Electrolytes in Organic Batteries.

Organic batteries using redox-active polymers and small organic compounds have become promising candidates for next-generation energy storage devices due to the abundance, environmental benignity, and diverse nature of organic resources. To date, tremendous research efforts have been devoted to developing advanced organic electrode materials and understanding the material structure-performance correlation in organic batteries. In contrast, less attention was paid to the correlation between electrolyte structure and battery performance, despite the critical roles of electrolytes for the dissolution of organic electrode materials, the formation of the electrode-electrolyte interphase, and the solvation/desolvation of charge carriers. In this review, we discuss the prospects and challenges of organic batteries with an emphasis on electrolytes. The differences between organic and inorganic batteries in terms of electrolyte property requirements and charge storage mechanisms are elucidated. To provide a comprehensive and thorough overview of the electrolyte development in organic batteries, the electrolytes are divided into four categories including organic liquid electrolytes, aqueous electrolytes, inorganic solid electrolytes, and polymer-based electrolytes, to introduce different components, concentrations, additives, and applications in various organic batteries with different charge carriers, interphases, and separators. The perspectives and outlook for the future development of advanced electrolytes are also discussed to provide a guidance for the electrolyte design and optimization in organic batteries. We believe that this review will stimulate an in-depth study of electrolytes and accelerate the commercialization of organic batteries.

A Pilot Study Evaluating the Effectiveness of a Training Module Designed to Improve Hospice Palliative Care Volunteers' Ability to Deal With Unusual End-of-Life Phenomena.

The need for training to help healthcare professionals and hospice palliative care volunteers deal with unusual experiences at or around the end of a person's life is an oft-repeated theme in the scientific literature. A pilot study was conducted to examine the effectiveness of a training module designed to improve volunteers' ability to recognize, understand, and respond to unusual end-of-life phenomena (EOLP) in their work with dying patients and their families. Twenty-four volunteers from two community-based hospice palliative care programs completed the 25-item Coping with Unusual End-of-Life Experiences Scale (CUEES) prior to and immediately after attending a lecture and PowerPoint training module. A series of paired samples t tests revealed significant pre- and post-training differences on 14 items, suggesting that volunteers felt more knowledgeable about EOLP, better prepared to deal with EOLP, and more comfortable talking about EOLP with others following the training. The need for additional data is discussed.

Treatment Outcomes in Global Systematic Review and Patient Meta-Analysis of Children with Extensively Drug-Resistant Tuberculosis.

Extensively drug-resistant tuberculosis (XDR TB) has extremely poor treatment outcomes in adults. Limited data are available for children. We report on clinical manifestations, treatment, and outcomes for 37 children (<15 years of age) with bacteriologically confirmed XDR TB in 11 countries. These patients were managed during 1999-2013. For the 37 children, median age was 11 years, 32 (87%) had pulmonary TB, and 29 had a recorded HIV status; 7 (24%) were infected with HIV. Median treatment duration was 7.0 months for the intensive phase and 12.2 months for the continuation phase. Thirty (81%) children had favorable treatment outcomes. Four (11%) died, 1 (3%) failed treatment, and 2 (5%) did not complete treatment. We found a high proportion of favorable treatment outcomes among children, with mortality rates markedly lower than for adults. Regimens and duration of treatment varied considerably. Evaluation of new regimens in children is required.

Treatment and outcomes in children with multidrug-resistant tuberculosis: A systematic review and individual patient data meta-analysis.

BACKGROUND: An estimated 32,000 children develop multidrug-resistant tuberculosis (MDR-TB; Mycobacterium tuberculosis resistant to isoniazid and rifampin) each year. Little is known about the optimal treatment for these children. METHODS AND FINDINGS: To inform the pediatric aspects of the revised World Health Organization (WHO) MDR-TB treatment guidelines, we performed a systematic review and individual patient data (IPD) meta-analysis, describing treatment outcomes in children treated for MDR-TB. To identify eligible reports we searched PubMed, LILACS, Embase, The Cochrane Library, PsychINFO, and BioMedCentral databases through 1 October 2014. To identify unpublished data, we reviewed conference abstracts, contacted experts in the field, and requested data through other routes, including at national and international conferences and through organizations working in pediatric MDR-TB. A cohort was eligible for inclusion if it included a minimum of three children (aged <15 years) who were treated for bacteriologically confirmed or clinically diagnosed MDR-TB, and if treatment outcomes were reported. The search yielded 2,772 reports; after review, 33 studies were eligible for inclusion, with IPD provided for 28 of these. All data were from published or unpublished observational cohorts. We analyzed demographic, clinical, and treatment factors as predictors of treatment outcome. In order to obtain adjusted estimates, we used a random-effects multivariable logistic regression (random intercept and random slope, unless specified otherwise) adjusted for the following covariates: age, sex, HIV infection, malnutrition, severe extrapulmonary disease, or the presence of severe disease on chest radiograph. We analyzed data from 975 children from 18 countries; 731 (75%) had bacteriologically confirmed and 244 (25%) had clinically diagnosed MDR-TB. The median age was 7.1 years. Of 910 (93%) children with documented HIV status, 359 (39%) were infected with HIV. When compared to clinically diagnosed patients, children with confirmed MDR-TB were more likely to be older, to be infected with HIV, to be malnourished, and to have severe tuberculosis (TB) on chest radiograph (p < 0.001 for all characteristics). Overall, 764 of 975 (78%) had a successful treatment outcome at the conclusion of therapy: 548/731 (75%) of confirmed and 216/244 (89%) of clinically diagnosed children (absolute difference 14%, 95% confidence interval [CI] 8%-19%, p < 0.001). Treatment was successful in only 56% of children with bacteriologically confirmed TB who were infected with HIV who did not receive any antiretroviral treatment (ART) during MDR-TB therapy, compared to 82% in children infected with HIV who received ART during MDR-TB therapy (absolute difference 26%, 95% CI 5%-48%, p = 0.006). In children with confirmed MDR-TB, the use of second-line injectable agents and high-dose isoniazid (15-20 mg/kg/day) were associated with treatment success (adjusted odds ratio [aOR] 2.9, 95% CI 1.0-8.3, p = 0.041 and aOR 5.9, 95% CI 1.7-20.5, p = 0.007, respectively). These findings for high-dose isoniazid may have been affected by site effect, as the majority of patients came from Cape Town. Limitations of this study include the difficulty of estimating the treatment effects of individual drugs within multidrug regimens, only observational cohort studies were available for inclusion, and treatment decisions were based on the clinician's perception of illness, with resulting potential for bias. CONCLUSIONS: This study suggests that children respond favorably to MDR-TB treatment. The low success rate in children infected with HIV who did not receive ART during their MDR-TB treatment highlights the need for ART in these children. Our findings of individual drug effects on treatment outcome should be further evaluated.

Diagnostic Accuracy of 68Ga-PSMA-11 PET/MRI Compared with Multiparametric MRI in the Detection of Prostate Cancer.

Purpose To compare the diagnostic accuracy of gallium 68 (68Ga)-labeled prostate-specific membrane antigen (PSMA)-11 PET/MRI with that of multiparametric MRI in the detection of prostate cancer. Materials and Methods The authors performed a retrospective study of men with biopsy-proven prostate cancer who underwent simultaneous 68Ga-PSMA-11 PET/MRI before radical prostatectomy between December 2015 and June 2017. The reference standard was whole-mount pathologic examination. Readers were blinded to radiologic and pathologic findings. Tumor localization was based on 30 anatomic regions. Region-specific sensitivity and specificity were calculated for PET/MRI and multiparametric MRI by using raw stringent and alternative neighboring approaches. Maximum standardized uptake value (SUVmax) in the tumor and Prostate Imaging Reporting and Data System (PI-RADS) version 2 grade were compared with tumor Gleason score. Generalized estimating equations were used to estimate population-averaged sensitivity and specificity and to determine the association between tumor characteristics and SUVmax or PI-RADS score. Results Thirty-two men (median age, 68 years; interquartile range: 62-71 years) were imaged. The region-specific sensitivities of PET/MRI and multiparametric MRI were 74% (95% confidence interval [CI]: 70%, 77%) and 50% (95% CI: 45%, 0.54%), respectively, with the alternative neighboring approach (P < .001 for both) and 73% (95% CI: 68%, 79%) and 69% (95% CI: 62%, 75%), respectively, with the population-averaged generalized estimating equation (P = .04). Region-specific specificity of PET/MRI was similar to that of multiparametric MRI with the alternative neighboring approach (88% [95% CI: 85%, 91%] vs 90% [95% CI: 87%, 92%], P = .99) and in population-averaged estimates (70% [95% CI: 64%, 76%] vs 70% [95% CI: 64%, 75%], P = .99). SUVmax was associated with a Gleason score of 7 and higher (odds ratio: 1.71 [95% CI: 1.27, 2.31], P < .001). Conclusion The sensitivity of gallium 68-labeled prostate-specific membrane antigen-11 PET/MRI in the detection of prostate cancer is better than that of multiparametric MRI. © RSNA, 2018 See also the editorial by Civelek in this issue.

Radiofrequency ablation of hepatocellular carcinoma as bridge therapy to liver transplantation: A 10-year intention-to-treat analysis.

In a long-term (10-year) study of radiofrequency ablation (RFA) of hepatocellular carcinoma (HCC) as bridging therapy in patients listed for orthotopic liver transplantation (LT), we evaluated the impact of RFA on waiting list dropout rate, post-LT tumor recurrence, and long-term intention-to-treat, disease-specific survival (DSS). From March 2004 to October 2014, RFA was performed as the initial stand-alone bridge therapy to LT for 121 patients (men/women ratio, 83:38; mean age, 60.0 years) with 156 de novo HCCs (mean size, 2.4 cm). Follow-up period from initial RFA ranged from 1.3 to 128.0 months (median, 42.9 months). We assessed the overall and tumor-specific waiting list dropout rates, post-LT tumor recurrence, and 10-year post-LT and intention-to-treat survival rates. Dropout from the waiting list due to tumor progression occurred in 7.4% of patients. HCC recurrence after LT occurred in 5.6% of patients. The post-LT overall survival (OS) rate at 5 and 10 years was 75.8% and 42.2%, respectively, and the recurrence-free survival (RFS) rate was 71.1% and 39.6%, respectively. Intention-to-treat OS, RFS, and DSS rates for the entire study population at 5 and 10 years were 63.5% and 41.2%, 60.8% and 37.7%, and 89.5% and 89.5%, respectively. CONCLUSION: RFA as a first-line stand-alone bridge therapy to LT achieves excellent long-term overall and tumor-specific survivals, with a low dropout rate from tumor progression despite long wait list times and a sustained low tumor recurrence rate upon post-LT follow-up of up to 10 years. (Hepatology 2017;65:1979-1990).

Preliminary Outcome of Microwave Ablation of Hepatocellular Carcinoma: Breaking the 3-cm Barrier?

PURPOSE: To evaluate preliminary outcomes after microwave ablation (MWA) of hepatocellular carcinoma (HCC) up to 5 cm and to determine the influence of tumor size. MATERIALS AND METHODS: Electronic records were searched for HCC and MWA. Between January 2011 and September 2014, 173 HCCs up to 5 cm were treated by MWA in 129 consecutive patients (89 men, 40 women; mean age, 66.9 y ± 9.5). Tumor characteristics related to local tumor progression and primary and secondary treatment efficacy were evaluated by univariate analysis. Outcomes were compared between tumors ≤ 3 cm and tumors > 3 cm. RESULTS: Technical success, primary efficacy, and secondary efficacy were 96.5%, 99.4%, and 94.2% at a mean follow-up period of 11.8 months ± 9.8 (range, 0.8-40.6 mo). Analysis of tumor characteristics showed no significant risk factor for local tumor progression, including subcapsular location (P = .176), tumor size (P = .402), and perivascular tumor location (P = .323). The 1-year and 2-year secondary or overall treatment efficacy rates for tumors measuring ≤ 3 cm were 91.2% and 82.1% and for tumors 3.1-5 cm were 92.3% and 83.9% (P = .773). The number of sessions to achieve secondary efficacy was higher in the larger tumor group (1.13 vs 1.06, P = .005). There were three major complications in 134 procedures (2.2%). CONCLUSIONS: With use of current-generation MWA devices, percutaneous ablation of HCCs up to 5 cm can be achieved with high efficacy.

The Oleaginous Yeast Metschnikowia pulcherrima Displays Killer Activity against Avian-Derived Pathogenic Bacteria.

Metschnikowia pulcherrima is a non-conventional yeast with potential to be used in biotechnological processes, especially those involving low-cost feedstock exploitation and biocontrol applications. The combination of traits that supports these industrial applications in M. pulcherrima also makes it an attractive option to study in the context of livestock health. In this study, we examined the specific interactions between M. pulcherrima and multiple avian pathogenic bacteria. We tested individual bacteria-yeast interactions and bacterial combinations in both solid and liquid media and in variable nutrient environments. Across multiple isolates of M. pulcherrima, we observed different levels of antimicrobial activity, varying from supporting the growth of competing bacteria through suppression and bacterial killing, and we found that these responses varied depending on the bacterial strains and media. We identified multiple molecular routes, including proteins produced by M. pulcherrima strains, that acted to control these microbial interactions. Furthermore, protein screening revealed that M. pulcherrima strains were induced to produce proteins specifically when exposed to bacterial strains, suggesting that fine-tuned mechanisms allow M. pulcherrima to function as a potential lynchpin in a microbial community.

Surface analysis of polymers treated by remote atmospheric pressure plasma.

The surfaces of high-density polyethylene (HDPE), poly(methyl methacrylate) (PMMA), and polyethersulfone (PES) were treated with a low-temperature, atmospheric pressure oxygen and helium plasma. The polymers were exposed to the downstream afterglow of the plasma, which contained primarily oxygen atoms and metastable oxygen molecules ((1)Delta(g) O(2)), and no ions or electrons. X-ray photoelectron spectroscopy (XPS) of HDPE revealed that 20% of the carbon atoms were converted into oxidized functional groups, with about half of these being carboxylic acids. Attenuated total reflection infrared spectroscopy of all three polymers was obtained in order to determine the types of functional groups formed by atmospheric plasma exposure. It was found that the polymers were rapidly oxidized with addition of alcohols, ketones, and carboxylic acids to the carbon backbone. Chain scission occurred on HDPE and PMMA, while on PES the aromatic groups underwent ring-opening and insertion of carboxylic acid.

"Masson's pseudoangiosarcoma" in a popliteal aneurysm: tumor or thrombus? Cause or effect?

A 44-year-old male presented to our vascular surgery unit with a partially thrombosed 22 mm popliteal aneurysm giving rise to progressive distal ischemia. Microscopy of embolus retrieved from the posterior tibial artery at bypass surgery revealed the unexpected finding of intravascular papillary endothelial hyperplasia (Masson's pseudoangiosarcoma).

Kinetic control of self-catalyzed indium phosphide nanowires, nanocones, and nanopillars.

The morphological phase diagram is reported for InP nanostructures grown on InP (111)B as a function of temperature and V/III ratio. Indium droplets were used as the catalyst and were generated in situ in the metalorganic vapor-phase epitaxy reactor. Three distinct nanostructures were observed: wires, cones, and pillars. It is proposed that the shape depends on the relative rates of indium phosphide deposition via the vapor-liquid-solid (VLS) and vapor-phase epitaxy (VPE) processes. The rate of VLS is relatively insensitive to temperature and results in vertical wire growth starting at 350 degrees C. By contrast, the rate of VPE accelerates with temperature and drives the lateral growth of cones at 385 degrees C and then pillars at 400 degrees C.

Self-catalyzed epitaxial growth of vertical indium phosphide nanowires on silicon.

Vertical indium phosphide nanowires have been grown epitaxially on silicon (111) by metalorganic vapor-phase epitaxy. Liquid indium droplets were formed in situ and used to catalyze deposition. For growth at 350 degrees C, about 70% of the wires were vertical, while the remaining ones were distributed in the 3 other <111> directions. The vertical fraction, growth rate, and tapering of the wires increased with temperature and V/III ratio. At 370 degrees C and V/III equal to 200, 100% of the wires were vertical with a density of approximately 1.0 x 10(9) cm(-2) and average dimensions of 3.9 mum in length, 45 nm in base width, and 15 nm in tip width. X-ray diffraction and transmission electron microscopy revealed that the wires were single-crystal zinc blende, although they contained a high density of rotational twins perpendicular to the <111> growth direction. The room temperature photoluminescence spectrum exhibited one peak centered at 912 +/- 10 nm with a FWHM of approximately 60 nm.

Fabrication and Characterization of Solid Composite Yarns from Carbon Nanotubes and Poly(dicyclopentadiene).

In this report, networks of carbon nanotubes (CNTs) are transformed into composite yarns by infusion, mechanical consolidation and polymerization of dicyclopentadiene (DCPD). The microstructures of the CNT yarn and its composite are characterized by scanning electron microscopy (SEM), high resolution transmission electron microscopy (HRTEM), and a focused ion beam used for cross-sectioning. Pristine yarns have tensile strength, modulus and elongation at failure of 0.8 GPa, 14 GPa and 14.0%, respectively. In the composite yarn, these values are significantly enhanced to 1.2 GPa, 68 GPa and 3.4%, respectively. Owing to the consolidation and alignment improvement, its electrical conductivity was increased from 1.0 × 105 S/m (raw yarn) to 5.0 × 105 S/m and 5.3 × 105 S/m for twisted yarn and composite yarn, respectively. The strengthening mechanism is attributed to the binding of the DCPD polymer, which acts as a capstan and increases frictional forces within the nanotube bundles, making it more difficult to pull them apart.

Semi-continuous pilot-scale microbial oil production with Metschnikowia pulcherrima on starch hydrolysate.

BACKGROUND: Heterotrophic microbial oils are potentially a more sustainable alternative to vegetable or fossil oils for food and fuel applications. However, as almost all work in the area is conducted on the laboratory scale, such studies carry limited industrial relevance and do not give a clear indication of what is required to produce an actual industrial process. Metschnikowia pulcherrima is a non-pathogenic industrially promising oleaginous yeast which exhibits numerous advantages for cost-effective lipid production, including a wide substrate uptake, antimicrobial activity and fermentation inhibitor tolerance. In this study, M. pulcherrima was fermented in stirred tank reactors of up to 350 L with 250-L working volume in both batch and semi-continuous operation to highlight the potential industrial relevance. Due to being food-grade, suitable for handling at scale and to demonstrate the oligosaccharide uptake capacity of M. pulcherrima, enzyme-hydrolysed starch in the form of glucose syrup was selected as fermentation feedstock. RESULTS: In batch fermentations on the 2-L scale, a lipid concentration of 14.6 g L-1 and productivity of 0.11 g L-1 h-1 were achieved, which was confirmed at 50 L (15.8 g L-1; 0.10 g L-1 h-1). The maximum lipid production rate was 0.33 g L-1 h-1 (daily average), but the substrate uptake rate decreased with oligosaccharide chain length. To produce 1 kg of dry yeast biomass containing up to 43% (w/w) lipids, 5.2 kg of the glucose syrup was required, with a lipid yield of up to 0.21 g g-1 consumed saccharides. In semi-continuous operation, for the first time, an oleaginous yeast was cultured for over 2 months with a relatively stable lipid production rate (around 0.08 g L-1 h-1) and fatty acid profile (degree of fatty acid saturation around 27.6% w/w), and without contamination. On the 250-L scale, comparable results were observed, culminating in the generation of nearly 10 kg lipids with a lipid productivity of 0.10 g L-1 h-1. CONCLUSIONS: The results establish the importance of M. pulcherrima for industrial biotechnology and its suitability to commercially produce a food-grade oil. Further improvements in the productivity are required to make M. pulcherrima lipid production industrial reality, particularly when longer-chain saccharides are involved.

The origins and genomic diversity of American Civil War Era smallpox vaccine strains.

Vaccination has transformed public health, most notably including the eradication of smallpox. Despite its profound historical importance, little is known of the origins and diversity of the viruses used in smallpox vaccination. Prior to the twentieth century, the method, source and origin of smallpox vaccinations remained unstandardised and opaque. We reconstruct and analyse viral vaccine genomes associated with smallpox vaccination from historical artefacts. Significantly, we recover viral molecules through non-destructive sampling of historical materials lacking signs of biological residues. We use the authenticated ancient genomes to reveal the evolutionary relationships of smallpox vaccination viruses within the poxviruses as a whole.

Can net energy values be determined from animal performance measurements? A review of factors affecting application of the California Net Energy System.

The California Net Energy System (CNES) can reliably project performance of feedlot cattle based on three factors: expected dry matter intake (DMI), some index of degree of maturity of cattle linked to body composition (fat and protein content), and an estimate of the net energy (NE) content of the diet. The CNES allowed feedlot managers to monitor growth and efficiency of individual pens of cattle. Through assigning distinct values for net energy for maintenance (NEm) vs. net energy for gain (NEg) of the metabolizable energy (ME) present in feeds, the CNES enables valid economic comparisons among feedstuffs, an appraisal not feasible based on total digestible nutrients or digestible energy (DE) values. Because NEm and NEg are linked mathematically to ME, the CNES also allows performance-adjusted ME (paME) value of diets to be calculated from observed DMI and growth or carcass measurements. Compared with other productivity measures (e.g., average daily gain and gain-to-feed ratio) that are confounded with and affected by DMI, the CNES logically separates production responses by cattle into two factors-DMI and ME of the diet. This enables research scientists or cattle producers to appraise responses within these two factors independently. In feeding studies, means of paME values were related closely to ME values of diets calculated from the ME of diet ingredients. But unlike ME values projected from diet analyses, paME estimates are affected by environmental conditions (e.g., season, weather, animal interactions, stress, nutritional history and deficiencies, associative effects of feeds, imprecise feed management, and animal healthfulness and disorders). These factors typically overestimate ME intake or increase energy requirements, both of which decrease energetic efficiency. By comparing paME with ME values calculated from diet composition, logical reasons behind performance responses to and quantitative benefits from feed additives, grain processing, hormone implants, and animal management can be appraised. Considering the evolution in cattle types, management and marketing conditions, and changes in diet ingredients and processing that have occurred during the past 50 yr, updating by a skilled committee to correct certain anomalies within the CNES as currently being applied seems appropriate. Developing simplified spreadsheets could help users evaluate their own dietary and management conditions and assure that the CNES continues to be widely applied by the feedlot industry within the United States and worldwide.