Exercise transiently increases the density of incipient blood clots in antiplatelet-treated lacunar stroke patients.

INTRODUCTION: Older individuals and, in particular, individuals at risk of recurrent stroke, may be susceptible to thrombosis when participating in exercise, however, this aspect has not been well investigated. METHODS: Clot microstructure and conventional markers of thrombotic risk were determined in twenty lacunar stroke patients and fifteen healthy age-matched controls before, immediately after and 1 h after a bout of moderate intensity cycling exercise. Data were analyzed using a linear mixed model approach. RESULTS: At rest, clot microstructure (1.69 ± 0.07 vs. 1.64 ± 0.05, corresponding to a difference of ~ 50% in normalized clot mass; p = 0.009) and thrombocyte count (73%; p < 0.0001) were higher, and activated partial thromboplastin time was lower (18%; p = 0.0001) in stroke patients compared to age-matched controls. Acute exercise increased thrombogenic markers similarly in the two groups: incipient clot microstructure (1.69 ± 0.07 vs. 1.74 ± 0.05; p = 0.0004 and 1.64 ± 0.05 vs. 1.71 ± 0.04; p < 0.0001, for stroke and controls respectively), plasma fibrinogen (12%; p < 0.0001 and 18%; p < 0.0001, for stroke and controls respectively) and the combined coagulation factors II, VII and X (p = 0.0001 and p < 0.0001, for stroke and controls respectively). CONCLUSION: The results show that exercise transiently increases the risk of blood clot formation in both stroke patients and controls, however, due to the higher baseline thrombogenicity in stroke patients, the post exercise risk of forming blood clots may be higher in this group. TRIAL REGISTRATION: Registered at ClinicalTrials.gov (NCT03635177).

Intramolecular Rhodium-Catalyzed [(3+2+2)] Carbocyclization Reactions with Dienylidenecyclopropanes: A Concise and Stereoselective Total Synthesis of the Sesquiterpene (+)-Zizaene.

The development of an intramolecular rhodium-catalyzed [(3+2+2)] carbocyclization reaction of alkylidenecyclopropanes (ACPs) tethered to 1,4- and 1,5-skipped dienes is described. This transformation offers a new approach for the construction of bridged tricyclic compounds with up to three quaternary centers, which are suitable for the synthesis of challenging bioactive natural products. For instance, the synthetic utility of this transformation is illustrated through a concise asymmetric total synthesis of the sesquiterpene (+)-zizaene in ten steps from a commercially available starting material.

Catalytic Enantioselective Alkylation of Prochiral Enolates.

The asymmetric alkylation of enolates is a particularly versatile method for the construction of α-stereogenic carbonyl motifs, which are ubiquitous in synthetic chemistry. Over the past several decades, the focus has shifted to the development of new catalytic methods that depart from classical stoichiometric stereoinduction strategies (e.g., chiral auxiliaries, chiral alkali metal amide bases, chiral electrophiles, etc.). In this way, the enantioselective alkylation of prochiral enolates greatly improves the step- and redox-economy of this process, in addition to enhancing the scope and selectivity of these reactions. In this review, we summarize the origin and advancement of catalytic enantioselective enolate alkylation methods, with a directed emphasis on the union of prochiral nucleophiles with carbon-centered electrophiles for the construction of α-stereogenic carbonyl derivatives. Hence, the transformative developments for each distinct class of nucleophile (e.g., ketone enolates, ester enolates, amide enolates, etc.) are presented in a modular format to highlight the state-of-the-art methods and current limitations in each area.

Enantioselective Rhodium-Catalyzed Pauson-Khand Reactions of 1,6-Chloroenynes with 1,1-Disubstituted Olefins.

An enantioselective rhodium(I)-catalyzed Pauson-Khand reaction (PKR) using 1,6-chloroenynes that contain challenging 1,1-disubstituted olefins is described. In contrast to the previous studies with these types of substrates, which are only suitable for a single type of tether and alkyne substituent, the new approach results in a more expansive substrate scope, including carbon and heteroatom tethers with polar and non-polar substituents on the alkene. DFT calculations provide critical insight into the role of the halide, which pre-polarizes the alkyne to lower the barrier for metallacycle formation and provides the proper steric profile to promote a favorable enantiodetermining interaction between substrate and chiral diphosphine ligand. Hence, the chloroalkyne enables the efficient and enantioselective PKR with 1,6-enynes that contain challenging 1,1-disubstituted olefins, thereby representing a new paradigm for enantioselective reactions involving 1,6-enynes.

Guiding epitaxial crystallization of amorphous solids at the nanoscale: Interfaces, stress, and precrystalline order.

The crystallization of amorphous solids impacts fields ranging from inorganic crystal growth to biophysics. Promoting or inhibiting nanoscale epitaxial crystallization and selecting its final products underpin applications in cryopreservation, semiconductor devices, oxide electronics, quantum electronics, structural and functional ceramics, and advanced glasses. As precursors for crystallization, amorphous solids are distinguished from liquids and gases by the comparatively long relaxation times for perturbations of the mechanical stress and for variations in composition or bonding. These factors allow experimentally controllable parameters to influence crystallization processes and to drive materials toward specific outcomes. For example, amorphous precursors can be employed to form crystalline phases, such as polymorphs of Al2O3, VO2, and other complex oxides, that are not readily accessible via crystallization from a liquid or through vapor-phase epitaxy. Crystallization of amorphous solids can further be guided to produce a desired polymorph, nanoscale shape, microstructure, or orientation of the resulting crystals. These effects enable advances in applications in electronics, magnetic devices, optics, and catalysis. Directions for the future development of the chemical physics of crystallization from amorphous solids can be drawn from the structurally complex and nonequilibrium atomic arrangements in liquids and the atomic-scale structure of liquid-solid interfaces.

Truncated Actin-Targeting Macrolide Derivative Blocks Cancer Cell Motility and Invasion of Extracellular Matrix.

Cancer metastasis is a complex process involving highly motile tumor cells that breach tissue barriers, enter the bloodstream and lymphatic system, and disseminate throughout the body as circulating tumor cells. The primary cellular mechanism contributing to these critical events is the reorganization of the actin cytoskeleton. Mycalolide B (MycB) is an actin-targeting marine macrolide that can suppress proliferation, migration, and invasion of breast and ovarian cancer cells at low nanomolar doses. Through structure-activity relationship studies focused on the actin-binding tail region (C24-C35) of MycB, we identified a potent truncated derivative that inhibits polymerization of G-actin and severs F-actin by binding to actin's barbed end cleft. Biological analyses of this miniature MycB derivative demonstrate that it causes a rapid collapse of the actin cytoskeleton in ovarian cancer cells and impairs cancer cell motility and invasion of the extracellular matrix (ECM) by inhibiting invadopodia-mediated ECM degradation. These studies provide essential proof-of-principle for developing actin-targeting therapeutic agents to block cancer metastasis and establish a synthetically tractable barbed end-binding pharmacophore that can be further improved by adding targeting groups for precision drug design.

Regio- and Diastereoselective Rhodium-Catalyzed Allylic Substitution with Unstabilized Benzyl Nucleophiles.

We have developed a highly regio- and diastereoselective rhodium-catalyzed allylic substitution of challenging alkyl-substituted secondary allylic carbonates with benzylzinc reagents, which are prepared from widely available benzyl halides. This process utilizes rhodium(III) chloride as a commercially available, high-oxidation state and bench-stable pre-catalyst to provide a rare example of a regio- and diastereoselective allylic substitution in the absence of an exogenous ligand. This reaction tolerates electronically diverse benzylzinc nucleophiles and an array of functionalized and/or challenging aliphatic allylic electrophiles. Finally, the configurational fluxionality of the rhodium-allyl intermediate is exploited to develop a novel diastereoselective process for the construction of vicinal acyclic ternary/ternary stereogenic centers, in addition to a cyclic ternary/quaternary derivative.

Regioselective and Stereospecific Rhodium-Catalyzed Allylic Cyanomethylation with an Acetonitrile Equivalent: Construction of Acyclic ß-Quaternary Stereogenic Nitriles.

A highly regioselective and stereospecific rhodium-catalyzed cyanomethylation of tertiary allylic carbonates for the construction of acyclic ß-quaternary stereogenic nitriles is described. This protocol represents the first example of a metal-catalyzed allylic substitution reaction using a triorganosilyl-stabilized acetonitrile anion, which permits access to several carbonyl derivatives that are challenging to prepare using conventional pronucleophiles. The synthetic utility of the stereospecific cyanomethylation is further exemplified through the construction of an intermediate utilized in the total synthesis of both (-)-epilaurene and (-)-α-cuparenone.

On the limits of experimental knowledge.

To demarcate the limits of experimental knowledge, we probe the limits of what might be called an experiment. By appeal to examples of scientific practice from astrophysics and analogue gravity, we demonstrate that the reliability of knowledge regarding certain phenomena gained from an experiment is not circumscribed by the manipulability or accessibility of the target phenomena. Rather, the limits of experimental knowledge are set by the extent to which strategies for what we call 'inductive triangulation' are available: that is, the validation of the mode of inductive reasoning involved in the source-target inference via appeal to one or more distinct and independent modes of inductive reasoning. When such strategies are able to partially mitigate reasonable doubt, we can take a theory regarding the phenomena to be well supported by experiment. When such strategies are able to fully mitigate reasonable doubt, we can take a theory regarding the phenomena to be established by experiment. There are good reasons to expect the next generation of analogue experiments to provide genuine knowledge of unmanipulable and inaccessible phenomena such that the relevant theories can be understood as well supported. This article is part of a discussion meeting issue 'The next generation of analogue gravity experiments'.

Dynamic Kinetic Resolution of Alkenyl Cyanohydrins Derived from α,ß-Unsaturated Aldehydes: Stereoselective Synthesis of E-Tetrasubstituted Olefins.

A novel dynamic kinetic resolution (DKR) of tetrasubstituted alkenyl cyanohydrins prepared from the corresponding α,ß-unsaturated aldehydes is described. The deprotonation of a geometrical mixture of tetrasubstituted alkenyl cyanohydrins with sodium diisopropylamide (NaDA) affords the allylic anions, which enables the equilibration of the E- and Z-olefins to permit the selective functionalization of the E-adduct. Theoretical studies indicate that the nature of the alkali metal cation is a critical component to lowering the barrier for interconversion between the two geometrical isomers, which provides the mechanistic basis for the DKR reaction. In addition, we demonstrate that the DKR reaction can be combined with a transition metal-catalyzed allylic substitution to generate a stereodefined E-tetrasubstituted olefin and quaternary center in a single cross-coupling reaction.

Enantioselective Rhodium-Catalyzed Allylic Alkylation of ß,γ-Unsaturated α-Amino Nitriles: Synthetic Homoenolate Equivalents.

An enantioselective rhodium-catalyzed allylic alkylation of ß,γ-unsaturated α-amino nitriles is described. This protocol provides a novel approach for the construction of ß-stereogenic carbonyl derivatives via the catalytic asymmetric alkylation of a homoenolate equivalent. The particularly challenging nature of this transformation is highlighted by the fact that three modes of selectivity must be manipulated, namely regio- and enantioselectivity, in addition to geometrical control. The γ-stereogenic cyanoenamine products can be readily hydrolyzed in situ to afford the ß-substituted carboxylic acids, which in turn provide expedient access to a number of related carbonyl derivatives. Additionally, control experiments indicate that the chiral rhodium-allyl intermediate facilitates the selective formation of the E-cyanoenamine products, which is critical since the Z-isomer affords significantly lower enantiocontrol.

Asymmetric Rhodium-Catalyzed Allylic Substitution Reactions: Discovery, Development and Applications to Target-Directed Synthesis.

The transition metal-catalyzed allylic substitution reaction is a particularly versatile method for the construction of carbon-carbon and carbon-heteroatom bonds. In this regard, the rhodium-catalyzed variant has emerged as a powerful method for the regioselective and stereospecific allylic substitution of chiral nonracemic secondary and tertiary allylic carbonates with a variety of carbon- and heteroatom-based nucleophiles. In addition, recent developments have made the analogous enantioselective process possible using prochiral nucleophiles with achiral allylic electrophiles, which represents a significant advance in this area. In this Perspective, the discovery, development and applications of these conceptually orthogonal strategies to target-directed synthesis are discussed, with a particular emphasis given to those methods developed in our laboratory.

High-energy astrophysics and the search for sources of gravitational waves.

The dawn of the gravitational-wave (GW) era has sparked a greatly renewed interest into possible links between sources of high-energy radiation and GWs. The most luminous high-energy sources-gamma-ray bursts (GRBs)-have long been considered as very likely sources of GWs, particularly from short-duration GRBs, which are thought to originate from the merger of two compact objects such as binary neutron stars and a neutron star-black hole binary. In this paper, we discuss: (i) the high-energy emission from short-duration GRBs; (ii) what other sources of high-energy radiation may be observed from binary mergers; and (iii) how searches for high-energy electromagnetic counterparts to GW events are performed with current space facilities. While current high-energy facilities, such as Swift and Fermi, play a crucial role in the search for electromagnetic counterparts, new space missions will greatly enhance our capabilities for joint observations. We discuss why such facilities, which incorporate new technology that enables very wide-field X-ray imaging, are required if we are to truly exploit the multi-messenger era.This article is part of a discussion meeting issue 'The promises of gravitational-wave astronomy'.

Intramolecular Thioether Migration in the Rhodium-Catalyzed Ene-Cycloisomerization of Alkenylidenecyclopropanes by a Metal-Mediated ß-Sulfide Elimination.

Reported is the first example of a rhodium-mediated ß-sulfide elimination, which represents a new mode of reactivity for late-transition-metal chemistry. This serendipitous discovery facilitates an ene-cycloisomerization of allylic-sulfide-containing alkenylidenecyclopropanes (ACPs) to afford five-membered carbo- and heterocyclic rings with concomitant intramolecular thioether migration. Interestingly, similar selectivity is obtained with both E- and Z-allylic sulfides and the reaction is also feasible with an allylic selenide. Mechanistic studies are consistent with an inner-sphere transfer of the sulfide, which is remarkable given the propensity for sulfides to poison transition-metal catalysts. Finally, this type of atom-economical rearrangement is envisioned to prompt the development of related processes given the utility of sulfides in target-directed synthesis.

A Concise, Efficient and Scalable Total Synthesis of Thapsigargin and Nortrilobolide from (R)-(-)-Carvone.

A concise, efficient and scalable synthesis of thapsigargin and nortrilobolide from commercially available (R)-(-)-carvone was developed. Our synthetic strategy is inspired by nature's carbon-carbon bond formation sequence, which facilitates the construction of a highly functionalized sesquiterpene lactone skeleton in five steps via an enantioselective ketone alkylation and a diastereoselective pinacol cyclization. We envision that this strategy will permit the construction of other members of the family, structural analogs and provide a practical synthetic route to these important bioactive agents. In addition, we anticipate that the prodrug Mipsagargin, which is currently in late-stage clinical trials for the treatment of cancer, will also be accessible via this strategy. Hence, the limited availability from natural sources, coupled with an estimated demand of one metric ton per annum for the prodrug, provides a compelling mandate to develop practical total syntheses of these agents.

Extended C-band tunable multi-channel InP-based coherent receiver PICs.

Fully integrated monolithic, multi-channel InP-based coherent receiver PICs and transceiver modules with extended C-band tunability are described. These PICs operate at 33 and 44 Gbaud per channel under dual polarization (DP) 16-QAM modulation. Fourteen-channel monolithic InP receiver PICs show integration and data rate scaling capability to operate at 44 Gbaud under DP 16-QAM modulation for combined 4.9 Tb/s total capacity. Six channel simultaneous operation of a commercial transceiver module at 33 Gbaud is demonstrated for a variety of modulation formats including DP 16-QAM for >1.2Tbit/s aggregate data capacity.

Relativistic jet activity from the tidal disruption of a star by a massive black hole.

Supermassive black holes have powerful gravitational fields with strong gradients that can destroy stars that get too close, producing a bright flare in ultraviolet and X-ray spectral regions from stellar debris that forms an accretion disk around the black hole. The aftermath of this process may have been seen several times over the past two decades in the form of sparsely sampled, slowly fading emission from distant galaxies, but the onset of the stellar disruption event has not hitherto been observed. Here we report observations of a bright X-ray flare from the extragalactic transient Swift J164449.3+573451. This source increased in brightness in the X-ray band by a factor of at least 10,000 since 1990 and by a factor of at least 100 since early 2010. We conclude that we have captured the onset of relativistic jet activity from a supermassive black hole. A companion paper comes to similar conclusions on the basis of radio observations. This event is probably due to the tidal disruption of a star falling into a supermassive black hole, but the detailed behaviour differs from current theoretical models of such events.

Enantioselective Rhodium-Catalyzed Allylic Alkylation of Prochiral α,α-Disubstituted Aldehyde Enolates for the Construction of Acyclic Quaternary Stereogenic Centers.

A highly enantioselective rhodium-catalyzed allylic alkylation of prochiral α,α-disubstituted aldehyde enolates with allyl benzoate is described. This protocol provides a novel approach for the synthesis of acyclic quaternary carbon stereogenic centers and it represents the first example of the direct enantioselective alkylation of an aldehyde enolate per se. The versatility of the α-quaternary aldehyde products is demonstrated through their conversion to a variety of useful motifs applicable to target-directed synthesis. Finally, mechanistic studies indicate that high levels of asymmetric induction are achieved from a mixture of prochiral (E)- and (Z)-enolates, which provides an exciting development for this type of transformation.

Challenges identified in a pilot outreach dental service for Traveller children in Hackney, East London.

IMPETUS FOR ACTION: Inequity of dental health and dental service use for Travellers in the UK. National guidance on improving community oral health, stresses an imperative to involve and engage with "those whose economic, social and environmental circumstances or lifestyle place them at high risk of poor oral health or make it difficult for them to access dental services". SOLUTION: Oral health promotion and simple treatments were provided on two Traveller sites from a mobile dental unit (MDU) over a 5-day period and patients with extensive oral disease were referred to a fixed-site clinic for continued care. OUTCOMES: Most children, 60%, reportedly brushed once daily or less, only 40% brushed twice daily. Obvious visual caries were evident in 23 out of the 35 children (66%). A moderate to high risk of developing future caries was identified in 92% of Traveller children based on their existing diet, oral hygiene practices and caries experience. FUTURE: Oral care was successfully provided on an MDU, but this is an expensive resource and should not be considered a permanent solution. Oral health promotion messages delivered in the families' homes or local community settings through their established health services, such as health visitors or community nurses, may help to reinforce good oral hygiene and diet practices and needs robust evaluation.

Encouraging intrinsic motivation in the clinical setting: teachers' perspectives from the self-determination theory.

INTRODUCTION: Self-determination theory postulates that the three basic psychological needs of autonomy, competence and relatedness have to be satisfied for students to achieve intrinsic motivation and internalisation of autonomous self-regulation towards academic activities. Consequently, the influence of the clinical teaching environment becomes crucial when satisfying these needs, particularly when promoting or diminishing students' intrinsic motivation. The aim of this study was to describe and understand how clinical teachers encourage intrinsic motivation in undergraduate dental students based on the three basic psychological needs described by the self-determination theory. METHODS: A qualitative case study approach was adopted, and data were collected through semistructured interviews with nine experienced undergraduate clinical teachers of one dental school in Santiago, Chile. Interview transcripts were analysed by two independent reviewers using a general inductive approach. FINDINGS: Several themes emerged outlining teaching strategies and behaviours. These themes included the control of external motivators; gradual transference of responsibility; identification and encouragement of personal interests; timely and constructive feedback; delivery of a vicarious learning experience; teamwork, team discussion, and presence of a safe environment, amongst others. Overall, teachers stressed the relevance of empowering, supporting and building a horizontal relationship with students. CONCLUSIONS: Our findings regarding dental education expand on the research outcomes from other health professions about how teachers may support students to internalise behaviours. An autonomy-supportive environment may lead students to value and engage in academic activities and eventually foster the use of an autonomy-supportive style to motivate their patients.