Rapid Emergency Department Physical Space Modifications for COVID-19: Keeping Patients and Health Care Workers Safe.

The COVID-19 pandemic has placed significant strain on emergency departments (EDs) that were not designed to care for many patients who may be highly contagious. This report outlines how a busy urban ED was adapted to prepare for COVID-19 via 3 primary interventions: (1) creating an open-air care space in the ambulance bay to cohort, triage, and rapidly test patients with suspected COVID-19, (2) quickly constructing temporary doors on all open treatment rooms, and (3) adapting and expanding the waiting room. This description serves as a model by which other EDs can repurpose their own care spaces to help ensure safety of their patients and health care workers.

Patellar tendon reconstruction using an extended gastrocnemius flap following cryogenic injury to the knee.

Cryogenic thermal necrosis after knee surgery is rare. We describe a patient who presented with an anterior knee soft tissue defect in conjunction with an extensor mechanism deficiency secondary to a cold thermal injury after an anterior cruciate ligament reconstruction. We treated the patient with a single stage surgical procedure combining patellar tendon reconstruction and soft tissue coverage utilizing the superficial portion of the patient's vascularized Achilles tendon attached to a medial gastrocnemius flap. The patient returned to unrestricted activities and has demonstrated this through a five year follow-up.

Tris(3,5-di-tert-butylcatecholato)molybdenum(VI): Lewis acidity and nonclassical oxygen atom transfer reactions.

In the solid state, tris(3,5-di-tert-butylcatecholato)molybdenum(VI) forms a dimer with seven-coordinate molybdenum and bridging catecholates. NMR spectroscopy indicates that the dimeric structure is retained in solution. The molybdenum center has a high affinity for Lewis bases such as pyridine or pyridine-N-oxide, forming seven-coordinate monomers with a capped octahedral geometry, as illustrated by the solid-state structure of (3,5-(t)Bu2Cat)3Mo(py). Structural data indicate that the complexes are best considered as Mo(VI) with substantial π donation from the nonbridging catecholates to molybdenum. Both the dimeric and the monomeric tris(catecholates) react rapidly with water to form free catechol and oxomolybdenum bis(catecholate) complexes. Monooxomolybdenum complexes are also obtained, more slowly, on reaction with dioxygen, with organic products consisting mostly of 3,5-di-tert-butyl-1,2-benzoquinone with minor amounts of the extradiol oxidation product 4,6-di-tert-butyl-1-oxacyclohepta-4,6-diene-2,3-dione. The pyridine-N-oxide complex reacts on heating (with excess pyO) to form initially (3,5-(t)Bu2Cat)2MoO(Opy) and ultimately MoO3(Opy), with quinone and free pyridine as the only organic products. The decay of (3,5-(t)Bu2Cat)3Mo(Opy) shows an accelerated, autocatalytic profile because the oxidation of its product, (3,5-(t)Bu2Cat)2MoO(Opy), produces an oxo-rich, catecholate-poor intermediate which rapidly conproportionates with (3,5-(t)Bu2Cat)3Mo(Opy), providing an additional pathway for its conversion to the mono-oxo product. The tris(catecholate) fragment Mo(3,5-(t)Bu2Cat)3 deoxygenates Opy in this nonclassical oxygen atom transfer reaction slightly less rapidly than does its oxidized product, MoO(3,5-(t)Bu2Cat)2.