A large number of postoperative pulmonary outcome measures have been used, but most are poorly defined. Our four recommended outcome measures include a new definition of postoperative pulmonary complications, incorporating an assessment of severity. These definitions will meet the needs of most clinical effectiveness trials of treatments to improve postoperative pulmonary outcomes.

Solid octaaqua(kappa(2)O-perchlorato)thorium(IV) perchlorate hydrate, [Th(H(2)O)(8)(ClO(4))](ClO(4))(3).H(2)O, 1, and aquaoxonium hexaaquatris(kappaO-trifluoromethanesulfonato)thorium(IV) trisaquahexakis(kappaO-trifluoromethanesulfonato)thorinate(IV), H(5)O(2)[Th(H(2)O)(6)(OSO(2)CF(3))(3)][Th(H(2)O)(3)(OSO(2)CF(3))(6)], 2, were crystallized from concentrated perchloric and trifluoromethanesulfonic acid solutions, respectively. 1 adopts a severely distorted tricapped trigonal prismatic configuration with an additional oxygen from the perchlorate ion at a longer distance. 2 consists of individual hexaaquatris(kappaO-trifluoromethanesulfonato)thorium(IV) and trisaquahexakis(kappaO-trifluoromethanesulfonato)thorinate(IV) ions and an aquaoxonium ion bridging these two ions through hydrogen bonding. The hydrated thorium(IV) ion is nine-coordinated in aqueous solution as determined by extended X-ray absorption fine structure (EXAFS) and large angle X-ray scattering (LAXS). The LAXS studies also showed a second hydration sphere of about 18 water molecules, and traces of a 3rd hydration sphere. Structural studies in aqueous solution of the hydrolysis products of thorium(IV) have identified three different types of hydrolysis species: a mu(2)O-hydroxo dimer, [Th(2)(OH)(2)(H(2)O)(12)](6+), a mu(2)O-hydroxo tetramer, [Th(4)(OH)(8)(H(2)O)(16)](8+), and a mu(3)O-oxo hexamer, [Th(6)O(8)(H(2)O)(n)](8+). Detailed structures of these three hydrolysis species are given. A compilation of reported solid state structures of actinoid(IV) compounds with oxygen donor ligands show a strong correlation between the An-O bond distance and the coordination number. The earlier reported U-O bond distance in the hydrated uranium(IV) ion in aqueous solution, confirmed in this study, is related to nine-coordination. The hydrated tri- and tetravalent actinoid ions in aqueous solution all seem to be nine-coordinated. The trivalent ions show a significant difference in bond distance to prismatic and capping water molecules in assumed tricapped trigonal prismatic configuration, while the tetravalent ions seem to form more regular structures, probably because of higher polarization.

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Antibiotics for bronchiolitis in children under two years of age.

The structures of the N,N'-dimethylpropyleneurea (dmpu) solvated lanthanoid(III) ions have been studied in dmpu solution (La-Nd, Sm-Lu) and in solid iodide salts (La-Nd, Sm, Gd-Lu) by extended X-ray absorption fine structure (EXAFS), and single crystal X-ray diffraction (La, Pr, Nd, Gd, Tb, Er, Yb, and Lu); the EXAFS studies were performed on both K and L(III) absorption edges. Because of the space-demanding properties of dmpu upon coordination, dmpu solvated metal ions often show coordination numbers lower than those found in corresponding hydrates and solvates of oxygen donor solvents without steric requirements beyond the size of the donor atom. All lanthanoid(III) ions are seven-coordinate in solution, except lutetium(III) which is six-coordinated in regular octahedral fashion, whereas in the solid iodide salts the dmpu solvated lanthanoid(III) ions are all six-coordinate in regular octahedral fashion. A comparison of Ln-O bond lengths in a large number of lanthanoid(III) complexes with neutral oxygen donor ligands and different configurations shows that the metal ion-oxygen distance is specific for each coordination number with a narrow bond distance distribution. This also shows that the radius of the coordinated oxygen atom in these compounds can be assumed to be 1.34 A as proposed for coordinated water, while for ethers such as tetrahydrofuran (thf) it is somewhat larger. Using this atomic radius of oxygen in coordinated water molecules, we have calculated the ionic radii of the lanthanoid(III) ions in four- to nine-coordination and evaluated using the bond lengths reported for homo- and heteroleptic complexes in oxygen donor solvates in solution and solid state. This yields new and revised ionic radii which in some instances are significantly different from the ionic radii normally referenced in the literature, including interpolated values for the elusive promethium(III) ion.

Chronic management of schizophrenia and schizoaffective disorders is frequently complicated by symptomatic relapse. An open-label, randomized, active-controlled, 2-year trial evaluated 710 patients with schizophrenia or related disorders who were switched from stable treatment with oral risperidone, olanzapine, or conventional neuroleptics to risperidone long-acting injectable (RLAI) or oral quetiapine. Primary effectiveness evaluation was time-to-relapse. Safety evaluations included adverse events (AEs) reported for the duration of the study, Extrapyramidal Symptom Rating Scale (ESRS), clinical laboratory tests, and vital signs. A total of 666 patients (n ¼ 329 RLAI, n ¼ 337 quetiapine) were evaluable for effectiveness measures. Baseline demographics were similar between treatment groups. Kaplan-Meier estimate of time-to-relapse was significantly longer with RLAI (po0.0001). Relapse occurred in 16.5% of patients with RLAI and 31.3% with quetiapine. RLAI and quetiapine were both safe and well tolerated. Weight gain affected 7% of patients with RLAI and 6% with quetiapine, with mean end point increases of 1.25 ± 6.61 and 0 ± 6.55 kg, respectively. There were no significant betweengroup differences in weight gain. ESRS total scores decreased similarly after randomization to either RLAI or quetiapine. Extrapyramidal AEs occurred in 10% of patients with RLAI and 6% with quetiapine. Treatment-emergent potentially prolactin-related AEs were reported in 15 (5%) patients with RLAI and 5 (2%) patients with quetiapine; hyperprolactinemia was reported in 43 (13.1%) patients with RLAI and 5 (1.5%) patients with quetiapine. Somnolence occurred in 2% of patients with RLAI and 11% with quetiapine. To our knowledge, this is the first report of a randomized clinical trial directly comparing relapse prevention with a second-generation long-acting injectable antipsychotic and oral therapy. Time-to-relapse in stable patients with schizophrenia or schizoaffective disorder was significantly longer in patients randomized to RLAI compared with those randomized to oral quetiapine. Both antipsychotics were generally well tolerated.

Powder pattern indexing can still be a challenge, despite the great recent advances in theoretical approaches, computer speed and experimental devices. More plausible unit cells, belonging to different crystal systems, are frequently found by the indexing programs, and recognition of the correct one may not be trivial. The task is, however, of extreme importance: in case of failure a lot of effort and computing time may be wasted. The classical figures of merit for estimating the unit‐cell reliability {i.e.M20 [de Wolff (1968). J. Appl. Cryst.1, 108–113] and FN [Smith & Snyder (1979). J. Appl. Cryst.12, 60–65]} sometimes fail. For this reason, a new figure of merit has been introduced in N‐TREOR09, the updated version of the indexing package N‐TREOR [Altomare, Giacovazzo, Guagliardi, Moliterni, Rizzi & Werner (2000). J. Appl. Cryst. 33, 1180–1186], combining the information supplied by M20 with additional parameters such as the number of unindexed lines, the degree of overlap in the pattern (the so‐called number of statistically independent observations), the symmetry deriving from the automatic evaluation of the extinction group, and the agreement between the calculated and observed profiles. The use of the new parameters requires a dramatic modification of the procedures used worldwide: in the approach presented here, extinction symbol and unit‐cell determination are simultaneously estimated. N‐TREOR09 benefits also from an improved indexing procedure in the triclinic system and has been integrated into EXPO2009, the updated version of EXPO2004 [Altomare, Caliandro, Camalli, Cuocci, Giacovazzo, Moliterni & Rizzi (2004). J. Appl. Cryst. 37, 1025–1028]. The application of the new procedure to a large set of test structures is described.

These observational data confirm that RLAI is an effective treatment in schizophrenia and high levels of adherence to therapy offers an opportunity for effective long-term disease management and significant sustained decreases in hospitalization.