Origin of Octafluorocyclopentene Polyelectrophilicity

Octafluorocyclopentene (OFCP) has found utility as a polyelectrophile in substitution cascades that form complex macrocyclic compounds. The Harran group synthesis of macrocyclic polypeptides depends on OFCP as a linker, combining with four different nucleophilic units of a polypeptide. We report a computational investigation of the origins of OFCP reactivity and a rationale for controlled mono-, di-, tri-, and tetrasubstitution of fluoride ions by heteroatomic nucleophiles. The roles of inductive, negative hyperconjugative, and resonance electron-donation by fluoride substituents are explored for the reaction of OFCP, less-fluorinated analogues, and common electrophilic alkenes with several different nucleophiles.

Use of Novel Homochiral Thioureas Camphor Derived as Asymmetric Organocatalysts in the Stereoselective Formation of Glycosidic Bonds

We synthesized six new camphor-derived homochiral thioureas 1-6, from commercially available (1R)-(-)-camphorquinone. These new compounds 1-6 were evaluated as asymmetric organocatalysts in the stereoselective formation of glycosidic bonds, with 2,3,4,6-tetra-O-benzyl-D-glucopyranosyl and 2,3,4,6-tetra-O-benzyl-D-galactopyranosyl trichloroacetimidates as donors, and several alcohols as glycosyl acceptors, such as methanol, ethanol, 1-propanol, 1-butanol, 1-octanol, iso-propanol, tert-butanol, cyclohexanol, phenol, 1-naphtol, and 2-naphtol. Optimization of the asymmetric glycosylation reaction was achieved by modifying reaction conditions such as solvent, additive, loading of catalyst, temperature, and time of reaction. The best result was obtained with 2,3,4,6-tetra-O-benzyl-D-galactopyranosyl trichloroacetimidates, using 15 mol% of organocatalyst 1, in the presence of 2 equiv of MeOH in solvent-free conditions at room temperature for 1.5 h, affording the glycosidic compound in a 99% yield and 1:73 α:β stereoselectivity; under the same reaction conditions, without using a catalyst, the obtained stereoselectivity was 1:35 α:β. Computational calculations prior to the formation of the products were modeled, using density functional theory, M06-2X/6-31G(d,p) and M06-2X/6-311++G(2d,2p) methods. We observed that the preference for β glycoside formation, through a stereoselective inverted substitution, relies on steric effects and the formation of hydrogen bonds between thiourea 1 and methanol in the complex formed.

A meta-analysis of the effects of colostrum heat treatment on colostral viscosity, immunoglobulin G concentration, and the transfer of passive immunity in newborn dairy calves

Newborn ruminants depend on colostrum intake immediately after birth to obtain immunoglobulins for effective transfer of passive immunity (TPI). As colostrum may also be a vehicle of infectious agents, heat treatment of raw colostrum is a practice aimed at eliminating or reducing its pathogen load. Despite the usefulness of heat treatment in preventing the transmission of infectious colostrum-borne diseases, heat treatment of colostrum may have some side effects. A systematic review and meta-analysis were conducted to summarize the effects of colostrum heat treatment on colostral viscosity and IgG concentration, and serum IgG concentration as a proxy for TPI in newborn calves fed raw versus heat-treated colostrum. Moderators were studied to identify sources of heterogeneity. Literature databases were searched for peer-reviewed articles published between 1946 and 2022. A Master of Science thesis was also included. Five, 21, and 19 original publications were quantitatively evaluated in 3 separate meta-analyses, based on predefined selection criteria. Two-level and 3-level random-effects meta-analysis revealed a significant overall effect of heat treatment on colostral viscosity and IgG concentration, and serum IgG concentration in newborns. Heat-treated colostrum had significantly higher viscosity (21.0 cP, 95% CI: 3.8 to 38.2) and lower IgG concentration (-7.4 g/L, 95% CI: -11.1 to -3.7) compared with raw colostrum. Overall, newborn calves fed heat-treated colostrum had higher serum IgG concentrations (2.8 g/L, 95% CI: 1.4 to 4.0) 24-48 h after birth than those fed with raw colostrum. Particularly, this positive effect on the serum IgG concentrations was seen when colostrum was heat-treated at ≤60°C (2.9 g/L, 95% CI: 0.9 to 4.2) and when the standard low-temperature low-time (LTLT) method was used for heat treatment (2.6 g/L, 95% CI: 0.1 to 5.1). Colostrum treated at >60-63.5°C tended to have higher viscosity (275.6 cP, 95% CI: -37.9 to 589.3) and had lower IgG concentration (-21.7 g/L, 95% CI: -27.3 to -16.1). Calves fed colostrum treated at this temperature range had significantly lower serum IgG (-4.2 g/L, 95% CI: -7.9 to -0.4) compared with those fed raw colostrum. Heat treatment of colostrum at 72-76°C was not associated with a significant increase in colostral viscosity (6.3 cP, 95% CI: -324.3 to 336.9) nor a reduction in IgG colostral concentration (-13.1 g/L, 95% CI: -26.5 to 0.2), but calves fed colostrum treated at this temperature range had a significant reduction in serum IgG (-11.3 g/L, 95% CI: -17.1 to -5.4). Feeding newborn calves with colostrum heat-treated at ≤60°C by the standard LTLT method, particularly within 2 h after birth, resulted in increased serum IgG concentration at 24-48 h of age. Importantly, delaying feeding of heat-treated colostrum to newborns beyond 2 h of age resulted in no significant difference in IgG serum levels compared with feeding raw colostrum, highlighting the importance of early administration of heat-treated colostrum to favor TPI. On-farm colostrum heat treating should achieve an equilibrium between pathogen elimination and the preservation of colostral immunoglobulins while minimizing undesired increases in viscosity. The beneficial effects of colostrum heat treatment on TPI can be negligible if colostrum feeding is not performed within 2 h after birth.

Including 8 hours of access to alfalfa in 1 or 2 grazing sessions in dairy cows fed a partial mixed ration: Effects on intake, behavior, digestion, and milk production and composition

The aim of this study was to evaluate the inclusion of alfalfa grazing during 8 h continuous or partitioned in 2 separated sessions of 4 h after each milking, on nutrient intake, digestibility, ruminal fermentation, feeding behavior, milk production, milk composition, and milk fatty acid profile, in late-lactation cows fed a partial mixed ration (PMR). Twelve dairy cows (193 ± 83 d in milk, 584 ± 71 kg of body weight) were housed in individual outdoor pens and assigned to treatments according to a 3 × 3 Latin square design replicated 4 times. The treatments were as follows: (1) control (T0), cows were fed a total mixed ration (TMR) provided ad libitum 20.0% crude protein (CP), 32.2% neutral detergent fiber (NDF); (2) fed a diet combining a PMR which had the same ingredient composition as the TMR (60% of ad libitum intake) + 1 session of 8 h of pasture (T8), continuous grazing alfalfa (Medicago sativa; 20.6% CP, 35.8% NDF) after the p.m. milking; and (3) PMR (60% of ad libitum intake) + 2 daily sessions of 4 h of access to pasture after each milking (T4+4). The experiment lasted 57 d and was divided into 3 periods of 19 d each. The first 12 d of each period was used for diet adaptation, and the last 7 d was used for data collection. No differences among treatments were observed for any of the productive variables, feeding efficiency, or purine derivatives excretion. Cows in T0 had greater intake and apparent digestibility of dry matter, organic matter, and nonfibrous carbohydrates compared with T4+4 and T8. Compared with T0, alfalfa grazing increased the concentration of C18:1 trans-11 and decreased those of C16:0 and C17:0 in milk fat. Cows in T4+4 consumed 1.1 more kg DM/d of alfalfa and N provided by alfalfa in the diet was 3 percentage points higher compared with T8 cows (266 vs. 229 g/d, respectively). In addition, T4+4 cows had a greater daily range of ruminal pH than T8 (0.73 vs. 0.93), and the highest concentrations of NH3-N were recorded during the a.m. grazing session while in T8 cows it occurred during the night. In conclusion, including 8 h of alfalfa grazing in T8 and T4+4 treatments allowed the substitution between 35.8 and 38.7% of the total dry matter intake (DMI) of a PMR (with a similar CP concentration to alfalfa) for pasture, maintaining milk solids production and increasing the C18:1 trans-11 of milk fat compared with a TMR in mid late-lactation cows. In an herbage plus PMR diet, splitting the 1 continuous grazing session of 8 h into 2 sessions of 4 h increased the proportion of energy and N provided by alfalfa pasture and reduced PMR intake, without modifying the total nutrient intake or productive performance of cows.

Cascade Synthesis of Fluorinated Spiroheterocyclic Scaffolding for Peptidic Macrobicycles

Octafluorocyclopentene (OFCP) engages linear, unprotected peptides in polysubstitution cascades that generate complex fluorinated polycycles. The reactions occur in a single flask at 0-25 °C and require no catalysts or heavy metals. OFCP can directly polycyclize linear sequences using native functionality, or fluorospiroheterocyclic intermediates can be intercepted with exogenous nucleophiles. The latter tactic generates molecular hybrids composed of peptides, sugars, lipids, and heterocyclic components. The platform can create stereoisomers of both single- and double-looped macrocycles. Calculations indicate that the latter can mimic diverse protein surface loops. Subsets of the molecules have low energy conformers that shield the polar surface area through intramolecular hydrogen bonding. A significant fraction of OFCP-derived macrocycles tested show moderate to high passive permeability in parallel artificial membrane permeability assays.

2-[3-(1H-Benzimidazol-2-yl)prop-yl]-1H-benzimidazol-3-ium 3,4,5-tri-hydroxy-benzoate-1,3-bis-(1H-benzimidazol-2-yl)propane-ethyl acetate (2/1/2.94): co-crystallization between a salt, a neutral mol-ecule and a solvent

The chemical formula of the title compound, 2C₁₇H₁₇N₄ ⁺·2C₇H₅O₅ ^-·C₁₇H₁₆N₄·2.94C₄H₈O₂, was established by X-ray diffraction of a single-crystal obtained by reacting 1,3-bis-(benzimidazol-2-yl)propane (L) and gallic acid (HGal) in ethyl acetate. The mol-ecular structure can be described as a salt (HL)⁺(Gal)^- co-crystallized with a mol-ecule L, with a stoichiometric relation of 2:1. Moreover, large voids in the crystal are filled with ethyl acetate, the amount of which was estimated by using a solvent mask during structure refinement, affording the chemical formula (HL ⁺·Gal^-)₂·L·(C₄H₈O₂)_2.94. The arrangement of components in the crystal is driven by O-H⋯O, N-H⋯O and O-H⋯N hydrogen bonds rather than by π-π or C-H⋯π inter-actions. In the crystal, mol-ecules and ions shape the boundary of cylindrical tunnels parallel to [100] via R (rings) and D (discrete) supra-molecular motifs. These voids, which account for about 28% of the unit-cell volume, contain disordered solvent mol-ecules.

Milk fatty acid profile from grass feeding strategies on 2 Holstein genotypes: Implications for health and technological properties

The objective of the study was to determine if a feeding system with a variable supply of grass promoted rapid changes in the fatty acid profile and technological and health indices of milk obtained from North American (NAHF) and New Zealand (NZHF) Holstein-Friesian cows. Two feeding strategies were conducted: fixed grass (GFix) and maximized grass intake when available (GMax). The results showed that as the grass intake increased in the GMax treatments, the relative amount of palmitic acid in milk decreased, whereas oleic, linoleic, linolenic, and conjugated linoleic acids increased, causing a reduction in the atherogenic, thrombogenic, and spreadability calculated indices. The changes occurred in rapid response to the changing diet, with reductions ranging from approximately 5 to 15% in the healthy and technological indices within a period of 15 d of grass intake increase. Differences were found between the 2 genotypes, with NZHF responding faster to changes in grass intake.

CHALLENGING THE DOGMAS: LAPAROSCOPIC COMMON BILE DUCT EXPLORATION THROUGH DIATHERMY, CHOLEDOCHOTOMY AND PRIMARY CLOSURE. LONG TERM OUTCOMES IN A REFERRAL CENTER

Introduction

Choledocholithiasis is a frequent pathology, unfortunately when its endoscopic management fails there is no consensus on how it should be addressed. The aim of this study was to evaluate the safety, feasibility and long-term outcomes of laparoscopic common bile duct exploration (LCDBE) using electrosurgery (coagulation) for choledochotomy followed by primary closure after endoscopic treatment failure.

Methods

A retrospective cohort of 168 patients who underwent LCDBE from 2013 to 2018 which was conducted all by choledochotomy. Clinical demographics, operative outcomes, recurrence rate of CBD stones, and long-term bile duct complications were analyzed.

Results

The male/female ratio was 90/78 and mean age was 73 years. Stone clearance was successful in 167 patients (99.4%). Nonlethal complications were noted in 3 patients during the surgery or in the immediate postoperative (1.79%) and managed with T-tube or endoscopically. No cases of surgery-related mortality were observed. There were no signs of any type of biliary injury or stricture observed in any of the patients during the 24-month follow-up period.

Conclusions

LCBDE through choledochotomy with diathermy and primary closure can be performed without increased risk of operative complications such as important and visual-impairment bleeding as well as long-term complications such as bile duct stricture or recurrent CBD stones. LCBDE with diathermy and primary closure is a safe and effective treatment option for choledocholithiasis for failed ERCP in terms of long-term outcome as well as short-term outcome.

Electrochemical and CD-spectroelectrochemical studies of the interaction between BSA and the complex [Cu(Bztpen)]2+, (Bztpen = (N-benzyl-N, N', N'-tris (pyridin-2-ylmethyl) ethylenediamine)

In this work we report the electrochemical, spectroscopical and spectro-electrochemical studies of a model complex [Cu^ΙΙ(Bztpen)]²⁺, (Bztpen = (N-benzyl-N,N',N'-tris(pyridin-2-ylmethyl)ethylenediamine) in order to propose a methodology to evaluate the interaction of potential metal based anticancer agents during electron transfer processes, with transport proteins such as Bovine Serum Albumin (BSA). It was possible to establish a reversible electron transfer [Cu^ΙΙ(Bztpen)]²⁺ +1e → [Cu^Ι(Bztpen)]⁺ and a weak interaction energy between BSA and [Cu^ΙΙ(Bztpen)] and [Cu^Ι(Bztpen)] species, with no adsorption of protein over the electrode surface. Circular Dichroism (CD) Spectroelectrochemistry, not reported before, reveals no significant changes in BSA structure during the electron transfer [Cu^ΙΙ(Bztpen)]²⁺ + 1e → [Cu^Ι(Bztpen)]⁺. CD experiments at variable temperature for BSA denaturalization in the absence and in the presence of [Cu^ΙΙ(Bztpen)]²⁺, shown no change in thermodynamic parameters due to low interaction between the transport protein and copper complex.

The Assessment of the Diagnostic Accuracy of Antigen-Detecting Rapid Diagnostic Test using Nasopharyngeal Swab Specimen in Detecting SARS-CoV-2 among Patients in a Private Hospital in Bulacan, Philippines

Introduction/Objective

Continuous progression of the COVID-19 outbreak prompted an expensive, limited, and slow-moving laboratory-based molecular testing capacity of the gold standard, Real-time Reverse Transcription- Polymerase Chain Reaction (rRT-PCR), in detecting SARS-CoV-2. The vital step in mitigation is utilizing an accurate diagnostic detection assay to deploy various preventive measures. Therefore, there is a need to evaluate an accessible, fast, and inexpensive point-of-care immunoassay, such as Antigen-detecting Rapid Diagnostic Tests (Ag- RDTs). Thus, the study aimed to assess the diagnostic accuracy of Ag-RDT in detecting SARS-CoV-2.

Methods/Case Report

A non-experimental, quantitative, and cross-sectional cohort study utilized 272 SARS-CoV-2 Ag-RDT with rRT-PCR confirmation collected from April 2021 to February 2022 in a private primary hospital laboratory database in Bulacan, Philippines. Diagnostic accuracy parameters of Ag-RDT included in the study are sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV).

Results (if a Case Study enter NA)

The overall sensitivity and specificity of Ag-RDT were 69.6% and 98.8%, respectively. Additionally, it exhibited a PPV of 84.2% and an NPV of 97.2%. With a hypothetical 1% prevalence, PPV and NPV were 36.8% and 99.7%. Meanwhile, PPV and NPV were 86.5% and 96.7% at 10% prevalence. High specificity denotes that positive Ag-RDT test results can be confidently considered in true SARS-CoV-2 infection, while low sensitivity entails that a negative result must be subjected to confirmatory tests. Furthermore, when prevalence increases, PPV increases while NPV decreases.

Conclusion

The study primarily encapsulated that the Ag-RDT cannot replace rRT-PCR in detecting SARS-CoV-2 infections. Despite its shortcomings, Ag-RDT is still valuable in areas with moderate-to-high disease prevalence and with limited access to confirmatory test due to its high predictive values and advantages. A larger number of positive results of rRT-PCR, evaluation of factors correlating to low sensitivity, and a prospective study are recommended for future studies.

Caregiver willingness to give TPT to children living with drug-resistant TB patients

BACKGROUND Pediatric household contacts (HHCs) of patients with multidrug-resistant TB (MDR-TB) are at high risk of infection and active disease. Evidence of caregiver willingness to give MDR-TB preventive therapy (TPT) to children is limited.METHODS This was a cross-sectional study of HHCs of patients with MDR-TB to assess caregiver willingness to give TPT to children aged <13 years.RESULTS Of 743 adult and adolescent HHCs, 299 reported caring for children aged <13 years of age. The median caregiver age was 35 years (IQR 27-48); 75% were women. Among caregivers, 89% were willing to give children MDR TPT. In unadjusted analyses, increased willingness was associated with TB-related knowledge (OR 5.1, 95% CI 2.3-11.3), belief that one can die of MDR-TB (OR 5.2, 95% CI 1.2-23.4), concern for MDR-TB transmission to child (OR 4.5, 95% CI 1.6-12.4), confidence in properly taking TPT (OR 4.5, 95% CI 1.6-12.6), comfort telling family about TPT (OR 5.5, 95% CI 2.1-14.3), and willingness to take TPT oneself (OR 35.1, 95% CI 11.0-112.8).CONCLUSIONS A high percentage of caregivers living with MDR- or rifampicin-resistant TB patients were willing to give children a hypothetical MDR TPT. These results provide important evidence for the potential uptake of effective MDR TPT when implemented.

Genetic background in pediatric pulmonary arterial hypertension. Should we change the current recommendations for genetic testing?

Background

Pulmonary arterial hypertension (PAH) is a rare and severe disease, genetically predisposed in a high proportion of patients. PAH is subclassified in different subtypes depending on the underlying condition. Gene variants are more frequent among heritable or idiopathic forms. Nevertheless, pathogenic variants have been described across the entire spectrum of this disease. Evidence regarding genetics in pediatric PAH is scarce [1].

Purpose

Our aim is to describe the prevalence of significant gene mutations among a pediatric PAH cohort and to define specific data in the different subtypes.

Methods

Samples for genetic studies were obtained from blood tests of patients included in the Spanish National Registry of Pediatric Pulmonary Hypertension (REHIPED). Guardians signed informed consent before the inclusion in the study. Qualitative variables were compared by Chi-square test. Quantitative variables were assessed by Kruskal-Wallis, considering the asymmetric distribution of variables. STATA 14.0 was used for analyses.

Results

Sixty four patients were included between 2011 and 2021. Median age of the entire sample was 7.1 years (2.0–12.6) and 42.2% of them were male. There were significant differences in the age at diagnosis and race between the different included groups (table). Pathogenic or likely pathogenic variants were more frequent in familial pulmonary venooclusive disease (PVOD) and familial PAH cases. A similar percentage of mutations were found in idiopathic cases and in PAH associated with congenital heart disease (Figure). Gene variants in the gene encoding the bone morphogenetic protein receptor type 2 (BMPR2) were the most frequent mutations in the PAH familial cohort and there was also the most frequent finding in congenital heart disease and sporadic PAH, in conjunction with the TBX4 gene. Homozygous or compound heterozygous EIF2AK4 (eukaryotic translation initiation factor 2 a kinase 4) mutations were found in all the patients diagnosed with PVOD. Heritable PAH and PVOD cases were diagnosed more frequently after family screening.

Conclusions

This study shows a comparable proportion of pathogenic-likely pathogenic gene mutations in patients diagnosed of pulmonary arterial hypertension associated with congenital heart disease and idiopathic cases, with similar distribution of specific genes. BMPR2 and TBX 4 were the most frequent gene variants in this pediatric PAH population. BMPR2 and EIF2AK4 are the most common mutations in familial PAH and PVOD subtypes, respectively.

Funding Acknowledgement

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): ACU holds a Rio Hortega Grant from the Instituto de Salud Carlos III, Spanish Ministry of Science and Innovation.JAT and NG hold grants from FEDER (Federaciόn Española de Enfermedades Raras) and from the FCHP. Table 1. Characteristics of PAH subtypesFigure 1. PAH and ACMG classification.

Intensification strategies for temperate hot-summer grazing dairy systems in South America: Effects of feeding strategy and cow genotype

Pasture-based dairy systems present the opportunity to increase productivity per hectare through increasing stocking rate and forage utilization. However, in the temperate hot-summer region of South America, different productive strategies are being adopted by farmers. The aim of this study was to quantify the effect of feeding strategy (FS) and cow genotype (G) on individual animal and whole-farm biophysical performance. A design with 2 × 2 levels of intensification aiming to increase home-grown forage utilization and milk output per hectare was evaluated. The experiment was a randomized complete block design with a 2 × 2 factorial arrangement of treatments, combining 2 feeding strategies with varying proportions of grazing in the annual feeding budget [grass fixed (GFix) and grass maximum (GMax)] and 2 Holstein Friesian cow genotypes [New Zealand (NZHF) or North American Holstein Friesian (NAHF)]. The effects of FS, G, and their interaction were analyzed using mixed models. New Zealand Holstein Friesian cows presented lower individual milk yield and higher milk component concentrations, maintained higher average body condition score, and increased body weight (BW) throughout the experiment, while presenting a better reproductive performance compared with the NAHF cows. Although all farmlets were planned at the same stocking rate on a per kilogram of BW basis, the current stocking rate changed as a result of animal performance and grass utilization resulting in NZHF cows achieving greater BW per hectare. The superior stocking rate led to greater milk solids production and feed consumption per hectare for the systems with NZHF cows. The GFix feeding strategy resulted in greater total home-grown forage harvest and conserved forage surplus than GMax. Overall, it was feasible to increase stocking rate and increase milk production per hectare from home-grown forage with differing feeding strategies and Holstein Friesian cow genotypes within grazing systems located in the temperate hot-summer climate region of South America. The interactions reported between FS × G highlight the superior productivity per hectare of NZHF cows within the GMax feeding strategy based on maximizing grazed pasture, which could represent a competitive intensification strategy in terms of cost of production for this region.

Syntheses of Atypically Fluorinated Peptidyl Macrocycles through Sequential Vinylic Substitutions

Small peptides containing combinations of cysteine, tyrosine, histidine, and serine residues react with octafluorocyclopentene (OFCP) to afford atypically structured macrocycles through successive vinylic substitutions. The reactions proceed rapidly in air at 0 °C and are tolerant of spectating tryptophan, asparagine, glutamine, and threonine residues. Hexapeptides of consensus sequence YXCXXC displace four fluorine atoms from OFCP to generate fluorinated macrobicyclic compounds that display dual-turn surfaces. The method provides facile access to a wide range of previously unknown heterocyclic structures.

Carbohydrate source offered in the prepartum diet did not affect postpartum metabolic status or milk yield in dairy cows

Increasing the provision of non-fibrous carbohydrates (NFC) during the prepartum period is a feeding strategy that has been recommended to facilitate the transition to the onset of lactation and improve dairy cow performance, but results are contradictory, probably because most studies have confounded the effects of level and source of energy. The objective of this experiment was to evaluate the effect of the source of carbohydrate offered in the prepartum diet on postpartum cow performance. Holstein dairy cows (n=24) were assigned to receive diets with either low (LNFC), or high (HNFC) levels of NFC during the last 3 weeks before expected calving date according to a randomized complete block design. Soybean hulls and corn grain were the main energy ingredients in the LNFC and HNFC total mixed rations (TMR), respectively, and diets were designed to be isocaloric and isoproteic. After calving, all cows were managed as a single group until day 56 postpartum and grazed on improved pastures and were supplemented with a TMR. Body condition score evaluation and blood sampling were performed weekly throughout the experimental period to monitor the metabolic status of the animals. Prepartum glucose concentrations tended to be greater in HNFC than LNFC, but there was no effect on prepartum or postpartum insulin concentrations. Although nutrient intake was greater in the immediate week after calving in HNFC than LNFC, treatment did not affect milk yield and composition. In conclusion, increasing the NFC intake during the prepartum period, at a similar level of energy and protein intake, had a marginal residual effect on postpartum intake, and did not affect metabolic status or milk production.

HIV testing uptake among the household contacts of multidrug-resistant tuberculosis index cases in eight countries

SETTING

The household contacts (HHCs) of multidrug-resistant tuberculosis (MDR-TB) index cases are at high risk of tuberculous infection and disease progression, particularly if infected with the human immunodeficiency virus (HIV). HIV testing is important for risk assessment and clinical management.

METHODS

This was a cross-sectional, multi-country study of adult MDR-TB index cases and HHCs. All adult and child HHCs were offered HIV testing if never tested or if HIV-negative >1 year previously when last tested. We measured HIV testing uptake and used logistic regression to evaluate predictors.

RESULTS

A total of 1007 HHCs of 284 index cases were enrolled in eight countries. HIV status was known at enrolment for 226 (22%) HHCs; 39 (4%) were HIV-positive. HIV testing was offered to 769 (98%) of the 781 remaining HHCs; 544 (71%) agreed to testing. Of 535 who were actually tested, 26 (5%) were HIV-infected. HIV testing uptake varied by site (median 86%, range 0-100%; P < 0.0001), and was lower in children aged <18 years than in adults (59% vs. 78%; adjusted for site P < 0.0001).

CONCLUSIONS

HIV testing of HHCs of MDR-TB index cases is feasible and high-yield, with 5% testing positive. Reasons for low test uptake among children and at specific sites-including sites with high HIV prevalence-require further study to ensure all persons at risk for HIV are aware of their status.

Reducing milking frequency in early lactation improved the energy status but reduced milk yield during the whole lactation of primiparous Holstein cows consuming a total mixed ration and pasture

To investigate the immediate and long-term performance effects of milking frequency during early lactation of primiparous dairy cows consuming a total mixed ration and pasture, 20 Holstein cows were assigned in a randomized block design to either once-daily (1×) or twice-daily (2×) milking during the first 8 wk of lactation (treatment period). After the treatment period, all cows were milked 2× until wk 43 of lactation. Cows were fed a total mixed ration (approximately 15 kg of DM/cow per day) and allowed to graze an oat pasture (Avena sativa). Dry matter intake was 19.1 kg of DM/cow per day on average and was not affected by treatments. Milk yield was 40% lower in cows milked 1× during the treatment period, and a carryover effect existed until wk 21 of lactation, resulting in a final reduction of 15% of milk yield in the whole lactation. Milk lactose concentration decreased, whereas fat and protein concentrations increased for cows milked 1×. Mobilization of energy reserves during the treatment period occurred in both groups, but cows milked 1× showed greater body condition score and greater backfat thickness. In conclusion, milking 1× during the first 8 wk of lactation resulted in immediate and carryover negative effects on milk and milk solid yield without affecting feed intake, resulting in the improved energy status of primiparous dairy cows.

Spatial differences in ambient coarse and fine particles in the Monterrey metropolitan area, Mexico: Implications for source contribution

The ambient air of the Monterrey Metropolitan Area (MMA) in Mexico frequently exhibits high levels of PM₁₀ and PM_2.5. However, no information exists on the chemical composition of coarse particles (PM_c = PM₁₀ - PM_2.5). A monitoring campaign was conducted during the summer of 2015, during which 24-hr average PM₁₀ and PM_2.5 samples were collected using high-volume filter-based instruments to chemically characterize the fine and coarse fractions of the PM. The collected samples were analyzed for anions (Cl^-, NO₃^-, SO₄^2-), cations (Na⁺, NH₄⁺, K⁺), organic carbon (OC), elemental carbon (EC), and 35 trace elements (Al to Pb). During the campaign, the average PM_2.5 concentrations did not showed significance differences among sampling sites, whereas the average PM_c concentrations did. In addition, the PM_c accounted for 75% to 90% of the PM₁₀ across the MMA. The average contribution of the main chemical species to the total mass indicated that geological material including Ca, Fe, Si, and Al (45%) and sulfates (11%) were the principal components of PM_c, whereas sulfates (54%) and organic matter (30%) were the principal components of PM_2.5. The OC-to-EC ratio for PM_c ranged from 4.4 to 13, whereas that for PM_2.5 ranged from 3.97 to 6.08. The estimated contribution of Secondary Organic Aerosol (SOA) to the total mass of organic aerosol in PM_2.5 was estimated to be around 70-80%; for PM_c, the contribution was lower (20-50%). The enrichment factors (EF) for most of the trace elements exhibited high values for PM_2.5 (EF: 10-1000) and low values for PM_c (EF: 1-10). Given the high contribution of crustal elements and the high values of EFs, PM_c is heavily influenced by soil resuspension and PM_2.5 by anthropogenic sources. Finally, the airborne particles found in the eastern region of the MMA were chemically distinguishable from those in its western region. Implications: Concentration and chemical composition patterns of fine and coarse particles can vary significantly across the MMA. Public policy solutions have to be built based on these observations. There is clear evidence that the spatial variations in the MMA's coarse fractions are influenced by clearly recognizable primary emission sources, while fine particles exhibit a homogeneous concentration field and a clear spatial pattern of increasing secondary contributions. Important reductions in the coarse fraction can come from primary particles' emission controls; for fine particles, control of gaseous precursors-particularly sulfur-containing species and organic compounds-should be considered.

Productive performance and digestive response of dairy cows fed different diets combining a total mixed ration and fresh forage

The purpose of this experiment was to determine the effects of feeding increasing levels of fresh forage (FF) as a proportion of total dry matter intake (DMI) on nutrient intake, rumen digestion, nutrient utilization, and productive performance of total mixed ration (TMR)-fed cows. Twelve dairy cows (90 ± 22 d in milk, 523 ± 88 kg of body weight, 7,908 ± 719 kg of milk production in the previous lactation) were housed in individual tiestalls and assigned to treatments according to a 3 × 3 Latin square design replicated 4 times. Treatments were 100% TMR (T100), 75% TMR plus 25% FF (T75), and 50% TMR plus 50% FF (T50). The experiment lasted 60 d, divided into 3 periods of 20 d each; the first 12 d of each period were used for diet adaptation and the last 8 d for data collection. The TMR (18.1% crude protein, 24.6% acid detergent fiber) and FF (Lolium multiflorum; 15.1% crude protein, 24.1% acid detergent fiber) were prepared and cut daily and offered to each cow individually. The highest DMI was reached in T100 and T75, which was reflected in greater intake of the different nutrients than T50. No differences were detected in the apparent total digestibility of the nutrients, mean ruminal pH, and total volatile fatty acid concentrations among treatments. Cows in T50 resulted in the lowest ruminal N-NH₃ concentration and the lowest microbial N flow to the duodenum. Milk yield was 8.5% higher from cows in T100 and T75 compared with T50, but we observed no differences for milk fat or milk protein yield among treatments. Milk fat of cows fed T50 had 8% more unsaturated fatty acids (FA) than that of cows fed T100, mostly because of a higher content of monounsaturated FA. Additionally, cows in T50 had a higher concentration of linoleic acid, vaccenic acid, and rumenic acid than T100. Meanwhile, the concentration of linoleic acid and vaccenic acid in cows fed T75 was higher than T100. The milk fat of the cows fed T50 and T75 had a lower n-6:n-3 ratio than T100. We concluded that including up to 29% of FF in the total DMI in combination with a TMR did not affect the intake or digestion of nutrients or the productive response in dairy cows and resulted in a higher concentration of desirable FA from a consumer's perspective.

Abstract B16: Evaluation of LDH inhibition as a treatment strategy in Ewing sarcoma

Long-term outcomes for patients with relapsed, recurrent, or metastatic Ewing sarcoma (ES) remain poor despite advances in multimodal chemotherapy and local tumor control. The discovery of new targets and novel therapies is therefore critical to improving care for these patients. Recent insights into the metabolic landscape of ES have revealed that the EWS/FLI1 fusion oncoprotein regulates metabolic pathways in this disease, including shifting glucose consumption away from oxidative metabolism and towards glycolysis, a pathway that relies on LDH. Targeting this increased dependence on glycolysis presents an opportunity to inhibit the growth of ES cells through a novel therapeutic approach, while potentially limiting the toxicity delivered to normal cells. We therefore sought to evaluate the activity of NCGC-737 and NCGC-006, two novel LDHA/B inhibitors identified and validated as part of the Experimental Therapeutics Program of the National Cancer Institute (NCI-NExT), in ES.

For in vitro studies, proliferation of ES cells lines was assessed after inhibition of LDHA/B by each agent using IncuCyte and MTS assays. Protein expression of phospho- and total LDH was evaluated by Western blot. LDH activity was assessed using the pyruvate-dependent oxidation of NADH. NAD/NADH levels were determined using NAD/NADH-Glo. Analysis of glycolytic profiles was performed using the Agilent Extracellular Flux Analyzer. For in vivo studies, female SCID mice underwent orthotopic injection of ES cells from established cell lines. When tumors reached a desired size, mice were randomized and then treated on a variety of dosing schedules. Toxicity assessments included evaluation of overall appearance, weekly weights, blood sampling, and full necropsies on selected mice. Tumors were measured twice per week for assessment of efficacy. Tumors were harvested at midpoints and at study endpoint for assessments of drug level, target inhibition, and biology.

ES cell lines displayed varying sensitivity to NCGC-737 and NCGC-006, with IC-50 values ranging from 50 nM to 500 nM. While protein expression of phospho-LDH, total LDH-A, and total LDH-B were not correlated with sensitivity to either agent, glycolytic profiles were predictive of sensitivity. Cell lines that underwent a greater reduction in glycolytic capacity (the change in ECAR measured before and after oligomycin treatment) after LDHA/B inhibition experienced a greater antiproliferative effect, while cell lines that were able to maintain glycolytic capacity despite LDHA/B inhibition exhibited less of an effect on growth. In vivo studies to describe the toxicity of these agents demonstrated that hemolysis was the primary dose-limiting toxicity, and was dose dependent. Additional toxicity studies of specific tissues are ongoing and will be reported. Preliminary in vivo studies to optimize dosing regimen established that compared to oral dosing, intravenous dosing resulted in higher and more consistent tumor drug levels and improved target inhibition, with up to 93% of intratumoral LDH activity inhibited. Efficacy studies are ongoing and will be reported.

Preclinical data suggest that inhibition of LDHA/B may represent a potentially novel therapeutic strategy in the treatment of ES.

Citation Format: Christine M. Heske, Anna E. Gibson, Josh T. Baumgart, Choh Yeung, Sameer H. Issaq, A Mendoza, Michelle S. Johnson, Guiseppe L. Squadrito, Lillian Culp, Victor M. Darley-Usmar, Len M. Neckers. Evaluation of LDH inhibition as a treatment strategy in Ewing sarcoma [abstract]. In: Proceedings of the AACR Special Conference: Pediatric Cancer Research: From Basic Science to the Clinic; 2017 Dec 3-6; Atlanta, Georgia. Philadelphia (PA): AACR; Cancer Res 2018;78(19 Suppl):Abstract nr B16.

Crystal structure of r-1,c-2-dibenzoyl-t-3,t-4-bis-(2-nitro-phen-yl)cyclo-butane

The condensation reaction of aceto-phenone (1-phenyl-ethan-1-one) with 2-nitro-benzaldehyde in the molten state yielded the expected chalcone, (E)-3-(2-nitro-phen-yl)-1-phenyl-prop-2-en-1-one, and, unexpectedly, the title compound, C₃₀H₂₂N₂O₆, which results from the syn head-to-head [2 + 2] cyclo-addition of the chalcone. The mol-ecular structure of the dimer shows that the four benzene rings of the substituents are oriented in such a way that potential steric hindrance is minimized, whilst allowing some degree of inter-molecular π-π inter-actions for crystal stabilization. In the mol-ecule, one nitro group is disordered over two positions, with occupancies for each part of 0.876 (7) and 0.127 (7).

Grating coupled SPR microarray analysis of proteins and cells in blood from mice with breast cancer

Biomarker discovery for early disease diagnosis is highly important. Of late, much effort has been made to analyze complex biological fluids in an effort to develop new markers specific for different cancer types. Recent advancements in label-free technologies such as surface plasmon resonance (SPR)-based biosensors have shown promise as a diagnostic tool since there is no need for labeling or separation of cells. Furthermore, SPR can provide rapid, real-time detection of antigens from biological samples since SPR is highly sensitive to changes in surface-associated molecular and cellular interactions. Herein, we report a lab-on-a-chip microarray biosensor that utilizes grating-coupled surface plasmon resonance (GCSPR) and grating-coupled surface plasmon coupled fluorescence (GCSPCF) imaging to detect circulating tumor cells (CTCs) from a mouse model (FVB-MMTV-PyVT). GCSPR and GCSPCF analysis was accomplished by spotting antibodies to surface cell markers, cytokines and stress proteins on a nanofabricated GCSPR microchip and screening blood samples from FVB control mice or FVB-MMTV-PyVT mice with developing mammary carcinomas. A transgenic MMTV-PyVT mouse derived cancer cell line was also analyzed. The analyses indicated that CD24, CD44, CD326, CD133 and CD49b were expressed in both cell lines and in blood from MMTV-PyVT mice. Furthermore, cytokines such as IL-6, IL-10 and TNF-α, along with heat shock proteins HSP60, HSP27, HSc70(HSP73), HSP90 total, HSP70/HSc70, HSP90, HSP70, HSP90 alpha, phosphotyrosine and HSF-1 were overexpressed in MMTV-PyVT mice.

Digestive response of dairy cows fed diets combining fresh forage with a total mixed ration

The objective of this experiment was to quantify the response of dairy cows fed a total mixed ration (TMR) to increasing access to high-quality temperate fresh forage with respect to energy intake, rumen fermentation, microbial protein flow, passage rate, nutrient digestion and utilization, and metabolic and endocrine profiles. Nine Holstein cows fed a TMR were assigned to the following treatments according to a 3×3 Latin square replicated 3 times with 20-d periods and sampling on the last 10 d of each period: 0 (T0), 4 (T4), or 8 (T8) h of daily access to fresh forage. The forage (Lolium multiflorum; 17.1% crude protein, 26.5% acid detergent fiber) was cut daily and offered ad libitum beginning at 0800h, and a TMR (16.1% crude protein, 22.9% acid detergent fiber) was offered ad libitum during the remaining time. Energy intake and balance were higher in T0 than in T8, which was reflected in higher blood glucose and insulin concentrations in T0. Total volatile fatty acid concentrations in the rumen were higher in T0 and T4 than in T8, pH was lower in T4 than in T8, and ammonia-N was higher in T0 than in T8. No differences among treatments were detected in microbial protein flow to the duodenum, digestibility of nutrients, apparent efficiency of energy, or N utilization for milk production, but the total mean retention time of feed in the digestive tract was higher in T8 than in T0. It is concluded that more than 4h of daily access to high-quality fresh forage in the diet of dairy cows fed a TMR reduced energy intake and balance but had no effects on nutrient digestion or utilization.

Crystal structures of ten enanti-opure Schiff bases bearing a naphthyl group

Enanti­opure imines synthesized starting from 2-naphthaldehyde and chiral liquid amines were characterized by X-ray diffraction.

Using a general solvent-free procedure for the synthesis of chiral Schiff bases, the following compounds were synthesized and their crystal structures determined: (S)-(+)-2-{[(1-phenyl­eth­yl)imino]­meth­yl}naphthalene, C₁₉H₁₇N, (1), (S)-(+)-2-({[(4-methyl­phen­yl)eth­yl]imino}­meth­yl)naphthalene, C₂₀H₁₉N, (2), (R)-(−)-2-({[(4-meth­oxy­lphen­yl)eth­yl]imino}­meth­yl)naphthalene, C₂₀H₁₉NO, (3), (R)-(−)-2-({[(4-fluoro­phen­yl)eth­yl]imino}­meth­yl)naphthalene, C₁₉H₁₆FN, (4), (S)-(+)-2-({[(4-chloro­phen­yl)eth­yl]imino}­meth­yl)naphthalene, C₁₉H₁₆ClN, (5), (S)-(+)-2-({[(4-bromo­phen­yl)eth­yl]imino}­meth­yl)naphthalene, C₁₉H₁₆BrN, (6), (S)-(+)-2-({[1-(naphthalen-1-yl)eth­yl]imino}­meth­yl)naph­thalene, C₂₃H₁₉N, (7), (S)-(+)-2-{[(1-cyclo­hexyl­eth­yl)imino]­meth­yl}naph­tha­lene, C₁₉H₂₃N, (8), (S)-(−)-2-{[(1,2,3,4-tetra­hydro­naphthalen-1-yl)imino]meth­yl}naphthalene, C₂₁H₁₉N, (9), and (+)-2-({[(1S,2S,3S,5R)-2,6,6-tri­methylbi­cyclo­[3.1.1]hept-3-yl]imino}­meth­yl}naphthalene, C₂₁H₂₅N, (10). The moiety provided by the amine generates conformational flexibility for these imines. In the crystals, no strong inter­molecular contacts are observed, in spite of the presence of aromatic groups.

Crystal structures of four chiral imine-substituted thio-phene derivatives

A series of thio-phenes substituted in positions 2 and 5 by imine groups have been synthesized using a solvent-free approach, and their crystal structures determined. The substituents are chiral groups, and the expected absolute configuration for each mol-ecule was confirmed by refinement of the Flack parameter. The compounds are 2,5-bis-[(S)-(+)-(1,2,3,4-tetra-hydro-naphthalen-1-yl)imino]-thio-phene, C26H26N2S, (I), 2,5-bis-{[(R)-(-)-1-(4-meth-oxy-phen-yl)eth-yl]imino-meth-yl}thio-phene, C24H26N2O2S, (II), 2,5-bis-{[(R)-(-)-1-(4-fluoro-phen-yl)eth-yl]imino-meth-yl}thio-phene, C22H20F2N2S, (III), and 2,5-bis-{[(S)-(+)-1-(4-chloro-phen-yl)eth-yl]imino-meth-yl}thio-phene, C22H20Cl2N2S, (IV). A common feature of all four mol-ecules is the presence of twofold symmetry. For (I), which crystallizes in the triclinic space group P1, this symmetry is non-crystallographic, but for (II) in C2 and the isomorphous structures (III) and (IV) that crystallize in P21212, the twofold symmetry is crystallographically imposed with one half of each mol-ecule in the asymmetric unit. The comparable mol-ecular symmetry in the four structures is also reflected in similar packing, with mol-ecules aggregated to form chains through weak C-H⋯S inter-actions.

Drugs of abuse, cytostatic drugs and iodinated contrast media in tap water from the Madrid region (central Spain):A case study to analyse their occurrence and human health risk characterization

This work analyses the presence of forty-eight emerging pollutants, including twenty-five drugs of abuse and metabolites, seventeen cytostatic drugs and six iodinated contrast media, in tap water from the Madrid Region. Analysis of the target compounds in the tap water was performed by means of (on-line or off-line) solid-phase extraction followed by analysis by liquid chromatography-tandem mass spectrometry. A preliminary human health risk characterization was undertaken for each individual compound and for different groups of compounds with a common mechanism of action found in tap water. The results of the study showed the presence of eight out of the twenty-five drugs of abuse and metabolites analysed, namely, the cocainics cocaine and benzoylecgonine, the amphetamine-type stimulants ephedrine, 3,4-methylenedioxymethamphetamine and methamphetamine, the opioid methadone and its metabolite 2-ethylene-1,5-dimethyl-3,3-diphenylpyrrolidine and, finally caffeine at concentrations ranging from 0.11 to 502 ng L(-1). Four out of the six analysed iodinated contrast media, namely, diatrizoate, iohexol, iomeprol and iopromide, were detected in at least one sample, with concentration values varying between 0.4 and 5 ng L(-1). Cytostatic compounds were not detected in any sample. Caffeine was the substance showing the highest concentrations, up to 502 ng L(-1), mainly in the drinking water sampling point located in Madrid city. Among the other drugs of abuse, the most abundant compounds were cocaine and benzoylecgonine, detected at concentrations ranging from 0.11 to 86 ng L(-1) and from 0.11 to 53 ng L(-1), respectively. Regarding iodinated contrast media, iohexol was the most ubiquitous and abundant compound, with a frequency of detection of 100% and concentrations from 0.5 to 5.0 ng L(-1) in basically the same range in all sampling points. Taking into account the results and types of treatment applied, ozonisation plus granular activated carbon filtration appears to be efficient in the removal of cocaine and benzoylecgonine. For the amphetamine-type stimulants, opioids and caffeine, ozonisation plus granular activated carbon filtration and ultrafiltration plus reverse osmosis showed higher removal efficiency than sand filtration. The human health risk characterization performed indicates that the lifetime consumption of the tap waters analysed has associated a negligible human health concern.

Pharmaceuticals and iodinated contrast media in a hospital wastewater: A case study to analyse their presence and characterise their environmental risk and hazard

This work analyses the presence of twenty-five pharmaceutical compounds belonging to seven different therapeutic groups and one iodinated contrast media (ICM) in a Spanish medium-size hospital located in the Valencia Region. Analysis of the target compounds in the hospital wastewater was performed by means of solid phase extraction (SPE) followed by liquid chromatography-tandem mass spectrometry analysis (HPLC-MS/MS). A screening level risk assessment combining the measured environmental concentrations (MECs) with dose-response data based on Predicted No Effect Concentration (PNEC) was also applied to estimate Hazard Quotients (HQs) for the compounds investigated. Additionally, the environmental hazard associated to the various compounds measured was assessed through the calculation of the Persistence, Bioaccumulation and Toxicity (PBT) Index, which categorizes compounds according to their environmentally damaging characteristics. The results of the study showed the presence of twenty-four out of the twenty-six compounds analysed at individual concentrations ranging from 5 ng L(-1) to 2 mg L(-1). The highest concentrations corresponded to the ICM iomeprol, found at levels between 424 and 2093 μg L(-1), the analgesic acetaminophen (15-44 μg L(-1)), the diuretic (DIU) furosemide (6-15 μg L(-1)), and the antibiotics (ABIs) ofloxacin and trimethoprim (2-5 μg L(-1)). The lowest levels corresponded to the anti-inflammatory propyphenazone, found at concentrations between 5 and 44 ng L(-1). Differences in terms of concentrations of the analysed compounds have been observed in all the therapeutic groups when comparing the results obtained in this and other recent studies carried out in hospitals with different characteristics from different geographical areas and in different seasons. The screening level risk assessment performed in raw water from the hospital effluent showed that the analgesics and anti-inflammatories (AAFs) acetaminophen, diclofenac, ibuprofen and naproxen, the antibiotics (ABIs) clarithromycin, ofloxacin and trimethoprim, and the β-blocker (BBL) propranolol were present at concentrations leading to HQ values higher than 10, thus indicating high risk. When applying a factor to take into account potential dilution and degradation processes, only the compound ibuprofen showed a HQ higher than 1. Likewise, the cumulative HQ or Toxic Units (TUs) calculated in the raw water for each of the therapeutic groups studied showed that these three classes of drugs were at concentrations high enough to potentially generate high risk to aquatic organisms while taking into account possible dilution and degradation processes only one of them, the AAFs can be considered to represent high risk. Finally, the environmental hazard assessment performed showed that the AAFs diclofenac and ibuprofen and the ABI clarithromycin have the highest, maximum value of 9 of PBT Index due to their inherent environmentally damaging characteristics of persistence, bioaccumulation and toxicity. The methodology followed in the present case study can be taken as a novel approach to classify and categorize pharmaceuticals on the basis of their occurrence in hospital effluents, their derived environmental risks, and their associated environmental hazard. This classification becomes important because it can be used as a model or orientation for hospitals in the process of developing environmentally sustainable policies and as an argument to justify the adoption of advanced, specific treatments for hospital effluents before being discharged into the public sewage system.

Prospective study of infantile haemangiomas: incidence, clinical characteristics and association with placental anomalies

BACKGROUND

The aetiology and exact incidence of infantile haemangiomas (IHs) are unknown. Prior studies have noted immunohistochemical and biological characteristics shared by IHs and placental tissue.

OBJECTIVES

We investigated the possible association between placental anomalies and the development of IHs, as well as the demographic characteristics and other risk factors for IHs.

PATIENTS AND METHODS

Pregnant women (n = 578) were prospectively enrolled and their offspring followed for 9 months. Placental evaluations were performed and demographic data collected on all mother-infant pairs.

RESULTS

We evaluated 594 infants: 34 haemangiomas [either IH or congenital (CH)] were identified in 29 infants, yielding an incidence of 4·5% for IH (27 infants) and 0·3% for CH (two infants). Placental anomalies were noted in almost 35% of haemangioma-related pregnancies, approximately twice the incidence noted in pregnancies with unaffected infants (P = 0·025). Other risk factors for IH included prematurity (P = 0·016) and low birth weight (P = 0·028). All IHs were present by 3 months of age, and cessation of growth had occurred in all by 9 months of age. Most occurred on the trunk. Of note, 20% of identified IHs were abortive or telangiectatic in nature, small focal lesions that did not proliferate beyond 3 months of age. Only one IH required intervention.

CONCLUSIONS

This is the first prospective American study to document the incidence of IHs in infants followed from birth to early infancy. The association with placental anomalies was statistically significant. The overall incidence mirrors prior estimates, but the need for treatment was lower than previously reported.

Feasibility and safety of biventricular repair in neonates with hypoplastic left heart complex

Hypoplastic left heart syndrome is a spectrum of structural cardiac malformations characterized by variable underdevelopment of the left heart-aorta complex. A minority of patients having a milder degree of left ventricular hypoplasia, described as hypoplastic left heart complex (HLHC), may be selected for biventricular repair. The objective of this study was to assess the outcome of the biventricular approach in HLHC. We evaluated retrospectively 30 neonates diagnosed with HLHC from the "12 de Octubre" University Hospital, following established criteria. We analyzed the echocardiographic data recorded just after birth and at last follow-up after surgery. All patients were operated on in the neonatal period using various surgical techniques. There were no early deaths and only 1 late death after a mean follow-up of 62.9 ± 43.8 months. All patients presented a significant growth of the left ventricular structures, with a Z-score increase of 1.17 ± 1.05 for mitral annulus, 1.72 ± 1.23 for aortic annulus, and 1.33 ± 1.46 for left ventricular end-diastolic diameter. Postoperatively, 18 patients showed a left valvular stenosis, and 17 patients underwent a reoperation and/or an interventional procedure. Freedom from surgery or interventional catheterizations at 1, 3 and 5 years was 53, 49 and 43%, respectively. The 29 current survivors are all in a good functional status. In our experience, we achieved good results from biventricular repair in patients with HLHC, with a significant growth of left heart structures and an excellent clinical status at a medium-term follow-up. Nevertheless, there was a high rate of reoperations and/or interventional catheterizations.

Crystal structure of (2S,4R)-ethyl 4-nitromethyl-1-[(S)-1-phenylethyl]-6-sulfanylidenepiperidine-2-carboxylate

In the title compound, C₁₇H₂₂N₂O₄S, a thio­piperidine derivative, the piperidine ring has an envelope conformation with the methyl­ene C atom opposite to the C=S bond as the flap. The nitro­methyl substituent is equatorial while the eth­oxy­carbonyl group is axial. The mean planes of the nitro­methyl group, the carb­oxy group and phenyl ring are inclined to the mean plane through the five planar atoms of the piperidine ring [maximum deviation = 0.070 (4) Å] by 56.8 (2), 83.8 (5) and 87.1 (2)°, respectively. There is an intra­molecular C—H⋯O hydrogen bond involving an H atom of the eth­oxy­carbonyl group and a nitro O atom. In the crystal, mol­ecules are linked by C—H⋯O hydrogen bonds, forming chains along [100]. The chains are linked by further C—H⋯O hydrogen bonds, forming corrugated layers lying parallel to (001).

A counteranion triggered arylation strategy using diaryliodonium fluorides

A mild and transition metal-free counteranion triggered arylation strategy has been developed using diaryliodonium fluorides.

A mild and transition metal-free counteranion triggered arylation strategy has been developed using diaryliodonium fluorides. The fluoride counteranion within the hypervalent iodonium species displays unusual reactivity that activates a phenolic O–H bond leading to electrophilic O-arylation. A wide range of phenols and diaryliodonium salts are compatible with this transformation under remarkably mild conditions. Furthermore, we pre-empt the wider implications of this strategy by demonstrating the compatibility of the arylation tactic with latent carbon nucleophiles.

Drugs of abuse and benzodiazepines in the Madrid Region (Central Spain): seasonal variation in river waters, occurrence in tap water and potential environmental and human risk

This work analyzes the seasonal variation (winter and summer) of ten drugs of abuse, six metabolites and three benzodiazepines in surface waters from the Jarama and Manzanares Rivers in the Madrid Region, the most densely populated area in Spain. The occurrence of these compounds in tap water in this region is also investigated and a preliminary human health risk characterization performed for those substances found in tap water. Finally, a screening level risk assessment that combines the measured environmental concentrations (MECs) with dose-response data to estimate Hazard Quotients (HQs) for the compounds studied is also presented. The results of this study show the presence of fourteen out of the nineteen compounds analyzed in winter and twelve of them in summer. The most ubiquitous compounds, with a frequency of detection of 100% in both seasons, were the cocaine metabolite benzoylecgonine (BE), the amphetamine-type stimulant (ATS) ephedrine (EPH), the opioid methadone (METH), the METH metabolite 2-ethylene-1,5-dimethyl-3,3-diphenylpyrrolidine (EDDP), and the three benzodiazepines investigated, namely alprazolam (ALP), diazepam (DIA) and lorazepam (LOR). The highest concentrations observed corresponded to EPH (1020ngL(-1) in winter and 250ngL(-1) in summer). The only compounds not detected in both seasons were heroin (HER) and its metabolite 6-acetylmorphine (6ACM), lysergic acid diethylamide (LSD) and its metabolite 2-oxo-3-hydroxy-LSD (O-H-LSD), and Δ(9)-tetrahydrocannabinol (THC). In terms of overall concentration, all sampling points presented higher concentrations in winter than in summer. Statistical analyses performed to gather evidence concerning occasional seasonal differences in the concentrations of individual substances between summer and winter showed statistically significantly higher concentrations (p<0.05) of BE, EPH and the opioid morphine (MOR) in winter than in summer. Two out of the nineteen compounds studied, namely cocaine (CO) and EPH, were detected in tap water from one sampling point at concentrations of 1.61 and 0.29ngL(-1), respectively. The preliminary human health risk characterization showed that no toxic effects could be expected at the detected concentration level in tap water. The screening level risk assessment showed that MOR, EDDP and the THC metabolite 11-nor-9-carboxy-Δ(9)-tetrahydrocannabinol (THC-COOH) were present in at least one of the sampling sites in a concentration leading to a Hazard Quotient (HQ) value between 1.0 and 10.0, thus indicating some possible adverse effects. The cumulative HQ or Toxic units (TUs) calculated for each of the groups studied showed that opioids and cannabinoids were present at concentrations high enough to potentially generate some adverse effects on at least one sampling point.