Lower limb cellulitis poses a significant burden for the Irish healthcare system. Accurate diagnosis is difficult, with a lack of validated evidence-based tools and treatment guidelines, and difficulties distinguishing cellulitis from its imitators. It has been suggested that around 30% of suspected lower limb cellulitis is misdiagnosed. An audit of 132 patients between May 2017 and May 2018 identified a pattern of misdiagnosis in approximately 34% of this cohort.
 
  The aim of this pilot project was to develop a streamlined service for those presenting to the emergency department with red legs/suspected cellulitis, through introduction of the 'Red Leg RATED' tool for clinicians.
 
  The tool was developed and introduced to emergency department clinicians. Individuals (n=24) presenting with suspected cellulitis over 4 weeks in 2018 were invited to participate in data gathering. Finally, clinician questionnaire feedback regarding the tool was evaluated.
 
  Fourteen participants consented, 6 female and 8 male with mean age of 65 years. The tool identified 50% (n=7) as having cellulitis, of those 57% (n=4) required admission, 43% (n=3) were discharged. The remainder who did not have cellulitis (n=7) were discharged. Before introduction of the tool, all would typically have been admitted to hospital for further assessment and management of suspected lower limb cellulitis. Overall, 72% (n=10) of patients who initially presented with suspected cellulitis were discharged, suggesting positive impact of the tool. Clinician feedback suggested all were satisfied with the tool and contents.
 
  The Red Leg RATED tool is user friendly and impacts positively on diagnosis treatment and discharge. Further evaluation is warranted.
 The Red Leg RATED tool is user friendly and impacts positively on diagnosis treatment and discharge. Further evaluation is warranted.John Tingle, Lecturer in Law, Birmingham Law School, University of Birmingham, discusses several publications from NHS Resolution that should provide essential educational content for enhanced training on patient safety.
  Hemodialysis accesses suffer from limited primary patency requiring frequent interventions, revisions, or even abandonment. Prolongation of access life and usability with minimization of these adverse events is paramount. Endovascular methods are established first-line interventions for failing arteriovenous access and treatment of venous outflow stenoses. The Primary goal of this feasibility study was to evaluate intravascular ultrasound (IVUS) during interventional treatments on outcomes in those undergoing angiography for failing hemodialysis access. Secondary goals were to determine differences between IVUS and angiography on vessel and lesion characteristics and impact on treatment.
 
  In this prospective, randomized controlled trial, patients scheduled for angiography to evaluate and treat a failing hemodialysis access were randomized to use of angiography (DSA) alone or angiography plus IVUS (DSA + IVUS). Patients were treated by a standardized protocol and seen in follow-up at 2weeks, and every 3montin this small population but should be further investigated in a larger trial.This article examines how the intersectionality between political, socio-cultural, and demographic factors influences femicide events and women's experiences in Gaza. Based on the testimonies of 13 female first-degree relatives of murdered women and 7 professionals, the article suggests the "politicological" logic of femicide to highlight the interrelationship between Israel's political and Palestinians' patriarchal control of the killed, the bereaved, and women's lives in Gaza. The article reveals that while all murderers are free and some have even fled Gaza, all women remain trapped in an immense political and patriarchal prison, lacking basic feelings of safety and the right to live.Nortopsentin D is part of a class of bis(indole) alkaloids known for their biological activity, including inhibitory activity in tumoral cells and antifungal activity.  https://www.selleckchem.com/products/alkbh5-inhibitor-2.html  Herein we describe the first total synthesis of nortopsentin D, in which amidine and dione undergo a pivotal condensation and subsequent cyclization via a pinacol-like rearrangement. This synthesis represents a unique strategy for the formation of 5,5-disubstituted (4H)-imidazol-4-one containing natural products, many of which have yet to succumb to total synthesis.Scospirosins A (1) and B (2), two unprecedented spiro ent-clerodane dimers with 6/6/10/6 and 6/6/6/6/6 ring systems, respectively, were isolated from Isodon scoparius. Their structures were unambiguously established by spectroscopic, X-ray crystallographic, and chemical approaches. A bioinspired protecting-group-free strategy for their synthesis was achieved on a gram scale and featured the application of green methods, including neat reaction, sensitized photooxygenation, and electrochemical oxidation. 2 exhibited selective immunosuppressive activity against the proliferation of T lymphocytes (IC50 = 1.42 μM).With the goal of accessing yet unknown SF5-cyclopropyl building blocks, the radical addition of SF5Cl to cyclopropenes was investigated. Addition of the SF5 radical occurs regioselectively at the less substituted carbon of cyclopropenes and trans to the most hindered substituent at C3, while chlorine atom transfer proceeds with moderate to high levels of diastereocontrol. The carbon-chlorine bond in the resulting adducts can undergo subsequent radical reduction or be involved in a radical cyclization.Phase-selective gelation refers to the selective gelation of one phase in an immiscible mixture. Thus far, all such examples have involved a molecular gelator forming nanofibers in (and thus gelling) the oil phase in an oil/water mixture. Here, for the first time, we report the counterpart to the above phenomenon, i.e., selective gelation of the water phase in an oil/water mixture (while leaving the oil undisturbed). This has been a challenging problem because moieties that gel water tend to be either amphiphilic or oil-soluble; thus, if combined with an oil/water mixture, they invariably form an emulsion. Our approach solves this problem by exploiting the tunable self-assembly of laponite (LAP) nanoparticles. Initially, LAP nanoparticles (25 nm disks) are dispersed in water, where they remain unaggregated due to the steric stabilization provided by a triblock copolymer (Pluronic P123) adsorbed on their surface. Thus, the dispersion is initially a low-viscosity sol. When an immiscible oil such as hexadecane is introduced above the sol, the mixture remains biphasic, and both phases remain unaffected.