Stable non-corrosive sulfonimide salt for 4-V-class lithium metal batteries.

Rechargeable lithium metal (Li0) batteries (RLMBs) are considered attractive for improving Li-ion batteries. Lithium bis(trifluoromethanesulfonyl)imide (LiTFSI) has been extensively used as a conducting salt for RLMBs due to its advantageous stability and innocuity. However, LiTFSI-based electrolytes are corrosive towards aluminium (Al0) current collectors at low potentials (>3.8 V versus Li/Li+), thereby excluding their application in 4-V-class RLMBs. Herein, we report on a non-corrosive sulfonimide salt, lithium (difluoromethanesulfonyl)(trifluoromethanesulfonyl)imide (LiDFTFSI), that remarkably suppresses the anodic dissolution of the Al0 current collector at high potentials (>4.2 V versus Li/Li+) and significantly improves the cycling performance of Li(Ni1/3Mn1/3Co1/3)O2 (NMC111) cells. In addition, this sulfonimide salt results in the growth of an advantageous solid electrolyte interphase on the Li0 electrode. The replacement of either LiTFSI or LiPF6 with LiDFTFSI endows a Li0||NMC111 cell with superior cycling stability and capacity retention (87% at cycle 200), demonstrating the decisive role of the salt anion in dictating the electrochemical performance of RLMBs.

Organocatalytic Enantioselective Vinylcyclopropane-Cyclopentene (VCP-CP) Rearrangement.

We have demonstrated that the catalytic and enantioselective vinylcyclopropane-cyclopentene rearrangement can be carried out on (vinylcyclopropyl)acetaldehydes through activation via enamine intermediates. The reaction makes use of racemic starting materials that, upon ring opening facilitated by the catalytic generation of a donor-acceptor cyclopropane, deliver an acyclic iminium ion/dienolate intermediate in which all stereochemical information has been deleted. The final cyclization step forms the rearrangement product, showing that chirality transfer from the catalyst to the final compound is highly effective and leads to the stereocontrolled formation of a variety of structurally different cyclopentenes.

Anion π-π Stacking for Improved Lithium Transport in Polymer Electrolytes.

Polymer electrolytes (PEs) with excellent flexibility, processability, and good contact with lithium metal (Li°) anodes have attracted substantial attention in both academic and industrial settings. However, conventional poly(ethylene oxide) (PEO)-based PEs suffer from a low lithium-ion transference number (TLi+), leading to a notorious concentration gradient and internal cell polarization. Here, we report two kinds of highly lithium-ion conductive and solvent-free PEs using the benzene-based lithium salts, lithium (benzenesulfonyl)(trifluoromethanesulfonyl)imide (LiBTFSI) and lithium (2,4,6-triisopropylbenzenesulfonyl)(trifluoromethanesulfonyl)imide (LiTPBTFSI), which show significantly improved TLi+ and selective lithium-ion conductivity. Using molecular dynamics simulations, we pinpoint the strong π-π stacking interaction between pairs of benzene-based anions as the cause of this improvement. In addition, we show that Li°âˆ¥Li° and Li°âˆ¥LiFePO4 cells with the LiBTFSI/PEO electrolytes present enhanced cycling performance. By considering π-π stacking interactions as a new molecular-level design route of salts for electrolyte, this work provides an efficient and facile novel strategy for attaining highly selective lithium-ion conductive PEs.

Single Lithium Ion Conducting "Binderlyte" for High-Performing Lithium Metal Batteries.

Rechargeable lithium metal batteries (LMBs) are deemed as a viable solution to improve the power and/or energy density of the contemporary lithium-ion batteries (LIBs). However, poor Li-ion diffusivity within high-energy cathodes causes sluggish kinetics of the corresponding redox reactions particularly at high C-rates, thereby largely impeding the performance of rechargeable LMBs. In this work, a dual-functional single Li-ion conducting polysalt is proposed as both catholyte and binding agent (coined "Binderlyte") for rechargeable LMBs. The designed Binderlyte is thermally and electrochemically stable, allowing its use for high-energy cathodes like Li(Ni1/3 Mn1/3 Co1/3 )O2 (NMC111). The implementation of designer Binderlyte endows the Li° || NMC111 cell with superior cycling stability and capacity retention even at an extremely high C-rate of 10C. In particular, the soft and flexible nature of the Binderlyte allows the thick NMC cathode to operate at extremely low porosity (20 vol%) with almost no capacity decay. This work may provide a paradigm shift on the design of innovative polymeric materials, which are essential for developing high-performing rechargeable LMBs.

Enhanced Lithium-Ion Conductivity of Polymer Electrolytes by Selective Introduction of Hydrogen into the Anion.

The anion chemistry of lithium salts plays a pivotal role in dictating the physicochemical and electrochemical performance of solid polymer electrolytes (SPEs), thus affecting the cyclability of all-solid-state lithium metal batteries (ASSLMBs). The bis(trifluoromethanesulfonyl)imide anion (TFSI- ) has long been studied as the most promising candidate for SPEs; however, the Li-ion conductivities of the TFSI-based SPEs still remain low (Li-ion transference number: ca. 0.2). In this work, we report new hydrogen-containing anions, conceived based on theoretical considerations, as an electrolyte salt for SPEs. SPEs comprising hydrogen-containing anions achieve higher Li-ion conductivities than TFSI-based ones, and those anions are electrochemically stable for various kinds of ASSLMBs (Li-LiFePO4 , Li-S, and Li-O2 batteries). This opens up a new avenue for designing safe and high-performance ASSLMBs in the future.

Transcription factor PRDM8 is required for rod bipolar and type 2 OFF-cone bipolar cell survival and amacrine subtype identity.

Retinal bipolar (BP) cells mediate the earliest steps in image processing in the visual system, but the genetic pathways that regulate their development and function are incompletely known. We identified PRDI-BF1 and RIZ homology domain containing 8 (PRDM8) as a highly conserved transcription factor that is abundantly expressed in mouse retina. During development and in maturity, PRDM8 is expressed strongly in BP cells and a fraction of amacrine and ganglion cells. To determine whether Prdm8 is essential to BP cell development or physiology, we targeted the gene in mice. Prdm8(EGFP/EGFP) mice showed nonprogressive b-wave deficits on electroretinograms, consistent with compromised BP cell function or circuitry resembling the incomplete form of human congenital stationary night blindness (CSNB). BP cell specification was normal in Prdm8(EGFP/EGFP) retina as determined by VSX2(+) cell numbers and retinal morphology at postnatal day 6. BP subtype differentiation was impaired, however, as indicated by absent or diminished expression of BP subtype-specific markers, including the putative PRDM8 regulatory target PKCα (Prkca) and its protein. By adulthood, rod bipolar (RB) and type 2 OFF-cone bipolar (CB) cells were nearly absent from Prdm8-null mice. Although no change was detected in total amacrine cell (AC) numbers, increased PRKCA(+) and cholinergic ACs and decreased GABAergic ACs were seen, suggesting an alteration in amacrine subtype identity. These findings establish that PRDM8 is required for RB and type 2 OFF-CB cell survival and amacrine subtype identity, and they present PRDM8 as a candidate gene for human CSNB.

Enantioselective Synthesis of Tertiary Propargylic Alcohols under N-Heterocyclic Carbene Catalysis.

A straightforward procedure to carry out the enantioselective benzoin reaction between aldehydes and ynones by employing a chiral N-heterocyclic carbene (NHC) as catalyst was developed. Under the optimized reaction conditions, these ynones undergo a clean and selective 1,2-addition with the catalytically generated Breslow intermediate, not observing any byproduct arising from competitive Stetter-type reactivity. This procedure allows the preparation of tertiary alkynyl carbinols as highly enantioenriched materials, which have the remarkable potential to be used as chiral building blocks in organic synthesis.

Wireless Ultrasound Guidance for Femoral Venous Cannulation in Electrophysiology: Impact on Safety, Efficacy, and Procedural Delay.

BACKGROUND: Ultrasound (US) guidance increases safety and efficacy in vascular cannulation and is considered the standard of care. However, barriers including workflow interference and the need to be assisted by a second operator limit its adoption in clinical routine. The use of wireless US (WUS) may overcome these barriers. The aim of this study was to assess the impact of a novel WUS probe during its initial implantation in an electrophysiology (EP) laboratory. METHODS: Thirty-six patients requiring femoral venous cannulation for EP procedures were included in this single center, prospective, observational study, comparing WUS guidance with the anatomical landmark approach. The primary endpoint was time to successful cannulation. Secondary endpoints included rate of unsuccessful punctures, accidental arterial punctures, and workflow interference. RESULTS: Compared with anatomical landmark approach, WUS guidance significantly reduced mean time to successful cannulation (87.3 ± 94.3 vs 238.1 ± 294.7 seconds, P < 0.01). Workflow interference was predominantly nonexistent or mild and decreased after the first three weeks of use. In addition, WUS guidance improved safety and efficacy, reducing the rate of accidental arterial punctures (0.02 ± 0.1 vs 0.25 ± 0.5 arterial punctures per cannulation, P < 0.05) and unsuccessful attempts (0.26 ± 0.8 vs 1.75 ± 2.1 attempts per cannulation, P < 0.01). CONCLUSIONS: WUS guidance resulted in faster, safer, and more effective femoral venous cannulation than the anatomical landmark approach without adding significant workflow interference. The application of wireless technology in this setting contributed to overcoming some of the barriers preventing a more widespread clinical use of US guidance.

Birc1e is the gene within the Lgn1 locus associated with resistance to Legionella pneumophila.

In inbred mouse strains, permissiveness to intracellular replication of Legionella pneumophila is controlled by a single locus (Lgn1), which maps to a region within distal Chromosome 13 that contains multiple copies of the gene baculoviral IAP repeat-containing 1 (Birc1, also called Naip; refs. 1-3). Genomic BAC clones from the critical interval were transferred into transgenic mice to functionally complement the Lgn1-associated susceptibility of A/J mice to L. pneumophila. Here we report that two independent BAC clones that rescue susceptibility have an overlapping region of 56 kb in which the entire Lgn1 transcript must lie. The only known full-length transcript coded in this region is Birc1e (also called Naip5).

Crystal structure and cation-anion interactions of potassium (Difluoromethanesulfonyl) (trifluorome thanesulfonyl)imide.

Sulfonimide salts are of great interest for battery use thanks to their special properties including sufficient superior chemical/thermal stabilities, structural flexibility, etc. In particular, the hydrogen-containing sulfonimide (difluoromethanesulfonyl)(trifluoromethanesulfonyl)imide anion {[N(SO2CF2H) (SO2CF3)]-, DFTFSI-}, stands out owing to its suppressed anion mobility and superior electrochemical properties. We herein report the structural analyses of potassium (difluoromethanesulfonyl)(trifluoromethanesulfonyl)imide {K [N(SO2CF2H) (SO2CF3)], KDFTFSI} by virtue of single crystal X-ray diffraction and computational approaches. Our results reveal that KDFTFSI crystallizes in a orthorhombic cell (space group: Pbcn) comprising of cationic and anionic layers, which is similar to the conventional sulfonimide salt, potassium bis(trifluoromethanesulfonyl)imide {K [N(SO2CF3)2], KTFSI}. Gas-phase density functional theory calculations show that the conversion from trans to cis DFTFSI- anions is hindered due to the presence of stabilizing intramolecular H-bonding interactions in the trans conformer; yet interaction with K+ substantially minimizes the energy difference between the two conformers due to the formation of strong tridentate K+ coordination with oxygen atoms in the cis KDFTFSI. This work is anticipated to provide further understanding on the structure-property relations of hydrogenated sulfonimide anions, and thus inspire the structural design of new anions for battery research.

Genetic control of high density lipoprotein-cholesterol in AcB/BcA recombinant congenic strains of mice.

Epidemiological studies show that high HDL-cholesterol (HDLc) decreases the risk of cardiovascular disease. To map genes controlling lipid metabolism, particularly HDLc levels, we screened the plasma lipids of 36 AcB/BcA RC mouse strains subjected to either a normal or a high-fat/cholesterol diet. Strains BcA68 and AcB65 showed deviant HDLc plasma levels compared with the parental A/J and C57BL/6J strains; they were thus selected to generate informative F2 crosses. Linkage analyses in the AcB65 strain identified a locus on chromosome 4 (Hdlq78) responsible for high post-high fat diet HDLc levels. This locus has been previously associated at genome-wide significance to two regions in the human genome. A second linkage analysis in strain BcA68 identified linkage in the vicinity of a gene cluster known to control HDLc levels. Sequence analysis of these candidates identified a de novo, loss-of-function mutation in the ApoA1 gene of BcA68 that prematurely truncates the ApoA1 protein. The possibility of dissecting the specific effects of this new ApoA1 deficiency in the context of isogenic controls makes the BcA68 mouse a valuable new tool.

[Vaping-induced lung injury]. / Injuria pulmonar por vapeo.

Vaping is considered to be the inhalation of aerosols generated by heating liquids. There are devices freely marketed for vaping, with electronic cigarettes being the most common. These products are associated with the appearance of lung injury, either vaping-induced lung injury (VAPI), or lung injury associated with vaping and electronic cigarettes (EVALI). We presented the case of a 54-year-old woman with a history of vaping in the last 9 months. She consulted for acute dyspnea (class IV) associated with nausea and vomiting of 18 hours of evolution. Upon admission, she presented respiratory failure. Orotracheal intubation was performed with mechanical ventilatory assistance. A chest tomography revealed bilateral diffuse alveolar infiltrates. The clinical picture was interpreted as VAPI/EVALI. The exact pathophysiology of vaping-induced lung injury is still unknown; dyspnea and cough are the most frequent symptoms. All patients have pathological radiological images. Respiratory support and systemic corticosteroids are the treatment of choice.

Se considera vapeo a la inhalación de aerosoles generados por el calentamiento de líquidos. Existen dispositivos que se comercializan libremente para realizar vapeo, siendo los cigarrillos electrónicos los más frecuentes. Estos productos están asociados a la aparición de injuria pulmonar, ya sea injuria pulmonar inducida por vapeo (VAPI), o injuria pulmonar asociada a vapeo y cigarrillos electrónicos (EVALI). Se presenta el caso de una mujer de 54 años con antecedentes de vapeo en los últimos 9 meses. Consultó por disnea clase funcional IV asociada a náuseas y vómitos de 18 h de evolución. Al ingreso presentó insuficiencia respiratoria. Se realizó intubación orotraqueal con asistencia ventilatoria mecánica; la tomografía de tórax evidenció infiltrados alveolares difusos bilaterales. Se interpretó el cuadro clínico como VAPI/EVALI. Aún se desconoce la fisiopatogenia exacta de la injuria pulmonar inducida por vapeo; la disnea y tos son los síntomas más frecuentes. Todos los pacientes tienen imágenes radiológicas patológicas. El soporte respiratorio y los corticoides sistémicos son el tratamiento de elección.

Value of advanced interatrial block in the diagnosis of the ischemic stroke's aetiology: A cohort study.

INTRODUCTION AND OBJECTIVES: Advanced interatrial block has been linked with atrial fibrillation (AF) (Bayes syndrome). On the other hand, the aetiology of the stroke remains unknown in approximately 20-25% of patients admitted due to ischaemic stroke. The aim of this study was to evaluate whether advanced interatrial block and CHADS2-VASC scale is linked to AF in patients admitted due to ischaemic stroke without previous AF history. METHODS: A prospective analysis of consecutive in-hospital patients admitted with ischemic stroke between January/2018 and April/2019 in a stroke hospital was performed. Patients had to be in sinus rhythm at admission and without previous history of AF/atrial flutter. During follow up patients receive the usual care. RESULTS: A total of 236 patients were included. The median follow-up was 540 days (407-695). 19 patients (8.1%) had advanced interatrial block at admission. Advanced interatrial block was associated with the diagnosis of AF during follow up (5 (26.3%) Vs 21 (9.7%) p=0.027). A CHADS2-VASC score>4 at admission was also associated with AF diagnosis during follow up (23(14.6%) vs 3(3.9%) p=0.009). CONCLUSION: This study confirms the association of advanced interatrial block and CHADS2-VASC>4 at admission with the diagnosis of AF during follow up in patients with ischemic stroke. This association could have important implications in patients with ischemic stroke who present advanced interatrial block and without previous history of AF.

Bispectral index monitoring to detect delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage.

PURPOSE: Evaluate the bispectral index (BIS) monitoring to detect delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (aSAH). MATERIALS AND METHODS: A single-center prospective study in patients with aSAH. BIS monitoring was recorded during 25-120 min in two periods, within the initial 72 h (BIS1) and between days 4 and 6 (BIS2) from admission. The median for each exported BIS parameter was analyzed. Transcranial Doppler (TCD) sonography was simultaneously performed with BIS1 (TCD1) and BIS2 (TCD2) monitoring. A multivariate logistic regression model was built to identify the variables associated with DCI. RESULTS: Sixty-four patients were included and 16 (25%) developed DCI. During BIS2 monitoring, significant differences were found in BIS value (left, p = 0.01; right, p = 0.009), 95% spectral edge frequency (left and right, p = 0.04), and total power (left and right, p = 0.04). In multivariable analysis, vasospasm on TCD2 (OR 42.8 [95% CI 3.1-573]; p = 0.005), a median BIS2 value <85 in one or both sides (OR 6.2 [95% CI 1.28-30]; p = 0.023), and age (OR 1.08 [95% CI 1.00-1.17]; p = 0.04) were associated with the development of DCI. CONCLUSIONS: BIS value is the most useful BIS parameter for detecting DCI after aSAH. Pending further validation, BIS monitoring might be even more accurate than TCD.

[Otomastoiditis as an initial clinical manifestation of Wegener's granulomatosis]. / Otomastoiditis como manifestacion clinica de granulomatosis de Wegener.

Wegener's granulomatosis (WG) forms part of a group of primary vasculitis of the small and medium-sized blood vessels, associated with antineutrophil cytoplasmic antibodies (ANCA). This disease may affect any body organ, especially the upper and lower airways and the kidneys. Hardly ever is otomastoiditis the first and only clinical manifestation of generalized Wegener's granulomatosis. We present the case of a patient whose disease started with the inflammation of the middle ear, which was unresponsive to the usual treatment. Later he developed nasal, pulmonary and renal compromise. The determination of ANCA and a transbronchial biopsy confirmed the diagnosis of WG. We report this case to express the view that otomastoiditis in adults, which is refractory to the usual treatment, may seldom be the first and only clinical manifestation of WG.

[COVID-19 experience in a private institution in Buenos Aires during the first month of the pandemic: 26 cases]. / Experiencia COVID-19 en un sanatorio privado de Buenos Aires durante el primer mes de la pandemia: 26 casos.

The first case of coronavirus (COVID-19) infection in Argentina was reported in Buenos Aires on March 3rd, 2020, in a patient who arrived from Milan. The aim of this study is to describe the clinical characteristics and course of illness of patients infected with Covid-19 that were hospitalized in a private clinical setting during March 2020. Sixty three patients suspected of COVID-19 infection, were admitted to our hospital during March 2020. Twenty six of these subjects were diagnosed positive by the RT-PCR for SARS Cov-2 in a nasopharyngeal swab specimen. We recorded data about epidemiological characteristics, clinical signs and symptoms, in addition to comorbidities, laboratory and radiological studies were done. The median age was 40 years (SD ± 15 years); there was an equal number of men and women; all the patients but one were coming from abroad; the most common symptom was fever (24/26 cases) and lymphopenia (n = 8). We found that there were patients in whom fever disappeared within the first 72h (n = 17) and another group in which the fever lasted six or more days (n = 7). One patient out of 26 died. The population of our study was young and almost all were imported cases, in alinement with the stage of the epidemic at the time when the study was conducted. We observed that there were two patterns in the fever curve but the persistence of it did not lead to a worse prognosis. Larger population studies are required in order to confirm these clinical findings.

El primer caso de infección por coronavirus (COVID-19) en Argentina se informó en Buenos Aires el 3 de marzo de 2020, en un paciente proveniente de Milán. El objetivo de este trabajo es describir las características clínicas y curso de la enfermedad de una serie de pacientes infectados con COVID-19 en un sanatorio privado durante el mes de marzo del 2020. Durante marzo 2020 se internaron 63 pacientes sospechosos de infección por COVID-19. Fueron diagnosticados 26 positivos para COVID-19 por hisopado nasofaríngeo, con el método RT-PCR para SARS Cov2. Se recopilaron datos sobre las características epidemiológicas, signos y síntomas, así como comorbilidades, laboratorio e imágenes. La edad promedio fue 40 años (SD ± 15 años); hubo un igual número de varones; solo 1 caso no venía del exterior. El síntoma más frecuente fue la fiebre (24/26 casos) y la linfopenia (8/26). En un grupo (n = 17) la fiebre se limitó dentro de las primeras 72 h y en otro, la fiebre duró 6 o más días (7 casos). Hubo un fallecido entre los 26 casos. La población de nuestro estudio era joven y la mayoría de los casos fueron importados, en concordancia con el estadio de la epidemia en el momento en que el estudio fue realizado. Observamos que hubo 2 patrones en la curva térmica pero la persistencia de la fiebre no implicó un peor pronóstico. Se necesitan estudios poblacionales más grandes para confirmar estos hallazgos clínicos.

[Not Available]. / ¿Es posible una red de benchmarking entre hospitales públicos? Proceso de creación de la Red.7.

INTRODUCTION: As a result of a prioritised improvement action during the second self-assessment using the EFQM Excellence Model carried out in Sierrallana Hospital (Cantabria, Spain), it was decided to form a Benchmarking Network between Hospitals. The objective of this work is to present how this action was developed to create the Benchmarking Network "Red.7". MATERIAL AND METHODS: Using the 2004 "Catálogo Nacional de Hospitales "we pre-selected hospitals which could be compared with ours. We asked for information on results indicators in the Health Services of the different regions and we selected those hospitals that could be integrated into the Benchmarking Network. We contacted the top management of the selected hospitals in order to offer them the possibility of participating in the Network. Finally we organised a scientific session to create the Network. RESULTS: We pre-selected 74 hospitals from 12 regions and 18 of them were selected. Seven of these 18 hospitals responded to our invitation, of which one decided to not participate. Finally the Benchmarking Network was created with 7 hospitals: Fundación Alcorcón; El Bierzo, Morales Messeguer, San Jorge, Sierrallana, Son Llàtzer and Valle del Nalón, hospital. CONCLUSIONS: The use of the EFQM Excellence Model permitted us to detect a gap in the comparison of results and best practices with other hospitals from the National Health Service, and we have been able to form an integrated Benchmarking Network with hospitals similar to ours in the different regions.

Electrolyte Additives for Room-Temperature, Sodium-Based, Rechargeable Batteries.

Owing to resource abundance, and hence, a reduction in cost, wider global distribution, environmental benignity, and sustainability, sodium-based, rechargeable batteries are believed to be the most feasible and enthralling energy-storage devices. Accordingly, they have recently attracted attention from both the scientific and industrial communities. However, to compete with and exceed dominating lithium-ion technologies, breakthrough research is urgently needed. Among all non-electrode components of the sodium-based battery system, the electrolyte is considered to be the most critical element, and its tailored design and formulation is of top priority. The incorporation of a small dose of foreign molecules, called additives, brings vast, salient benefits to the electrolytes. Thus, this review presents progress in electrolyte additives for room-temperature, sodium-based, rechargeable batteries, by enlisting sodium-ion, Na-O2 /air, Na-S, and sodium-intercalated cathode type-based batteries.

The AcB/BcA recombinant congenic strains of mice: strategies for phenotype dissection, mapping and cloning of quantitative trait genes.

The AcB/BcA gene discovery platform consists of a series of 36 recombinant congenic strains (RCS) produced from the second backcross generation of the progenitor mouse strains A/J and C57BL/6J. Each individual inbred RCS carries 12.5% of the donor genome in 87.5% of the background genome. As the two parental strains are known to vary in the expression of resistance and susceptibility to a considerable number of mouse models of human diseases, the AcB/BcA RCS platform represents a valuable and versatile genetic tool to study many different phenotypes. RCS can be used to follow the segregation of single gene effects in individual strains, or to look at association/dissociation of mechanistic aspects of complex phenotypes. In addition, one can select strains with fixed alleles at known loci to look for novel gene effects, or use strains with overlapping congenic segments to delineate minimal QTL, intervals. The AcB/BcA RCS platform was used by our group and others to study a series of complex phenotypes including nociception, malaria susceptibility and lipid metabolism. Linkage mapping in secondary crosses and gene expression analysis in targeted organs allowed the identification of chromosomal regions, genes, and biological pathways which might unravel novel targets for preventive and therapeutic interventions.