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OBJECTIVES Autologous CD133+ bone marrow stem cells may improve cardiac function. This randomized, single-blind clinical trial inquired whether a combined transepicardial and transseptal implantation of CD133+ stem cells during coronary artery bypass grafting (CABG) improve cardiac function with ejection fraction (EF) changes as a primary endpoint in patients with low EF. METHODS Thirty patients with coronary heart disease and EF less then 35% were randomized to undergo CABG alone or CABG with transseptal and transepicardial implantation of CD133+. Cardiac function was evaluated using cardiac magnetic resonance imaging (MRI) before and 6 months after CABG. RESULTS Preoperative EF was lower in the intervention group (25.88% ± 5.66%) than in the control group (30.18% ± 3.85%; P = .04). The adverse event incidence was similar between both groups. At 6 months, EF changes were significantly higher (8.69% ± 9.49; P = .04) in the CD133+ group than in the CABG-only group. Compared to the control group, significant improvements were seen in the wall motion score index (P = .003) and scar size proportion (P = .047) in the CD133+ group. The quality of life (QOL), assessed by a 6-minute walking test, showed considerable improvement in the CD133+ group compared to that in the control group (P = .03). The Minnesota Living with Heart Failure Questionnaire (MLHFQ) scale did not show improvement in the intervention group (P = .09, vs control). CONCLUSION Combined transepicardial and transseptal autologous CD133+ BMC implantation during bypass grafting improved cardiac function in low EF coronary artery disease patients. © 2020 The Authors. selleck products Journal of Cardiac Surgery Published by Wiley Periodicals, Inc.BACKGROUND Patients who refuse allogeneic blood transfusions (alloBT) on the basis of religious doctrine, such as Jehovah’s Witnesses (JWs), can pose a challenge when undergoing surgical procedures. During cardiac surgery, special considerations regarding surgical techniques and blood loss minimization strategies can lead to improved outcomes. Limited literature exists to guide the use of four-factor prothrombin complex concentrate (4PCC) in this patient population undergoing cardiac surgery. STUDY DESIGN AND METHODS This retrospective, single-center study evaluated the impact of 4PCC on hemoglobin (Hgb) change from baseline to postoperative nadir within a 7-day period among patients who refused alloBT during cardiac surgery. This study identified patients who refused alloBT from January 2011 to June 2017. Multivariable linear regression was used to control for confounding variables to evaluate the effectiveness of 4PCC. RESULTS During the study timeframe, 79 patients met inclusion criteria, all of whom identified as JWs, and underwent cardiac surgery. Of these, 19 received intraoperative 4PCC. Multivariable linear regression found no difference in Hgb change in patients who received 4PCC vs those who did not. No significant differences were found in mortality, thromboembolic complications, or in-hospital postoperative events. CONCLUSIONS In JWs undergoing cardiac surgery who refuse alloBT, intraoperative use of 4PCC was not associated with a difference in Hgb change within 7 days postoperatively when adjusting for confounding variables. In the event of excessive blood loss, the utilization of 4PCC may provide a viable option in JW patients who undergo cardiac surgery where few options exist to mitigate blood loss. © 2020 Wiley Periodicals, Inc.Reactions of [RuC=C(H)-1,4-C6H4CºCH(PPh3)2Cp]BF4 ([1a]BF4) with HX, give [RuCºC-1,4-C6H4-C(X)=CH2(PPh3)2Cp] (X = Cl, Br) from facile Markovnikov addition of halide anions to the putative quinoidal cumulene cation [Ru(=C=C=C6H4=C=CH2)(PPh3)2Cp]+. Similarly, [MC=C(H)-1,4-C6H4-CºCH(LL)Cp ]BF4 [M(LL)Cp´ = Ru(PPh3)2Cp ([1a]BF4); Ru(dppe)Cp* ([1b]BF4); Fe(dppe)Cp ([1c]BF4); Fe(dppe)Cp* ([1d]BF4)] react with H+/H2O to give the acyl-functionalised complexes [MCºC-1,4-C6H4-C(=O)CH3(LL)Cp´]. The Markovnikov addition of the nucleophile to the remote alkyne is difficult to rationalise from the vinylidene form of the precursor and is much more satisfactorily explained from initial isomerisation to the quinoidal cumulene  [M(=C=C=C6H4=C=CH2)(LL)Cp´]+ prior to attack at the more exposed, remote quaternary carbon. Thus, whilst representative acetylide complexes [Ru(CºC-1,4-C6H4-CºCH)(PPh3)2Cp] and [Ru(CºC-1,4-C6H4-CºCH)(dppe)Cp*] reacted with the small electrophiles [CN]+ and [C7H7]+ at the β-carbon to give vinylidene complexes,  trityl cation ([CPh3]+)  reacted with [M(CºC-1,4-C6H4-CºCH)(LL)Cp´] at the  exposed end of the carbon-rich ligand to give the putative quinoidal cumulene complexes [MC=C=C6H4=C=C(H)CPh3(LL)Cp´]+, which were isolated as the water adducts [MCºC-1,4-C6H4-C(=O)CH2CPh3(LL)Cp´].  Evincing the scope of the reaction, the (5-ethynyl-2-thienyl)vinylidene complexes [MC=C(H)-2,5-cC4H2S-CºCH(LL)Cp´]BF4 add water readily to give [MCºC-2,5-cC4H2S-C(=O)CH3(LL)Cp´]. © 2020 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.Tethered and untethered ruthenium half-sandwich complexes were synthesized and characterized spectroscopically. X-ray crystallographic analysis of three untethered and two tethered RuNHC complexes were also carried out. These RuNHC complexes catalyze transfer hydrogenation of aromatic ketones in refluxing 2-propanol, optimally in the presence of (25 mol%) KOH. Under these conditions, the formation of 2-3 nm-sized Ru(0) nanoparticles was detected by TEM measurements. A solid-state NMR investigation of the nanoparticles suggested that the NHC ligands were bound to the surface of RuNPs. This base promoted route to NHC stabilized ruthenium nanoparticles directly from arene-tethered ruthenium-NHC complexes and from untethered ruthenium-NHC complexes is more convenient than previously known routes to NHC stabilized Ru nano-catalysts. Similar catalytically active RuNPs were also generated from the reaction of a mixture of [RuCl2(p-cymene)]2 and the NHC precursor with KOH in refluxing isopropanol. The transfer hydrogenation catalyzed by these NHC stabilized RuNPs possess a high turn-over number. The catalytic efficiency significantly reduced if nanoparticles were exposed to air or allowed to aggregate and precipitate by cooling the reaction mixtures during the reaction. © 2020 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.