Air and moisture stable homoleptic bis(diimidazolylidine)nickel(II) complexes, ([(diNHC)(2)Ni](2+)) 3a,b and their corresponding silver(I) 4a,b and palladium(II) 5a,b complexes were synthesized and characterized by NMR and single crystal X-ray analysis. The catalytic potential of complex 3a was assessed in Mizoroki-Heck and Suzuki-Miyaura coupling reactions. In the Suzuki-Miyaura coupling reaction, nickel precatalyst 3a was active for the coupling of aryl chlorides as well as aryl fluorides. The analogously synthesized Pd(II) complexes resulted in formation of (diNHC)PdCl(2) species which were not active for the coupling of aryl fluorides. For the Mizoroki-Heck reaction, it was found that aryl iodides could be activated in the absence of nickel or palladium precatalysts when using Na(2)CO(3) or NEt(3) as base while aryl iodides and aryl bromides could be activated in the Suzuki-Miyaura reaction sans precatalyst when K(3)PO(4) was used as base.

Patient: Male, 80Final Diagnosis: Neurotoxicity due acyclovirSymptoms: Confusion • hallucinationMedication: AcyclovirClinical Procedure: —Specialty: NephrologyObjective:Unusual clinical courseBackground:The elderly population in the United States and the world is rapidly increasing. With aging, immunity and kidney function decrease, thus predisposing people to viral illnesses for which there is no effective prophylaxis. Herpes zoster afflicts the elderly and other immunocompromised patients, like those with end-stage renal disease, transplant recipients, and cancer patients, causing significant morbidity and sometimes mortality. Treating herpes zoster becomes problematic when the regular pharmacokinetics of the antiviral drugs are disturbed.Case Report:An 83-year-old African American man with end-stage kidney disease (ESRD) and on chronic peritoneal dialysis (PD) developed herpes zoster, for which he received the manufacturer-recommended intravenous dose of acyclovir. Shortly after taking the medication, he developed confusion, disorientation, and visual hallucinations. He was switched from PD to hemodialysis (HD), with successful recovery. Examination of the cerebrospinal fluid for meningitis and imaging studies of the head were negative. Serum levels of acyclovir were elevated.Conclusions:Even when the acyclovir dose is properly adjusted for kidney function based on the current manufacturer’s recommendations, it can cause neurotoxicity. Here, we discuss the pharmacokinetics of acyclovir and make some recommendations with regard to dose adjustment in patients with ESRD.

Service Level Agreements (SLAs) define the level of service that a service provider must deliver. An SLA is a contract between service provider and consumer, and includes appropriate actions to be taken upon violation of the contractual obligations. However, implementing an SLA using existing IT infrastructure is difficult, requiring a lot of manual effort to translate an SLA into code, model it with the given programming language, and ensure the required monitoring support is available for efficient monitoring and tracking of the SLAs.In this paper, we present a solution for modeling an SLA contract. It is designed to be configurable, reusable, extensible and inheritable, thus providing great flexibility to construct complex SLAs. We also introduce an algorithmic generation pattern to create the necessary artifacts to implement an SLA presented in this paper. The resulting artifacts automatically monitor a business process and evaluate whether the SLA is violated during runtime execution. The proposed approach is designed to require minimal human intervention.

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