Heteroallene Insertions into Tin(II) Alkoxide Bonds.

A series of iso-carbamate complexes have been synthesized by the reaction of [SnII(OiPr)2] or [SnII(OtBu)2] with either aryl or alkyl isocyanates, ONC-R (R = 2,4,6-trimethylphenyl (Mes), 2,6-diisopropylphenyl (Dipp), isopropyl (iPr), cyclohexyl (Cy) and tert-butyl (tBu)). In the case of aryl isocyanates, mono-insertion occurs to form structurally characterized complexes [Sn{κ2-N,O-R-NC(OiPr)O}(µ-OiPr)]2 (1: R = Mes, 2: R = Dipp) and [Sn{κ2-N,O-R-NC(OtBu)O}(µ-OtBu)]2 (3: R = Mes, 4: R = Dipp). The complicated solution-state chemistry of these species has been explored using 1H DOSY experiments. In contrast, reactions of tin(II) alkoxides with alkyl isocyanates result in the formation of bis-insertion products [Sn{κ2-N,O-R-NC(OiPr)O}2] (5: R = iPr, and 6: R = Cy) and [Sn{κ2-N,O-R-NC(OtBu)O}2] (7: R = iPr, 8: R = Cy), of which complexes 6-8 have also been structurally characterized. 1H NMR studies show that the reaction of tBu-NCO with either [Sn(OiPr)2] or [Sn(OtBu)2] results in a reversible mono-insertion. Variable-temperature 2D 1H-1H exchange spectroscopy (VT-2D-EXSY) was used to determine the rate of exchange between free tBu-NCO and the coordinated tBu-iso-carbamate ligand for the {OiPr} alkoxide complex, as well as the activation energy (Ea = 92.2 ± 0.8 kJ mol-1), enthalpy (ΔH‡ = 89.4 ± 0.8 kJ mol-1), and entropy (ΔS‡ = 12.6 ± 2.9 J mol-1 K-1) for the process [Sn(OiPr)2] + tBu-NCO ↔ [Sn{κ2-N,O-tBu-NC(OiPr)O}(OiPr)]. Attempts to form Sn(II) alkyl carbonates by the insertion of CO2 into either [Sn(OiPr)2] or [Sn(OtBu)2] proved unsuccessful. However, 119Sn{1H} NMR spectroscopy of the reaction of excess CO2 with [Sn(OiPr)2] reveals the presence of a new Sn(II) species, i.e., [(iPrO)Sn(O2COiPr)], VT-2D-EXSY (1H) of which confirms the reversible alkyl carbonate formation (Ea = 70.3 ± 13.0 kJ mol-1; ΔH‡ = 68.0 ± 1.3 kJ mol-1 and ΔS‡ = -8.07 ± 2.8 J mol-1 K-1).

On the Risk of Nitrosamine Contamination During Drug Product Blister Packaging.

Most N-Nitrosamine compounds are found to be genotoxic in several animal species. Some are classified as probable or possible human carcinogens and very low acceptable daily intake has been established such as 96 ng/day for N-nitrosodimethylamine (NDMA) and 26.5 ng/N-nitrosodiethylamine (NDEA). The pharmaceutical industry has considered all processing areas for potential formation or contamination of N-nitrosamine. One risk is the potential contamination of nitrosamine during drug product blister packaging using lidding foils containing nitrocellulose, and different approaches have been used by pharmaceutical companies to evaluate and mitigate this risk. Herein we share a perspective from IQ Consortium N-nitrosamine Working Group on some of the approaches and corresponding results. From these assessments, it was concluded that the risk of nitrosamine contamination during blister packaging is negligible. The approaches shared in this perspective can be incorporated into risk assessment for nitrosamine contamination during drug product packaging at other pharmaceutical companies.

A clinical risk score to identify patients with COVID-19 at high risk of critical care admission or death: An observational cohort study.

BACKGROUND: The COVID-19 pandemic continues to escalate. There is urgent need to stratify patients. Understanding risk of deterioration will assist in admission and discharge decisions, and help selection for clinical studies to indicate where risk of therapy-related complications is justified. METHODS: An observational cohort of patients acutely admitted to two London hospitals with COVID-19 and positive SARS-CoV-2 swab results was assessed. Demographic details, clinical data, comorbidities, blood parameters and chest radiograph severity scores were collected from electronic health records. Endpoints assessed were critical care admission and death. A risk score was developed to predict outcomes. FINDINGS: Analyses included 1,157 patients. Older age, male sex, comorbidities, respiratory rate, oxygenation, radiographic severity, higher neutrophils, higher CRP and lower albumin at presentation predicted critical care admission and mortality. Non-white ethnicity predicted critical care admission but not death. Social deprivation was not predictive of outcome. A risk score was developed incorporating twelve characteristics: age>40, male, non-white ethnicity, oxygen saturations<93%, radiological severity score>3, neutrophil count>8.0 x109/L, CRP>40 mg/L, albumin<34 g/L, creatinine>100 µmol/L, diabetes mellitus, hypertension and chronic lung disease. Risk scores of 4 or higher corresponded to a 28-day cumulative incidence of critical care admission or death of 40.7% (95% CI: 37.1 to 44.4), versus 12.4% (95% CI: 8.2 to 16.7) for scores less than 4. INTERPRETATION: Our study identified predictors of critical care admission and death in people admitted to hospital with COVID-19. These predictors were incorporated into a risk score that will inform clinical care and stratify patients for clinical trials.