Palladium-anchored donor-flexible pyridylidene amide (PYA) electrocatalysts for CO2 reduction.

The conversion of CO2 into CO as a substitute for processing fossil fuels to produce hydrocarbons is a sustainable, carbon neutral energy technology. However, the electrochemical reduction of CO2 into a synthesis gas (CO and H2) at a commercial scale requires an efficient electrocatalyst. In this perspective, a series of six new palladium complexes with the general formula [Pd(L)(Y)]Y, where L is a donor-flexible PYA, N2,N6-bis(1-ethylpyridin-4(1H)-ylidene)pyridine-2,6-dicarboxamide, N2,N6-bis(1-butylpyridin-4(1H)-ylidene)pyridine-2,6-dicarboxamide, or N2,N6-bis(1-benzylpyridin-4(1H)-ylidene)pyridine-2,6-dicarboxamide, and Y = OAc or Cl-, were utilized as active electrocatalysts for the conversion of CO2 into a synthesis gas. These palladium(ii) pincer complexes were synthesized from their respective H-PYA proligands using 1,8-diazobicyclo[5.4.0]undec-7-ene (DBU) or sodium acetate as a base. All the compounds were successfully characterized by various physical methods of analysis, such as proton and carbon NMR, FTIR, CHN, and single-crystal XRD. The redox chemistry of palladium complexes toward carbon dioxide activation suggested an evident CO2 interaction with each Pd(ii) catalyst. [Pd(N2,N6-bis(1-ethylpyridin-4(1H)-ylidene)pyridine-2,6-dicarboxamide)(Cl)]Cl showed the best electrocatalytic activity for CO2 reduction into a synthesis gas under the acidic condition of trifluoracetic acid (TFA) with a minimum overpotential of 0.40 V, a maximum turnover frequency (TOF) of 101 s-1, and 58% FE of CO. This pincer scaffold could be stereochemically tuned with the exploration of earth abundant first row transition metals for further improvements in the CO2 reduction chemistry.

Diagnostic Outcome of Genetic Testing for Neuromuscular Disorders in a Tertiary Center.

ABSTRACT: Genetic testing is an effective and reliable modality in clinical neuromuscular diagnosis. The recent developments in testing methods and increasing reliance on genetic testing in clinical practice require more studies to examine the benefits and advantages of such tests. We examined the results of single-gene sequencing/repeat analysis, panels, and whole-genome sequencing (WES) of 514 tests of 393 patients. All patients were suspected of a neuromuscular disorder and the samples were either WBC or muscle tissue. 28.60% (n.147) of the tests were positive while 23.74% (n.122) were VUS. In single-gene sequencing/repeat analysis, 43.08% were positive, in panels, 23.17% were positive, while 30.00% were positive in WES. Our results showed consistency with current studies and improvement of the utility of genetic testing. Although some obstacles are identified, providing statistical data can support more usage and popularity of genetic testing among physicians and patients.

Patient preference for virtual versus in-person visits in neuromuscular clinical practice.

INTRODUCTION/AIMS: It is unknown if patients with neuromuscular diseases prefer in-person or virtual telemedicine visits. We studied patient opinions and preference on virtual versus in-person visits, and the factors influencing such preferences. METHODS: Telephone surveys, consisting of 11 questions, of patients from 10 neuromuscular centers were completed. RESULTS: Five hundred and twenty surveys were completed. Twenty-six percent of respondents preferred virtual visits, while 50% preferred in-person visits. Sixty-four percent reported physical interaction as "very important." For receiving a new diagnosis, 55% preferred in-person vs 35% reporting no preference. Forty percent were concerned about a lack of physical examination vs 20% who were concerned about evaluating vital signs. Eighty four percent reported virtual visits were sufficiently private. Sixty eight percent did not consider expenses a factor in their preference. Although 92% were comfortable with virtual communication technology, 55% preferred video communications, and 19% preferred phone calls. Visit preference was not significantly associated with gender, diagnosis, disease severity, or symptom management. Patients who were concerned about a lack of physical exam or assessment of vitals had significantly higher odds of selecting in-person visits than no preference. DISCUSSION: Although neither technology, privacy, nor finance burdened patients in our study, more patients preferred in-person visits than virtual visits and 40% were concerned about a lack of physical examination. Interactions that occur with in-person encounters had high importance for patients, reflecting differences in the perception of the patient-physician relationship between virtual and in-person visits.

Exploring the role of botulinum toxin in critical care.

INTRODUCTION: Botulinum neurotoxin (BoNT) is one of the most potent and extensively studied neurotoxins with clinical applications across several different medical specialties. This review article explores the latest evidence for therapeutic applications of BoNT in patients receiving critical management in an intensive care unit (ICU). AREAS COVERED: The authors did a literature search in PubMed, Google Scholar, and Texas Medical Center Library database for studies describing the use of BoNT in a critical care setting. They extracted information on study design, patient selection, methodology, and results of relevant studies. Based on initial identification of 85 studies and after conducting screening, the authors identified 61 studies to be included in this review. In an ICU setting, BoNT has been used for several neurological and non-neurological indications. However, the supporting evidence is mostly limited to small observational studies. EXPERT OPINION: The use of BoNT in this setting is largely underutilized due to paucity of well-designed clinical trials and financial barriers. Further research is needed to provide evidence for the safety and efficacy of BoNT and to optimize the dosing and injection techniques for various conditions encountered in this setting.

Comparison of First-Pass Efficacy Among Four Mechanical Thrombectomy Techniques: A Single-Center Experience.

BACKGROUND: First-pass efficacy (FPE) is an established marker of technical and clinical efficacy among mechanical thrombectomy (MT) techniques. It is unclear what the optimal approach is in achieving FPE. We present a single-center experience comparing rates of FPE among 2 MT techniques and evaluate the potential predictors of FPE among other outcomes. METHODS: A single-center retrospective analysis was carried out of patients with consecutive large-vessel occlusion strokes (LVOS) of anterior circulation from September 2015 to April 2019 who underwent MT and for whom data were available on the status of FPE. Four MT techniques were identified: ADAPT (a direct first-pass aspiration), SrADAPT (stent retriever with aspiration), SRBG (stent retriever with balloon guide catheter), and STRAP (stent retriever-aspiration and proximal flow arrest). The primary outcome was FPE and secondary outcomes included the rate of successful reperfusion. RESULTS: Among 226 patients with LVOS of the anterior circulation who underwent MT, data were available for 164 on FPE for the 4 MT techniques. SRBG was the most prevalent technique. No significant difference was found in rates of FPE among the 4 MT techniques (P = 0.332). No independent predictors of FPE were identified on multivariable analysis. STRAP had the highest rate of successful reperfusion compared with the other techniques (P = 0.049) and was the only independent predictor of that outcome (P = 0.027). CONCLUSIONS: Among patients with LVOS of the anterior circulation, the rate of FPE did not differ among the 4 MT techniques. There were no predictors of FPE among the studied variables. STRAP was the only predictor of successful reperfusion.