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The objective of this study is to find a correlation between internal jugular vein (IJV) sonography and left ventricular filling pressure (LVFP) and a threshold to predict LVFP. A sample of 54 patients were included in 2 hospitals in Nice and 1 hospital in France from September 2020 to June 2021.IJV diameter was measured at inspiration and expiration in a patient lying down at 45° before realizing an echocardiography which allowed to determine two groups : normal and elevated LVFP. The ratio IJV/common carotid was also calculated.The median of RIJV diameter during inspiration was 0.30cm [0.1-0.99] for the normal LVFP group and 1.26cm [0.74-1.56] in the elevated LVFP group with significant difference (pA threshold lower than 0.59cm for IJV diameter was predictive of normal LVFP with a sensibility of 62% and specificity of 88%. A threshold greater than 1.08cm was predictive of elevated LVFP with a sensibility of 64% and specificity of 86%.The ratio of RIJV/common carotid found similar results but measures during expiration and with the LIJV do not seem to be useful in practice.Conclusion: right internal jugular vein ultrasound appeared to be helpful for extracellular assessment with a sensibility of 60-65% and a specificity >80%.; L’objectif de cette étude est de trouver une corrélation entre la veine jugulaire interne (VJI) à l’échographie et les pressions de remplissages du ventricule gauche (PRVG) afin de définir un seuil prédicitif des PRVG.54 patients ont été inclus dans 2 hôpitaux de Nice et un hôpital de Cannes de septembre 2020 à juin 2021.Le diamètre de la veine jugulaire interne était mesuré à l’inspiration et expiration, à droite comme à gauche chez un patient allongé à 45° en coupe transversale, le rapport VJI/carotide était également calculé.La médiane du diamètre de la VJI droite à l’inspiration était de 0.30 [0.1-0.99] pour le groupe PRVG normales et de 1.26cm [0.74-1.56] dans le groupe (pressions de remplissages du ventricule gauche) PRVG élevées avec une différence significative (pUn seuil de diamètre inférieur à 0.59cm était prédictif des pressions de remplissages du ventricule gauche (PRVG) normales avec une sensibilité de 62% et une spécificité de 88%.Un seuil de diamètre supérieur à 1.08cm était prédictif des pressions de remplissages du ventricule gauche (PRVG) élevées avec une sensibilité de 64% et une spécificité de 86%.Le ratio veine jugulaire interne (VJI)/carotide retrouvait des résultats similaires mais les mesures à l’expiration de la VJI droite ainsi que de la VJI gauche à l’inspiration et expiration ne semblaient pas utilisables en pratique.Conclusion : l’échographie de la veine jugulaire interne droite à l’inspiration semble être utile pour l’évaluation de la volémie avec une sensibilité de 60*65% et une spécificité >80%

Testing plays a crucial role in software development for ensuring quality. Mutation testing in general and higher order mutation in particular are the good techniques to evaluate the quality of test data, i.e. determining if test data can uncover errors. However, higher order mutation is often very costly because of huge number of generated mutants. In this work, we focus on reducing the cost of higher order mutation testing. We propose different strategies to combine first order mutants to generate less number of higher order mutants for a program under test, but keep the quality of generated mutants. The proposed strategies are experimented on a set of different programs and the results show the effectiveness in terms of number of generated mutants and mutation score.

The synthesis of the chiral core structure of the lissoclimide class of anti-tumour agents containing three rings, including a chiral succinimide subunit and an exocyclic double bond, has been investigated. The compound 7 was obtained, without the use of any protecting groups for the alcohol at C-12, via an asymmetric boron-mediated aldol addition as the key step to install the chiral centres of the rare succinimido methanol moiety. This was followed by a sequence of lactonisation, microwave-assisted amidation and imidation reactions.

International audience; C-Naphthyl glycosides displaying a 1,5-difunctionality on the naphthalene ring that can undergo oxidation to bromonaphthoquinone are key intermediates in the synthesis of natural C-aryl glycoside analogues. In this area, sugar-modified derivatives are of specific interest, but their synthesis is challenging. The de novo access to such compounds has been investigated through a [4+2] heterocycloaddition route, previously validated in a model series. For this purpose, two new dienophiles, conveniently protected at the phenolic positions, were synthesized. From an extensive study of their reactivity towards a range of 4-hetero-substituted (''prosugar'') heterodienes, the expected heteroadducts were stereoselectively obtained in acceptable yields. Application of the hydroboration/reduction/oxidation sequence did not afford the target C-glycosides from the reduced adducts. The negative effect of the conformational bias of the substrate on this tandem reaction is discussed. ((C) Wiley-VCH Verlag GmbH & Co. KGaA, 69451 Weinheim, Germany, 2009)

An efficient and practical total synthesis of aigialomycin D 1 is described. This concise synthetic route features the use of readily available starting materials with the key transformations being the formation of the macrocycle by RCM under microwave irradiation conditions to effect complete E-selectivity, and regio- and stereospecific formation of the 1′,2′-double bond. The synthesis of aigialomycin D is achieved with the longest linear sequence of only 11 steps and an overall yield of 19%.

Based on a heterocyclic Diels–Alder strategy, a concise synthesis of 5-aza-analogues of angucyclines bearing a 2-deoxy-C-glycoside subunit is reported. Starting from a common intermediate, a peracetylated D-2-deoxyglucose could be linked to carbons C9 or C10 of the tetracyclic framework. Further manipulations of the sugar residue allowed the installation of bromo and azido substituents at carbon C6′.

[reaction: see text] Under standard hydroboration-oxidation conditions, the dihydropyrans 4 underwent a highly stereocontrolled tandem reaction, involving the expected hydration of the double bond together with the reduction of the ketal moiety. This unprecedented transformation gives rise to a short, [4 + 2]-based synthetic route to (+/-)-beta-C-naphthyl-2-deoxyglycosides 5, which allows a significant structural and functional diversity at C-6. We thus described the first synthesis of (+/-)-C-aryl-6-fluoro and -6,6-difluoro olivosides, via the allylic mono- and difluorides produced by regioselective fluorination of, respectively, hydroxyalkyl and oxoalkyl dihydropyran derivatives.

112 p. While globalization brings with it many opportunities, it also creates many challenges. In their rush to establish a presence in the Chinese market; many multi-national companies fail to recognize the importance of dealing with cultural differences as a key success factor. In today's international workplace, acquiring and developing cultural intelligence skills are a basis for the mobile executive's success in a culturally diverse environment. Master of Business Administration

An efficient and practical total synthesis of aigialomycin D 1 is described. This concise synthetic route features the use of readily available starting materials with the key transformations being the formation of the macrocycle by RCM under microwave irradiation conditions to effect complete E-selectivity, and regio- and stereospecific formation of the 1′,2′-double bond. The synthesis of aigialomycin D is achieved with the longest linear sequence of only 11 steps and an overall yield of 19%.

The synthesis of two new heterodienes and their regioselective [4+2]cycloaddition reactions with several bromo-naphthoquinones allowed us to prepare the first angucyclinone and angucycline 5-aza-analogues.

Reaction of polysubstituted 2-hydroxyalkyldihydropyrans with DAST led regiospecifically to fluorination at the exocyclic position, except for primary alcohols. Difluorination of carbonylated analogues with deoxo-fluor™ occurred also regioselectively. The unexpected stability and synthetic potential of these new allylic fluorides are discussed.