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Articles outside of the United States were excluded. Four themes emerged from the literature (1) improved patient attitudes toward ACP, (2) effective communication surrounding care preferences, (3) strengthened connection between preferred and delivered care, and (4) increased patient involvement in ACP. CONCLUSION Chronic diseases such as heart failure and COPD have a high symptom burden punctuated by exacerbations, making it difficult to know when introduction of ACP discussions would be most beneficial. Future research should focus on a deeper evaluation of when to introduce ACP conversations in this population and which ACP interventions are effective to facilitate these discussions.AIMS Most out-of-hospital cardiac arrests occur at home with dismal bystander defibrillation rates. We investigated automated external defibrillator coverage of home arrests, and the proportion potentially reachable with an automated external defibrillator before emergency medical service arrival according to different bystander activation strategies. METHODS AND RESULTS Cardiac arrests in homes (private/nursing/senior homes) in Copenhagen, Denmark (2008-2016) and registered automated external defibrillators (2007-2016), were identified. Automated external defibrillator coverage (distance from arrest to automated external defibrillator) and accessibility at the time of arrest were examined according to route distance to nearest automated external defibrillator and emergency medical service response time. The proportion of arrests reachable with an automated external defibrillator by bystander was calculated using two-way (from patient to automated external defibrillator and back) and one-way (from automated e the automated external defibrillator to the patient.An efficient kinetic resolution of propargyloxy dicarbonyl compounds via asymmetric [2,3]-Wittig rearrangement was achieved by using a chiral N,N'-dioxide/NiII complex catalyst. Various chiral α-allenyl alcohols were obtained in high enantioselectivities under mild conditions. The utility of this method was readily demonstrated in the asymmetric synthesis of the chiral 2,5-dihydrofuran derivative.Tiglianes such as prostratin and related diterpenoids are biologically significant natural molecules and long-standing targets for organic synthesis community. Due to the complex polycyclic scaffolds, high oxygenation level, and dense functional groups and stereocenters, their de novo chemical syntheses still face formidable challenges despite extensive efforts in the past 40 years. This account details the development of a modular and concise synthesis of prostratin, a potent anti-HIV and anticancer agent. The key approach in this synthesis involved a sequence of oxidative dearomatization and sequential stereoselective installation of peripheral groups to rapidly build the contiguously substituted cyclohexane C-ring. Adavivint Inspired by Wender's work, an acid- and solvent-controlled stereodivergent formation of cyclopropane D-ring was developed. Mechanistic investigations by computational methods revealed that the competition between intra- and intermolecular hydrogen bonding led to different conformations, thus favoring different protonation processes. The designed and unexpected chemistry along this campaign reflected the uniqueness of the natural structures and should be amenable to future chemical syntheses of related complex polycyclic molecules.Cationic polymers condense nucleic acids into nanosized complexes (polyplexes) that are widely explored for nonviral gene delivery, but their strong electrostatic binding with DNA causes inefficient intracellular gene release and translation, and thereby unsatisfactory gene transfection efficiencies. Facilitated intracellular dissociation of polyplexes by making the polymer undergo positive-to-negative/neutral charge-reversal can effectively solve these problems, but they must be sufficiently stable during the delivery. Herein, we report the first glutathione (GSH)-specific intracellular labile polyplexes for cancer-targeted gene delivery. Adavivint The polymer is made from p-(2,4-dinitrophenyloxybenzyl)-ammonium cationic moieties, whose p-2,4-dinitrophenyl ether is cleaved specifically by GSH, rather than other biological thiols, triggering the conversion of the ammonium cation to the carboxylate anion and thus the fast intracellular DNA release of the polyplexes. link2 Furthermore, the polyplexes coated with PEG-functionalized lipids are stable in biological fluids to gain long blood circulation for tumor accumulation. Adavivint Thus, the efficient tumor accumulation and cell transfection of the polyplexes loaded with tumor suicide gene TRAIL give rise to potent antitumor activity similar to the first-line chemotherapy drug paclitaxel but much less adverse effects.Herein, two bis(dicyanomethylene)-substituted quinoidal molecules QBDT and QTBDT-3H were designed and synthesized to explore the open-shell effect on tuning the charge transport behavior of organic π-functional materials. The biradical character of QTBDT-3H was confirmed by DFT calculation, variable-temperature NMR, electron spin resonance (ESR), and superconducting quantum-interfering device (SQUID). The open-shell character enables QTBDT-3H an ambipolar characteristic under ambient conditions with highly balanced electron and hole mobilities of 0.32 and 0.16 cm2 V-1 s-1, respectively.As vast numbers of new chemicals are introduced to market annually, we are faced with the grand challenge of protecting humans and the environment while minimizing economically and ethically costly animal testing. In silico models promise to be the solution we seek, but we find ourselves at crossroads of future development efforts that would ensure standalone applicability and reliability of these tools. A conscientious effort that prioritizes experimental testing to support the needs of in silico models (versus regulatory needs) is called for to achieve this goal. Using economic analogy in the title of this work, we argue that a prudent investment is to go all-in to support in silico model development, rather than gamble our future by keeping the status quo of a "balanced portfolio" of testing approaches. We discuss two paths to future in silico toxicology-one based on big-data statistics ("broadsword"), and the other based on direct modeling of molecular interactions ("scalpel")-and offer rationale that the latter approach is more transparent, is better aligned with our quest for fundamental knowledge, and has a greater potential to succeed if we are willing to transform our toxicity-testing paradigm.The reactions of iridium- and osmium-carbyne hydride cations [HIrCH]+ and [HOsCH]+ with ethylene have been studied using mass spectrometry with isotopic-labeling in the gas phase. The carbyne reactivity is compared with that of the rhodium, cobalt, and iron analogues [TMCH2]+ (TM = Fe, Co, and Rh), which were determined to have the carbene structures. Besides the cycloaddition/dehydrogenation reaction in forming the [TMC3H4]+ + H2 (TM = Ir and Os) products, a second reaction pathway producing the [TMC2H2]+ ion and CH4 via triple hydrogen atom transfer reactions to the carbyne carbon is observed to be the major channel. The latter channel is not observed in the rhodium, cobalt, and iron carbene cation reactions. Quantum-chemical calculations indicate that the distinct reactivity is not due to different initial structures of the reactants. link2 link2 Both reaction channels are predicted to be thermodynamically exothermic and kinetically facile for the carbyne cations, and the reactions proceed with the initial formation of a carbene intermediate via hydride-carbyne coupling. The latter channel is also exothermic but kinetically unfavorable for the rhodium, cobalt, and iron carbene cations.We report an investigation of the optical properties, structure, and vibrational modes of SbxAs37-xS48I15 glasses (0 at. % less then x less then 37 at. %). Optical parameters such as the refractive index, the absorption coefficient, and the optical band gap are correlated with the glass composition. All parameters were found to follow an almost linear dependence with the antimony content x. link3 Both the refractive index and the absorption edge wavelength exhibit a systematic increase against x. Off-resonant Raman spectra of the glasses spectra were measured and analyzed. Structural units, representative of the glass structure, were optimized by density functional theory (DFT) calculations, providing vibrational spectra in agreement with the experiments. Raman spectra were interpreted based on the harmonic frequencies and the activities of vibrational modes obtained by the DFT analysis. The results showed evidence in favor of statistical mixing of iodine atoms, among the various pyramidal units, hence discarding structural models suggesting the presence of isolated pyramidal molecules of the types AsI3/SbI3. Both experimental data and DFT results suggested that iodine atoms exhibit much higher propensity to replace sulfur atoms in antimony than in arsenic-based pyramids. In addition, comparison of experimental and simulated spectra of selected clusters in mixed glasses indicates that it is more probable to find corner-sharing Sb-based pyramids than As-based ones.Objectives To evaluate stereoacuity, fusional vergence amplitudes, and refractive errors in patients with attention-deficit hyperactivity disorder (ADHD). Materials and Methods Twenty-three patients who were newly diagnosed as having ADHD and had not started medication, and 48 children without ADHD were included. Retrospective data analysis of comprehensive eye examination, stereoacuity, and fusional vergence amplitudes of the patients were performed. Results The mean age at ADHD diagnosis was 10.68±2.34 (7-16) years in the ADHD group (14 male, 9 female) and 12.23±2.16 (7-15) years in the control group (25 male, 23 female) patients (p=0.605). The mean stereoacuity was 142.14±152.65 (15-480) sec/arc in patients with ADHD and 46.3±44.11 (15-240) sec/arc in the control group (p less then 0.001). For ADHD patients, the mean convergence and divergence amplitudes at distance were 19.87±8.40 (6 to 38) prism diopter (PD) and -9.09±-4.34 (-4 to -25) PD, and 37.30±12.81 (14 to 70) PD and -13.13±-3.45 (-4 to -20) PD at near, respectively. The mean cycloplegic spherical equivalent was 1.06±1.13 (-1 to 4.63) diopter in ADHD patients, with 6 patients having significant refractive errors (hyperopia in 4 patients, astigmatism in 2 patients). There were no significant differences between groups in terms of spherical equivalents (p=0.358) or convergence and divergence amplitudes at distance (p=0.289 and p=0.492, respectively) or near (p=0.452 and p=0.127, respectively). Conclusion Fusional vergence amplitudes did not present significant difference, while the mean value of stereoacuity was significantly lower in newly diagnosed ADHD patients prior to treatment.Objectives Age-related macular degeneration (AMD) is the most common cause of central vision loss in individuals aged 65 years and older in developed countries. Earlier imaging systems did not enable visualization of the peripheral retina in diseases affecting the macula. With the introduction of new-generation devices, the peripheral retina is easily visualized. In our study, we aimed to evaluate the incidence of peripheral retinal changes in the color and autofluorescence fundus images of patients with AMD. link3 Materials and Methods In the study group, 550 eyes of 277 patients who were diagnosed with AMD and 90 eyes of 45 healthy patients in the control group were evaluated. link3 An ultra-wide-angle imaging device was used to record standard 200° color and autofluorescence fovea-centered fundus images followed by superior and inferior fundus images obtained using the device’s fixation light. The fundus images were examined in 3 sections zone 1, zone 2, and zone 3. Results Evaluation of color fundus images revealed peripheral retinal changes in 67.