We have discovered a dual (i. e., soft and hard) Lewis acidity of alumina that enables rapid one-pot π-extension through the activation of terminal alkynes followed by C-F activation. The tandem reaction introduces an acenaphthene fragment – an essential moiety of geodesic polyarenes. This reaction provides quick access to elusive non-alternant polyarenes such as π-extended buckybowls and helicenes through three-point annulation of the 1-(2-ethynyl-6-fluorophenyl)naphthalene moiety. The versatility of the developed method was demonstrated by the synthesis of unprecedented structural fragments of elusive geodesic graphene nanoribbons.Protein adaptations to extreme environmental conditions are drivers in biotechnological process optimization and essential to unravel the molecular limits of life. Most proteins with such desirable adaptations are found in extremophilic organisms inhabiting extreme environments. The deep sea is such an environment and a promising resource that poses multiple extremes on its inhabitants. Conditions like high hydrostatic pressure and high or low temperature are prevalent and many deep-sea organisms tolerate multiple of these extremes. While molecular adaptations to high temperature are comparatively good described, adaptations to other extremes like high pressure are not well-understood yet. To fully unravel the molecular mechanisms of individual adaptations it is probably necessary to disentangle multifactorial adaptations. In this study, we evaluate differences of protein structures from deep-sea organisms and their respective related proteins from nondeep-sea organisms. We created a data collection of 1281 experimental protein structures from 25 deep-sea organisms and paired them with orthologous proteins. We exhaustively evaluate differences between the protein pairs with machine learning and Shapley values to determine characteristic differences in sequence and structure. The results show a reasonable discrimination of deep-sea and nondeep-sea proteins from which we distinguish correlations previously attributed to thermal stability from other signals potentially describing adaptions to high pressure. While some distinct correlations can be observed the overall picture appears intricate.Contemplation has been defined as „taking a long loving look at the real.” In the realm of the scholarship of nursing and midwifery, the pulls and counterpulls between disease and illness and between patient and person, for example, require that scholars and practitioners develop an understanding of the way their minds work and of the way they come to know. This dialogue takes a (short) loving look at the foundations of spirituality and spiritual development in human consciousness and invites readers to contemplate and appreciate their lives as scholars and practitioners.

Inter-scan motion is a substantial source of error in

R

1

estimation methods based on multiple volumes, for example, variable flip angle (VFA), and can be expected to increase at 7T where

B

1

fields are more inhomogeneous. The established correction scheme does not translate to 7T since it requires a body coil reference. Here we introduce two alternatives that outperform the established method. Since they compute relative sensitivities they do not require body coil images.

The proposed methods use coil-combined magnitude images to obtain the relative coil sensitivities. The first method efficiently computes the relative sensitivities via a simple ratio; the second by fitting a more sophisticated generative model.

R

1

maps were computed using the VFA approach. Multiplere a body coil is typically not available. The open-source code for all methods is made publicly available.

The proposed methods simplify inter-scan motion correction of R 1 maps and are applicable at both 3T and 7T, where a body coil is typically not available. The open-source code for all methods is made publicly available.Previous cases of dental barotrauma have been reported in pilots and divers. We report a case of dental barotrauma and barodontalgia in a diving physician accompanying patients during hyperbaric oxygen treatment, and due to pressure changes in the hyperbaric chamber. The physician developed sharp pain localised to the right maxillary molars but radiating to the face, ear and head during decompression from 243 kPa (2.4 atmospheres absolute). The pain intensified following completion of decompression and was consistent with irreversible pulpitis. Clinical examination and panoramic radiography suggested fracture of a heavily restored tooth due to barotrauma. This was managed by tooth extraction. The physician subsequently discontinued accompanying the patients during their hyperbaric oxygen treatment sessions. Dentists and maxillofacial surgery specialists suggest waiting for a minimum of four weeks or until the tooth socket and/or oral tissue has healed sufficiently to minimise the risk of infection or further trauma before exposure to further pressure change. Although seemingly rare, and despite the comparatively slow pressure changes, dental barotrauma can occur in hyperbaric chamber occupants.

SARS-CoV-2 (COVID-19) was declared a global pandemic on 11 March 2020 and has become a serious threat to public health. As it can easily be transmitted through droplets and aerosols, there is an increased risk of transmission in enclosed environments such as hyperbaric oxygen treatment (HBOT) units if preventive measures are not taken.

A 16-year-old female tested positive for SARS-CoV-2 during HBOT for idiopathic sudden sensorineural hearing loss. The other patients and the inside attendant who attended the sessions with her were regarded as contacts, tested for SARS-CoV-2, and quarantined until the test results were available. Ultimately, none of them tested positive.

As HBOT in multiplace chambers entails a high risk of SARS-CoV-2 transmission, we strictly adapted our practice to consider that every patient could be a potential asymptomatic carrier. Therefore, the negative results of all contacts in this case and the fact that no confirmed cases of COVID-19 were reported suggests that these measures successfully prevented SARS-CoV-2 transmission in our HBOT clinic. SARS-CoV-2 transmission can be prevented if sufficient protective measures are taken.

As HBOT in multiplace chambers entails a high risk of SARS-CoV-2 transmission, we strictly adapted our practice to consider that every patient could be a potential asymptomatic carrier. Therefore, the negative results of all contacts in this case and the fact that no confirmed cases of COVID-19 were reported suggests that these measures successfully prevented SARS-CoV-2 transmission in our HBOT clinic. SARS-CoV-2 transmission can be prevented if sufficient protective measures are taken.

Pneumorrhachis is a rare clinical entity that is usually asymptomatic. Previous reports have associated such events with epidural insertion using a loss of resistance (LOR) to air technique. This report describes a case of symptomatic epidural pneumorrhachis following epidural anaesthesia using LOR to saline.

A 32-year-old American Society of Anesthesiologists (ASA) Classification II female patient was admitted for unplanned caesarean section. Epidural anaesthesia was performed at the L3-4 space using LOR to saline. The procedure, including delivery of the neonate, was uneventful. In the recovery room, a local anaesthetic infusion via an elastomeric pump (infusion 'balloon’) was started. Two hours after initiation of the infusion the patient complained of motor blockade, so it was stopped. Two hours later she remained paraparetic, and a neurologist assessment was required. A computed tomography scan showed epidural pneumorrhachis at the L2-3 level. The patient was referred for emergent hyperbaric oxygen treatment (US Navy Treatment Table 5) and following one session the patient recovered completely.

Anaesthetists should be aware of this rare complication, which is easily overlooked. Hyperbaric oxygen treatment is a first line treatment for gas-associated lesions with neurological impairment. Timely referral is essential to prevent irreversible deficits.

Anaesthetists should be aware of this rare complication, which is easily overlooked. Hyperbaric oxygen treatment is a first line treatment for gas-associated lesions with neurological impairment. Timely referral is essential to prevent irreversible deficits.Nowhere is redundancy more indispensable than extended range cave diving. Training and practice in this discipline ensure divers are equipped with backup regulators, gauges, lights, and adequate breathing gas for a safe exit, emergencies, and decompression. Depending on penetration distances and depth, open circuit cave diving may require carrying more gas cylinders than can be logistically managed by the diver themselves while maintaining safe gas supply margins. Consequently, divers are forced to either stage cylinders in the cave prior to the dive or rely on resupply from support divers. Both scenarios have significant drawbacks. Due to the improved efficiency of breathing gas utilisation and other advantages, closed circuit rebreathers (CCR) have enabled extended range cave diving. With increasing depths, penetration distances, and bottom times, these divers must also plan for an increasing amount of open circuit bail-out gas in the event of CCR failure. Staged cylinders have traditionally been utilised, but this strategy has limitations due to the advanced dives needed to place them and equipment degradation due to prolonged water immersion, which can often result in cylinder and regulator corrosion with consequent leakage of contents over time. Consequently, a growing number of CCR divers are foregoing open-circuit bailout altogether by carrying an additional CCR system for bailout. Although these bailout rebreathers may facilitate further exploration and have certain advantages, the risks of diving with two complex machines remain to be clearly defined.

Evidence across healthcare specialties suggests that simulation-based education improves practices and patient outcomes. However, simulation has yet to be widely used in hyperbaric medicine education. We aimed to identify the most relevant clinical scenarios for inclusion in a simulation-based curriculum for hyperbaric medicine.

After ethics approval, we used a modified Delphi consensus method. We assembled an initial questionnaire and distributed it online in English and French to an international group of hyperbaric physicians and operators using a snowball recruitment technique. Participants rated the list of scenarios using a 5-point scale ranging from 1 (least relevant) to 5 (most relevant). Scenarios judged by at least 80% of participants to be relevant (score 4 or 5) were automatically included. Scenarios that did not meet this threshold and new scenarios suggested by participants during the first round were included in a second round.

Seventy-one participants from nine countries, including both physicians and non-physicians, completed the first round and 34 completed the second.