Silica sulfuric acid as an efficient and reusable heterogeneous catalyst has been used for the preparation of amidines 2 from formIMIDATE 1 by reaction with aromatic amines at room temperature in good to excellent yields. IMIDATE was prepared by treatment of equimolar quantities of triethyl orthoformate and diaminomaleonitrile in refluxing dioxane. All the compounds were characterized fully by spectroscopic techniques.

The aryl-(Z)-N-[2-amino-1, 2-dicyanovinyl] formamidine 2 cyclize in solvent-free conditions and in the presence of a base to give a 5-amino-1-aryl-4-cyanoimidazoles 3. Silica sulfuric acid as an efficient and reusable heterogeneous catalyst has been used for the preparation of amidines 2 from formIMIDATE 1 through reaction with aromatic amines at room temperature and in good to excellent yields. All these derivatives were fully characterized by spectroscopic data.

Background: Accreditation is the most powerful evaluation tool to validate a health care organization’, s attainment of standards set by an external peer review team. Objectives: This study was done to identify and develop a comprehensive framework of standards affecting the performance of limited surgery centers. Methods: This mixed-method study was conducted in 2019. Twenty experts were selected by the snowball sampling method. Initially, the basic concepts of criteria were designed according to the result of expert interviews. Then, 20 experts were asked to rate the importance of each criterion qualitatively based on a 5-point Likert scale from highly important to unimportant. Experts’,opinions were inquired in three stages, followed by rating and determining the content impact of the extracted standards using the DEMATEL method. Results: The conceptual model and then the initial model were designed. The basic conceptual model was identified in three main domains of patient safety, clinical care, and management and leadership. The highest weight was related to “, safe discharge and follow-up of the patient”, , which gained the first priority. “, Prevention and management of common surgical complications”, , “, infection prevention”, , “, continuing post-surgical care”, , “, IMIDATE and emergency care”, , and “, surgical and anesthesia care”,had the second to sixth priority among the ten subfactors, respectively. Conclusions: According to our findings, the formulation of the standards of the limited surgical centers should be more focused on the safety and management of surgical complications.