 (n=25) the knee was approached through the fibers of the medial vastus. Preoperative assessment did not reveal any statistical differences between the groups, and blood loss, operation time, biochemistry values and radiographic evaluation were also similar. However, a higher number of lateral releases, a loss of knee extension and a reduced range of motion were significantly associated with classical parapatellar arthrotomy. As the number of operative or postoperative complications was not increased, we recommend the mid-vastus approach for total knee arthroplasty.

Immunohistochemical analysis of mechanoreceptors in the human posterior cruciate ligament: a demonstration of its proprioceptive role and clinical relevance

Although long-term studies report successful results with total knee arthroplasty (TKA), performed with or without posterior cruciate ligament (PCL) retention, controversy exists as to which is preferable in regard to patient outcome and satisfaction. The possible proprioceptive role of the PCL may account for a more normal feeling of the arthroplasty. Although the PCL has been examined using various histological techniques, immunohistochemical techniques are the most sensitive for neural elements. Therefore an immunohistochemical study was designed to determine the patterns of innervation, the morphological types of the proprioceptors, and their immunohistochemical profile. During TKA, samples were obtained from 22 osteoarthritic PCLs and subjected to immunohistochemical analysis with mouse monoclonal antibodies against neurofilament protein (NFP), S100 protein (S100P), epithelial membrane antigen (EMA), and vimentin (all present in neuromechanoreceptors). Three normal PCLs from cadaveric specimens were also obtained and analyzed for comparison. Five types of sensory corpuscles were observed in both the normal and the arthritic PCLs: simple lamellar, Pacini-like, Ruffini, Krause-like, and morphologically unclassified. Their structure included a central axon, inner core, and capsule in lamellar and Pacini corpuscles and variable intracorpuscular axons and periaxonal cells in the Ruffini and Krause-like corpuscles. The immunohistochemical profile showed the central axon to have NFP immunoreactivity, periaxonal cells to have S100P and vimentin immunoreactivity, and the capsule to have EMA and vimentin immunoreactivity. Nerve fibers and free nerve endings displayed NFP and S100P immunoreactivity. The immunohistochemical profile of the PCL sensory corpuscles is almost identical to that of cutaneous sensory corpuscles. Some prior histological studies of the PCL reported Golgi-like mechanoreceptors, and others found encapsulated corpuscles but no Golgi-like structures. This report determined the innervation of the PCL by the more sensitive immunohistochemical means, revealing four major types of encapsulated mechanoreceptors. The plentiful and varied types of encapsulated mechanoreceptors found in even the arthritic PCL suggests a rich proprioceptive role. It is controversial as to whether preservation of the PCL at TKA improves postoperative proprioception. Our findings tend to support those clinical reports of improved proprioception after PCL-retaining versus PCL-substituting TKAs. The presence of many and varied types of mechanoreceptors may account for the improved stair climbing reported in patients with PCL-retaining TKA and may contribute to patient satisfaction and a more normal feeling after TKA.

Influence of intramedullary versus extramedullary alignment guides on final total knee arthroplasty component position: a radiographic analysis

A prospective study of 116 consecutive Kinemax cemented posterior cruciate ligament-retaining total knee arthroplasties was carried out. Similar surgical technique was used with a single variable: 61 were implanted using intramedullary guides on the tibia and 55 were implanted using extramedullary guides on the tibia. A radiographic study was performed after at least 1 year of follow-up to evaluate postoperative component position and compare the difference in the accuracy of positioning of the femoral and tibial components. Radiographic analysis showed that satisfactory position was achieved using both types of instrumentation. No statistically significant difference was observed in either the coronal or sagittal plane of the femoral component and the sagittal plane positioning of the tibial component. However, the coronal plane positioning of the tibial component revealed a statistically significant difference (P < .01), with intramedullary guides being superior to extramedullary guides. Also observed, was that using either technique, patients with less accurate postoperative positioning tended to be obese, with wide intramedullary canals. Patients with significant extraarticular deformities, marked bowing, and those with prior surgery or fractures may not be suitable for intramedullary guides, and they may require the use of extramedullary guides and intraoperative radiographic control. The ideal indication for the use of intramedullary instrumentation is in the patient who is not obese, with no extraarticular deformity, and with a well-defined, but not excessively wide, tibial medullary canal. Since tibial component malalignment in general, and coronal plane malalignment in particular, may adversely affect the long-term survival of total knee arthroplasties, the use of intramedullary alignment instrumentation is recommended when possible.

[Vaccinal coverage for measles and pertussis: a study in 7 regions of Italy]

During the year 1993 a series of surveys aimed to estimate the immunization coverage against measles and pertussis have been carried out in seven Italian regions and two large towns (Milan and Naples). Mothers of children aged between 12 and 23 months, randomly selected from the list of newborns, by using the EPI cluster sampling, have been interviewed in order to determine the reasons for absent or incomplete vaccinations. The observed coverage for pertussis ranges between 8% in the Molise region and 71% in the town of Milan; coverage for measles ranges between 9% in the town of Naples and 52% in the region Lombardy. The most commonly reported reason for not-vaccinating for pertussis has been the negative advise given by the caring physician. Immunization against measles has often not been administered because of relative contraindications and the negative advise by the physicians. The coverage for the two non-compulsory vaccinations are low compared to compulsory vaccinations and to the immunization level reported for most European countries, pointing out that further health education is needed for improving the up-take of such voluntary vaccinations.