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BACKGROUND: Smooth muscle cell (SMC) phenotypic switching has been increasingly detected in aortic aneurysm and dissection (AAD) tissues. However, the diverse SMC phenotypes in AAD tissues and the mechanisms driving SMC phenotypic alterations remain to be identified. METHODS: We examined the transcriptomic and epigenomic dynamics of aortic SMC phenotypic changes in mice with angiotensin II-induced AAD by using single-cell RNA sequencing and single-cell sequencing assay for transposase-accessible chromatin. SMC phenotypic alteration in aortas from patients with ascending thoracic AAD was examined by using single-cell RNA sequencing analysis. RESULTS: Single-cell RNA sequencing analysis revealed that aortic stress induced the transition of SMCs from a primary contractile phenotype to proliferative, extracellular matrix-producing, and inflammatory phenotypes. Lineage tracing showed the complete transformation of SMCs to fibroblasts and macrophages. Single-cell sequencing assay for transposase-accessible chromatin analysis indicated that these phenotypic alterations were controlled by chromatin remodeling marked by the reduced chromatin accessibility of contractile genes and the induced chromatin accessibility of genes involved in proliferation, extracellular matrix, and inflammation. IRF3 (interferon regulatory factor 3), a proinflammatory transcription factor activated by cytosolic DNA, was identified as a key driver of the transition of aortic SMCs from a contractile phenotype to an inflammatory phenotype. In cultured SMCs, cytosolic DNA signaled through its sensor STING (stimulator of interferon genes)-TBK1 (tank-binding kinase 1) to activate IRF3, which bound and recruited EZH2 (enhancer of zeste homolog 2) to contractile genes to induce repressive H3K27me3 modification and gene suppression. In contrast, double-stranded DNA-STING-IRF3 signaling induced inflammatory gene expression in SMCs. In Sting-/- mice, the aortic stress-induced transition of SMCs into an inflammatory phenotype was prevented, and SMC populations were preserved. Finally, profound SMC phenotypic alterations toward diverse directions were detected in human ascending thoracic AAD tissues. CONCLUSIONS: Our study reveals the dynamic epigenetic induction of SMC phenotypic alterations in AAD. DNA damage and cytosolic leakage drive SMCs from a contractile phenotype to an inflammatory phenotype.
Subject(s)
Aortic Aneurysm, Thoracic , Aortic Aneurysm , Aortic Dissection , Humans , Mice , Animals , Epigenomics , Phenotype , Aortic Aneurysm, Thoracic/genetics , Aortic Aneurysm, Thoracic/metabolism , Aortic Dissection/genetics , Myocytes, Smooth Muscle/metabolism , DNA/metabolism , Chromatin/metabolism , Epigenesis, Genetic , Cells, CulturedABSTRACT
BACKGROUND: The benefits of chemotherapy in stage II colon cancer remain unclear, but it is recommended for high-risk stage II disease. Which patients receive chemotherapy and its impact on survival remains undetermined. METHODS: The National Cancer Database was surveyed between 2004 and 2016 for stage II colon cancer patients. Patients were categorized as high- or average-risk as defined by the National Comprehensive Cancer Network. The demographic characteristics of high- and average-risk patients who did and did not receive chemotherapy were compared using univariate and multivariable analyses. The survival of high- and average-risk patients was compared based on receipt of chemotherapy with Cox hazard ratios and Kaplan-Meier curves. RESULTS: Overall, 84,424 patients met the inclusion criteria. A total of 34,868 patients were high-risk and 49,556 were average-risk. In high-risk patients, the risk factors for not receiving chemotherapy included increasing age, distance from the treatment facility, Charlson-Deyo score, and lack of insurance. In average-risk patients, factors associated with receipt of chemotherapy were decreasing age, distance from the treatment facility, Charlson-Deyo score, and non-academic association of the treatment facility. In both, chemotherapy was significantly associated with increased survival on the Kaplan-Meier curve. In the Cox hazard ratio, only high-risk patients benefited from chemotherapy (hazard ratio 1.183, confidence interval 1.116-1.254). CONCLUSIONS: Factors associated with not receiving chemotherapy in high-risk stage II colon cancers included increasing age, medical comorbidities, increasing distance from the treatment facility, and lack of insurance. Chemotherapy is associated with improved overall survival in high-risk patients.
Subject(s)
Colonic Neoplasms , Humans , Neoplasm Staging , Chemotherapy, Adjuvant , Proportional Hazards Models , Risk Factors , Colonic Neoplasms/pathologyABSTRACT
BACKGROUND: Research presentation has benefits, including CV building, networking, and collaboration. A measurable standard for achievement is publication in a peer-reviewed journal. Expectations regarding the likelihood of publication are unknown for studies presented at a national surgical scientific meeting. This study aims to evaluate predictors of manuscript publication arising from abstracts presented at a national surgical scientific meeting. METHODS: Abstracts presented at the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) Meeting 2019 were reviewed. Identification of published manuscripts was completed using MedLine, Embase, and Google Scholar 28 months after the presentation to allow for time for publication. Factors evaluated for association with publication included author and abstract measures. Descriptive analyses and multivariable statistics were performed. RESULTS: 724 abstracts (160 podiums, 564 posters) were included. Of the podium presentations, 128 (80%) were published in a median of 4 months after the presentation. On univariable and multivariable analyses, there was no association between publication and abstract topic, gender, degree, number of publications, or H-indices of first and senior authors. 154 (27.3%) poster presentations were published with a median of 13 months. On univariable analysis, there was a statistically significant difference regarding the abstract topic (p = 0.015) and senior author degree (p = 0.01) between published and unpublished posters. Multivariable analysis demonstrated that colorectal surgery (OR 2.52; CI 1.02-6.23) and metabolic/obesity (OR 2.53; CI 1.09-5.84) are associated with an increased odd of publication. There was an inverse association with female senior authors (OR 0.53; CI 0.29-0.98), while additional degrees (e.g., doctorate and/or master's degree) of the senior authors were associated with an increased publication rate (OR 1.80; CI 1.00-3.22). CONCLUSION: 80% of podiums but only 27% of posters were ultimately published. While some predictors of poster publication were noted, it is unclear if these are why these projects fail to publish. Future research is warranted to determine if there are effective strategies to increase poster publication rates.
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Interactions between metal centers in dimeric transition metal complexes (TMCs) play important roles in their excited-state energetics and pathways and, thus, affect their photophysical properties relevant to their applications, for example, photoluminescent materials and photocatalysis. Here, we report electronic and nuclear structural dynamics studies of two photoexcited pyrazolate-bridged [Pt(ppy)(µ-R2pz)]2-type Pt(II) dimers (ppy = 2-phenylpyridine, µ-R2pz = 3,5-substituted pyrazolate): [Pt(ppy)(µ-H2pz)]2 (1) and [Pt(NDI-ppy)(µ-Ph2pz)]2 (2, NDI = 1,4,5,8-naphthalenediimide), both of which have distinct ground-state Pt-Pt distances. X-ray transient absorption (XTA) spectroscopy at the Pt LIII-edge revealed a new d-orbital vacancy due to the one-electron oxidation of the Pt centers in 1 and 2. However, while a transient Pt-Pt contraction was observed in 2, such an effect was completely absent in 1, demonstrating how the excited states of these complexes are determined by the overlap of the Pt (dz2) orbitals, which is tuned by the steric bulk of the pyrazolate R-groups in the 3- and 5-positions. In tandem with analysis of the Pt-Pt distance structural parameter, we observed photoinduced electron transfer in 2 featuring a covalently linked NDI acceptor on the ppy ligand. The formation and subsequent decay of the NDI radical anion absorption signals were detected upon photoexcitation using optical transient absorption spectroscopy. The NDI radical anion decayed on the same time scale, hundreds of picoseconds, as that of the d-orbital vacancy signal of the oxidized Pt-Pt core observed in the XTA measurements. The data indicated an ultrafast formation of the charge-separated state and subsequent charge recombination to the original Pt(II-II) species.
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PURPOSE OF REVIEW: Radiation-associated valvular disease (RAVD) is characterized by late valvular manifestations following radiation exposure to the mediastinum. Review of current guidelines was performed to examine best practices to reduce risk and optimize outcomes in this patient population. RECENT FINDINGS: Early and consistent screening and comprehensive and careful planning are critical in managing RAVD. Due to long latency periods, serial screening and targeted evaluation of risk factors are essential to early detection. Varying and complex presentations of RAVD require an integrated team of experienced specialists equipped with multimodality imaging-based screening protocols to stratify risk, plan intervention, and evaluate treatment response. Patients with valvular manifestations associated with radiation therapy call for an individualized plan of care involving longitudinal multimodality imaging-based screening and experienced decision-making regarding timing and strategy of intervention to improve patient outcomes.
Subject(s)
Heart Valve Diseases , Multimodal Imaging , Heart Valve Diseases/diagnostic imaging , Heart Valve Diseases/etiology , Humans , Risk FactorsABSTRACT
Three new copper(I) complexes [Cu(LX)2]+(PF6-) (where LX stands for 2,9-dihalo-1,10-phenanthroline and X = Cl, Br, and I) have been synthesized in order to study the impact of halogen substituents tethered in the α position of the chelating nitrogen atoms on their physical properties. The photophysical properties of these new complexes (hereafter named Cu-X) were characterized in both their ground and excited states. Femtosecond ultrafast spectroscopy revealed that early photoinduced processes are faster for Cu-I than for Cu-Cl or Cu-Br, both showing similar behaviors. Their electronic absorption and electrochemical properties are comparable to benchmark [Cu(dmp)2]+ (where dmp stands for 2,9-dimethyl-1,10-phenanthroline); furthermore, their optical features were fully reproduced by time-dependent density functional theory and ab initio molecular dynamics calculations. All three complexes are luminescent at room temperature, showing that halogen atoms bound to positions 2 and 9 of phenanthroline are sufficiently bulky to prevent strong interactions between the excited Cu complexes and solvent molecules in the coordination sphere. Their behavior in the excited state, more specifically the extent of the photoluminescence efficiency and its dependence on the temperature, is, however, strongly dependent on the nature of the halogen. A combination of ultrafast transient absorption spectroscopy, temperature-dependent steady-state fluorescence spectroscopy, and computational chemistry allows one to gain a deeper understanding of the behavior of all three complexes in their excited state.
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Four photophysically interesting dimolybdenum paddlewheel compounds are synthesized and characterized: I and II contain amide ligand (N,3-diphenyl-2-propynamide), and III and IV contain thioamide ligand (N,3-diphenyl-2-propynethioamide). I and III are trans-Mo2L2(O2C-TiPB)2-type compounds, and II and IV are Mo2L4-type compounds, where O2C-TiPB is 2,4,6-triisopropylbenzoate. I-IV display strong light absorption due to metal to ligand charge transfer (MLCT) transitions from molybdenum to the amide/thioamide ligands. Charge transfer dynamics in the MLCT excited states of I-IV have been examined using femtosecond transient absorption (fs-TA) spectroscopy and femtosecond time-resolved infrared (fs-TRIR) spectroscopy. The asymmetric amide/thioamide ligands show two forms of regioarrangements in the paddlewheel compounds. Analyses of the ν(C≡C) bands in the fs-TRIR spectra of I and II show similar electron density distribution over ligands in their 1MLCT S1 states where only two amide ligands are involved and the transferred electron is mainly localized on one of them. The fs-TRIR spectra of III and IV, however, show different charge distribution patterns where the transferred electron is fully delocalized over two thioamide ligands in III and partially delocalized in IV. Fast interligand electron transfer (ILET) was recognized as the explanation for the various charge distribution patterns, and ILET was shown to be influenced by both the ligands and the ligand arrangements.
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The interligand charge dynamics of the lowest singlet metal-to-ligand charge-transfer states (1MLCT S1 states) of a series of quadruply bonded trans-Mo2(NN)2(O2C-X)2 paddlewheel compounds are investigated, where NN is a π-accepting phenylpropiolamidinate ligand and O2C-X (X = Me, tBu, TiPB, or CF3) is an auxiliary carboxylate ligand. The compounds show strong light absorption in the visible region due to MLCT transitions from the Mo2 center to the NN ligands. The transferred electron density was followed by femtosecond time-resolved infrared (fs-TRIR) spectroscopy with vibrational reporters such as the ethynyl groups on the NN ligands. The observed fs-TRIR spectra show that these compounds have asymmetric 1MLCT S1 excited states where the transferred electron mainly resides on a single NN ligand. The presence of interligand electron transfer (ILET) is suggested to explain the shape of the ν(C≡C) bands and the influence of auxiliary ligands and solvents on the interligand electronic coupling. The ILET in the 1MLCT S1 state is shown to be sensitive to the functional groups on the auxiliary ligands while being less responsive to changes in solvents.
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In this work we demonstrate the use of the push-pull model system 4-(dimethylamino)benzonitrile (DMABN) as a convenient molecular probe to investigate the local solvation structure and dynamics by means of time-resolved infrared spectroscopy (TRIR). The photochemical features associated with this system provide several advantages due to the high charge separation between the ground and charge transfer states involving the characteristic nitrile bond, and an excited state lifetime that is long enough to observe the slow solvation dynamics in organic solvents and ionic liquids. The conversion from a locally excited state to an intramolecular charge transfer state (LE-ICT) in ionic liquids shows similar kinetic lifetimes in comparison to organic solvents. This similarity confirms that such conversion depends solely on the intramolecular reorganization of DMABN in the excited state, and not by the dynamics of solvation. In contrast, the relative shift of the ν(CN) vibration during the relaxation of the ICT state reveals two distinct lifetimes that are sensitive to the solvent environment. This study reveals a fast time component which is attributed to the dipolar relaxation of the solvent and a slower time component related to the rotation of the dimethylamino group of DMABN.
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Materials and molecular systems exhibiting long-lived electronic coherence can facilitate coherent transport, opening the door to efficient charge and energy transport beyond traditional methods. Recently, signatures of a possible coherent, recurrent electronic motion were identified in femtosecond pump-probe spectroscopy experiments on a binuclear platinum complex, where a persistent periodic beating in the transient absorption signal's anisotropy was observed. In this study, we investigate the excitonic dynamics that underlie the suspected electronic coherence for a series of binuclear platinum complexes exhibiting a range of interplatinum distances. Results suggest that the long-lived coherence can only result when competitive electronic couplings are in balance. At longer Pt-Pt distances, the electronic couplings between the two halves of the binuclear system weaken, and exciton localization and recombination is favored on short time scales. For short Pt-Pt distances, electronic couplings between the states in the coherent superposition are stronger than the coupling with other excitonic states, leading to long-lived coherence.
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Photoinduced metal-to-ligand charge transfer transitions afford numerous applications in terms of photon energy harvesting. The majority of metal complexes studied to date involve diamagnetic systems of d(6), d(8), and d(10) transition metals. These typically have very short-lived, â¼100 fs, singlet metal to ligand charge transfer ((1)MLCT) states that undergo intersystem crossing to triplet metal to ligand charge transfer ((3)MLCT) states that are longer lived and are responsible for much of the photophysical studies. In contrast, the metal-metal quadruply bonded complexes of molybdenum and tungsten supported by carboxylate, O2CR, and related amidinate ligands (RN)2C(R') have relatively long-lived (1)MLCT states arising from M2δ to Lπ* transitions. These have lifetimes in the range 1-20 ps prior to intersystem crossing to T1 states that may be (3)MLCT or (3)MMδδ* with lifetimes of 1-100 ns and 1-100 µs, respectively. The M2 quadruply bonded complexes take the form M2L4 or M2L4-nL'n where n = 1-3. Thus, in their photoexcited MLCT states, these compounds pose the question of how the charge resides on the ligands. This Account reviews the current knowledge of how charge is positioned with time in S1 and T1 states with the aid of active IR reported groups located on the ligands, for example, C≡X multiple bonds (X = C, N, or O). Several examples of localized and delocalized charge distributions are noted along with kinetic barriers to the interconversion of MLCT and δδ* states. On the 50th anniversary of the recognition of the MM quadruple bond, these complexes are revealing some remarkable features in the study of the photophysical properties of metal-ligand charge transfer states.
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The influence of molecular structure on excited-state properties and dynamics of a series of cyclometalated platinum dimers was investigated through a combined experimental and theoretical approach using femtosecond transient absorption (fs TA) spectroscopy and density functional theory (DFT) calculations. The molecules have the general formula [Pt(ppy)(µ-R2pz)]2, where ppy = 2-phenylpyridine, pz = pyrazolate, and R = H, Me, Ph, or (t)Bu, and are strongly photoluminescent at room temperature. The distance between the platinum centers in this A-frame geometry can be varied depending on the steric bulk of the bridging pyrazolate ligands that exert structural constraints and compress the Pt-Pt distance. At large Pt-Pt distances there is little interaction between the subunits, and the chromophore behaves similar to a monomer with excited states described as mixtures of ligand-centered and metal-to-ligand charge transfer (LC/MLCT) transitions. When the Pt(II) centers are brought closer together with bulky bridging ligands, they interact through their dz(2) orbitals and the S1 and T1 states are best characterized as metal-metal-to-ligand charge transfer (MMLCT) in character. The results of the femtoseconds TA experiments reveal that intersystem crossing (ISC) occurs on ultrafast time scales (τS1 < 200 fs), while there are two relaxation processes occurring within the triplet manifold, τ1 = 0.5-3.2 ps and τ2 = 20-70 ps; the longer time constants correspond to the presence of bulkier bridging ligands. DFT calculations illustrate that the Pt-Pt distances further contract in the T1 (3)MMLCT states; therefore, slower relaxation may be related to a larger structural reorganization. Subsequent investigations using faster time resolution are planned to measure the ISC process as well as to identify any potential coherent interaction(s) between the platinum centers that may occur.
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The compounds cis-Mo2(DAniF)2(L)2 have been prepared, where DAniF = (N,N')-p-dianisyl formamidinate and L = thienyl-2-carboxylate (Th), 2,2'-bithienyl-5-carboxylate (BTh), and 2,2':5',5â³-terthienyl-5-carboxylate (TTh). The compounds have been characterized by proton nuclear magnetic resonance ((1)H NMR), ultraviolet-visible (UV-vis) absorption and emission, differential pulse voltammetry, and time-resolved transient absorption and infrared (IR) spectroscopy. An X-ray crystal structure was obtained for the thienyl complex. The related salt [(n)Bu4N]2[Mo2(DAniF)2(TTh-CO2)2], where TTh-CO2 = 2,2':5',2â³-terthienyl-5,5â³-dicarboxylate, has also been prepared and employed in the attachment of the complex to TiO2 nanoparticles. The latter have been characterized by ground-state Fourier transform infrared spectroscopy (FTIR) and femtosecond time-resolved IR spectroscopy. The time-resolved data provide evidence for sub-picosecond charge injection from the Mo2 center to the semiconducting oxide particle.
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From the reactions between Mo2(DAniF)3pivalate (DAniF = N,N'-di(p-anisyl)formamidinate) and the carboxylic acids LH, the title compounds Mo2(DAniF)3L have been prepared and characterized: compounds I (L = O2CC≡CPh), II (L = O2CC4H2SC≡CH), and III (L = O2CC6H4-p-CN). The new compounds have been characterized in their ground states by spectroscopy ((1)H NMR, ultraviolet-visible absorption, near-infrared absorption, and steady state emission), cyclic voltammetry, and density functional theory calculations. The compounds show strong metal Mo2 to ligand L δ-π* transitions in their visible spectra. The nature of the S1 (1)MLCT and T1 states has been probed by time-resolved (femtosecond and nanosecond) transient absorption and infrared spectroscopy. The observed shifts of the C≡C and C≡N vibrational modes are found to be consistent with the negative charge being localized on the single L in the S1 states, while the T1 states are (3)Mo2 δδ*. The present results are compared to earlier studies of the photoexcited states of trans-Mo2(2,4,6-triisopropylbenzoate)2L2 compounds that have been assigned as either localized or delocalized.
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From the reaction between M2(T(i)PB)4 and 2 equiv of 5-ethynylthiophene-2-carboxylic acid (H-ThCCH) in toluene, the complexes trans-M2(T(i)PB)2(ThCCH)2, where M = Mo (I) or W (II) and T(i)PB = 2,4,6-triisopropyl benzoate, have been isolated and characterized by (1)H NMR, IR, MALDI-TOF MS, UV-vis, steady-state emission, transient absorption, and time-resolved infrared (TRIR) spectroscopies and single-crystal X-ray crystallography for I. The molecular structure of I confirms the trans-substitution pattern and the extended conjugation of the ethynylthienyl ligands via interaction with the Mo2δ orbital. The HOMO of both I and II is the M2δ orbital, and the intense color of the compounds (I is red and II is blue) is due to the M2δ-to-ThCCH (1)MLCT transition. The S1 states for I and II are (1)MLCT. The T1 state is (3)MLCT for II, but (3)MoMoδδ* for I. The TRIR spectra of the ν(C≡C) stretch in the MLCT states are consistent with the delocalization of the electron over both ThCCH ligands. Compound I is shown to be a synthon for the preparation of trans-Mo2(T(i)PB)2(ThCCPh)2 (III) and trans-Mo2(T(i)PB)2(ThCCAuPPh3)2 (IV). Both III and IV have been characterized spectroscopically and by single-crystal X-ray diffraction. The structure of III indicates the extended π-conjugation of the trans-ethynyl-thienyl units extends to the added phenyl rings.
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The preparation of the homoleptic MM quadruply bonded complexes Mo2(O2CC6H4-p-X)4, where X = C≡C-H (I) or C≡N (II), is reported along with the solution characterization data and electronic structure calculations employing density functional theory. The compounds are colored orange (I) and red (II) due to the metal-to-ligand charge transfer involving the HOMO, Mo2δ, and LUMO, which is a ligand-based π* combination. Studies of the S1 state, (1)MLCT, by femtosecond time-resolved infrared spectroscopy indicate that the negative charge is distributed principally over two trans ligands. The T1 states are (3)MoMoδδ* as determined by NIR emission and nanosecond transient absorption.
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2-(2-Pyridyl)-4-methylthiazole carboxylic acid (PMT-H) and rhenium tricarbonyl chloride react to form the red crystalline compound fac-Re(PMT-H)(CO)3Cl, I, which is an analog of the well-known Re(bpy)(CO)3Cl molecule, where bpy is 2,2'-bipyridine. The acids PMT-H (2 equiv) and Re(PMT-H)(CO)3Cl (2 equiv) also react with Mo2(T(i)PB)4 (T(i)PB = 2,4,6-triisopropylbenzoate) in toluene to give the red compound trans-Mo2(T(i)PB)2(PMT)2, II, and the royal blue compound trans-Mo2(T(i)PB)2[(PMT)Re(CO)3Cl]2, III, respectively. The X-ray and spectroscopic characterization of I confirms its close relationship with Re(bpy)(CO)3Cl, as does the spectroscopic characterization of compounds II and III as analogs of other compounds of the form trans-M2(TiPB)2L2, where L is a π-acceptor ligand. Electronic structure calculations on model compounds II' and III', where formate ligands substitute for T(i)PB, show that the highest occupied molecular orbital (HOMO) in II is Mo2δ. When the Re(CO)3Cl unit is attached to the PMT ligand to form III, this orbital is stabilized significantly and now becomes associated with a close in energy band of Re d(6), t2g type orbitals. Oxidation of III is shown to be Mo2-based, as evident by EPR spectroscopy, and the lowest-energy electronic absorption corresponds to a Mo2δ-to-PMT π* transition. The S1 states in both II and III are metal-to-ligand charge-transfer (MLCT), and the lowest-energy triplet sate, T1 is (3)MoMoδδ*, as evidenced by its steady state emission spectral features. The excited states of compounds I (T1) and III (S1 and T1) have been investigated by time-resolved infrared spectroscopy (TRIR). The spectral features of I parallel those for Re(bpy)(CO)3Cl, with the lowest-energy T1 state corresponding to Re dπ to PMT-H π* charge transfer, producing higher-energy CO stretching vibrations relative to the ground state. For III, the CO vibrations are shifted to lower energy, consistent with charge being located on the PMT ligand, which enhances Re-to-CO backbonding. In the MoMoδδ* T1 state, however, the backbonding is reduced to the PMT ligand, and the CO stretches are at slightly higher energy relative to the ground state.
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From the reactions between M(2)(T(i)PB)(4) and HO(2)CC(6)H(5)-η(6)-Cr(CO)(3) (2 equiv), the title compounds trans-M(2)(T(i)PB)(2)[O(2)CC(6)H(5)-η(6)-Cr(CO)(3)](2), where M = Mo or W, and T(i)PB = 2,4,6-triisopropylbenzoate have been prepared and characterized. Compound I (M = Mo) was characterized by a single crystal X-ray structural determination which revealed a centrosymmetric MoMo quadruply bonded molecule. Compound I is red and the tungsten complex II is blue as a result of intense metal-to-ligand charge transfer (MLCT), which is principally M(2)δ to benzoate π* with some chromium t(2g) participation, according to calculations employing density functional theory. Compound I shows dual emission from S(1) and T(1) states that are assigned (1)MLCT and (3) MoMoδδ*, respectively. Both complexes have been studied by time-resolved infrared spectroscopy (TRIR) in the region of the carbonyl stretching frequency. Compound II displays a shift of ν(CO) to lower energy in both the (1)MLCT and (3)MLCT states in THF, while I in CH(2)Cl(2) shows ν(CO) bands shifted to both higher and lower energy. We attribute the shift to higher energy seen for I to a Cr t(2g) to benzoate π* transition which mixes with the Mo(2)δ to benzoate charge transfer upon excitation at 514 nm. In THF compound I undergoes a reversible photodissociation, potentially due to CO loss. Based on the TRIR of the carbonyl vibrations, it is proposed that the MLCT states are delocalized over both benzoate Cr(CO)(3) groups, as supported by calculations.
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OBJECTIVES: The authors report etiologies and outcomes and devise a risk model in a large contemporary cohort of patients with isolated tricuspid regurgitation (TR). BACKGROUND: Isolated TR is a challenging clinical entity with heterogeneous etiology and often poor outcomes, with a paucity of recent research regarding the epidemiology of isolated TR. METHODS: Consecutive patients with isolated TR graded at least moderate to severe on echocardiography from January 2004 to December 2018 (n = 9,045, mean age 70.4 ± 15.4 years, 60.3% women) were studied. TR etiologies were individually adjudicated as secondary or primary, with subcategories. All-cause death during follow-up was the primary endpoint, with associations between etiology and outcomes analyzed and a risk model created. RESULTS: Primary and secondary TR etiologies were present in 470 (5.2%) and 8,575 (94.8%) patients, respectively. The main secondary etiologies were left heart disease in 4,664 (54.4%), atrial functional in 2,086 (24.3%), and pulmonary disease in 1,454 (17.0%), and the main primary etiologies were endocarditis in 222 (47.2%), degenerative or prolapse in 86 (18.3%), and prosthetic valve failure in 79 (16.8%). There were 3,987 deaths (44.0%) over a mean follow-up period of 2.6 ± 3.3 years. In unadjusted analyses, patients with secondary TR had worse survival than those with primary TR (HR: 1.56; 95% CI: 1.32-1.85), but this result was not statistically significant in multivariable analysis. The authors devised and internally validated a risk score for predicting 1-year mortality in these patients. CONCLUSIONS: Secondary TR constituted 95% of isolated significant TR and conferred worse survival than primary TR in unadjusted but not adjusted analyses. The present novel risk score stratifies the risk for 1-year death and may influence decision making for management in these high-risk patients.