COVID-19-associated hepatic artery pseudoaneurysms.

Cases of coronary and pulmonary artery pseudoaneurysms secondary to COVID-19 have been reported in the literature and are supposed to be secondary to inflammatory and vasculitis processes linked to a viral multisystem inflammatory syndrome. Although the incidence of COVID-19-associated liver injury ranges from 14% to 53% in hospitalized patients, COVID-19-associated hepatic artery pseudoaneurysms have never been reported so far. We present the case of a patient whose follow-up CT after cryoablation of renal cell carcinoma revealed seven fusiform pseudoaneurysms of the two hepatic arteries secondary to COVID-19. Anticoagulant or anti-inflammatory treatments were not introduced. Vascular lesions were unchanged on the 3-month follow-up CT. At 6-month CT, the proximal pseudoaneurysm was replaced by a proximal occlusion of the accessory RHA.

Electron transfer in extended systems: characterization by periodic density functional theory including the electronic coupling.

We describe a new computer implementation of electron transfer (ET) theory in extended systems treated by periodic density functional theory (DFT), including the calculation of the electronic coupling transition element VAB. In particular, the development opens up the full characterization of electron transfer in the solid state. The approach is valid for any single-determinant wavefunction with localized character representing the electronic structure of the system, from Hartree-Fock (HF) theory, to density functional theory (DFT), hybrid DFT theory, DFT+U theory, and constrained DFT (cDFT) theory. The implementation in CP2K reuses the high-performance functions of the code. The computational cost is equivalent to only one iteration of an HF calculation. We present test calculations for electron transfer in a number of systems, including a 1D-model of ferric oxide, hematite Fe2O3, rutile TiO2, and finally bismuth vanadate BiVO4.

Maximal orbital analysis of molecular wavefunctions.

We describe a new way to decompose one-electron orbitals of a molecule into atom-centered or fragment-centered orbitals by an approach that we call "maximal orbital analysis" (MOA). The MOA analysis is based on the corresponding orbital transformation (COT) that has the unique mathematical property of maximizing any sub-trace of the overlap matrix, in Hilbert metric sense, between two sets of nonorthogonal orbitals. Here, one set comprises the molecule orbitals (Hartree-Fock, Kohn-Sham, complete-active-space, or any set of orthonormal molecular orbitals), the other set comprises the basis functions associated with an atom or a group of atoms. We show in prototypical molecular systems such as a water dimer, metal carbonyl complexes, and a mixed-valent transition metal complex, that the MOA orbitals capture very well key aspects of wavefunctions and the ensuing chemical concepts that govern electronic interactions in molecules. © 2019 Wiley Periodicals, Inc.

Single-Amino Acid Modifications Reveal Additional Controls on the Proton Pathway of [FeFe]-Hydrogenase.

The proton pathway of [FeFe]-hydrogenase is essential for enzymatic H2 production and oxidation and is composed of four residues and a water molecule. A computational analysis of this pathway in the [FeFe]-hydrogenase from Clostridium pasteurianum revealed that the solvent-exposed residue of the pathway (Glu282) forms hydrogen bonds to two residues outside of the pathway (Arg286 and Ser320), implying that these residues could function in regulating proton transfer. In this study, we show that substituting Arg286 with leucine eliminates hydrogen bonding with Glu282 and results in an ∼3-fold enhancement of H2 production activity when methyl viologen is used as an electron donor, suggesting that Arg286 may help control the rate of proton delivery. In contrast, substitution of Ser320 with alanine reduces the rate ∼5-fold, implying that it either acts as a member of the pathway or influences Glu282 to permit proton transfer. Interestingly, quantum mechanics/molecular mechanics and molecular dynamics calculations indicate that Ser320 does not play a structural role or indirectly influence the barrier for proton movement at the entrance of the channel. Rather, it may act as an additional proton acceptor for the pathway or serve in a regulatory role. While further studies are needed to elucidate the role of Ser320, collectively these data provide insights into the complex proton transport process.

Toward molecular catalysts by computer.

CONSPECTUS: Rational design of molecular catalysts requires a systematic approach to designing ligands with specific functionality and precisely tailored electronic and steric properties. It then becomes possible to devise computer protocols to design catalysts by computer. In this Account, we first review how thermodynamic properties such as redox potentials (E°), acidity constants (pKa), and hydride donor abilities (ΔGH(-)) form the basis for a framework for the systematic design of molecular catalysts for reactions that are critical for a secure energy future. We illustrate this for hydrogen evolution and oxidation, oxygen reduction, and CO conversion, and we give references to other instances where it has been successfully applied. The framework is amenable to quantum-chemical calculations and conducive to predictions by computer. We review how density functional theory allows the determination and prediction of these thermodynamic properties within an accuracy relevant to experimentalists (∼0.06 eV for redox potentials, ∼1 pKa unit for pKa values, and 1-2 kcal/mol for hydricities). Computation yielded correlations among thermodynamic properties as they reflect the electron population in the d shell of the metal center, thus substantiating empirical correlations used by experimentalists. These correlations point to the key role of redox potentials and other properties (pKa of the parent aminium for the proton-relay-based catalysts designed in our laboratory) that are easily accessible experimentally or computationally in reducing the parameter space for design. These properties suffice to fully determine free energies maps and profiles associated with catalytic cycles, i.e., the relative energies of intermediates. Their prediction puts us in a position to distinguish a priori between desirable and undesirable pathways and mechanisms. Efficient catalysts have flat free energy profiles that avoid high activation barriers due to low- and high-energy intermediates. The criterion of a flat energy profile can be mathematically resolved in a functional in the reduced parameter space that can be efficaciously calculated by means of the correlation expressions. Optimization of the functional permits the prediction by computer of design points for optimum catalysts. Specifically, the optimization yields the values of the thermodynamic properties for efficient (high rate and low overpotential) catalysts. We are on the verge of design of molecular electrocatalysts by computer. Future efforts must focus on identifying actual ligands that possess these properties. We believe that this can also be achieved through computation, using Taft-like relationships linking molecular composition and structure with electron-donating ability and steric effects. We note also that the approach adopted here of using free energy maps to decipher catalytic pathways and mechanisms does not account for kinetic barriers associated with elementary steps along the catalytic pathway, which may make thermodynamically accessible intermediates kinetically inaccessible. Such an extension of the approach will require further computations that, however, can take advantage of Polanyi-like linear free energy relationships linking activation barriers and reaction free energies.

Molecular dynamics study of the proposed proton transport pathways in [FeFe]-hydrogenase.

Possible proton transport pathways in Clostridium pasteurianum (CpI) [FeFe]-hydrogenase were investigated with molecular dynamics simulations. This study was undertaken to evaluate the functional pathway and provide insight into the hydrogen bonding features defining an active proton transport pathway. Three pathways were evaluated, two of which consist of water wires and one of predominantly amino acid residues. Our simulations suggest that protons are not transported through water wires. Instead, the five-residue motif (Glu282, Ser319, Glu279, H2O, Cys299) was found to be the likely pathway, consistent with previously made experimental observations. The pathway was found to have a persistent hydrogen bonded core (residues Cys299 to Ser319), with less persistent hydrogen bonds at the ends of the pathway for both H2 release and H2 uptake. Single site mutations of the four residues have been shown experimentally to deactivate the enzyme. The theoretical evaluation of these mutations demonstrates redistribution of the hydrogen bonds in the pathway, resulting in enzyme deactivation. Finally, coupling between the protein dynamics near the proton transport pathway and the redox partner binding regions was also found as a function of H2 uptake and H2 release states, which may be indicative of a correlation between proton and electron movement within the enzyme.

The nature of photogenerated charge separation among different crystal facets of BiVO4 studied by density functional theory.

Charge separation among different crystal facets of a semiconductor has been observed experimentally, but the underlying reasons behind this phenomenon are unknown. In this work, the activation energies of carrier hopping and the mobility of electron/hole transport along seven low-index crystal orientations of bulk BiVO4 have been calculated using a small polaron model. The calculated mobility and our previous experimental results reveal that there is a parallel relationship between the carrier mobility along the crystal axis and the carrier preferred accumulation on the corresponding crystal facets. It is proposed that the mobility of electrons (or holes) along the crystal axis [hkl] might be essentially related to the charge separation among the indices of corresponding facets (hkl); namely, the mobility of electrons (or holes) along the crystal axis [hkl] is the largest among all possible crystal axes, and the photogenerated electrons (or holes) tend to be accumulated on the indices of the corresponding facet (hkl) when the surface factors like surface band bending, surface energetic differences, etc. are not considered.

[For metaethics nursing. Some indications Introductory]. / Pour une métaéthique des soins infirmiers. Quelques indications introductives.

In our scientific and cultural context, clinical ethics and organizational ethics play a crucial role in the field of nursing care, but they need a so-called meta-ethics whose aim is to verify and to justify their use of concepts and procedures. Such a meta-ethics lets appear a fundamental competence - empathy, in a very specific meaning - and a meta-principle that regulates the application of classical biomedical principles.

External validation of an artificial intelligence solution for the detection of elbow fractures and joint effusions in children.

PURPOSE: The purpose of this study was to conduct an external validation of an artificial intelligence (AI) solution for the detection of elbow fractures and joint effusions using radiographs from a real-life cohort of children. MATERIALS AND METHODS: This single-center retrospective study was conducted on 758 radiographic sets (1637 images) obtained from consecutive emergency room visits of 712 children (mean age, 7.27 ± 3.97 [standard deviation] years; age range, 7 months and 10 days to 15 years and 10 months), referred for a trauma of the elbow. For each set, fracture and/or effusion detection by eleven senior radiologists (reference standard) and AI solution was recorded. Diagnostic performance of the AI solution was measured via four different approaches: fracture detection (presence/absence of fracture as binary variable), fracture enumeration, fracture localization and lesion detection (fracture and/or a joint effusion used as constructed binary variable). RESULTS: The sensitivity of the AI solution for each of the four approaches was >89%. Greatest sensitivity of the AI solution was obtained for lesion detection (95.0%; 95% confidence interval: 92.1-96.9). The specificity of the AI solution ranged between 63% (for lesion detection) and 77% (for fracture detection). For all four approaches, the negative predictive values were >92% and the positive predictive values ranged between 54% (for fracture enumeration and localization) and 73% (for lesion detection). Specificity was lower for plastered children for all approaches (P < 0.001). CONCLUSION: The AI solution demonstrates high performances for detecting elbow's fracture and/or joint effusion in children. However, in our context of use, 8% of the radiographic sets ruled-out by the algorithm concerned children with a genuine traumatic elbow lesion.

Hydrogen Evolution Reaction on Single-Atom Pt Doped in Ni Matrix under Strong Alkaline Condition.

Pt catalyst has been considered as the state-of-the-art catalyst for hydrogen evolution reaction (HER) under acid condition. However, its catalytic kinetics under alkaline conditions is not well-understood. Herein, we report a Ni-Pt(SAs) (SAs = single atoms) catalyst with Pt atomically dispersed in a Ni matrix, and it possesses an impressive HER performance with an overpotential as low as 210 mV at 500 mA cm-2 in strong alkaline electrolyte (7 M KOH), which is much higher than Pt nanoparticle-modified Ni catalyst (Ni-Pt(NPs)). Kinetics analysis reveals that Pt doping in the Ni matrix can accelerate the Volmer step on the Ni-Pt surface. Moreover, Ni-Pt(SAs) displays a more favorable kinetics for H2 formation reaction at high current density than Ni-Pt(NPs). Theoretical calculations reveal that atomically dispersed Pt weakens the adsorption of both H and OH on the surface of Ni-Pt electrode and promotes H2 formation from surface H on Ni-Pt(SAs).

The role of pendant amines in the breaking and forming of molecular hydrogen catalyzed by nickel complexes.

We present the results of a comprehensive theoretical investigation of the role of pendant amine ligands in the oxidation of H(2) and formation of H(2) by [Ni(P(R)(2)N(R')(2))(2)](2+) electrocatalysts (P(R)(2)N(R')(2) is the 1,5-R'-3,7-R derivative of 1,5-diaza-3,7-diphosphacyclooctane, in which R and R' are aryl or alkyl groups). We focus our analysis on the thermal steps of the catalytic cycle, as they are known to be rate-determining for both H(2) oxidation and production. We find that the presence of pendant amine functional groups greatly facilitates the heterolytic H(2) bond cleavage, resulting in a protonated amine and a Ni hydride. Only one single positioned pendant amine is required to serve this function. The pendant amine can also effectively shuttle protons to the active site, making the redistribution of protons and the H(2) evolution a very facile process. An important requirement for the overall catalytic process is the positioning of at least one amine in close proximity to the metal center. Indeed, only protonation of the pendant amines on the metal center side (endo position) leads to catalytically active intermediates, whereas protonation on the opposite side of the metal center (exo position) leads to a variety of isomers, which are detrimental to catalysis.

Insight from molecular modelling: does the polymer side chain length matter for transport properties of perfluorosulfonic acid membranes?

We present a detailed analysis of the nanostructure of the short side chain (SSC) perfluorosulfonic acid membrane and its effect on H(2)O clustering, H(3)O(+) and H(2)O diffusion, and mean residence times of H(2)O near SO(3)(-) groups based on molecular dynamics simulations. We studied a range of hydration levels (λ) at temperatures of 300 and 360 K, and compare the results to our findings in the benchmark Nafion® membrane. The water cluster diameter is nearly the same in the two membranes, while the extent of SO(3)(-) clustering is more in the SSC membrane. The calculated cluster diameter of about 2.4 nm is in excellent agreement with the recently proposed cylindrical water channel model of these membranes. The diffusion coefficients of H(2)O and H(3)O(+) are similar in SSC and Nafion membranes. Raising the temperature of the SSC membrane from 300 to 360 K provides a much bigger increase in proton vehicular diffusion coefficient (by a factor of about 4) than changing the side chain length. H(3)O(+) ions are found to exchange more frequently with SO(3)(-) partners at the higher temperature. Our key findings are that (a) the hydrophobic-hydrophilic separation in the two membranes is surprisingly similar; (b) at all hydration levels studied, the long side chain of Nafion is bent and is effectively equivalent to a short side chain in terms of extension into the water domain; (c) vehicular proton transport occurs mainly between SO(3)(-) groups; and (d) changing the size of the simulation cell does not change the results significantly. The simulations are validated in good agreement with the corresponding experimental values for the simulated membrane density and diffusion coefficients of H(2)O.

A comparative ab initio study of the primary hydration and proton dissociation of various imide and sulfonic acid ionomers.

We compare the role of neighboring group substitutions on proton dissociation of hydrated acidic moieties suitable for proton exchange membranes through electronic structure calculations. Three pairs of ionomers containing similar electron withdrawing groups within the pair were chosen for the study: two fully fluorinated sulfonyl imides (CF(3)SO(2)NHSO(2)CF(3) and CF(3)CF(2)SO(2)NHSO(2)CF(3)), two partially fluorinated sulfonyl imides (CH(3)SO(2)NHSO(2)CF(3) and C(6)H(5)SO(2)NHSO(2)CF(2)CF(3)), and two aromatic sulfonic acid based materials (CH(3)C(6)H(4)SO(3)H and CH(3)OC(6)H(3)OCH(3)C(6)H(4)SO(3)H). Fully optimized counterpoise (CP) corrected geometries were obtained for each ionomer fragment with the inclusion of water molecules at the B3LYP/6-311G** level of density functional theory. Spontaneous proton dissociation was observed upon addition of three water molecules in each system, and the transition to a solvent-separated ion pair occurred when four water molecules were introduced. No considerable quantitative or qualitative differences in proton dissociation, hydrogen bond networks formed, or water binding energies were found between systems containing similar electron withdrawing groups. Each of the sulfonyl imide ionomers exhibited qualitatively similar results regarding proton dissociation and separation. The fully fluorinated sulfonyl imides, however, showed a greater propensity to exist in dissociated and ion-pair separated states at low degrees of hydration than the partially fluorinated sulfonyl imides. This effect is due to the additional electron withdrawing groups providing charge stabilization as the dissociated proton migrates away from the imide anion.

External validation of a commercially available deep learning algorithm for fracture detection in children.

PURPOSE: The purpose of this study was to conduct an external validation of a fracture assessment deep learning algorithm (Rayvolve®) using digital radiographs from a real-life cohort of children presenting routinely to the emergency room. MATERIALS AND METHODS: This retrospective study was conducted on 2634 radiography sets (5865 images) from 2549 children (1459 boys, 1090 girls; mean age, 8.5 ± 4.5 [SD] years; age range: 0-17 years) referred by the pediatric emergency room for trauma. For each set was recorded whether one or more fractures were found, the number of fractures, and their location found by the senior radiologists and the algorithm. Using the senior radiologist diagnosis as the standard of reference, the diagnostic performance of deep learning algorithm (Rayvolve®) was calculated via three different approaches: a detection approach (presence/absence of a fracture as a binary variable), an enumeration approach (exact number of fractures detected) and a localization approach (focusing on whether the detected fractures were correctly localized). Subgroup analyses were performed according to the presence of a cast or not, age category (0-4 vs. 5-18 years) and anatomical region. RESULTS: Regarding detection approach, the deep learning algorithm yielded 95.7% sensitivity (95% CI: 94.0-96.9), 91.2% specificity (95% CI: 89.8-92.5) and 92.6% accuracy (95% CI: 91.5-93.6). Regarding enumeration and localization approaches, the deep learning algorithm yielded 94.1% sensitivity (95% CI: 92.1-95.6), 88.8% specificity (95% CI: 87.3-90.2) and 90.4% accuracy (95% CI: 89.2-91.5) for both approaches. Regarding age-related subgroup analyses, the deep learning algorithm yielded greater sensitivity and negative predictive value in the 5-18-years age group than in the 0-4-years age group for the detection approach (P < 0.001 and P = 0.002) and for the enumeration and localization approaches (P = 0.012 and P = 0.028). The high negative predictive value was robust, persisting in all of the subgroup analyses, except for patients with casts (P = 0.001 for the detection approach and P < 0.001 for the enumeration and localization approaches). CONCLUSION: The Rayvolve® deep learning algorithm is very reliable for detecting fractures in children, especially in those older than 4 years and without cast.

Cognitive performance in relapsing remitting multiple sclerosis: a longitudinal study in daily practice using a brief computerized cognitive battery.

BACKGROUND: There is need for a cognitive test battery that can be easily used in clinical practice to detect or monitor cognitive performance in patients with multiple sclerosis (MS). In order to conduct, in this patient group, a preliminary investigation of the validity and utility of a brief computerized battery, the Cognitive Drug Research (CDR) battery, we longitudinally assessed cognition in patients with relapsing remitting (RR) MS. METHODS: Forty-three mildly disabled, clinically active RRMS patients were repeatedly assessed with the Digit Symbol Substitution Test (DSST), Paced Auditory Serial Addition Test (PASAT) and five composite scores derived from the CDR computerized cognitive test system (CDR System): Power of Attention, Continuity of Attention, Quality of Working Memory, Quality of Episodic Memory and Speed of Memory. The Multiple Sclerosis Functional Composite (MSFC) and Expanded Disability Status Scale (EDSS) measured disability. RESULTS: The composite scores from the CDR battery generally showed excellent test-retest reliability over the repeated assessments, though was low on occasions for the Quality of Working Memory and Quality of Episodic Memory measures. The CDR measures tended to be highly correlated with other measures of cognition (DSST and PASAT) and were also strongly related to disability (EDSS and MSFC). Baseline scores indicated large impairments to visual information processing speed and attention (DSST, Cohen's d 1.1; Power of Attention d 1.4 [reaction time on tasks of focussed and sustained attention]), and a moderate impairment both to sustained attention (Continuity of Attention d 0.6) and complex information processing speed (Speed of memory d 0.7 [reaction time on tasks of working and episodic Memory]), when compared to normative data derived from healthy volunteers enrolled in a series of separate, prior clinical trials. Working memory (Quality of Working Memory) and episodic memory (Quality of Episodic Memory) were unimpaired. CONCLUSIONS: Preliminary validation of the CDR System indicated that for most, but not all measures psychometric properties were adequate and the measures were related to disability (EDSS and MSFC) and other measures of cognition.

About the barriers to reaction of CCl4 with HFeOH and FeCl2.

The reactions of zerovalent iron with water and carbon tetrachloride are of interest for environmental remediation of contaminated water and soil. Atom-dropping experiments have shown that the reactions of iron atoms with water and CCl(4) may produce HFeOH and FeCl(2), respectively, but these compounds are themselves unreactive toward CCl(4) at the low temperatures under which the atom-dropping experiments were performed. We report a modeling study of these reactions using density functional theory, ab initio Hartree-Fock and couple-cluster theory, and principles of Marcus-Hush theory to characterize the underlying intrinsic barriers and rationalize the experimental results. Electron-correlated CCSD(T) calculations (at B3LYP/TZVP optimized structures) show that the transition state for Cl atom transfer from CCl(4) to HFeOH arises from crossing of electronic states in which the configuration of Fe changes from a quintet high spin state in the Fe(II) reactant to a sextet high spin state in the Fe(III) products. The crossing point is 23.8 kcal/mol above a long-range precursor complex that is 2.1 kcal/mol more stable than the separated reactants. The electronic structure changes in these Cl atom transfer reactions involve unpairing of d electrons in Fe(II) and their recoupling with Cl-C σ bond electrons. These processes can be conveniently described by invoking the self-exchange reactions HFeOH/HFeClOH, FeCl(2)/FeCl(3), and CCl(4)/(•)CCl(3) for which we determined the energy barriers to be 15.5, 13.1, 18.6 kcal/mol, respectively. For the cross reaction FeCl(2)/CCl(4), we estimated a barrier of 16.6 kcal/mol relative to the separated reactants and 21.1 kcal/mol from the precursor complex. The magnitudes of the reaction barriers are consistent with reports of the absence of products in the atom-dropping experiments.

Comment on "New insights in the electrocatalytic proton reduction and hydrogen oxidation by bioinspired catalysts: a DFT investigation".

In the title paper, Vetere et al. reported a computational investigation of the mechanism of H(2) oxidation/proton reduction using a model of nickel-based electrocatalysts that incorporates pendant amines in cyclic phosphorus ligands. These catalysts are attracting considerable attention owing to their high turnover rates and relatively low overpotentials. These authors interpreted the results of their calculations as evidence for a symmetric bond cleavage of H(2) leading directly to two protonated amines in concert with a two-electron reduction of the Ni(II) site to form a Ni(0) diproton state. Proton reduction would involve a reverse symmetric bond formation. We report here an analysis that refutes the interpretation by these authors. We give, for the same model system, the structure of a heterolytic cleavage transition state consistent with the presence of the Ni(II) center acting as a Lewis acid and the pendant amines acting as Lewis bases. We present the associated intrinsic reaction coordinate (IRC) pathway connecting the dihydrogen (η(2)-H(2)) adduct and a hydride-proton state. We report also the transition state and associated IRC for the proton rearrangement from a hydride-proton state to a diproton state. Finally, we complete the characterization of the transition state reported by Vetere et al. through a determination of the corresponding IRC. In summary, H(2) oxidation/proton reduction with this class of catalysts involves a heterolytic bond breaking/formation.

Solid-state (55)Mn NMR spectroscopy of bis(µ-oxo)dimanganese(IV) [Mn(2)O(2)(salpn)(2)], a model for the oxygen evolving complex in photosystem II.

We have examined the antiferromagneticly coupled bis(µ-oxo)dimanganese(IV) complex [Mn(2)O(2)(salpn)(2)] (1) with (55)Mn solid-state NMR at cryogenic temperatures and first-principle theory. The extracted values of the (55)Mn quadrupole coupling constant, C(Q), and its asymmetry parameter, η(Q), for 1 are 24.7 MHz and 0.43, respectively. Further, there was a large anisotropic contribution to the shielding of each Mn(4+), i.e. a Δσ of 3375 ppm. Utilizing broken symmetry density functional theory, the predicted values of the electric field gradient (EFG) or equivalently the C(Q) and η(Q) at ZORA, PBE QZ4P all electron level of theory are 23.4 MHz and 0.68, respectively, in good agreement with experimental observations.

Disappearance of essential tremor after stroke.

Improvement of a patient's essential tremor (ET) after a stroke has rarely been reported. In such patients, cerebral imaging could help to identify structures involved in the maintenance of ET and improves the knowledge of its physiopathology. This article reports the disappearance of ET, after a stroke in 4 patients and reviews similar previously published cases. These cases suggest that the interruption of cerebellar loops during a stroke could be responsible for the disappearance of ET.