Symmetrical and Mixed Tris(acyl)phosphines: Synthesis, Oxidation and Photochemistry

Herein, we present a convenient synthesis for symmetrical and mixed substituted tris(acyl)phosphines (TAPs) starting from red phosphorus. All TAPs exhibit a phosphaalkene-acylphosphine equilibrium, which was investigated in detail by variable-temperature (VT) NMR spectroscopy supported by density-functional theory (DFT) calculations. Depending on the substituents, two phosphaalkene derivatives and ten acylphosphine derivatives could be isolated. NMR spectroscopy and single-crystal X-ray crystallography enabled a clear structural assignment of these compounds. Oxidation of selected TAPs led to the formation of the corresponding tris(acyl)phosphine oxides (TAPOs). Furthermore, their spectroscopic properties as well as their photochemistry was investigated. Especially, the TAPO compounds were evaluated for their suitability as photoinitiators by CIDNP spectroscopy, photobleaching measurements and by storage stability tests.

Symmetrical and Mixed Tris(acyl)phosphines: Synthesis, Oxidation and Photochemistry

Invited for the cover of this issue are the groups of M. Haas, G. Gescheidt and H. Grützmacher from the Graz University of Technology and the ETH Zürich. The image depicts a phosphorus mine, where the workers are acid chlorides using their shovels and red phosphorus to provide the chemicals necessary to produce novel reagents. Read the full text of the article at 10.1002/chem.202302535.

A Series of 69 COVID-related Dermatoses With Biopsy, Immunohistochemistry With Anti-spike 3, in situ Hybridization and PCR: A Critical Reappraisal of Viral Involvement in COVID-19 Skin Lesions

BACKGROUND

Despite the large number of articles published on skin lesions related to COVID-19, clinicopathological correlation has not been performed consistently and immunohistochemistry to demonstrate spike 3 protein expression has not been validated through RT-PCR.

MATERIAL AND METHODS

We compiled 69 cases of patients with confirmed COVID-19, where skin lesions were clinically and histopathologically studied. Immunohistochemistry (IHC) and RT-PCR was performed in skin biopsies.

RESULTS

After a careful review of the cases, 15 were found to be dermatosis not related to COVID-19, while the rest of the lesions could be classified according to their clinical characteristics as vesicular (4), maculopapular eruptions (41), urticariform (9), livedo and necrosis (10) and pernio-like (5). Although histopathological features were similar to previously reported results, we found two previously unreported findings, maculopapular eruptions with squamous eccrine syringometaplasia and neutrophilic epitheliotropism. IHC showed in some cases endothelial and epidermal staining but RT-PCR was negative in all the tested cases. Thus, direct viral involvement could not be demonstrated.

CONCLUSIONS

Despite presenting the largest series of confirmed COVID-19 patients with histopathologically studied skin manifestations, direct viral involvement was difficult to establish. Vasculopathic and urticariform lesions seem to be those more clearly related to the viral infection, despite IHC or RT-PCR negative results failed to demonstrate viral presence. These findings, as in other dermatological areas, highlight the need of a clinico-pathological correlation to increase knowledge about viral involvement in COVID-19 skin-related lesions.

A Series of 69 COVID-related Dermatoses With Biopsy, Immunohistochemistry With Anti-spike 3, in situ Hybridization and PCR: A Critical Reappraisal of Viral Involvement in COVID-19 Skin Lesions

BACKGROUND

Despite the large number of articles published on skin lesions related to COVID-19, clinicopathological correlation has not been performed consistently and immunohistochemistry to demonstrate spike 3 protein expression has not been validated through RT-PCR.

MATERIAL AND METHODS

We compiled 69 cases of patients with confirmed COVID-19, where skin lesions were clinically and histopathologically studied. Immunohistochemistry (IHC) and RT-PCR was performed in skin biopsies.

RESULTS

After a careful review of the cases, 15 were found to be dermatosis not related to COVID-19, while the rest of the lesions could be classified according to their clinical characteristics as vesicular (4), maculopapular eruptions (41), urticariform (9), livedo and necrosis (10) and pernio-like (5). Although histopathological features were similar to previously reported results, we found two previously unreported findings, maculopapular eruptions with squamous eccrine syringometaplasia and neutrophilic epitheliotropism. IHC showed in some cases endothelial and epidermal staining but RT-PCR was negative in all the tested cases. Thus, direct viral involvement could not be demonstrated.

CONCLUSIONS

Despite presenting the largest series of confirmed COVID-19 patients with histopathologically studied skin manifestations, direct viral involvement was difficult to establish. Vasculopathic and urticariform lesions seem to be those more clearly related to the viral infection, despite IHC or RT-PCR negative results failed to demonstrate viral presence. These findings, as in other dermatological areas, highlight the need of a clinico-pathological correlation to increase knowledge about viral involvement in COVID-19 skin-related lesions.

Synthesis and Characterization of a Variety of α,ω-Bisacylpolysilanes-A Study on Reactivity and Accessibility

In this study, a variety of α,ω-bisacylpolysilanes were synthesized via two synthetic protocols. The first method for obtaining these compounds is based on the substitution reaction of bromine either on silica gel or by the use of silver salts. Surprisingly, instead of the expected bromine substitution product PhC(O)(SiMe₂)₂C(O)Ph 4a, we found the formation of the diastereomer PhC(O)(SiMe₂)₂CBrPhOCBrPh(SiMe₂)₂C(O)Ph 4b indicating a more complex reaction cascade. On the other hand, the phenylated compound 3b yielded the expected bromine substitution product PhC(O)(SiPh₂)₂C(O)Ph 4c. For the second protocol, we utilized the Corey-Seebach approach to isolate other representatives of this compound class. We found that the substituents at the α-silicon atoms influence the selectivity of the dethioketalization. While the ethylated and phenylated disilanes 5b,c yield the expected bisacyldisilanes 6a,b, the methylated disilane 4a undergoes a BF₃-induced Si-Si bond breakage followed by an intermolecular sila-aldol reaction. This hitherto unknown sila-aldol reaction results in the formation of the enantiomer PhC(O)SiMe₂C(OMe)PhSiMe₂F 6c in excellent yields. All isolated compounds were analyzed by a combination of NMR spectroscopy, ultraviolet-visible (UV-vis) spectroscopy, single-crystal X-ray crystallography, and mass spectrometry. Furthermore, the photochemical pathways of two representative examples (4b,c) were examined.

Do germanium-based photoinitiators have the potential to replace the well-established acylphosphine oxides?

In the last few decades, there has been an increasing demand for photoinitiators with growing requirements. Nowadays, photoinitiators need to fulfill several requirements such as a low level of toxicity, biocompatibility, fast polymerization rates, high activities, good photobleaching and much more in order to remain competitive on the market. Accordingly, we compare acylphosphine oxides and acylgermanes, two common classes of photoinitiators, with respect to their various synthetic pathways, toxicity, availability and performance.

Synthesis of Stable Dianionic Cyclic Silenolates and Germenolates

In this contribution a convenient synthetic method to obtain the previously unknown dianionic cyclic silenolates and germenolates is described. These dianions 2a,b and 4a,b are easily accessible via a one-pot synthetic protocol in high yields. Their structural properties were analyzed by a combination of NMR, single-crystal X-ray crystallography, and DFT quantum mechanical calculations. Moreover, the reactivity of 2a,b and 4a,b with selected examples of electrophiles was investigated. 2a and 4a were reacted with ClSiiPr₃ to give new examples of polysilanes and polygermanes with exocyclic double bonds. The reaction of 2b with ClSiMe₂SiMe₂Cl led to the formation of the acyl bicyclo[2.2.2]octasilane 6. Moreover, the reaction of 2a,b and 4a,b with MeI, as an example of a carbon-centered electrophile, led to selective alkylation reactions at the negatively charged silicon and germanium atoms. The corresponding methylated structures 9a,b and 10a,b were formed in nearly quantitative yields. The competitive reactivity of the silyl and silenolate anion toward 1 equiv of ClSiMe₃ showed that the outcome of the reaction was strongly influenced by the substituent at the carbonyl moiety. 2a reacted with 1 equiv of ClSiMe₃ to give the corresponding cyclic silenolate S₁a, which demonstrated that the silyl anion is more nucleophilic than the silenolate with attached aromatic groups. 2b, on the other hand, reacted with 1 equiv of ClSiMe₃ to give the bicyclic compound 11via an intramolecular sila-Peterson alkenation reaction. These findings clearly showed that the alkyl-substituted silenolate is more nucleophilic than the silyl anion. This paper demonstrates that 2a,b and 4a,b have the potential to be used as unique building blocks for complex polysilane and polygermane frameworks.

SARS-CoV-2 endothelial infection causes COVID-19 chilblains: histopathological, immunohistochemical and ultrastructural study of seven paediatric cases

Background

Chilblains (‘COVID toes’) are being seen with increasing frequency in children and young adults during the COVID‐19 pandemic. Detailed histopathological descriptions of COVID‐19 chilblains have not been reported, and causality of SARS‐CoV‐2 has not yet been established.

Objectives

To describe the histopathological features of COVID‐19 chilblains and to explore the presence of SARS‐CoV‐2 in the tissue.

Methods

We examined skin biopsies from seven paediatric patients presenting with chilblains during the COVID‐19 pandemic. Immunohistochemistry for SARS‐CoV‐2 was performed in all cases and electron microscopy in one.

Results

Histopathology showed variable degrees of lymphocytic vasculitis ranging from endothelial swelling and endotheliitis to fibrinoid necrosis and thrombosis. Purpura, superficial and deep perivascular lymphocytic inflammation with perieccrine accentuation, oedema, and mild vacuolar interface damage were also seen. SARS‐CoV‐2 immunohistochemistry was positive in endothelial cells and epithelial cells of eccrine glands. Coronavirus particles were found in the cytoplasm of endothelial cells on electron microscopy.

Conclusions

Although the clinical and histopathological features were similar to other forms of chilblains, the presence of viral particles in the endothelium and the histological evidence of vascular damage support a causal relation of the lesions with SARS‐CoV‐2. Endothelial damage induced by the virus could be the key mechanism in the pathogenesis of COVID‐19 chilblains and perhaps also in a group of patients severely affected by COVID‐19 presenting with features of microangiopathic damage.

What is already known about this topic?

Despite the high number of cases of chilblains seen during the COVID‐19 pandemic, a definite causative role for SARS‐CoV‐2 has not yet been proven.

Different pathogenetic hypotheses have been proposed, including coagulation anomalies, interferon release and external factors.

What does this study add?

The demonstration of SARS‐CoV‐2 in endothelial cells of skin biopsies by immunohistochemistry and electron microscopy confirms that these lesions are part of the spectrum of COVID‐19.

Virus‐induced vascular damage and secondary ischaemia could explain the pathophysiology of COVID‐19 chilblains.

Our findings support the hypothesis that widespread endothelial infection by SARS‐CoV‐2 could have a pathogenetic role in the severe forms of COVID‐19.

Linked Comment:  Wetter. Br J Dermatol 2020; 183:611.

[Objective hearing tests in pediatric audiology: AGERA recommendations for follow-up diagnosis in infants that fail newborn hearing screening tests]

This paper presents the recommendations compiled by the German Electric Response Audiometry Working Group (Arbeitsgruppe Elektrische Reaktions-Audiometrie, AGERA) and the Association of German Audiologists and Neuro-otologists (Arbeitsgemeinschaft Deutschsprachiger Audiologen und Neurootologen, ADANO) for infants that fail newborn hearing screening (NHS) tests. Outlined are procedures for follow-up diagnosis using objective hearing tests to rule out or confirm a therapeutically relevant auditory defect and assessment of the severity thereof.

Absence of BRAF and HRAS mutations in eruptive Spitz naevi

BACKGROUND

Eruptive Spitz naevi have been reported rarely in the literature. In solitary Spitz naevi, BRAF and HRAS mutations, as well as increased copy numbers of chromosome 11p have been identified.

OBJECTIVES

To investigate the genetic changes underlying eruptive Spitz naevi.

METHODS

We report on a 16-year-old boy who developed multiple disseminated eruptive Spitz naevi within a few months. We analysed BRAF, HRAS, KRAS and NRAS genes in 39 naevi from this patient for hotspot mutations. Furthermore, comparative genomic hybridization analysis was performed in three lesions.

RESULTS

None of the Spitz naevi displayed a mutation in the analysed genes, and no chromosomal imbalances were observed. Conclusions  Our results indicate that the typical genetic alterations described in solitary Spitz naevi appear to be absent in eruptive Spitz naevi. Yet unknown alternative genetic alterations must account for this rare syndrome.

Circulating endocannabinoids and N-acyl-ethanolamides in patients with sleep apnea--specific role of oleoylethanolamide

OBJECTIVE

The endocannabinoid system promotes diverse effects on fat and glucose metabolism as well as on energy balance and sleep regulation. The role of N-acylethanolamides like oleoylethanolamide (OEA) and other endocannabinoids such as anandamide (AEA) and 2-arachidonyl-glycerol (2-AG) has not yet been investigated in patients with sleep apnea.

DESIGN AND METHODS

We measured circulating OEA, AEA and 2-AG in patients with sleep apnea (n = 20) and healthy control subjects (n = 57). Respiratory distress index (RDI) as measured by polysomnography was used as a quantitative index of sleep apnea.

RESULTS

In patients with sleep apnea OEA serum concentrations were significantly higher than in control subjects (8.4 pmol/ml (95% CI 6.9;9.9) vs. 4.0 (3.5;4.5); p<0.0001, adjusted for body mass index (BMI), fasting insulin, HDL and LDL cholesterol). In contrast, AEA (2.9 (95% CI 1.9;3.9) vs. 1.8 (1.4;2.1), p = 0.09) and 2-AG (20.0 (-14.5;54.5) vs. 32.8 (21.4;44.2), p = 0.56) were not significantly different between patients with sleep apnea and control subjects after adjustment. In the sleep apnea group, OEA serum concentrations were associated with RDI (r (2) = 0.28, p = 0.02) and BMI (r (2) = 0.32, p = 0.01). However, OEA was not associated with BMI in the control group (p = 0.10).

CONCLUSIONS

These results indicate that among the three analyzed fatty acid derivatives, OEA plays a specific role in patients with sleep apnea. Together with animal data, the 2-fold elevation of OEA serum concentrations could be interpreted as a neuroprotective mechanism against chronic oxidative stressors and a mechanism to promote wakefulness in patients with nocturnal sleep deprivation and daytime hypersomnolence.

[Quality assurance of a universal newborn hearing screening. Recommendations of the German Society of Phoniatrics and Pediatric Audiology]

Statutory implementation of a universal newborn hearing screening requires a continuous quality assurance monitoring. Therefore, at the Annual Meeting in 2007, the members of the German Society of Phoniatrics and Pediatric Audiology passed a recommendation on measures of quality assurance applied to newborn hearing screening. This recommendation describes the procedures, performance, location, time frame, and technical prerequisites of the screening and of potentially necessary follow-ups, the definition of hearing loss to be detected, the performing and responsible professional groups and their qualifications for the screening, the regulation of repeat and control screenings, the confirmation diagnostics and initiation of therapy, the information of parents, the documentation of screening results, the aims and organization of a tracking system, the tasks of regional screening centers and of a supraregional institution for the quality assurance of the hearing screening, the central collection of person and screening-related quality relevant data, and the accessibility of defined data sets as predisposition for cost analyses and quality reports.

Detection of MSC-like cells in soft tissue sarcoma cell lines and primary tumors

11000

Background: Soft tissue sarcomas (STS) are a heterogeneous group of mesodermal tumors hypothetically originating from mesenchymal stem cells (MSC). While the expression profile of bone marrow derived MSCs and their in vitro differentiation potential have been examined extensively, knowledge regarding the in vivo counterparts of MSC is still evolving. We hypothesized that MSC-like cells within STS could represent sarcoma initiating cells. Methods: To target rare human cell populations including MSCs, an exclusive antibody panel was developed. The target antigens include platelet-derived growth factor receptor-β (CD140b), HER-2/erbB2 (CD340), TNFRSF16 (CD217), frizzled-4 (CD344), the recently described W8B2 antigen, as well as several surface antigens identified by novel antibodies. To define the expression pattern of MSC-markers in STS, both cell lines and primary tumor samples in suspension and in snap frozen sections were investigated. To reveal functional differences between identified rare tumor populations single cell proliferation kinetics were investigated after FACS-sorting. Results: All cell lines und primary tumor samples revealed expression of selected markers. Antigens identifying subpopulations within all sarcoma samples investigated, were selected for functional studies. These included frizzled-4, TNFRSF16, W5C5 and W8B2. Liposarcoma (SW872), leiomyosarcoma (SK-LMS) and fibrosarcoma (HT1080) cell lines enclosed subpopulations with differential expression of above markers and by FACS based limiting dilution it was demonstrated that only fractions of viable cells contained proliferative capacity. Cells lacking expression of CD271 had lower proliferative capacity compared to mock sorted HT1080 or SK-LMS, while CD271+ SW872 had significantly higher proliferation. The antigen defined by W5C5 identified cells with high proliferative capacity compared to control in SW872 and SK-LMS and its lack in HT1080 identified a subpopulation with largely reduced proliferation. Conclusions: Subpopulations within STS cell lines and primary sarcoma tissue express novel MSC-markers and display increased proliferative capacity, potentially reflecting the existence of sarcoma initiating cells.

No significant financial relationships to disclose.

Dynamic optimization of hybridoma growth in a fed-batch bioreactor

This study addressed the problem of maximizing cell mass and monoclonal antibody production from a fed-batch hybridoma cell culture. We hypothesized that inaccuracies in the process model limited the mathematical optimization. On the basis of shaker flask data, we established a simple phenomenological model with cell mass and lactate production as the controlled variables. We then formulated an optimal control algorithm, which calculated the process-model mismatch at each sampling time, updated the model parameters, and re-optimized the substrate concentrations dynamically throughout the time course of the batch. Manipulated variables were feed rates of glucose and glutamine. Dynamic parameter adjustment was done using a fuzzy logic technique, while a heuristic random optimizer (HRO) optimized the feed rates. The parameters selected for updating were specific growth rate and the yield coefficient of lactate from glucose. These were chosen by a sensitivity analysis. The cell mass produced using dynamic optimization was compared to the cell mass produced for an unoptimized case, and for a one-time optimization at the beginning of the batch. Substantial improvements in reactor productivity resulted from dynamic re-optimization and parameter adjustment. We demonstrated first that a single offline optimization of substrate concentration at the start of the batch significantly increased the yield of cell mass by 27% over an unoptimized fermentation. Periodic optimization online increased yield of cell mass per batch by 44% over the single offline optimization. Concomitantly, the yield of monoclonal antibody increased by 31% over the off-line optimization case. For batch and fed-batch processes, this appears to be a suitable arrangement to account for inaccuracies in process models. This suggests that implementation of advanced yet inexpensive techniques can improve performance of fed-batch reactors employed in hybridoma cell culture.

[High-caloric nutrition in radiochemotherapy, nasogastric tube and parenteral nutrition versus PEG (percutaneous endoscopic controlled gastrostomy)]

The advantages and problems of different types of artificial feeding are discussed. For patients needing long-term nutritional support, we see the following special advantages of PEG: physiological enteral nutrition with an only small risk of tube dislocation, no additional handicap of the natural swallowing procedure and without stigmatizing the patient by an external visible tube (Tab. 3). To help to spread this method of artificial feeding for the benefit of the patient, this article gives some informations on how to cope with the problems that might occur when using PEG (for example: a diet plan for building up the tube food nutrition (Tab. 4).