Controlling A x Mn[Fe(CN)6] charge transfer pathways through tilt-engineering for enhanced metal-to-metal interactions.

The induction of structural distortion in a controlled manner through tilt engineering has emerged as a potent method to finely tune the physical characteristics of Prussian blue analogues. Notably, this distortion can be chemically induced by filling their pores with cations that can interact with the cyanide ligands. With this objective in mind, we optimized the synthetic protocol to produce the stimuli-responsive Prussian blue analogue A x Mn[Fe(CN)6] with A = K+, Rb+, and Cs+, to tune its stimuli-responsive behavior by exchanging the cation inside pores. Our crystallographic analyses reveal that the smaller the cation, the more pronounced the structural distortion, with a notable 20-degree Fe-CN tilting when filling the cavities with K+, 10 degrees with Rb+, and 2 degrees with Cs+. Moreover, this controlled distortion offers a means to switch on/off its stimuli-responsive behavior, while modifying its magnetic response. Thereby empowering the manipulation of the PBA's physical properties through cationic exchange.

Unlocking room-temperature bistable spin transition at the nanoscale: the synthesis of core@shell [Fe(NH2trz)3(NO3)2]@SiO2 nanoparticles.

In this work, we address the synthesis of stable spin-crossover nanoparticles capable of undergoing a hysteretic spin transition at room temperature. For this purpose, we use the reverse-micelle protocol to prepare naked [Fe(NH2trz)3](NO3)2 and core@shell [Fe(NH2trz)3](NO3)2@SiO2 nanoparticles. Through meticulous adjustment of synthetic parameters, we achieved nanoparticle sizes ranging from approximately 40 nm to 60 nm. Our findings highlight that [Fe(NH2trz)3](NO3)2 presents a modest thermal hysteresis of 7 K, which decreases by downsizing. Conversely, silica-coated nanoparticles with sizes of ca. 60 and 40 nm demonstrate a remarkable hysteretic response of approximately 30 K, switching their spin state around room temperature. Moreover, the presence of a SiO2 shell substantially enhances the nanoparticles' stability against oxidation. In this context, the larger 60 nm [Fe(NH2trz)3](NO3)2@SiO2 hybrid remains stable in water for up to two hours, enabling the observation of an unreported water-induced spin transition after 30 min. Therefore, this work also introduces an intriguing avenue for inducing spin transitions through solvent exchange, underscoring the versatility and potential of these nanoparticles.

Autosomal recessive agammaglobulinemia due to defect in µ heavy chain caused by a novel mutation in the IGHM gene.

Agammaglobulinemia is a primary immunodeficiency disorder characterized by profoundly low or absent serum antibodies and low or absent circulating B cells. The most common form is X-linked agammaglobulinemia (XLA) caused by mutations in BTK gene. The remaining cases, clinically similar to XLA, are autosomal recessive agammaglobulinemia (ARA). Nearly 30% of ARA cases present mutations in the µ heavy constant region gene IGHM. Here, we present a 7-month-old patient, born from non-consanguineous parents, who is affected by ARA due to defect in the µ heavy chain. The genetic study showed that the patient is compound heterozygous for an IGHM gene deletion and the novel nonsense mutation X57331.1:g.275C>A (p.Tyr43*) (ClinVar Accession Number: SCV000537868.1). This finding allows for an adequate genetic counseling to the family and also broadens the spectrum of already described point mutations at this locus. The IGHM gene is very complex and it is likely that yet unidentified mutations appear in other patients.

Gender gap in medical care in ST segment elevation myocardial infarction networks: Findings from the Catalan network Codi Infart. / Brecha de género en los cuidados médicos en las redes de atención al infarto agudo de miocardio con elevación del segmento ST: hallazgos de la red catalana Codi Infart.

OBJECTIVE: To assess the impact of gender upon the prognosis and medical care in a regional acute ST-elevation myocardial infarction management network. DESIGN: An observational study was made of consecutive patients entered in a prospective database. SCOPE: The Catalan acute ST-elevation myocardial infarction management network. PATIENTS: Patients treated between January 2010 and December 2011. INTERVENTIONS: Primary angioplasty, thrombolysis or conservative management. VARIABLES OF INTEREST: Time intervals, proportion and type of reperfusion, overall mortality, and in-hospital complication and overall mortality at 30 days and one year were compared in relation to gender. RESULTS: Of the 5,831 patients attended by the myocardial infarction network, 4,380 had a diagnosis of acute ST-elevation myocardial infarction, and 961 (21.9%) were women. Women were older (69.8±13.4 vs. 60.6±12.8 years; P<.001), had a higher prevalence of diabetes (27.1 vs. 18.1%, P<.001), Killip class>I (24.9 vs. 17.3%; P<.001) and no reperfusion (8.8 vs. 5.2%; P<.001) versus men. In addition, women had greater delays in medical care (first medical contact-to-balloon: 132 vs. 122min; P<.001, and symptoms onset-to-balloon: 236 vs. 210min; P<.001). Women presented higher percentages of overall in-hospital complications (20.6 vs. 17.4%; P=.031), in-hospital mortality (4.8 vs. 2.6%; P=.001), 30-day mortality (9.1 vs. 4.5%; P<.001) and one-year mortality (14.0 vs. 8.3%; P<.001) versus men. Nevertheless, after multivariate adjustment, no gender differences in 30-day and one-year mortality were observed. CONCLUSIONS: Despite a higher risk profile and poorer medical management, women present similar 30-day and one-year outcomes as their male counterparts in the context of the myocardial infarction management network.

[Perioperative management of atrial fibrillation]. / Manejo perioperatorio de la fibrilación auricular.

Atrial fibrillation is a frequent complication in the perioperative period. When it appears there is an increased risk of perioperative morbidity due to stroke, thromboembolism, cardiac arrest, myocardial infarction, anticoagulation haemorrhage, and hospital readmissions. The current article focuses on the recommendations for the management of perioperative atrial fibrillation based on the latest Clinical Practice Guidelines on atrial fibrillation by the European Society of Cardiology and the Spanish Society of Cardiology. This article pays special attention to the preoperative management, as well as to the acute perioperative episode. For this reason, the latest recommendations for the control of cardiac frequency, antiarrhythmic treatment and anticoagulation are included.

Primary immunosuppression and outcome differences after heart transplantation: tacrolimus versus cyclosporine.

BACKGROUND: The superiority of tacrolimus (Tac) as primary immunosuppression for heart transplantation (HT) compared with cyclosporine (CsA) is still under debate. Outcomes of comparison studies are not consistent; the duration of these studies has been limited. The aim of this study was to evaluate long-term outcomes of patients undergoing HT based on primary immunosuppression regime. METHODS AND RESULTS: We analyzed a single-center registry of all HT patients between 1998 and 2009, comparing outcomes based on primary immunosuppressions (Tac or CsA). Patients who died before starting immunosuppression were excluded. A total of 197 patients entered the study; 103 received Tac and 94 CsA. There were no differences between groups in baseline characteristics, United Network for Organ Sharing status 1A or ventricular assist device use, except for ischemia time (195 ± 50 min in Tac group vs 182 ± 55 min in CsA; P = .08) and days on waiting list (164 ± 155 vs 100 ± 73; P < .001). After mean follow-ups of 4.5 ± 2.3 years in the Tac group and 6.3 ± 4.3 years in the CsA group, there were 19 and 36 deaths, respectively. Kaplan-Meier analysis showed increased survival for the Tac group (log rank P = .04). Tac also was significantly superior to CsA regarding mortality (relative risk 0.55; 95% confidence interval, 0.31-0.98; P = .04). CONCLUSIONS: In our series the use of tacrolimus resulted in improved long-term survival compared with cyclosporine. At 1-year follow-up, there were no differences in acute rejection episodes or the appearance of vasculopathy.