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Background and Purpose: Rapid access to acute stroke treatment improves clinical outcomes in patients with ischemic stroke. We aimed to shorten the time to admission and to acute stroke treatment for patients with acute stroke in the Hamburg metropolitan area by collaborative multilevel measures involving all hospitals with stroke units, the Emergency Medical Services (EMS), and health-care authorities. Methods: In 2007, an area-wide stroke care quality project was initiated. The project included mandatory admission of all stroke patients in Hamburg exclusively to hospitals with stroke units, harmonized acute treatment algorithms among all hospitals, repeated training of the EMS staff, a multimedia educational campaign, and a mandatory stroke care quality monitoring system based on structured data assessment and quality indicators for procedural measures. We analyzed data of all patients with acute stroke who received inhospital treatment in the city of Hamburg during the evaluation period from the quality assurance database data and evaluated trends of key quality indicators over time. Results: From 2007 to 2016, a total of 83,395 patients with acute stroke were registered. During this period, the proportion of patients admitted within ≤3 h from symptom onset increased over time from 27.8% in 2007 to 35.2% in 2016 (p < 0.001). The proportion of patients who received rapid thrombolysis (within ≤30 min after admission) increased from 7.7 to 54.1% (p < 0.001). Conclusions: Collaborative stroke care quality projects are suitable and effective to improve acute stroke care.

In this article, we argue that the software “Fab City OS” fosters circular design. Our methodology is that we first define circular design from literature and then explain how “Fab City OS” fosters it. We argue from the context of the widespread availability of computer-aided design (CAD) tools and fabrication machines (CNC, 3D printer…). We see this in combination with increasing ease of access to places of production (Fab-, Textile-, Bio-, … Labs). If combined via Fab City OS, the two can leverage the potential of design for a circular economy. As the name says, Fab City OS is meant to be the operating system for “Fab Cities” (Díez, 2018). Fab City OS builds upon the work of Dr.-Ing. Tobias Redlich .

Daten zum Outcome im Langzeitverlauf schwer betroffener Schlaganfallpatienten nach der Entlassung aus der neurologischen Fruhrehabilitation (NFR) sind wichtig zur Steuerung der Fruhrehabilitationsphase und der weiteren ambulanten Betreuung. Analyse des Outcomes von Patienten nach schwerem Schlaganfall 3 und 12 Monate nach Abschluss der NFR. Telefoninterviews von Schlaganfallpatienten (ICD-10: I61, I60, I63 und I64 sowie OPS 8‑552) 3 und 12 Monate nach Entlassung aus den NFR-Abteilungen der drei Hamburger Asklepios Kliniken. Strukturierte Interviews mit Erfassung u. a. von Behinderung (modifizierte Rankin-Skala, mRS; Fruhreha-Barthel-Index, FRBI) und Lebensqualitat (SF-12). Insgesamt 270 von 1045 behandelten Schlaganfallpatienten wurden zwischen 10/2015 und 11/2017 in die Studie eingeschlossen. Datenanalyse: nach 3 Monaten 200 Patienten, nach 12 Monaten 151 Patienten. Verlaufsdaten (n = 151) dokumentierten eine signifikante Verbesserung des medianen FRBI (p

Background and Purpose: Quality indicators (QI) are an accepted tool to measure performance of hospitals in routine care. We investigated the association between quality of acute stroke care defined by overall adherence to evidence-based QI and early outcome in German acute care hospitals. Methods: Patients with ischemic stroke admitted to one of the hospitals cooperating within the ADSR (German Stroke Register Study Group) were analyzed. The ADSR is a voluntary network of 9 regional stroke registers monitoring quality of acute stroke care across 736 hospitals in Germany. Quality of stroke care was defined by adherence to 11 evidence-based indicators of early processes of stroke care. The correlation between overall adherence to QI with outcome was investigated by assessing the association between 7-day in-hospital mortality with the proportion of QI fulfilled from the total number of QI the individual patient was eligible for. Generalized linear mixed model analysis was performed adjusted for the variables age, sex, National Institutes of Health Stroke Scale and living will and as random effect for the variable hospital. Results: Between 2015 and 2016, 388 012 patients with ischemic stroke were reported (median age 76 years, 52.4% male). Adherence to distinct QI ranged between 41.0% (thrombolysis in eligible patients) and 95.2% (early physiotherapy). Seven-day in-hospital mortality was 3.4%. The overall proportion of QI fulfilled was median 90% (interquartile range, 75%–100%). In multivariable analysis, a linear association between overall adherence to QI and 7-day in-hospital-mortality was observed (odds ratio adherence P Conclusions: Higher quality of care measured by adherence to a set of evidence-based process QI for the early phase of stroke treatment was associated with lower in-hospital mortality.

Patienten mit schweren neurologischen Krankheitsbildern werden nach Abschluss der Akutbehandlung in einer neurologisch-neurochirurgischen Fruhrehabilitation der Phase B behandelt. Uber die Halfte dieser Patienten hat einen Schlaganfall. In dieser Arbeit erfolgt eine Beschreibung des rehabilitativen Verlaufes von Patienten, differenziert nach dem jeweils vorliegenden Schlaganfallsubtyp Hirninfarkt, intrazerebrale Blutung oder nicht-traumatische Subarachnoidalblutung. Mit dem Erhebungsinstrument der Hamburger Asklepios Kliniken fur die Schlaganfallfruhrehabilitation wurde zwischen 07/12 und 12/16 der fruhrehabilitative Verlauf sowie der Aufnahme- und Entlassungsstatus von insgesamt 1327 Schlaganfallpatienten mit Hirninfarkt (921 Patienten), intrazerebraler Blutung (324 Patienten) und nicht-traumatischer Subarachnoidalblutung (82 Patienten) dokumentiert. Es erfolgte eine deskriptive und analytische Auswertung der Daten. Es zeigte sich ein positiver Effekt der Fruhrehabilitation auf die Erholung aller Schlaganfallsubtypen mit einer Verbesserung des Fruhreha-Barthel-Index, einer Reduktion der vorhandenen Kathetersysteme und der Verlegung der Mehrheit der Patienten in eine weiterfuhrende Rehabilitationseinrichtung. Auch veranschaulichten die Daten den teilweise komplexen Verlauf der Fruhrehabilitation, hervorgerufen durch haufige medizinische Komplikationen, den hohen Anteil an Begleiterkrankungen und der grosen Anzahl an Kathetersystemen bei Aufnahme als Hinweis auf Storung verschiedener Organfunktionen. Die einzelnen Schlaganfallsubtypen unterschieden sich wesentlich in den Patientencharakteristika (Alter, Geschlechtsverteilung) und im rehabilitativen Verlauf (Latenz bis zum Einschluss in die Phase B, Dauer der rehabilitativen Behandlung, Fruhreha-Barthel-Index bei Aufnahme, Haufigkeit von bestimmten Kathetersystemen, Begleiterkrankungen und Komplikationen). Aufgrund dieser Unterschiede im rehabilitativen Verlauf sollte eine Betrachtung von Daten aus der neurologisch-neurochirurgischen Fruhrehabilitation differenziert nach dem jeweiligen Schlaganfallsubtyp erfolgen. In Germany patients with severe neurological diseases are treated in early neurological-neurosurgical rehabilitation after completing acute care. More than half of these patients have a stroke. In this work we described the rehabilitative course of patients, differentiated according to the stroke subtype ischemic stroke, intracerebral hemorrhage or non-traumatic subarachnoid hemorrhage. We documented between 07/12 and 12/16 with a special survey instrument the rehabilitative course including admission and discharge status of 1327 patients with ischemic stroke (921 patients), intracerebral hemorrhage (324 patients) or non-traumatic subarachnoid hemorrhage (82 patients). We performed a descriptive and analytical evaluation of the data. We found a positive effect of early neurological rehabilitation on the recovery of all stroke sub-types with an improvement in the Early Rehabilitation Barthel Index after completing early rehabilitation, a reduction in existing catheter systems, and the transfer of the majority of patients to further institutional rehabilitation facilities. The data also illustrated the high morbidity of the patients, caused by frequent medical complications, the high proportion of concomitant diseases and the large number of catheter systems on admission. The individual types of stroke differed significantly in the patient characteristics (age, sex distribution) and in the rehabilitative course (latency of admission after acute stroke treatment, duration of rehabilitative treatment, Early Rehabilitation Barthel Index at admission, rate of certain catheter systems, comorbidities and complications). Due to these differences in the rehabilitative course, data from the neurological-neurosurgical early rehabilitation should be differentiated according to the respective stroke subtype.

Data on the long-term effects on quality of life of patients after severe stroke and discharge from early institutional rehabilitation are important for guiding the early rehabilitation phase and the further outpatient care.Analysis of the outcome of patients following severe stroke 3 and 12 months after discharge from early neurological rehabilitation.Analysis of the Asklepios Hamburg multicenter early stroke rehabilitation registry (ICD 10: I61, I60, I63 and OPS 8‑552). Structured interviews with documentation of disabilities using the early rehabilitation Barthel index (ERBI), modified Rankin scale (mRS) and quality of life (12-item short form health survey, SF-12). Assessment of further treatment and complications 3 and 12 months after discharge from the early rehabilitation departments by telephone interviews.Out of 1045 treated stroke patients 270 were enrolled between October 2015 and November 2017 and 200 and 151 patients could be followed up after 3 and 12 months, respectively. There was a significant improvement (p 0.001) in the median ERBI (151 patients at 12 months). Factors influencing a poorer functional outcome (higher mRS) at 12 months were a higher mRS at discharge (OR 5.43 [1.18, 25.09], p = 0.03) and age (per decade OR 1.5 [1.09, 2.02]; p = 0.01). Female sex reduced the risk for a poorer outcome after 12 months (OR 0.49 [0.25, 0.96]; p = 0.04). Quality of life (SF-12) was not different over time. The mental quality of life showed no differences (p = 0.32) compared to a historical, significantly less (p0.001) handicapped stroke collective.The surviving severe stroke patients recovered significantly up to 12 months after discharge. The mental quality of life did not differ from that of a historical less handicapped collective.

3-Oxo-5-alkynoic acid esters, on treatment with a carbophilic catalyst, undergo 6-endo-dig cyclization reactions to furnish either 2-pyrones or 4-pyrones in high yields. The regiochemical course can be dialed in by the proper choice of the alcohol part of the ester and the π-acid. This transformation is compatible with a variety of acid-sensitive groups as witnessed by a number of exigent applications to the total synthesis of natural products, including pseudopyronine A, hispidine, phellinin A, the radininol family, neurymenolide, violapyrone, wailupemycin and an unnamed brominated 4-pyrone of marine origin. Although the reaction proceeds well in neutral medium, the rate is largely increased when HOAc is used as solvent or co-solvent, which is thought to favor the protodeauration of the reactive alkenyl-gold intermediates as the likely rate-determining step of the catalytic cycle. Such intermediates are prone to undergo diauration as an off-cycle event that sequesters the catalyst; this notion is consistent with literature data and supported by the isolation of the gem-diaurated complexes 12 and 15. Furthermore, silver catalysis allowed access to be gained to 2-alkoxypyridine and 2-alkoxyisoquinoline derivatives starting from readily available imidate precursors.

Die neurologische Fruhrehabilitation nach Schlaganfall ist ein wesentlicher Faktor, um den Behinderungsgrad langfristig zu senken. Je fruher die rehabilitative Behandlung von Schlaganfallpatienten einsetzt, desto besser ist das funktionelle Outcome. Mit einem eigens entwickelten Erhebungsinstrument wurden Daten von 333 Schlaganfallpatienten in 3 Hamburger Fruhrehabilitationseinrichtungen uber 20 Monate gesammelt und deskriptiv analysiert. Es ergaben sich unterschiedliche Ruckbildungstendenzen der verschiedenen Symptome, einen nicht unerheblichen Anteil an Komplikationen und eine relativ hohe Rate an weiterfuhrenden stationaren rehabilitativen Masnahmen. Die entwickelten Qualitatsindikatoren decken die relevanten Aspekte der Rehabilitation mit wenigen Kennzahlen ab. Aus den erhobenen Daten lasst sich ein Qualitatsmanagement-System entwickeln, um die Behandlungsqualitat weiter zu verbessern.

Background: Patients with minor acute ischemic stroke or transient ischemic attack are at high risk for subsequent stroke, and more potent antiplatelet therapy in the acute setting is needed. However, the potential benefit of more intense antiplatelet therapy must be assessed in relation to the risk for major bleeding. The SOCRATES trial (Acute Stroke or Transient Ischemic Attack Treated With Aspirin or Ticagrelor and Patient Outcomes) was the first trial with ticagrelor in patients with acute ischemic stroke or transient ischemic attack in which the efficacy and safety of ticagrelor were compared with those of aspirin. The main safety objective was assessment of PLATO (Platelet Inhibition and Patient Outcomes)–defined major bleeds on treatment, with special focus on intracranial hemorrhage (ICrH). Methods: An independent adjudication committee blinded to study treatment classified bleeds according to the PLATO, TIMI (Thrombolysis in Myocardial Infarction), and GUSTO (Global Use of Strategies to Open Occluded Coronary Arteries) definitions. The definitions of ICrH and major bleeding excluded cerebral microbleeds and asymptomatic hemorrhagic transformations of cerebral infarctions so that the definitions better discriminated important events in the acute stroke population. Results: A total of 13 130 of 13 199 randomized patients received at least 1 dose of study drug and were included in the safety analysis set. PLATO major bleeds occurred in 31 patients (0.5%) on ticagrelor and 38 patients (0.6%) on aspirin (hazard ratio, 0.83; 95% confidence interval, 0.52–1.34). The most common locations of major bleeds were intracranial and gastrointestinal. ICrH was reported in 12 patients (0.2%) on ticagrelor and 18 patients (0.3%) on aspirin. Thirteen of all 30 ICrHs (4 on ticagrelor and 9 on aspirin) were hemorrhagic strokes, and 4 (2 in each group) were symptomatic hemorrhagic transformations of brain infarctions. The ICrHs were spontaneous in 6 and 13, traumatic in 3 and 3, and procedural in 3 and 2 patients on ticagrelor and aspirin, respectively. In total, 9 fatal bleeds occurred on ticagrelor and 4 on aspirin. The composite of ICrH or fatal bleeding included 15 patients on ticagrelor and 18 on aspirin. Independently of bleeding classification, PLATO, TIMI, or GUSTO, the relative difference between treatments for major/severe bleeds was similar. Nonmajor bleeds were more common on ticagrelor. Conclusions: Antiplatelet therapy with ticagrelor in patients with acute ischemic stroke or transient ischemic attack showed a bleeding profile similar to that of aspirin for major bleeds. There were few ICrHs. Clinical Trial Registration: URL: http://www.clinicaltrials.gov . Unique identifier: NCT01994720.

The reaction of [MeSCH2Li·(tmeda)] with 9-Cl-9-BBN led to the formation of the unprecedented boron heterocycle 3, which is an inner salt formally composed of boronium and borate subunits. This product rearranges upon heating to the thermodynamically more stable Ci-symmetric dimer 4, which can also be directly prepared if 9-MeO-9-BBN is chosen as the starting material instead of 9-Cl-9-BBN. The reasons for the different outcomes are discussed, and the solid-state structures of the dimeric products 3 and 4, as well as of the derived α-functionalized organoboron species 6, 9, and 12, are presented.

Transient ischemic attack (TIA) is associated with high short-term risk of stroke, especially in the early phase following the event. Data about the impact of the early hospitalization in a stroke unit on patients with TIA are sparse. This study compares the prognostic impact of the stroke unit concept with conventional care on patients with TIA.During a 30-month period (beginning April 2005), 878 patients (mean age, 70±12years; 44.3% female) with TIA admitted within 24h of symptom onset were prospectively evaluated. The adjusted logistic regression analyses were used to estimate the odds ratio for the stroke risk during hospitalization and the 90-day mortality.Of 878 patients, 591 (67.3%) were treated in the stroke unit, and 287 (32.7%) underwent conventional care. Patients receiving stroke-unit care had significantly higher rates of cranial computed tomography (96.3% vs. 88.1%; P.001) and brain-supplying artery ultrasound (97.1% vs. 91.3%; P.001) investigations. The stroke risk during hospitalization was 1.7% in patients treated in stroke unit and 2.4% in patients received a conventional care. A relevant difference between the groups was not found (1.7% vs. 2.4%; P=.45). The 90-day mortality rate was 1.7% in the stroke unit group compared to 2.2% in the conventional care group (1.7% vs. 2.2%; P=.66). The adjusted logistic regression analyses revealed no difference in stroke rates (odds ratio, 0.68; 95% confidence interval, 0.24-1.9) and in the 90-day mortality (odds ratio, 0.63; 95% confidence interval, 0.2-1.96) between the stroke unit concept and conventional care.The prognostic impact of the stroke unit care for patients with transient ischemic attack appears to be similar to that of the conventional care. Further randomized studies are needed to investigate the impact of stroke-unit care on patients with transient ischemic attack.

Background and Purpose— Prospective data on the safety of endovascular thrombectomy in acute stroke patients on non–vitamin K antagonist oral anticoagulants are lacking. Methods— Prospective multicenter observational study. Patients with ischemic stroke undergoing thrombectomy with or without preceding thrombolysis were enrolled into the Registry of Acute Ischemic Stroke Under New Oral Anticoagulants. Baseline characteristics and functional outcome at 3 months were assessed. Hemorrhagic transformation and symptomatic intracranial hemorrhage were analyzed. Reperfusion was graded using the modified Thrombolysis in Cerebral Infarction score. Results— Of 28 patients treated with thrombectomy, 5 had received also systemic thrombolysis (18%). Intracranial hemorrhage was observed in 46%, but symptomatic intracranial hemorrhage occurred only in 1 patient. Successful reperfusion (Thrombolysis in Cerebral Infarction score, 2b–3) was achieved in 59%. At 3 months, 19% had a modified Rankin Scale score of 0 to 2, and mortality was 26%. Conclusions— Thrombectomy in non–vitamin K antagonist oral anticoagulant patients seems safe although a comparatively high rate of asymptomatic hemorrhagic transformation was noted. Confirmation in larger prospective controlled cohorts is necessary. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT01850797.

BACKGROUND Microvascular imaging (MVI), a new ultrasound technology, is used to analyze brain perfusion at the patient's bedside. This study aims to evaluate the diagnostic and prognostic value of MVI in patients with acute ischemic stroke (AIS). METHODS Nineteen patients suffering from AIS (mean age, 70.9 ± 12.2 years; 47% female; mean NIHSS-score, 12 ± 8) were investigated within the first 12 hours after symptom onset. We used the iU22 (Philips) system (S5–1 probe; low-mechanical index; depth, 13 cm), and 2 bolus injections of an ultrasound contrast agent (2.4 mL SonoVue™ per injection). The area of maximal perfusion deficit (AMPD) was compared with infarction on follow-up cranial computed tomography (CT) and NIHSS score 24 hours after stroke onset. RESULTS Of 19 patients, 15 patients (79%) had sufficient insonation conditions. Of these patients, 12 had infarctions. The sensitivity and specificity of detecting infarctions with ultrasound perfusion imaging were 91% and 67%, respectively. A significant correlation existed between the AMPD and NIHSS score at 24 hours after symptom onset (P= .023), and with occlusion of the internal carotid artery (P= .005). CONCLUSION Performing bedside MVI in the early phase of AIS provides information on brain parenchyma perfusion and prognosis of AIS.

Nitride- and alkylidyne complexes of molybdenum endowed with triarylsilanolate ligands are excellent (pre)catalysts for alkyne-metathesis reactions of all sorts, since they combine high activity with an outstanding tolerance toward polar and/or sensitive functional groups. Structural and reactivity data suggest that this promising application profile results from a favorable match between the characteristics of the high-valent molybdenum center and the electronic and steric features of the chosen Ar(3)SiO groups. This interplay ensures a well-balanced level of Lewis acidity at the central atom, which is critical for high activity. Moreover, the bulky silanolates, while disfavoring bimolecular decomposition of the operative alkylidyne unit, do not obstruct substrate binding. In addition, Ar(3)SiO groups have the advantage that they are more stable within the coordination sphere of a high-valent molybdenum center than tert-alkoxides, which commonly served as ancillary ligands in previous generations of alkyne metathesis catalysts. From a practical point of view it is important to note that complexes of the general type [(Ar(3)SiO)(3)Mo≡X] (X = N, CR; R = aryl, alkyl, Ar = aryl) can be rendered air-stable with the aid of 1,10-phenanthroline, 2,2'-bipyridine or derivatives thereof. Although the resulting adducts are themselves catalytically inert, treatment with Lewis acidic additives such as ZnCl(2) or MnCl(2) removes the stabilizing N-donor ligand and gently releases the catalytically active template into the solution. This procedure gives excellent results in alkyne metathesis starting from air-stable and hence user-friendly precursor complexes. The thermal and hydrolytic stability of representative molybdenum alkylidyne and -nitride complexes of this series was investigated and the structure of several decomposition products elucidated.

No agreement exists about which protocol for in-vitro clot formation is suitable for sonothrombolysis investigations. Lysis rates vary considerably because of different clotting processes and cannot be compared. We aim to establish a new protocol for in-vitro coagulation to permit standardized sonothrombolysis investigations. The proposed procedure is based upon clots prepared from platelet-rich plasma (PRP). This clot material (group A) was compared with the two most commonly used procedures, namely, recalcification of citrate-anticoagulated whole venous blood (group B) and spontaneous clotting of nonanticoagulated venous blood (group C). Histological examinations were performed and clot stability was tested under physiological flow conditions in vitro for all groups (each n = 10). Lysis rates measured by mass loss were compared using buffered plasma and recombinant tissue plasminogen activator (60 kU/ml), or buffered plasma alone. PRP clots displayed a high degree of similarity to emboli specimens in histological examinations and remained stable under pulsatile flow conditions. B and C clots were mechanically unstable and did not resist physiological flow and pressure. Measuring the lysis rate by weighing seems to be inaccurate, with lowest variability in PRP clots. PRP clots appeared more resistant to lysis. PRP clots should be used for standardized sonothrombolysis investigations.

Transcranial sonography (TCS) of the basal ganglia is a non-invasive tool to study movement disorders. Very few studies have addressed the question of whether TCS may detect specific echofeatures in patients with primary dystonia. The basal ganglia including the substantia nigra (SN) and the ventricular system were investigated by TCS in 84 primary dystonia patients and 43 neurologically healthy controls. Any hyperechogenicity of the lenticular nucleus was present in 57.5% of the patients and in 50.0% of the controls (p = 0.453). While marked hyperechogenicity was more frequently present in the patients (17.8 vs. 7.9%), this difference was not significant (p = 0.227). No differences in the occurrence of hyperechogenicity were detectable either in the caudate nucleus (21.6 vs. 39.5%, p = 0.122) or the thalamus (4.1 vs. 0%, p = 0.199). Marked hyperechogenicity of the caudate nucleus was rare in dystonia (4.1%) and absent in controls. There was no relationship between the side of basal ganglia hyperechogenicity and the clinically affected side of cervical dystonia. The area of SN echogenicity was similar in patients and controls (0.19 ± 0.14 vs. 0.20 ± 0.13 cm(2)), but correlated negatively with increasing disease duration in the dystonia patients (ρ = -0.257, p = 0.028). Width of the third ventricle correlated with increasing age (ρ = 0.511, p = 0.000) and, in patients, with disease duration (ρ = 0.244, p = 0.034) and severity of cervical dystonia (ρ = 0.281, p = 0.038). No characteristic abnormalities were found in the basal ganglia of primary dystonia patients. It remains to be explored whether this is due to a true absence of signal alterations in the basal ganglia of dystonia patients or to limitations of the current technology used.

Background and Purpose— We conducted this prospective study to evaluate the time course of hemorrhagic transformation (HT) and arterial recanalization in the early phase of ischemic stroke using transcranial sonography (TCS). Methods— Fifty-five patients with acute ischemic hemispheric stroke Results— Of 20 patients with HT, 18 displayed by computed tomography could be identified by TCS. In 1 patient, TCS provided a wrong positive result, and in another 2 patients with small cortical HT, a wrong negative result was provided (sensitivity 90.0%, specificity 97.4%). HT was detected in the first 60 hours after symptom onset in 62.5% of patients treated with tissue plasminogen activator in comparison to 33.3% without thrombolysis. Recanalization of middle cerebral artery occurred earlier in tissue plasminogen activator-treated patients compared to those without tissue plasminogen activator treatment (in the first 60 hours after symptom onset: 78.5% vs 50.0%, respectively; P =0.34). There was a significant time difference between middle cerebral artery recanalization and HT occurrence (n=13, median time interval: 20 vs 60 hours; P =0.035). Conclusions— Transcranial ultrasound is a useful bedside method to depict and closely monitor HT in patients with acute hemispheric stroke. The strong influence of tissue plasminogen activator treatment on HT could be demonstrated. HT development is dependent on the time of artery recanalization.

A series of unprecedented organoiron complexes of the formal oxidation states -2, 0, +1, +2, and +3 is presented, which are largely devoid of stabilizing ligands and, in part, also electronically unsaturated (14-, 16-, 17- and 18-electron counts). Specifically, it is shown that nucleophiles unable to undergo beta-hydride elimination, such as MeLi, PhLi, or PhMgBr, rapidly reduce Fe(3+) to Fe(2+) and then exhaustively alkylate the metal center. The resulting homoleptic organoferrate complexes [(Me 4Fe)(MeLi)][Li(OEt 2)] 2 ( 3) and [Ph 4Fe][Li(Et 2O) 2][Li(1,4-dioxane)] ( 5) could be characterized by X-ray crystal structure analysis. However, these exceptionally sensitive compounds turned out to be only moderately nucleophilic, transferring their organic ligands to activated electrophiles only, while being unable to alkylate (hetero)aryl halides unless they are very electron deficient. In striking contrast, Grignard reagents bearing alkyl residues amenable to beta-hydride elimination reduce FeX n ( n = 2, 3) to clusters of the formal composition [Fe(MgX) 2] n . The behavior of these intermetallic species can be emulated by structurally well-defined lithium ferrate complexes of the type [Fe(C 2H 4) 4][Li(tmeda)] 2 ( 8), [Fe(cod) 2][Li(dme)] 2 ( 9), [CpFe(C 2H 4) 2][Li(tmeda)] ( 7), [CpFe(cod)][Li(dme)] ( 11), or [Cp*Fe(C 2H 4) 2][Li(tmeda)] ( 14). Such electron-rich complexes, which are distinguished by short intermetallic Fe-Li bonds, were shown to react with aryl chlorides and allyl halides; the structures and reactivity patterns of the resulting organoiron compounds provide first insights into the elementary steps of low valent iron-catalyzed cross coupling reactions of aryl, alkyl, allyl, benzyl, and propargyl halides with organomagnesium reagents. However, the acquired data suggest that such C-C bond formations can occur, a priori, along different catalytic cycles shuttling between metal centers of the formal oxidation states Fe(+1)/Fe(+3), Fe(0)/Fe(+2), and Fe(-2)/Fe(0). Since these different manifolds are likely interconnected, an unambiguous decision as to which redox cycle dominates in solution remains difficult, even though iron complexes of the lowest accessible formal oxidation states promote the reactions most effectively.

Background and Purpose— Sonothrombolysis is a new treatment approach in acute ischemic stroke. The results of a monocenter, randomized clinical study are presented. Methods— Subjects with acute middle cerebral artery main stem occlusion were randomized into a target group receiving 1-hour transcranial continuous insonation using a 1.8-MHz Doppler ultrasound (US) probe or a control group. All underwent standard thrombolysis with intravenous recombinant tissue-type plasminogen activator. Results— Thirty-seven subjects were included; 19 subjects were treated in the target (US) group and 18 in the control (no-US) group, all with no residual flow in the middle cerebral artery main stem occlusion (Thrombolysis in Brain Ischemia recanalization grade 0). Compared with the no-US group, the US group showed greater improvement in National Institutes of Health Stroke Scale values at days 1 and 4 and a higher median Thrombolysis in Brain Ischemia grade 1 hour after recombinant tissue-type plasminogen activator initiation. Recanalization (complete or partial) after 1 hour occurred in 57.9% of the US group and 22.2% of the no-US group ( P =0.045). After 90 days, 4 subjects from the US group had a modified Rankin Score ≤1 (none from the no-US group) and 8 had a Barthel Index ≥95 (none from the no US group; P =0.106 and P =0.003, respectively). Three subjects from the US group (15.8%) developed a symptomatic intracranial hemorrhage as did one (5.6%) in the no-US group ( P =0.60). Conclusions— This small randomized study indicates a beneficial impact of transcranial ultrasound on recanalization and short-term outcome in subjects with middle cerebral artery main stem occlusion and recombinant tissue-type plasminogen activator treatment.

Ziel: Die Diagnose zerebrovaskularer Erkrankungen stutzt sich zunehmend auf den Einsatz ultraschallbasierter Verfahren. Das kontrastmittelgestutzte, transkranielle Bolus Harmonic Imaging (BHI) hat hierbei einen hohen Stellenwert. Die Auswertung der aufgezeichneten Bildsequenz erfolgt durch geubte Arzte jedoch manuell und ist somit zeitaufwendig. Das Ziel der hier beschriebenen drei Verfahren ist die sichere, vollautomatische Erkennung von Perfusionsdefekten des Gehirns. Material und Methoden: Mit dem BHI werden Ultraschallbildsequenzen aufgezeichnet, die die Kontrastmitteldynamik im Gehirn wiedergeben. Diese Bilder werden mit drei verschiedenen Verfahren automatisch ausgewertet. Zum einen wird ein regelbasiertes System beschrieben, welches aus den aufgezeichneten Ultraschallbildern Parameterbilder extrahiert und diese mithilfe von Expertenwissen nach perfundierten und minderperfundierten Gehirnarealen klassifiziert. Zum zweiten erfolgt die Klassifikation der Gehirngebiete unuberwacht mit dem K-Means-Verfahren. Hierzu wird jedes der Parameterbilder als eine Dimension des zu klassifizierenden Merkmalsraums betrachtet, sodass eine unuberwachte Segmentierung der minderperfundierten Gehirnbereiche moglich ist. Drittens wird die gesamte Bildsequenz anhand der Kontrastmitteldynamik pixelweise klassifiziert. Hierbei kann darauf verzichtet werden, Parameterbilder extrahieren zu mussen. In allen drei Fallen ist es im Anschluss notwendig, die beim HI auftretenden Streifenartefakte automatisch zu erkennen. Abschliesend wird ein Aussagenbild generiert, in dem die gefundenen Minderperfusionen markiert sind. Ergebnisse: Die drei Verfahren wurden auf einem 26 Patienten umfassenden Kollektiv klinisch validiert. Hierbei hat sich herausgestellt, dass insbesondere die Segmentierung anhand der Kontrastmitteldynamik dazu geeignet ist, Minderperfusionen automatisch zu erkennen. Es konnte auf diesem Patientenkollektiv eine Sensitivitat von 100 % bei einer Spezifitat von 100 % erreicht werden. Schlussfolgerungen: Alle drei Verfahren erscheinen geeignet, ischamische Gehirngebiete zu erkennen. Hierbei liefert die Klassifikation von Gehirngebieten nach der Kontrastmitteldynamik die besten Ergebnisse, da sie robust gegenuber Rauschen ist. Zudem ist es das schnellste Verfahren, da die Extraktion von Parameterbildern entfallt. Es ist notwendig, die Sensitivitat und Spezifitat auf einem groseren Patientenkollektiv zu validieren. Eine sichere, vollautomatische Erkennung von Perfusionsdefekten direkt am Patientenbett scheint somit moglich zu sein. Purpose: The diagnosis of ischemic stroke relies increasingly on the usage of ultrasound-based methods. One of the recent methods is the transcranial, contrast agent-based Bolus Harmonic Imaging (BHI) method. The captured image sequence is manually examined by clinical experts thus resulting in a time-consuming procedure. The purpose of this study is to evaluate three different methods to analyze BHI image sequences automatically for the detection of ischemic brain tissue. Materials and Method: BHI captures an image sequence that provides information on the dynamic behavior of the ultrasound contrast agents. This image sequence is analyzed using three different procedures. First a system relying on expert knowledge is used to determine perfusion defects. This procedure requires parametric images, which are previously extracted from the image sequence. The parameter images are then categorized by an unsupervised classification method in well-perfused and ischemic tissue by regarding the parametric images as features describing the perfusion. Thirdly, the whole image sequence can be interpreted as a pixel-by-pixel behavior out of contrast agents. The dynamic curve of each pixel can be automatically classified as perfused and ischemic tissue by the K-Means method without extracting parametric images. In all three cases a closing step is necessary for the accurate interpretation of the results. Transcranial ultrasound imaging produces typical stripe artifacts that have to be detected and eliminated. A result image is then created and provides a conclusion about perfusion reduction in brain tissue. Results: All three methods have been validated on the basis of 26 patients by clinical experts. The segmentation on the contrast agent kinetics has proven to be most effective. According to our patient database, it provides the highest detection accuracy, resulting in a sensitivity of 100 % and a specificity of 100 %. Conclusion: The presented methods seem to be adequate for detecting ischemic brain tissue. The classification of contrast agent kinetics provides the best results and has further advantages. It is robust with respect to noise and the calculation is fast because the extraction of parametric images is omitted. The very high sensitivity and specificity must be validated in a larger patient population. Reliable and automated detection of perfusion defects at the bedside seems to be possible.

Objective: To investigate substantia nigra (SN) echogenicity in members of a family with homozygous and heterozygous PTEN induced kinase ( PINK1 ) mutations with or without signs of Parkinson’s disease (PD). Methods: Transcranial sonography (TCS) was used to investigate 20 members of a family with PINK1 mutations, including four homozygous and 11 heterozygous mutation carriers and five individuals with no mutation. For comparison, a healthy control group of 18 subjects without a positive family history of PD (control group) and a healthy control group of 15 subjects with a positive family history of sporadic PD (relative group) were investigated. For statistical analysis, the larger area of the two SNs echogenicity (aSNmax) of each individual was selected. Results: A significantly increased aSNmax was found for all subgroups compared with the control group. The group of homozygous carriers of a PINK1 mutation had a significantly increased aSNmax compared with all of the other subgroups, except the group of heterozygous mutation carriers. Conclusions: These findings in carriers of a PINK1 mutation are comparable with those in carriers of Parkin mutations and non-genetic PD. The increased aSNmax in family members without a mutation suggests an additional contributing factor independent of the PINK1 mutation that may also play a role in relatives of patients with sporadic PD.

Conflicting reports are found in the literature on whether the ortho-pyrrolophane derivative 6, which has been named "butylcycloheptylprodigiosin" even though it is a cyclononane derivative, is a natural product or merely a mis-assigned structure. This dispute has now been resolved by an unambiguous total synthesis of this complex alkaloid which confirms the initial structure assignment. The chosen approach is largely catalysis-based, featuring the first application of a "Narasaka-Heck" reaction in natural product chemistry. This palladium-catalyzed transformation allows the unsaturated oxime ester 26 to be converted into the bicyclic dihydropyrrole 27. Other notable reactions of the reported approach to 6 are a regioselective Tsuji-Trost reaction of the doubly allylic acetate 21 with methyl acetoacetate, a base-induced aromatization of 27 to the corresponding pyrrole 28, a chemoselective oxidation of the benzylic methyl group in 33 with cerium ammonium nitrate in a biphasic reaction medium that does not affect the labile pyrrole nucleus, and a Suzuki cross-coupling for the completion of the heterocyclic domain. Diversification in the latter step leads to a set of analogues that differ from the natural product in the terminal (hetero)arene ring. This structural modification results in complete loss of the very pronounced ability of the parent compound 6 to induce oxidative cleavage in double stranded DNA in the presence of Cu II . Several cyclono-nane-, cyclononene- and cyclononadiene derivatives prepared en route to 6 have been characterized by crystal structure analysis, allowing the conformational behavior of nine-membered carbocycles to be studied.

The present paper summarizes recommendations on transcranial sonography (TCS) application in neurodegenerative diseases, resulting from a consensus meeting of the European Society of Neurosonology and Cerebral Hemodynamics. TCS of distinct infra- and supratentorial brain structures detects characteristic changes in several movement disorders, such as abnormal hyperechogenicity of substantia nigra (SN) in Parkinson's disease and of lenticular nucleus in dystonia, Wilson's disease and atypical Parkinsonian disorders. In healthy adults, the TCS finding of marked SN hyperechogenicity indicates a subclinical functional impairment of the nigrostriatal dopaminergic system. The finding of marked SN hyperechogenicity in combination with normal lenticular-nucleus echogenicity discriminates idiopathic Parkinson's disease from multiple-system atrophy and progressive supranuclear palsy with a positive predictive value of more than 90%. As TCS is a quick and noninvasive method, using the same duplex-ultrasound machines as for investigation of intracranial vessels, applicable even in agitated patients, this method has a great potential to be more widely used.

Summary Objectives: Cerebral vascular diseases are detectable by CT/MRI-based methods. Drawbacks of these methods are that they are expensive, time-consuming and intolerable to critically ill patients. Ultrasound, as an inexpensive bedside method, promises to become an alternative. Among other harmonic imaging methods, the diminution harmonic imaging (DHI) method is known, which determines perfusion-related parameters by analyzing ultrasound contrast agent (UCA) diminution kinetics based on constant UCA infusion. The shortcoming of DHI is that the used mathematical model can only determine these parameters by least squares fitting the model onto the data. Methods: In this work, the underlying mathematical model is further developed such that it becomes possible to directly calculate the parameters from the image data. Furthermore, the new model offers an improved way to estimate the spatial distribution of the destruction coefficient necessary for accurately determining the destruction power of the ultrasound pulse on the contrast agent. Results: The direct calculation of the perfusion coefficient is much faster thanthe former fitting of the model. Perfusion as well as destruction coefficients are displayed as color-coded images. In an example, a region with perfusion deficits (as shown in a MR image of the same patient) is clearly identifiable. Conclusions: Displaying the parameters as color-coded images facilitates result interpretation for the diagnosing physician. The results are preliminary and still have to be validated, but they suggest that the new DHI model improves the significance of ultrasound as a diagnostic help.

A set of tethered bis-benzophenone or -benzaldehyde derivatives was subjected to intramolecular McMurry reactions, thus affording hybrids with cyclophane and crown ether substructures (“crownophanes”). All macrocycles were formed in reasonable yields even at rather high concentrations. A comparative study showed that low-valent titanium [Ti] exerts a strong template effect whereas alkali metal salts accumulating during its preparation have only little influence upon the preorganization of the substrates in a favorable podand-like conformation. Ester linkages in the tethers turned out to be only partly compatible with the reaction conditions. Crystal structures of crownophanes 7, 8, and 12 are described. A 1H- and 13C-NMR study on the complexation of Ag(+1) by 8 and 10 revealed that the endocyclic arene entities rather than the polyether chains are the major sites of interaction of the cation with its host.

Ultrasound perfusion imaging of the cerebral microcirculation is a new semi-invasive bedside technique to evaluate human brain perfusion. Several approaches have been evaluated for the qualitative assessment of brain perfusion in healthy subjects and in patients suffering from acute ischemic stroke. The analysis of ultrasound contrast agent bolus kinetics yields various time-intensity curve parameters that qualitatively describe regional brain perfusion. In healthy subjects, there is a close correlation between the time to peak intensity measurements as performed by perfusion ultrasound and perfusion-weighted MRI. In the acute phase of ischemic stroke, the peak signal increase is the most useful curve parameter to predict the area of definite infarction. Ultrasound perfusion imaging performed in the early phase can predict the outcome of the individual stroke patient. Diminution and Replenishment kinetics are new modalities for the visualization of brain perfusion, the latter being more promising because of the fast imaging time resulting in a lower vulnerability to movement artifacts. The different approaches will have to be compared regarding their ability to provide valid thresholds for differentiation between normal and abnormal perfusion in the acute stroke situation. At present, the foremost limitations of transcranial ultrasound perfusion imaging are attenuation phenomena, caused by the temporal bone, which might be overcome by new imaging systems that are currently under development.

Background: We aimed to analyse the course of early recanalization and corresponding functional outcome in patients with an acute occlusion of the carotid T who were treated conservatively or underwent intravenous thrombolysis. Methods: Forty-two patients with an acute occlusion of the carotid T within 6 h were recruited from consecutive admissions to a neurological department participating in the Duplex Sonography in Acute Stroke study. All patients underwent a standardized admission and follow-up procedure. Colour-coded duplex sonography was performed on admission, 30 min after thrombolysis, and at 6 and 24 h after onset of symptoms. Recanalization of the carotid T was classified as complete, partial and absent. Functional outcome was rated with the modified Rankin scale (mRS) at 3 months as favourable (mRS 0–2) or poor (mRS 3–6). Results: Within 6 h, complete or partial recanalization occurred in 1 of 27 patients treated conservatively and in 6 of 15 thrombolysed patients. Intravenous thrombolysis predicted early recanalization also after adjustment for age, sex, cardioembolic stroke aetiology and time to treatment (adjusted odds ratio, OR, 39.7; 95% confidence interval, CI, 2.0–801.7; p = 0.016). An early recanalization was the only selected predictor of a favourable outcome (OR, 13.6; 95% CI, 1.0–179.0; p = 0.047) at regression analysis, and was achieved in 3 thrombolysed patients but in none with conservative medical treatment. Conclusions: In patients treated conservatively, functional outcome is poor and early recanalization rarely occurs. The latter can be achieved by intravenous thrombolysis with a rate comparable to that found at an intra-arterial approach without major intracranial bleeding complications. Early recanalization is associated with a better functional outcome.

AIM Perfusion harmonic imaging is a new method to evaluate brain perfusion. The purpose of our study was to describe flow by analysing the kinetics of ultrasound contrast enhancement in a flow model after bolus injection of an ultrasound contrast agent (UCA). METHODS We performed an in-vitro study with an open-circuit flow model and SonoVue(R) given as bolus injection. Bolus kinetics was analysed by harmonic imaging (SONOS 5500, 1.8/3.6 MHz, MI: 1.6) at a fixed frame rate (0.67 Hz). Five different flow rates from 1.8 to 21.6 ml/min were tested. We generated time-intensity curves (TIC) from the grey scale loops. Five parameters (time-to-peak-intensity [TTP], peak-intensity [PI], area under the curve [AUC], positive gradient [PG] and full width at half maximum [FWHM]) were correlated with flow rate. RESULTS The analysis of both TTP and PG versus flow rate indicated a highly significant linear correlation (r = - 0.96, P

A concise, practical and stereoselective entry into macrocyclic (E)-alkenes is outlined comprising a sequence of ring closing alkyne metathesis (RCAM), trans-selective hydrosilylation of the resulting cycloalkynes catalyzed by [Cp∗Ru(MeCN)3]PF6, and a protodesilylation of the ensuing vinylsilanes with AgF in aq. THF/MeOH. Moreover, the first examples of intramolecular enyne–yne metathesis reactions catalyzed by the Schrock alkylidyne complex (tBuO)3WCCMe3 are reported; the resulting cyclic enynes can be converted along similar lines into the corresponding (E,E)-configured 1,3-dienes in good overall yields. Cycloalkyne 4 and the (E)-configured cyclic olefins 6 and 21 were characterized by X-ray crystallography.

Background and Purpose— Initial reports indicate that transcranial harmonic imaging after ultrasound contrast agent bolus injection (BHI) can detect cerebral perfusion deficits in acute ischemic stroke. We evaluated parametric images of the bolus washout kinetics. Methods— Twenty-three patients with acute internal carotid artery infarction were investigated with perfusion harmonic imaging after SonoVue bolus injection ≤40 hour after the onset of symptoms. The findings were compared with those of cranial computed tomography (CCT) and clinical course 4 months after stroke. Results— Images of pixel-wise peak intensity (PPI) and time to peak intensity could be calculated for all patients. Spearman rank correlations of r =0.772 ( P r =0.572 ( P =0.008) between area of PPI signal decrease and area of infarction in the follow-up CCT as well as outcome after 4 months were obtained, respectively. Conclusions— In the early phase of acute ischemic stroke, BHI after SonoVue bolus injection is a useful ultrasound tool for analyzing cerebral perfusion deficits at the patient’s bedside. BHI data correlate with the definite area of infarction and outcome after 4 months.

Background and Purpose— Color-coded perfusion maps can be calculated from ultrasound harmonic gray-scale imaging data after ultrasound contrast agent bolus injection to analyze brain tissue perfusion. First reports indicate that this method can display cerebral perfusion deficits in acute ischemic stroke. We performed a prospective patient study to evaluate this approach. Methods— Thirty consecutive patients suffering from acute middle cerebral artery infarction who presented to our department within 12 hours after symptom onset were investigated with ultrasound perfusion harmonic imaging (PHI) after Levovist bolus injection. Color-coded perfusion maps were calculated from the ultrasound data. In addition, the original gray-scale images were analyzed in cine mode. Findings were compared with those of cranial CT. Results— All 30 patients suffered from acute ischemic stroke of the middle cerebral artery territory (median National Institutes of Health Stroke Scale score, 16 points). Twenty-three of the 30 patients (76.7%) had sufficient PHI insonation conditions. In 19 of these 23 patients (82.6%), a marked deficit in contrast enhancement could be visualized by initial PHI with the color-coded parameter images and cine-mode images. In 17 of the 23 (73.9%), the perfusion deficit was found on the parameter images. The area of hypoperfusion in the initial PHI investigation corresponded to the definite area of infarction in follow-up cranial CT. In 3 of 23 patients (13.0%), a perfusion deficit could be demonstrated in PHI, although the supplying artery was found patent by transcranial color-coded duplex sonography. Conclusions— With PHI, it is possible to display cerebral perfusion deficits in acute ischemic stroke. PHI yields additional information on the perfusion state of the human brain compared with extracranial and transcranial color-coded duplex sonography.

Initial reports indicate that cerebral perfusion deficits in acute ischemic stroke might be detectable by means of transcranial harmonic imaging after an ultrasound contrast agent (UCA) bolus injection. Twenty-four patients with acute middle cerebral artery (MCA) infarction were investigated twice with perfusion harmonic imaging (PHI) after Levovist (Schering, Berlin, Germany) bolus injection no longer than 12 h after symptom onset. The findings were compared with those of cranial computed tomography (CCT). All 24 patients suffered from acute ischemic stroke of the MCA territory (median National Institutes of Health Stroke Scale score: 15 points). Corresponding to the area of infarction in follow-up CCT, a marked contrast deficit was visualized in 19 of 24 patients by initial PHI, which had a sensitivity and specificity of 86.4% and 96.2%, respectively, for predicting the occurrence and localization of a definite infarction in the midthalamic plane. The area of hypoperfusion in the initial PHI investigation correlated with the definite area of infarction in follow-up CCT (r=0.66, p

This review gives a summary on current ultrasound contrast agents and their composition. Methods of brain imaging using UCA, like harmonic imaging and acoustic emission, are also described. Besides contrast-enhanced conventional color duplexsonography of the extracranial brain supplying arteries, transcranial contrast investigation of the basal cerebral arteries and visualization of cerebral microcirculation are also discussed in this paper. Another main topic are the interactions between UCA, human tissue and the ultrasound system.

With ultrasound (US) contrast agent (UCA) continuous infusion providing a steady state, mean tissue microbubble velocity can be assessed by analyzing the reappearance rate after microbubble destruction with US energy (refill kinetics). In this study, we investigated this new approach for the assessment of human cerebral perfusion. A total of 12 healthy volunteers were investigated transtemporally with increasing pulsing intervals (250, 500, 750, 1000, 1250, 1500, 2000, 3000 and 4000 ms) and two UCA infusion rates (0.5 and 1.0 mL/min of Optison). Intensity vs. pulsing interval curves were analyzed using an exponential curve fit and parameters of the curve (plateau echo enhancement, A, representing the microbubble concentration within the interrogated tissue; rate constant, beta, which is related to blood flow and their product, F = Abeta) were compared. For 20/20 investigations being available for further analysis, it was possible to generate a typical exponential intensity vs. pulsing interval curve from the ipsilateral thalamus. The plateau echo enhancement A showed a significant (p = 0.02), and the beta as well as the F values displayed a nonsignificant (p = 0.06, both), increase with infusion rate. The qualitative analysis of beta and F parameter images displayed the most homogeneous visualisation of perfusion in the ipsilateral thalamus and main territory of the middle cerebral artery. In conclusion, it is possible to display the UCA refill kinetics in human cerebral microcirculation after microbubble destruction by transcranial US. Grey-scale harmonic imaging allows a quantitative approach to cerebral perfusion with a large interindividual variation of the parameters.

The Leitner and Furstner groups reported (Furstner, A.; Koch, D.; Langemann, K.; Leitner, W.; Six, C. Angew Chem., Int. Ed. Engl. 1997, 36, 2466) on the ring closing metathesis (RCM) of a 16-membered diene dissolved in supercritical CO2 (scCO2). The authors found that the cyclic product, indicative of an intramolecular RCM event, was formed in excellent yield when the CO2 density was high, but oligomers were formed by an acyclic diene metathesis (ADMET) pathway at lower CO2 densities. These results suggest that changes in the CO2 density lead to changes in the intra- vs intermolecular interactions between the 16-membered diene dissolved in scCO2. To assess this issue in more detail, we have prepared 6-(1-pyrenyl)hexyl-11-(1-pyrenyl)undecanoate [1-Py(CH2)10COO(CH2)61-Py] in which we replaced the terminal alkenes of Letiner and Furstner's original diene with the fluorophore pyrene. We have studied the pyrene excimer formation of 1-Py(CH2)10COO(CH2)61-Py when it is dissolved in five organic solvents (cyclohe...