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New tetranuclear and octanuclear mixed-valent cobalt(II/III) pivalate clusters, namely, [NaCo4(O2CCMe3)6(HO2CCMe3)2(teaH)2(N3)]·2H2O (in two polymorphic modifications, 1 and 1a) and [Co8(O2CCMe3)10(teaH)4(N3)](Me3CCO2)·MeCN·H2O (2) have been synthesized by ultrasonic treatment of a dinuclear cobalt(II) pivalate precursor with sodium azide and triethanolamine (teaH3) ligand in acetonitrile. The use of Dy(NO3)3·6H2O in a similar reaction led to the precipitation of a tetranuclear [NaCo4(O2CCMe3)4(teaH)2(N3)(NO3)2(H2O)2]·H2O (3) cluster and a heterometallic hexanuclear [Co3Dy3(OH)4(O2CCMe3)6(teaH)3(H2O)3](NO3)2·H2O (4) cluster. Single-crystal X-ray analysis showed that 1 (1a) and 3 consist of a tetranuclear pivalate/teaH3 mixed-ligand cluster [CoII2CoIII2(O2CCMe3)4(teaH)2(N3)]+ decorated with sodium pivalates [Na(O2CCMe3)2(HO2CCMe3)2]- (1 or 1a) or sodium nitrates [Na(NO3)2]- (3) to form a square-pyramidal assembly. In 2, the cationic [Co8(O2CCMe3)10(teaH)4(N3)]+ cluster comprises a mixed-valent {CoII4CoIII4} core encapsulated by an azide, 4 teaH2- alcoholamine ligands, and 10 bridging pivalates. Remarkably, in this core, the µ4-N3- ligand joins all four CoII atoms. The heterometallic hexanuclear compound 4 consists of a cationic [CoIII3DyIII3(OH)4(O2CCMe3)6(teaH)3(H2O)3]2+ cluster, two NO3- anions, and a crystallization water molecule. The arrangement of metal atoms in 4 can be approximated as the assembly of a smaller equilateral triangle defined by three Dy sites with a Dy···Dy distance of 3.9 Å and a larger triangle formed by Co sites [Co···Co, 6.1-6.2 Å]. The interpretation of the magnetic properties of clusters 2-4 was performed in the framework of theoretical models, taking into account the structural peculiarities of clusters and their energy spectra. The behavior of clusters 2 and 3 containing CoII ions with orbitally nondegenerate ground states is determined by the zero-field splitting of these states and Heisenberg exchange interaction between the ions. To get a good understanding of the observed magnetic behavior of cluster 4, we take into consideration the crystal fields acting on the DyIII ions, the ferromagnetic coupling of neighboring DyIII ions, and the intercluster antiferromagnetic exchange. For all examined clusters, the developed models describe well the observed temperature dependence of the magnetic susceptibility and the field dependence of magnetization. The computational results apparently show that in cluster 4 two DyIII ions with similar nearest surroundings demonstrate single-molecule-magnet (SMM) behavior, while the strong rhombicity of the ligand surrounding hinders the SMM behavior of the third DyIII ion.
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BACKGROUND: Sudden cardiac death (SCD) is a major public health concern worldwide, affecting all age and social groups. METHODS: In this retrospective study, of the 8265 autopsies performed in the Institute of Legal Medicine, 1618 cases of SCD were included. The aim of this study is to identify demographic characteristics, etiological factors, epidemiological characteristics and risk factors that lead to SCD. RESULTS: The highest incidence of SCD was in age group 40-69 years (65.0%), 71.6% of this age group being men. Of the total number, 32.1% (520) occurred in the emergency room. The most common cause of sudden death is represented by coronary atherosclerotic disease, reported in 89.8% (1453) of cases, tricoronary lesions being found in 60% (870) of cases. Etiological factors of SCD encountered during autopsies were acute myocardial infarction in 13.9% (225), dilated cardiomyopathy 43.9% (710), cardiac hypertrophy 579 (36.07%), pericarditis 1.9% (30), myocarditis 1.73% (28) and adipositas cordis 5% (81). Along with epicardial fat and BMI, alcohol consumption was recorded in 17.9% (290), this being a potential trigger. CONCLUSIONS: Based on forensic autopsy and histological findings, a wide variety of factors are involved in the etiopathogenesis of SCD, some of which can be eliminated through preventive measures implemented early.
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BACKGROUND: As the COVID-19 pandemic evolved, concerns grew about its impact on pregnant women. This study aimed to determine how SARS-CoV-2 affects pregnancy, birth, and newborns, in order to identify vulnerable individuals and provide proper care. METHODS: This is a retrospective case-control study of 398 pregnant women who delivered at the Emergency Clinical County Hospital in Sibiu, Romania from 1 February 2020 to 31 March 2022. Patients were initially grouped and compared based on their RT-PCR SARS-CoV-2 test results into the COVID group (cases) (N = 199) and non-COVID group (control) (N = 199). The COVID cases were further divided and compared according to the pre-Delta (N = 105) and Delta/Omicron (N = 94) SARS-CoV-2 variants. COVID cases and control groups were compared to identify correlations between sociodemographic factors, pregnancy outcomes, and SARS-CoV-2 infection. The same comparisons were performed between pre-Delta and Delta/Omicron groups. RESULTS: There were no significant differences concerning maternal residence, while educational level and employment proportion were higher among the positively tested patients. No significant differences were found for neonatal and pregnancy complications between COVID cases and control groups. Except for a lower mean gestational age, no significant differences were found between pre-Delta and Delta/Omicron periods. The maternal mortality in the infected group was 0.5% (1 case). CONCLUSIONS: Our study showed that SARS-CoV-2 infection at birth did not significantly affect maternal and neonatal outcomes, not even considering the SARS-CoV-2 strain.
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BACKGROUND: Transportation of sick newborns is a major predictor of outcome. Prompt identification of the sickest newborns allows adequate intervention and outcome optimization. An optimal scoring system has not yet been identified. AIM: To identify a rapid, accurate, and easy-to-perform score predictive for neonatal mortality in outborn neonates. MATERIAL AND METHODS: All neonates admitted by transfer in a level III regional neonatal unit between 1 January 2015 and 31 December 2021 were included. Infants with congenital critical abnormalities were excluded (N = 15). Gestational age (GA), birth weight (BW), Apgar score, place of birth, time between delivery and admission (AT), early onset sepsis, and sick neonatal score (SNS) were collected from medical records and tested for their association with mortality, including in subgroups (preterm vs. term infants); GA, BW, and AT were used to develop MSNS-AT score, to improve mortality prediction. The main outcome was all-cause mortality prediction. Univariable and multivariable analysis, including Cox regression, were performed, and odds ratio and hazard ratios were calculated were appropriate. RESULTS: 418 infants were included; 217/403 infants were born prematurely (53.8%), and 20 died (4.96%). Compared with the survivors, the non-survivors had lower GA, BW, and SNS scores (p < 0.05); only the SNS scores remained lower in the subgroup analysis. Time to admission was associated with an increased mortality rate in the whole group and preterm infants (p < 0.05). In multiple Cox regression models, a cut-off value of MSNS-AT score ≤ 10 was more precise in predicting mortality as compared with SNS (AUC 0.735 vs. 0.775) in the entire group and in the preterm infants group (AUC 0.885 vs. 0.810). CONCLUSIONS: The new MSNS-AT score significantly improved mortality prediction at admission in the whole study group and in preterm infants as compared with the SNS score, suggesting that, besides GA and BW, AT may be decisive for the outcome of outborn preterm infants.