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The self-assembly of 2,6-diformyl-4-methylphenol (DFMP) and 1-amino-2-propanol (AP)/2-amino-1,3-propanediol (APD) in the presence of copper(II) ions results in the formation of six new supramolecular architectures containing two versatile double Schiff base ligands (H3L and H5L1) with one-, two-, or three-dimensional structures involving diverse nuclearities: tetranuclear [Cu4(HL2−)2(N3)4]·4CH3OH·56H2O (1) and [Cu4(L3−)2(OH)2(H2O)2] (2), dinuclear [Cu2(H3L12−)(N3)(H2O)(NO3)] (3), polynuclear [Cu2(H3L12−)(H2O)(BF4)(N3)]·H2On (4), heptanuclear [Cu7(H3L12−)2(O)2(C6H5CO2)6]·6CH3OH·44H2O (5), and decanuclear [Cu10(H3L12−)4(O)2(OH)2(C6H5CO2)4] (C6H5CO2)2·20H2O (6). X-ray studies have revealed that the basic building block in 1, 3, and 4 is comprised of two copper centers bridged through one μ-phenolate oxygen atom from HL2− or H3L12−, and one μ-1,1-azido (N3−) ion and in 2, 5, and 6 by μ-phenoxide oxygen of L3− or H3L12− and μ-O2− or μ3-O2− ions. H-bonding involving coordinated/uncoordinated hydroxy groups of the ligands generates fascinating supramolecular architectures with 1D-single chains (1 and 6), 2D-sheets (3), and 3D-structures (4). In 5, benzoate ions display four different coordination modes, which, in our opinion, is unprecedented and constitutes a new discovery. In 1, 3, and 5, Cu(II) ions in [Cu2] units are antiferromagnetically coupled, with J ranging from −177 to −278 cm−1.

Introduction Topical anesthesia (TA) of the nasal fossa has been shown to be sufficient for patient comfort during nasal endoscopy. However, investigators need to know how soon after the administration of TA they can accurately evaluate olfactory capability. Thus, the main aim of this study was to assess, in healthy volunteers (HV), when the effects of TA wear off to accurately measure olfactory capability after its administration. Methods A prospective, single‐center, pilot study was conducted to evaluate the duration of the effect of TA on olfactory capability, using the UPSIT. Thirty healthy volunteers were recruited and analyzed. Following baseline testing (UPSIT), TA was administered intranasally (lidocaine + oxymetazoline). Then, participants underwent three additional UPSIT evaluations at distinct time points: immediately post‐application (T0), 10 min (T + 10), and 30 min post‐application (T + 30). The primary outcome was the change in UPSIT score from baseline to each subsequent time point. Paired t‐tests were applied to compare within‐subject score differences across time points. Significance was defined as p < 0.05, and the R software was used. Results For the 30 HV included, the mean UPSIT at T0 was 32.8 ± 3.1. At T1, the mean UPSIT (29.6 ± 4.0) was significantly lower than at T0 (3.13 ± 3.7‐point, p < 0.0001). At T2, the mean UPSIT was 31.7 ± 4.2, without any significant difference from T0 (−1.03 ± 3.5‐point, p = 0.350). At T3, the mean UPSIT was 31.7 ± 3.1, without any significant difference compared to T0 (−1.07 ± 2.6‐point, p = 0.067). Regarding subgroup analysis between healthy volunteers with or without ITH, their own perception of smell and UPSIT were significantly different. Conclusion Immediately after receiving 4 sprays per nostril, the mean UPSIT—with testing begun directly after the spray was administered—was significantly lower than baseline, dropping under the threshold for normal olfactory function. It was fully recovered by ten min. Level of Evidence 3.

The reaction of 2,6-diformyl-4-methylphenol (DFMF) with 1-amino-2-propanol (AP) and tris(hydroxymethyl)aminomethane (THMAM) was investigated in the presence of Cobalt(II) salts, (X = ClO4−, CH3CO2−, Cl−, NO3−), sodium azide (NaN3), and triethylamine (TEA). In one pot, the variation in Cobalt(II) salt results in the self-assembly of dinuclear, tetranuclear, and H-bonding-directed polynuclear coordination complexes of Cobalt(III), Cobalt(II), and mixed-valence CoIICoIII: [Co2III(H2L−1)2(AP−1)(N3)](ClO4)2 (1), [Co4(H2L−1)2(µ3-1,1,1-N3)2(µ-1,1-N3)2Cl2(CH3OH)2]·4CH3OH (2), [Co2IICo2III(HL−2)2(µ-CH3CO2)2(µ3-OH)2](NO3)2·2CH3CH2OH (3), and [Co2IICo2III (H2L12−)2(THMAM−1)2](NO3)4 (4). In 1, two cobalt(III) ions are connected via three single atom bridges; two from deprotonated ethanolic oxygen atoms in the side arms of the ligands and one from the1-amino-2-propanol moiety forming a dinuclear unit with a very short (2.5430(11) Å) Co-Co intermetallic separation with a coordination number of 7, a rare feature for cobalt(III). In 2, two cobalt(II) ions in a dinuclear unit are bridged through phenoxide O and μ3-1,1,1-N3 azido bridges, and the two dinuclear units are interconnected by two μ-1,1-N3 and two μ3-1,1,1-N3 azido bridges generating tetranuclear cationic [Co4(H2L−1)2(µ3-1,1,1-N3)2(µ-1,1-N3)2Cl2(CH3OH)2]2+ units with an incomplete double cubane core, which grow into polynuclear 1D-single chains along the a-axis through H-bonding. In 3, HL2− holds mixed-valent Co(II)/Co(III) ions in a dinuclear unit bridged via phenoxide O, μ-1,3-CH3CO2−, and μ3-OH− bridges, and the dinuclear units are interconnected through two deprotonated ethanolic O in the side arms of the ligands and two μ3-OH− bridges generating cationic tetranuclear [Co2IICo2III(HL−2)2(µ-CH3CO2)2(µ3-OH)2]2+ units with an incomplete double cubane core. In 4, H2L1−2 holds mixed-valent Co(II)/Co(III) ions in dinuclear units which dimerize through two ethanolic O (μ-RO−) in the side arms of the ligands and two ethanolic O (μ3-RO−) of THMAM bridges producing centrosymmetric cationic tetranuclear [Co2IICo2III (H2L1−2)2(THMAM−1)2]4+ units which grow into 2D-sheets along the bc-axis through a network of H-bonding. Bulk magnetization measurements on 2 demonstrate that the magnetic interactions are completely dominated by an overall ferromagnetic coupling occurring between Co(II) ions.

Objectives To quantify the current proportion of women in otolaryngology at different levels of professorship and determine whether these proportions differ by US region. Methods Academic rank and gender at all ACGME‐accredited otolaryngology programs in the United States were determined from departmental websites, Doximity, and LinkedIn from November 2021 to March 2022. Individuals were then further organized using US Census Bureau‐designated regions. Results Among the 2682 faculty positions at 124 ACGME‐accredited programs, women held 706 (26.3%) of these positions. Female representation was highest at the assistant professorship level, with women holding 286 (37.2%) positions out of a total 769. At the associate professorship level, women held 141 (27.6%) of the 511 total positions. The largest gender disparity is seen at the full professorship level; only 69 (13.6%) positions out of 508 were held by women. Out of every region and rank, only assistant professorship in the West had no significant difference in percentages of men and women (p = .710). Female representation of professors in the Northeast was significantly lower than that of our reference group (the South; β = −10.9, p = .020). Conclusions Otolaryngology has exhibited great progress in increasing female representation, with assistant professorship in the West reaching gender parity. However, the gender gap at other faculty levels still leaves much to be desired, particularly in senior ranks. The lack of otolaryngologists at senior ranks is detrimental to mentorship of junior faculty, residents, and medical students. Renewed efforts should be made to decrease the gender disparity in the South, Northeast, and particularly at the professorship level. Gender gaps still exist at every rank and region in otolaryngology in the United States, with one exception‐assistant professorship in the West. Female representation was lowest at the professorship rank in the Northeast. Renewed and added efforts must be made to increase the recruitment of medical students and mentorship of junior faculty, residents, and medical students in the field.

Objective This novel pilot study constructs a social deprivation index (SDI) and utilizes an area deprivation index (ADI) to evaluate the link between social determinants of health and rhinology patient experiences. Methods Adult patients undergoing outpatient care of chronic rhinitis and chronic rhinosinusitis at a tertiary academic medical center were recruited to participate in a telephone survey assessing symptoms, social/emotional consequences of disease, and barriers to care on a 5‐point Likert scale. Sociodemographic characteristics were utilized to rate SDI on an 8‐point scale. ADI was obtained by area code of residence. Ordered logistic regression was used to examine associations between the SDI/ADI and perceptions of rhinology care. Results Fifty patients were included. Individuals with higher SDI scores (i.e., more socially deprived) experienced more severe nasal congestion (p = .007). Furthermore, higher national ADI correlated with increased severity of smell changes (p = .050) and facial pressure (p = .067). No association was seen between either deprivation index and global/psychiatric symptoms. While no correlations were found between higher SDI and difficulties with the costs of prescriptions, rhinologist's visits, or saline, higher SDI was correlated with decreased difficulty with surgery costs (p = .029), and individuals with higher national ADI percentile had increased difficulties obtaining nasal saline (p = .029). Conclusion Worse social deprivation is associated with difficulties obtaining saline rinses and increased severity of nasal/sinus symptoms in an urban, underserved, majority‐Black population. These findings suggest social factors affect access to and quality of rhinology care in a complex and nuanced way and highlight the need for a specific SDI to further study social determinants of health in rhinology. Level of Evidence 2c. We construct a social deprivation index and utilize an area deprivation index to study social determinants of health and rhinology patient experiences. Worse social deprivation is associated with difficulties obtaining the most basic of rhinology care—saline rinses, as well as increased severity of nasal/sinus symptoms in an urban, underserved, majority‐Black population.

Chronic obstructive pulmonary disease (COPD) predominantly affects older adults. However, the co-morbid occurrence of geriatric conditions has been understudied. Characterize the prevalence of geriatric conditions among community-dwelling U.S. older adults with self-reported COPD. We conducted a nationally representative, cross-sectional study of 3,005 U.S. community-dwelling older adults (ages 57-85 years) from the National Social Life, Health, and Aging Project (NSHAP). We evaluated the prevalence of select geriatric conditions (multimorbidity, functional disability, impaired physical function, low physical activity, modified frailty assessment, falls, polypharmacy, and urinary incontinence) and psychosocial measures (frequency of socializing, sexual activity in the last year, loneliness, cognitive impairment, and depressive symptoms) among individuals with self-reported COPD as compared to those without. Using multivariate logistic and linear regressions, we investigated the relationships between COPD and these geriatric physical and psychosocial conditions. Self-reported COPD prevalence was 10.7%, similar to previous epidemiological studies. Individuals with COPD had more multimorbidity [modified Charlson score 2.6 (SD 1.9) vs. 1.6 (SD 1.6)], more functional disability (58.1 vs. 29.6%; adjusted OR 3.1, 95% CI 2.3, 4.3), falls in the last year (28.4 vs. 20.8%; adjusted OR 1.4, 95% CI 1.01, 2.0), impaired physical function (75.8 vs. 56.6%; adjusted OR 2.1, 95% CI 1.1, 3.7), more frequently reported extreme low physical activity (18.7 vs. 8.1%; adjusted OR 2.3, 95% CI 1.5, 3.5) and higher frailty prevalence (16.0 vs. 2.7%; adjusted OR 6.3, 95% CI 3.0,13.0) than those without COPD. They experienced more severe polypharmacy (≥10 medications, 37.5 vs. 16.1%; adjusted OR 2.9, 95% CI 2.0, 4.2). They more frequently reported extreme social disengagement and were lonelier, but the association with social measures was eliminated when relationship status was accounted for, as those with COPD were less frequently partnered. They more frequently endorsed depressive symptoms (32.0 vs. 18.9%, adjusted OR 1.9, 95% CI 1.4, 2.7). There was no noted difference in cognitive impairment between the two populations. Geriatric conditions are common among community-dwelling older adults with self-reported COPD. A \"beyond the lung\" approach to COPD care should center on active management of geriatric conditions, potentially leading to improved COPD management, and quality of life.

Osteoprotegerin (OPG) is involved in various biological processes, including bone remodeling, vascular calcification and pancreatic β-cell function. Although some clinical studies have shown an increase in serum OPG level during pregnancy, the role of OPG in gestational diabetes mellitus (GDM) is largely unknown. Therefore, we explored the effect of OPG in metabolic homeostasis during pregnancy. We initially evaluated serum OPG levels using ELISA and western blotting techniques on samples from GDM patients. We also assessed OPG expression levels in maternal mice. We then used blastocysts transduced with lentiviruses capable of trophoblast-specific transgene expression to establish placenta-specific OPG knockdown or overexpression mouse models for functional and mechanistic investigation after embryo transplantation. We found that OPG expression was positively associated with GDM in clinical samples, and OPG levels were significantly increased in GDM patient sera and term placenta. Serum OPG was significantly increased in maternal compared to non-pregnant mice, and expression levels of OPG were the highest in placenta compared with other organs, including bone, liver and pancreas. OPG was also significantly increased in pregnant mice fed a high-fat diet (HFD). Placenta-specific OPG knockdown induced glucose intolerance, decreased β-cell proliferation and decreased serum insulin levels, whereas placenta-specific OPG overexpression promoted glucose tolerance and enhanced β-cell proliferation, which increased serum insulin production and decreased fetal weight in HFD-feeding pregnant mice. Placenta-derived OPG (pl-OPG) regulated glucose homeostasis during pregnancy via enhancement of β-cell proliferation, which suggests a potential therapeutic application of OPG for GDM.

Expression of the transcription factor interferon regulatory factor 4 (IRF4) is required for the development of lung conventional DCs type 2 (cDC2s) that elicit Th2 responses, yet how IRF4 functions in lung cDC2s throughout the acute and memory allergic response is not clear. Here, we used a mouse model that loses IRF4 expression after lung cDC2 development to demonstrate that mice with IRF4-deficient DCs display impaired memory responses to allergen. This defect in the memory response was a direct result of ineffective Th2 induction and impaired recruitment of activated effector T cells to the lung after sensitization. IRF4-deficient DCs demonstrated defects in their migration to the draining lymph node and in T cell priming. Finally, T cells primed by IRF4-competent DCs mediated potent memory responses independently of IRF4-expressing DCs, demonstrating that IRF4-expressing DCs are not necessary during the memory response. Thus, IRF4 controlled a program in mature DCs governing Th2 priming and effector responses, but IRF4-expressing DCs were dispensable during tissue-resident memory T cell-dependent memory responses.

Objective Airborne spread of the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) remains a significant risk for healthcare workers. Understanding transmission of SARS‐CoV‐2 in the hospital could help minimize nosocomial infection. The objective of this pilot study was to measure aerosolization of SARS‐CoV‐2 in the hospital rooms of COVID‐19 patients. Methods Two air samplers (Inspirotec) were placed 1 and 4 m away from adults with SARS‐CoV‐2 infection hospitalized at an urban, academic tertiary care center from June to October 2020. Airborne SARS‐CoV‐2 concentration was measured by quantitative reverse transcription polymerase chain reaction and analyzed by clinical parameters and patient demographics. Results Thirteen patients with COVID‐19 (eight females [61.5%], median age: 57 years old, range 25–82) presented with shortness of breath (100%), cough (38.5%) and fever (15.4%). Respiratory therapy during air sampling varied: mechanical ventilation via endotracheal tube (n = 3), high flow nasal cannula (n = 4), nasal cannula (n = 4), respiratory helmet (n = 1), and room air (n = 1). SARS‐CoV‐2 RNA was identified in rooms of three out of three intubated patients compared with one out of 10 of the non‐intubated patients (p = .014). Airborne SARS‐CoV‐2 tended to decrease with distance (1 vs. 4 m) in rooms of intubated patients. Conclusions Hospital rooms of intubated patients had higher levels of aerosolized SARS‐CoV‐2, consistent with increased aerosolization of virus in patients with severe disease or treatment with positive pressure ventilation through an endotracheal tube. While preliminary, these data have safety implications for health care workers and design of protective measures in the hospital. Level of Evidence 2 We measured aerosolized SARS‐CoV‐2 in air in the rooms of hospitalized COVID‐19 patients. Viral genetic material was detected in rooms containing intubated patients, and higher viral loads were detected 1m from the upper airway of intubated patients compared with 4m away. These findings suggest that severe COVID‐19 or treatment with mechanical ventilation through an endotracheal tube results in increased SARS‐CoV‐2 aerosolization in the hospital, which has implications for risk to health care workers.

The ability to listen critically to one's own playing and to others, when playing in an ensemble, is very important for musicians. Students can detect mistakes, produce desired tones, create subtle dynamic shades, project sensitive phrasing and collaborate well with others if they have good critical listening skills. In this column, five teachers share their ideas on developing critical listening skills with \"American Music Teacher\" readers.