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Objective To establish and validate a risk prediction model for postoperative delirium (POD) in patients with head and neck cancer (HNC) resection with free flap repair and to provide a reference for clinical practice. Methods This study has been reviewed and approved by the Ethics Committee, and informed consent has been obtained from patients. This study retrospectively collected and evaluated the risk factors and vital signs of patients undergoing head and neck cancer free flap reconstruction in the Department of Oromaxillofacial Head and Neck Oncology, Xuzhou Central Hospital from January 1, 2016, to January 1, 2022. A total of 241 cases were included, of which 171 cases were used to establish the prediction model, and 70 cases were collected for internal verification. Univariate and multivariate logistic analyses and the R Studio software package were used for modeling and statistical analysis. Results The research model finally included five risk factors: age, blood transfusion, postoperative sleep disorder and postoperative VAS pain value. The area under the working characteristic curve (AUC) of the subjects in the training set of the model was 0.869 (95% CI: 0.789-0.948), the Youden index was 0.692, the predictive value was 0.215, the sensitivity was 85.3%, the specificity was 83.9%, and the goodness of fit of the Hosmer Lemeshow test was 10.336 (P = 0.242). The model fit well. The validation set was verified according to the model. The C index was 0.827 (95% CI: 0.681-0.973), and the model prediction effect was very good. Conclusion This model may be applied to predict postoperative delirium for patients with head and neck cancer resection and free flap repair, which has a high predictive value for the risk of HNC-POD at admission. The use of this model may help to better implement preventive treatment and nursing measures.

The isoperfluoropropyl group (i-C3F7) is an emerging motif in pharmaceuticals, agrichemicals and functional materials. However, isoperfluoropropylated compounds remain largely underexplored, presumably due to the lack of efficient access to these compounds. Herein, we disclose the practical and efficient isoperfluoropropylation of aromatic C-H bonds through the invention of a hypervalent-iodine-based reagent-PFPI reagent, that proceeds via a Ag-X coupling process. The activation of the PFPI reagent without any catalysts or additives was demonstrated in the synthesis of isoperfluoropropylated electron-rich heterocycles, while its activity under photoredox catalysis was shown in the synthesis of isoperfluoropropylated non-activated arenes. Detailed mechanistic experiments and DFT calculations revealed a SET-induced concerted mechanistic pathway in the photoredox reactions. In addition, the unique conformation of i-C3F7 in products, that involved intramolecular hydrogen bond was investigated by X-ray single-crystal diffraction and variable-temperature NMR experiments. The isoperfluoropropyl group (i-C3F7) is an analogue of the trifluoromethyl group (CF3) featuring a stronger electron-withdrawing effect and more steric hindrance, giving it a unique role in synthetic chemistry, however, direct isoperfluoropropylation remains challenging. Here, the authors develop a highly reactive electrophilic hypervalent-iodine based i-C3F7 reagent and demonstrate its use for the efficient isoperfluoropropylation of aromatic C–H bonds. [ABSTRACT FROM AUTHOR]

Recently, two-dimensional (2D) boron nanosheets have been predicted to exhibit exceptional physical and chemical properties, which is expected to be widely used in advanced electronics, optoelectronic, energy storage and conversion devices. However, the experimental application of 2D boron nanosheets in hydrogen evolution reactiuon (HER) has not been reported. Here, we have grown ultrathin boron nanosheets on tungsten foils via chemical vapor deposition. The prepared triclinic boron nanosheets are highly crystalline, which perfectly match the structure in the previous theoretical calculations. Notably, the boron nanosheets show excellent HER performance. The Tafel slope is only 64 mV dec -1 and the nanosheets can maintain good stability under long-time cycle in acidic solution. The improvement of performance is mainly due to the metal properties and a large number of exposed active sites on the boron nanosheets, which is confirmed by first-principle calculations., (© 2021 IOP Publishing Ltd.)