The nature of the terminal oxidant in oxidation reactions is an important reaction variable that can profoundly impact the mechanism, efficiency, and practicality of a synthetic protocol. One might ...reasonably categorize catalytic oxidation reactions into either "oxygenase" type reactions, in which the oxidant serves as an atom- or group-transfer reagent, or "oxidase" type reactions, where the oxidant is involved in catalyst turnover but does not become structurally incorporated into the product. As the field of photoredox catalysis has matured over the past decade, many successful oxygenase-type photoreactions have been reported. The development of photocatalytic oxidase reactions, on the other hand, has been somewhat slower. This tutorial review presents selected examples of some of the key classes of terminal oxidants that have been used in the design of photoredox oxidase transformations, along with the mechanistic features and benefits of each.
Public health concerns such as multi- and extensive drug-resistant tuberculosis, bioterrorism, pandemic influenza, and severe acute respiratory syndrome have intensified efforts to prevent ...transmission of infections that are completely or partially airborne using environmental controls. One such control, ultraviolet germicidal irradiation (UVGI), has received renewed interest after decades of underutilization and neglect. With renewed interest, however, come renewed questions, especially regarding efficacy and safety. There is a long history of investigations concluding that, if used properly, UVGI can be safe and highly effective in disinfecting the air, thereby preventing transmission of a variety of airborne infections. Despite this long history, many infection control professionals are not familiar with the history of UVGI and how it has, and has not, been used safely and effectively. This article reviews that history of UVGI for air disinfection, starting with its biological basis, moving to its application in the real world, and ending with its current status.
Social isolation and loneliness are associated with increased mortality and higher health care spending in older adults. Hearing loss is a common condition in older adults and impairs communication ...and social interactions. The objective of this review is to summarize the current state of the literature exploring the association between hearing loss and social isolation and/or loneliness.
PubMed, Embase, CINAHL Plus, PsycINFO, and the Cochrane Library.
Articles were screened for inclusion by 2 independent reviewers, with a third reviewer for adjudication. English-language studies of older adults with hearing loss that used a validated measure of social isolation or loneliness were included. A modified Newcastle-Ottawa Scale was used to assess the quality of the studies included in the review.
Of the 2495 identified studies, 14 were included in the review. Most of the studies (12/14) were cross-sectional. Despite the heterogeneity of assessment methods for hearing status (self-report or objective audiometry), loneliness, and social isolation, most multivariable-adjusted studies found that hearing loss was associated with higher risk of loneliness and social isolation. Several studies found an effect modification of gender such that among women, hearing loss was more strongly associated with loneliness and social isolation than among men.
Our findings that hearing loss is associated with loneliness and social isolation have important implications for the cognitive and psychosocial health of older adults. Future studies should investigate whether treating hearing loss can decrease loneliness and social isolation in older adults.
The merger of photoredox catalysis with transition metal catalysis, termed metallaphotoredox catalysis, has become a mainstay in synthetic methodology over the past decade. Metallaphotoredox ...catalysis has combined the unparalleled capacity of transition metal catalysis for bond formation with the broad utility of photoinduced electron- and energy-transfer processes. Photocatalytic substrate activation has allowed the engagement of simple starting materials in metal-mediated bond-forming processes. Moreover, electron or energy transfer directly with key organometallic intermediates has provided novel activation modes entirely complementary to traditional catalytic platforms. This Review details and contextualizes the advancements in molecule construction brought forth by metallaphotocatalysis.
The classification of neuroendocrine neoplasms (NENs) differs between organ systems and currently causes considerable confusion. A uniform classification framework for NENs at any anatomical location ...may reduce inconsistencies and contradictions among the various systems currently in use. The classification suggested here is intended to allow pathologists and clinicians to manage their patients with NENs consistently, while acknowledging organ-specific differences in classification criteria, tumor biology, and prognostic factors. The classification suggested is based on a consensus conference held at the International Agency for Research on Cancer (IARC) in November 2017 and subsequent discussion with additional experts. The key feature of the new classification is a distinction between differentiated neuroendocrine tumors (NETs), also designated carcinoid tumors in some systems, and poorly differentiated NECs, as they both share common expression of neuroendocrine markers. This dichotomous morphological subdivision into NETs and NECs is supported by genetic evidence at specific anatomic sites as well as clinical, epidemiologic, histologic, and prognostic differences. In many organ systems, NETs are graded as G1, G2, or G3 based on mitotic count and/or Ki-67 labeling index, and/or the presence of necrosis; NECs are considered high grade by definition. We believe this conceptual approach can form the basis for the next generation of NEN classifications and will allow more consistent taxonomy to understand how neoplasms from different organ systems inter-relate clinically and genetically.
Oxidative heterofunctionalization reactions are among the most attractive methods for the conversion of alkenes and heteroatomic nucleophiles into complex saturated heterocycles. However, the ...state-of-the-art transition-metal-catalyzed methods to effect oxidative heterofunctionalizations are typically limited to unhindered olefins, and different nucleophilic partners generally require quite different reaction conditions. Herein, we show that Cu(II)-mediated radical–polar crossover allows for highly efficient and exceptionally mild photocatalytic oxidative heterofunctionalization reactions between bulky tri- and tetrasubstituted alkenes and a wide variety of nucleophilic partners. Moreover, we demonstrate that the broad scope of this transformation arises from photocatalytic alkene activation and thus complements existing transition-metal-catalyzed methods for oxidative heterofunctionalization. More broadly, these results further demonstrate that Cu(II) salts are ideal terminal oxidants for photoredox applications and that the combination of photocatalytic substrate activation and Cu(II)-mediated radical oxidation can address long-standing challenges in catalytic oxidation chemistry.
BACKGROUND/OBJECTIVES
Medicare has become an increasingly complex program to navigate with numerous choices available to beneficiaries with important implications for their financial exposure and ...access to care. Although research has identified poor health literacy as a barrier to understanding Medicare, little information is available on the experience of individuals with hearing loss. This study examined how hearing loss impacts Medicare beneficiaries in understanding the program, their ability to compare and review plan options, and their satisfaction with available information.
DESIGN
Cross‐sectional analysis using multivariate ordinal logistic regression.
SETTING
Nationally representative survey of Medicare beneficiaries in the United States (Medicare Current Beneficiary Survey MCBS) 2017.
PARTICIPANTS
A total of 10,510 Medicare beneficiaries were analyzed, representing 50,084,169 beneficiaries with survey weights applied.
MEASUREMENTS
The primary outcome was difficulty understanding Medicare, determined by this MCBS question: “Overall, how easy or difficult do you think the Medicare program is to understand?” The predictor of interest was self‐reported hearing loss measured categorically as no trouble, a little trouble, and a lot of trouble hearing. Covariates included age, sex, race, educational attainment, household income relative to the federal poverty level, enrollment in either traditional Medicare or Medicare Advantage, dementia diagnosis, trouble with vision, and number of chronic conditions.
RESULTS
Medicare beneficiaries with a little or a lot of trouble hearing had 18% (95% confidence interval CI odds ratio OR = 1.10–1.27) and 25% (95% CI OR = 1.07–1.47) increased odds of reporting greater difficulty with understanding Medicare, respectively, compared with those with no hearing trouble. About one in five Medicare beneficiaries with hearing loss identified that their hearing made it difficult to find Medicare information.
CONCLUSION
The existing tools to support Medicare beneficiaries’ understanding and navigation of the program must evolve to meet the needs of those with hearing loss, a highly prevalent condition among Medicare beneficiaries. J Am Geriatr Soc 68:2336–2342, 2020.
Background/Objectives
Age‐related hearing loss (ARHL) is a widely prevalent yet manageable condition that has been linked to neurocognitive and psychiatric comorbidities. Multiple barriers hinder ...older individuals from being diagnosed with ARHL through pure‐tone audiometry. This is especially true during the COVID‐19 pandemic, which has resulted in the closure of many outpatient audiology and otolaryngology offices. Smartphone‐based hearing assessment apps may overcome these challenges by enabling patients to remotely self‐administer their own hearing examination. The objective of this review is to provide an up‐to‐date overview of current mobile health applications (apps) that claim to assess hearing.
Design
Narrative review.
Measurements
The Apple App Store and Google Play Store were queried for apps that claim to assess hearing. Relevant apps were downloaded and used to conduct a mock hearing assessment. Names of included apps were searched on four literature databases (PubMed/MEDLINE, EMBASE, Cochrane Library, and CINAHL) to determine which apps had been validated against gold standard methods.
Results
App store searches identified 44 unique apps. Apps differed with respect to the type of test offered (e.g., hearing threshold test), cost, strategies to reduce ambient noise, test output (quantitative vs qualitative results), and options to export results. Validation studies were identified for seven apps.
Conclusion
Given their low cost and relative accessibility, smartphone‐based hearing apps may facilitate screening for ARHL, particularly in the setting of limitations on in‐person medical care due to COVID‐19. However, app features vary widely, few apps have been validated, and user‐centered designs for older adults are largely lacking. Further research and validation efforts are necessary to determine whether smartphone‐based hearing assessments are a feasible and accurate screening tool for ARHL.
Key Points
Age‐related hearing loss is a prevalent yet undertreated condition among older adults.
Why Does this Paper Matter?
Smartphone‐based hearing test apps may facilitate remote screening for hearing loss, but limitations surrounding app validation, usability, equipment calibration, and data security should be addressed.
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