Stereoselective synthesis of the C1-C29 part of amphidinol 3.

Stereoselective synthesis of the C1-C29 part of amphidinol 3 (AM3) was achieved. The C1-C20 part was assembled from three building blocks via regioselective cross metathesis to form the C4-C5 double bond and addition of an alkenyllithium and a lithium acetylide to two Weinreb amides followed by asymmetric reduction to form the C9-C10 and C14-C15 bonds, respectively. The C21-C29 part was synthesized via successive cross metathesis and oxa-Michael addition sequence to construct the 1,3-diol system at C25 and C27 and Brown asymmetric crotylation to introduce the stereogenic centers at C23 and C24. Coupling of the C1-C20 and C21-C29 parts was achieved by Julia-Kocienski olefination and regio- and stereoselective dihydroxylation of the C20-C21 double bond in the presence of the C4-C5 and C8-C9 double bonds to afford the C1-C29 part of AM3.

Experiences of nurses in charge of COVID-19 critical care patients during the initial stages of the pandemic in Japan.

The fatality rate of the coronavirus disease (COVID-19) at the beginning of the pandemic was as high as 8.5%, and it was considered to be an intractable infectious disease. Reports regarding early experiences are essential for improving nurses' quality of care, patient safety, and working conditions during future pandemics. Therefore, this study aimed to describe the experiences of nurses who were in charge of critically ill COVID-19 patients during the early stages of the pandemic in Japan. This was a qualitative study. Participants were nurses who were in charge of critically ill COVID-19 patients in an emerging contagious disease ward between February and April 2020. Interviews were conducted in groups of 2-3 persons based on an interview guide using an online conferencing application to prevent infection. Consent to participation was obtained from 19 nurses. Five categories of experiences were generated from the analysis: "Fear of risk to my own life and to those of others around me", "The shock of finding myself amid an infectious disease pandemic", "Anxiety about unknown challenges", "Driven by a sense of purpose", and "Growth as nurses". Working under harsh conditions where nurses' safety is threatened may affect the quality of care and nurses' mental health. Therefore, nurses should receive both short-term and long-term support.

Validity and Reliability of the Japanese Version of the Florida Patient Acceptance Survey.

BACKGROUND AND PURPOSE: Patient acceptance of implantable cardioverter defibrillators (ICDs) is one of the factors influencing clinical outcomes. This study aimed to develop a Japanese version of the Florida Patient Acceptance Survey (FPAS; a measure of acceptance of ICDs), examine its reliability and validity, and test instrument reliability and ability to generate valid data in a new population. METHODS: 122 outpatients with ICD, cardiac resynchronization therapy defibrillator (CRTD) completed the FPAS, the 12-Item Short-Form Health Survey developed for the Medical Outcomes Study, and the Hospital Anxiety and Depression Scale. RESULTS: Confirmatory and exploratory factor data analyses yielded a three-factor model with nine items. This version of the FPAS had high internal consistency, both for the single factor scale and all other subscales; Cronbach's 𝛼 ranged from .78 to. 84. CONCLUSION: The scale was shown to be valid and reliable for assessing device acceptability in Japanese patients with ICD.

Nursing care for patients with COVID-19 on extracorporeal membrane oxygenation (ECMO) support.

In Japan, four medical facilities including our own - the National Center for Global health and Medicine (NCGM) - have been designated for the treatment of specified infectious diseases by the Minister of Health, Labour, and Welfare. Here, we report our nursing care for patients with severe COVID-19 on extracorporeal membrane oxygenation (ECMO) support. In addition to infection control measures in the form of an N95 mask, a water-repellent isolation gown, a cap, a shielded mask on top of the N95, and double-layered gloves, nurses were required to wear one-piece suits (DuPont™ Tyvek®) and use powered air-purifying respirators (PAPRs). While closed system catheters are normally changed once a day to limit aerosol exposure, they are now changed once every 4 days. Nursing care included equipment checks, monitoring of hemodynamics and respiratory status, management of anticoagulants, observation of the patients general condition, management of sedatives and analgesics, prevention of medical device-related pressure ulcers and bedsores, and maintenance of hygiene. Fundamentally sound nursing remains the best practice for patient treatment and management. During nursing care for patients with COVID-19 on ECMO, infection control measures should be faithfully and properly followed.