ABSTRACT
cis-1,2-Dihydrocatechols 5 (X = Me and Cl), which are available in the homochiral form through the whole-cell biotransformation of toluene and chlorobenzene, respectively, undergo Diels-Alder cycloaddition reactions with a range of electron-deficient dienophiles at 19 kbar (1.9 GPa). The favored products of such reactions are adducts of the general form 7 and that arise through the operation of a contrasteric or syn-addition pathway. In contrast, the acetonide derivatives of metabolites 5 undergo anti-selective addition reactions under the same conditions and so producing adducts of the general form 11. Bicyclo[2.2.2]octenes 7 and 11, which embody carbocyclic frameworks of opposite enantiomeric form, are useful scaffolds for chemical synthesis. Computational studies reveal that syn-adduct formation is kinetically and normally thermodynamically favored over anti-adduct formation when the free diols 5 are involved, but the reverse is so when the corresponding acetonides participate as the 4π-addend. Furthermore, the reactions become more exothermic as pressure increases while, concurrently, the activation barrier diminishes and at 6 GPa (60 kbar) almost vanishes.
ABSTRACT
This quality improvement project focuses on geriatric syndromes in patients 55 years and older admitted to a Minnesota substance abuse treatment center. Age-specific assessments identify abnormal conditions or geriatric syndromes, which prompt earlier nursing and medical interventions. Nursing staff attended a training program that focused on older adults and the use of the Fulmer SPICES tool for patients over the age of 55 years. Pretest and posttest scores showed a positive change in nursing knowledge with an increase in mean test scores of 10.32 (SD = 1.763) to 12.81 (SD = 1.545), p = .000. A 2-month preimplementation and postimplementation chart audit identified changes in assessment findings using the SPICES tool with an increase in adverse outcomes (1.03%) including sleep problems in 75.4% (n = 43) of the target population.
Subject(s)
Clinical Competence , Geriatric Assessment , Nursing Diagnosis , Opioid-Related Disorders/diagnosis , Aged , Female , Health Services for the Aged , Humans , Inservice Training , Male , Middle Aged , Minnesota , Opioid-Related Disorders/nursingABSTRACT
11beta-hydroxysteroid dehydrogenase type 1 (11beta-HSD1) has attracted considerable attention during the past few years as a potential target for the treatment of diseases associated with metabolic syndrome. In our ongoing work on 11beta-HSD1 inhibitors, a series of new 2-amino-1,3-thiazol-4(5 H)-ones were explored. By inserting various cycloalkylamines at the 2-position and alkyl groups or spirocycloalkyl groups at the 5-position of the thiazolone, several potent 11beta-HSD1 inhibitors were identified. An X-ray cocrystal structure of human 11beta-HSD1 with compound 6d (Ki=28 nM) revealed a large lipophilic pocket accessible by substitution off the 2-position of the thiazolone. To increase potency, analogues were prepared with larger lipophilic groups at this position. One of these compounds, the 3-noradamantyl analogue 8b, was a potent inhibitor of human 11beta-HSD1 (Ki=3 nM) and also inhibited 11beta-HSD1 activity in lean C57Bl/6 mice when evaluated in an ex vivo adipose and liver cortisone to cortisol conversion assay.