The Effect of Conductive Additive Morphology and Crystallinity on the Electrochemical Performance of Ni-Rich Cathodes for Sulfide All-Solid-State Lithium-Ion Batteries.

Sulfide electrolyte all-solid-state lithium-ion batteries (ASSLBs) that have inherently nonflammable properties have improved greatly over the past decade. However, determining both the stable and functional electrode components to pair with these solid electrolytes requires significant investigation. Solid electrolyte comprises 20-40% of the composite cathode electrode, which improves the ionic conductivity. However, this results in thick electrolyte that blocks the electron pathways in the electrode, significantly lowering the electrochemical performance. The application of conductive carbon material is required to overcome this issue, and, hence, determining the carbon properties that result in the most stable performance in the sulfide solid electrolyte is vital. This study analyzes the effect of the cathode conductive additive's morphology on the electrochemical performance of sulfide electrolyte-based ASSLBs. Carbon black (CB) and carbon nanotubes (CNTs), which provide electron pathways at the nanoscale and sub-micron scale, and carbon nanofiber (CNF), which provides electron pathways at the tens-of-microns scale, are all tested individually as potential conductive additives. When the CNF, with its high crystallinity, is used as a conductive material, the electrochemical performance shows an excellent initial discharge capacity of 191.78 mAh/g and a 50-cycle capacity retention of 83.9%. Conversely, the CB and the CNTs, with their shorter pathways and significantly increased surface area, show a relatively low electrochemical performance. By using the CNF to provide excellent electrical conductivity to the electrode, the polarization is suppressed. Furthermore, the interfacial impedance across the charge transfer region is also reduced over 50 cycles compared with the CB and CNT composite cells. These findings stringently analyze and emphasize the importance of the morphology of the carbon conductive additives in the ASSLB cathode electrodes, with improvements in the electrochemical performance being realized through the application of long-form two-dimensional crystalline CNFs.

Monkeypox vaccination in the global south: Fighting a war without a weapon.

Background: The Mpox outbreak awakened countries worldwide to renew efforts in epidemiological surveillance and vaccination of susceptible populations. In terms of Mpox vaccination, various challenges exist in the global south, which impede adequate vaccine coverage, especially in Africa. This paper reviewed the situation of Mpox vaccination in the global south and potential ameliorative approaches. Methods: A review of online literature from PubMed and Google Scholar concerning Mpox vaccination in countries belonging to the 'global south' category was done between August and September, 2022. The major focus areas included inequity in global vaccine distribution, challenges impeding vaccine coverage in the global south, and potential strategies for bridging the gap in vaccine equity. The papers that met the inclusion criteria were collated and narratively discussed. Results: Our analysis revealed that, while the high-income countries secured large supplies of the Mpox vaccines, the low- and middle-income countries were unable to independently access substantial quantities of the vaccine and had to rely on vaccine donations from high-income countries, as was the case during the COVID-19 pandemic. The challenges in the global south particularly revolved around inadequate vaccine production capacity due to lack of qualified personnel and specialized infrastructure for full vaccine development and manufacturing, limited cold chain equipment for vaccine distribution, and consistent vaccine hesitancy. Conclusion: To tackle the trend of vaccine inequity in the global south, African governments and international stakeholders must invest properly in adequate production and dissemination of Mpox vaccines in low- and middle-income countries.

Air- and Moisture Robust Surface Modification for Ni-Rich Layered Cathode Materials for Li-Ion Batteries.

The mainstream of high-energy cathode development is focused on increasing the Ni-ratio in layered structured cathode materials. The increment of the Ni portion in the layered cathode material escalates not only the deliverable capacity but also the structural degradation. High-Ni layered cathodes are highly vulnerable to exposure to air that contains CO2 and H2 O, forming problematic residual lithium compounds at the surface. In this work, a novel air- and moisture robust surface modification is reported for LiNi0.8 Co0.1 Mn0.1 O2 (NCM811) via the sol-gel coating method that selectively coats the internal surface area of the polycrystalline morphology secondary particles. Bare-, Li2 SnO3 -coated and LiCoO2 -coated NCM811 are exposed to different ambient environments (air, hot-air, and moisture-air) to systematically investigate the correlation between the internal/external coating morphology and performance degradations. The LiCoO2 -coated NCM811s exhibit high-capacity retention after exposure to all environments, due to the internal surface coating that prevents the penetration of harmful compounds into the polycrystalline NCM811. On the other hand, the Li2 SnO3 -coated NCM811s exposed to the ambient environments show gradual capacity fading, implying the occurrence of internal degradation. This paper highlights the impact of the internal degradation of polycrystalline NCM811 after environmental exposure and the correct coating mechanisms required to successfully prevent it.

Analysis of Electrochemical Performance with Dispersion Degree of CNTs in Electrode According to Ultrasonication Process and Slurry Viscosity for Lithium-Ion Battery.

Lithium-ion batteries (LIBs) continue to dominate the battery market with their efficient energy storage abilities and their ongoing development. However, at high charge/discharge C-rates their electrochemical performance decreases significantly. To improve the power density properties of LIBs, it is important to form a uniform electron transfer network in the cathode electrode via the addition of conductive additives. Carbon nanotubes (CNTs) with high crystallinity, high electrical conductivity, and high aspect ratio properties have gathered significant interest as cathode electrode conductive additives. However, due to the high aggregational properties of CNTs, it is difficult to form a uniform network for electron transfer within the electrode. In this study, to help fabricate electrodes with well-dispersed CNTs, various electrodes were prepared by controlling (i) the mixing order of the conductive material, binder, and active material, and (ii) the sonication process of the CNTs/NMP solution before the electrode slurry preparation. When the binder was mixed with a well sonicated CNTs/NMP solution, the CNTs uniformly adsorbed to the then added cathode material of LiNi0.6Co0.2Mn0.2O2 and were well-dispersed to form a flowing uniform network. This electrode fabrication process achieved > 98.74% capacity retention after 50 cycles at 5C via suppressed polarization at high current densities and a more reversible H1-M phase transition of the active material. Our study presents a novel design benchmark for the fabricating of electrodes applying well-dispersed CNTs, which can facilitate the application of LIBs in high current density applications.

Development of High-Energy Anodes for All-Solid-State Lithium Batteries Based on Sulfide Electrolytes.

All-solid-state Li batteries (ASSBs) promise better performance and higher safety than the current liquid-based Li-ion batteries (LIBs). Sulfide ASSBs have been extensively studied and considerably advanced in recent decades. Research on identifying suitable cathode materials for sulfide ASSBs is currently well established, with great progress being made in the commercialization of layered cathodes in the liquid-based LIBs. Research on anode materials for sulfide ASSBs is of great importance for enhancing the battery energy density. However, it seems that little has been published that summarizes studies of anode materials for sulfide ASSBs and suggests future research directions. Thus, within this Minireview, we aim to provide an overview of previous and current research focused on anode materials for sulfide ASSBs and to suggest a future research direction for developing suitable anode systems for sulfide ASSBs.

Transcriptome Profiling of Osteoblasts in a Medaka (Oryzias latipes) Osteoporosis Model Identifies Mmp13b as Crucial for Osteoclast Activation.

Matrix metalloproteases (MMPs) play crucial roles in extracellular matrix (ECM) modulation during osteoclast-driven bone remodeling. In the present study, we used transcriptome profiling of bone cells in a medaka model for osteoporosis and bone regeneration to identify factors critical for bone remodeling and homeostasis. This identified mmp13b, which was strongly expressed in osteoblast progenitors and upregulated under osteoporotic conditions and during regeneration of bony fin rays. To characterize the role of mmp13b in bone remodeling, we generated medaka mmp13b mutants by CRISPR/Cas9. We found that mmp13b mutants form normal numbers of osteoblasts and osteoclasts. However, osteoclast activity was severely impaired under osteoporotic conditions. In mmp13b mutants and embryos treated with the MMP13 inhibitor CL-82198, unmineralized collagens and mineralized bone matrix failed to be degraded. In addition, the dynamic migratory behavior of activated osteoclasts was severely affected in mmp13b mutants. Expression analysis showed that maturation genes were downregulated in mmp13b deficient osteoclasts suggesting that they remain in an immature and non-activated state. We also found that fin regeneration was delayed in mmp13b mutants with a concomitant alteration of the ECM and reduced numbers of osteoblast progenitors in regenerating joint regions. Together, our findings suggest that osteoblast-derived Mmp13b alters the bone ECM to allow the maturation and activation of osteoclasts during bone remodeling in a paracrine manner. Mmp13b-induced ECM alterations are also required to facilitate osteoblast progenitor recruitment and full regeneration of bony fin rays.

Colorimetric and fluorescent TRAP assays for visualising and quantifying fish osteoclast activity.

Histochemical detection of tartrate-resistant acid phosphatase (TRAP) activity is a fundamental technique for visualizing osteoclastic bone resorption and assessing osteoclast activity status in tissues. This approach has mostly employed colorimetric detection, which has limited quantification of activity in situ and co-labelling with other skeletal markers. Here we report simple colorimetric and fluorescent TRAP assays in zebrafish and medaka, two important model organisms for investigating the pathogenesis of bone disorders. We show fluorescent TRAP staining, utilising the ELF97 substrate, is a rapid, robust and stable system to visualise and quantify osteoclast activity in zebrafish, and is compatible with other fluorescence stains, transgenic lines and antibody approaches. Using this approach, we show that TRAP activity is predominantly found around the base of the zebrafish pharyngeal teeth, where osteoclast activity state appears to be heterogeneous.

Association of baseline hematoma and edema volumes with one-year outcome and long-term survival after spontaneous intracerebral hemorrhage: A community-based inception cohort study.

BACKGROUND: Hospital-based studies have reported variable associations between outcome after spontaneous intracerebral hemorrhage and peri-hematomal edema volume. AIMS: In a community-based study, we aimed to investigate the existence, strength, direction, and independence of associations between intracerebral hemorrhage and peri-hematomal edema volumes on diagnostic brain CT and one-year functional outcome and long-term survival. METHODS: We identified all adults, resident in Lothian, diagnosed with first-ever, symptomatic spontaneous intracerebral hemorrhage between June 2010 and May 2013 in a community-based, prospective inception cohort study. We defined regions of interest manually and used a semi-automated approach to measure intracerebral hemorrhage volume, peri-hematomal edema volume, and the sum of these measurements (total lesion volume) on first diagnostic brain CT performed at ≤3 days after symptom onset. The primary outcome was death or dependence (scores 3-6 on the modified Rankin Scale) at one-year after intracerebral hemorrhage. RESULTS: Two hundred ninety-two (85%) of 342 patients (median age 77.5 y, IQR 68-83, 186 (54%) female, median time from onset to CT 6.5 h (IQR 2.9-21.7)) were dead or dependent one year after intracerebral hemorrhage. Peri-hematomal edema and intracerebral hemorrhage volumes were colinear (R2 = 0.77). In models using both intracerebral hemorrhage and peri-hematomal edema, 10 mL increments in intracerebral hemorrhage (adjusted odds ratio (aOR) 1.72 (95% CI 1.08-2.87); p = 0.029) but not peri-hematomal edema volume (aOR 0.92 (0.63-1.45); p = 0.69) were independently associated with one-year death or dependence. 10 mL increments in total lesion volume were independently associated with one-year death or dependence (aOR 1.24 (1.11-1.42); p = 0.0004). CONCLUSION: Total volume of intracerebral hemorrhage and peri-hematomal edema, and intracerebral hemorrhage volume alone on diagnostic brain CT, undertaken at three days or sooner, are independently associated with death or dependence one-year after intracerebral hemorrhage, but peri-hematomal edema volume is not. DATA ACCESS STATEMENT: Anonymized summary data may be requested from the corresponding author.

Infection Control in Dental Anesthesiology: A Time for Preliminary Reconsideration of Current Practices.

Relegated to clinical afterthought, the topic of infection control has never taken center stage in our modern dental sedation and anesthesiology practices. Surgical and procedural masks, gloves, gowns, protective eyewear, and appropriate surgical attire have remained de rigueur in both fashion and custom for decades. However, the emergence of certain seminal events throughout health care history has driven mandated changes when practitioners, staff, patients, and the surrounding communities were exposed or put at risk of exposure to infectious disease. Hepatitis, human immunodeficiency virus, and now the global COVID-19 pandemic involving the novel coronavirus SARS-CoV-2, have forced us into rethinking our current practices. This review article will contextualize previous epidemics and their influence on infection control in dental settings, and it will explore the rapid evolution of current modifications to personal protective equipment and infection mitigation practices specific to sedation and anesthesia in dentistry.

TIRADS Management Guidelines in the Investigation of Thyroid Nodules; Illustrating the Concerns, Costs, and Performance.

CONTEXT: Ultrasound (US) risk-stratification systems for investigation of thyroid nodules may not be as useful as anticipated. OBJECTIVE: We aimed to assess the performance and costs of the American College of Radiology Thyroid Image Reporting And Data System (ACR-TIRADS). DESIGN SETTINGS AND PARTICIPANTS: We examined the data set upon which ACR-TIRADS was developed, and applied TR1 or TR2 as a rule-out test, TR5 as a rule-in test, or applied ACR-TIRADS across all nodule categories. We assessed a hypothetical clinical comparator where 1 in 10 nodules are randomly selected for fine needle aspiration (FNA), assuming a pretest probability of clinically important thyroid cancer of 5%. RESULTS: The gender bias (92% female) and cancer prevalence (10%) of the data set suggests it may not accurately reflect the intended test population. Applying ACR-TIRADS across all nodule categories did not perform well, with sensitivity and specificity between 60% and 80% and overall accuracy worse than random selection (65% vs 85%). Test performance in the TR3 and TR4 categories had an accuracy of less than 60%. Using TR5 as a rule-in test was similar to random selection (specificity 89% vs 90%). Using TR1 and TR2 as a rule-out test had excellent sensitivity (97%), but for every additional person that ACR-TIRADS correctly reassures, this requires >100 ultrasound scans, resulting in 6 unnecessary operations and significant financial cost. CONCLUSIONS: Perhaps surprisingly, the performance ACR-TIRADS may often be no better than random selection. The management guidelines may be difficult to justify from a cost/benefit perspective. A prospective validation study that determines the true performance of TIRADS in the real-world is needed.

Comparing the Efficacy of a Compound Topical Anesthetic Versus Benzocaine: A Pilot Study.

To compare the effectiveness of a combination of 10% lidocaine, 10% prilocaine, and 4% tetracaine versus 20% benzocaine for use as a topical anesthetic agent prior to dental injections. A double-blind randomized prospective clinical trial was conducted with 26 participants receiving a topical anesthetic of 20% benzocaine (control) and 26 participants receiving a compound topical anesthetic mixture of 10% lidocaine, 10% prilocaine, and 4% tetracaine (experimental) prior to a maxillary infiltration injection. The procedure was conducted by 1 operator with the Wand® injection system. Pain was assessed directly with visual analog scale (VAS) scores and indirectly by measuring changes in heart rate at 4 different time points. Complications associated with the application of the topical anesthetics were also assessed. The experimental group had a significantly higher mean VAS score of 19.5 ± 19.7 mm versus 14.2 ± 14.6 mm for the control group (p < .001). No significant differences in heart rate at any of the 4 measured time points compared with baseline were noted for either group. The experimental group had a significantly higher incidence of complications, including tissue sloughing, when compared with the control group (p < .001). Participants in the control group reported significantly lower VAS scores than those in the experimental group. Both types of topical anesthetic showed similar impacts on alterations to heart rate. No benefits were seen with the use of 10% lidocaine, 10% prilocaine, and 4% tetracaine as a topical anesthetic prior to a maxillary infiltration of local anesthetic when compared with 20% benzocaine.

Advancing the Safe Delivery of Office-Based Dental Anesthesia and Sedation: A Comprehensive and Critical Compendium.

The provision for and administration of dental office-based sedation and anesthesia requires considerations and preparations that are unique to dentistry and unlike that of any other office-based and nonoperating room procedures. Anesthesia providers who have only performed dental cases in an operating room are often unaware of the idiosyncrasies and risks associated with performing sedation and anesthesia in the dental office. This article explores the demographics, patient characteristics, morbidity, mortality, and clinical concerns with an in-depth discussion of the dental operating environment. The content is integrated with the current medical and dental guidelines for office-based anesthesia.

Pitch Characteristics Before Ulnar Collateral Ligament Reconstruction in Major League Pitchers Compared With Age-Matched Controls.

BACKGROUND: Ulnar collateral ligament reconstruction (UCLR) is commonly performed in Major League Baseball (MLB) pitchers, but little is known about the preoperative pitch type and velocity characteristics of pitchers who go on to undergo UCLR. HYPOTHESIS: Pitchers who required UCLR have thrown a greater percentage of fastballs and have greater pitch velocities compared with age-matched controls in the season before injury. STUDY DESIGN: Case-control study; Level of evidence, 3. METHODS: MLB pitchers active during the 2002 to 2015 seasons were included. The UCLR group consisted of MLB pitchers who received UCLR between 2003 and 2015, utilizing the season before surgery (2002-2014) for analysis. The control group comprised age-matched controls of the same season. Players who pitched less than 20 innings in the season before surgery were excluded. Pitch types were recorded as percentage of total pitches thrown. Pitch velocities were recorded for each pitch type. Pitch type and pitch velocities during preoperative seasons for UCLR pitchers were compared with age-matched controls using univariate and multivariate models. RESULTS: A total of 114 cases that went on to UCLR and 3780 controls were included in the study. Pitchers who went on to UCLR appear to have greater fastball, slider, curveball, changeup, and split-fingered fastball velocities; there were no significant differences in pitch selection between the 2 groups. CONCLUSION: In the season before surgery, MLB pitchers who underwent UCLR demonstrated greater fastball, slider, curveball, changeup, and split-fingered fastball velocities, with no significant difference in pitch type.

Management of Patients With Cardiovascular Implantable Electronic Devices in Dental, Oral, and Maxillofacial Surgery.

The prevalence of cardiovascular implantable electronic devices as life-prolonging and life-saving devices has evolved from a treatment of last resort to a first-line therapy for an increasing number of patients. As these devices become more and more popular in the general population, dental providers utilizing instruments and medications should be aware of dental equipment and medications that may affect these devices and understand the management of patients with these devices. This review article will discuss the various types and indications for pacemakers and implantable cardioverter-defibrillators, common drugs and instruments affecting these devices, and management of patients with these devices implanted for cardiac dysrhythmias.

Potent Inhalational Anesthetics for Dentistry.

Nitrous oxide and the volatile inhalational anesthetics have defined anxiety and pain control in both dentistry and medicine for over a century. From curious experimentation to spectacular public demonstrations, the initial work of 2 dentists, Horace Wells and William T. G. Morton, persists to this day in modern surgery and anesthesia. This article reviews the history, similarities, differences, and clinical applications of the most popular inhalational agents used in contemporary dental surgical settings.

Novel finding of optic nerve central T2 hypointensity utilizing 3 Tesla MR imaging.

We sought to report a central T2 hypointensity within the optic nerve on 3 T MRI studies obtained as part of the NASA Flight Medicine Visual Impairment Intracranial Pressure Protocol that had not been described previously. Twenty-one astronauts, who had undergone MRI of both orbits with direct coronal T2 sequences between 2010 and 2012, were retrospectively included. Two of the astronauts did not have previous exposure to microgravity at the time of their scans. A central T2 hypointensity was observed in 100% of both right and left eyes. It was completely visualized throughout the nerve course in 15 right eyes (71.4%) and in 19 left eyes (90.5%).We describe a new finding seen in all study participants: a central T2 hypointensity in the epicenter of the optic nerve. We speculate that this T2 hypointensity may represent flow voids caused by the central retinal vessels.

Degenerative meniscus: Pathogenesis, diagnosis, and treatment options.

The symptomatic degenerative meniscus continues to be a source of discomfort for a significant number of patients. With vascular penetration of less than one-third of the adult meniscus, healing potential in the setting of chronic degeneration remains low. Continued hoop and shear stresses upon the degenerative meniscus results in gross failure, often in the form of complex tears in the posterior horn and midbody. Patient history and physical examination are critical to determine the true source of pain, particularly with the significant incidence of simultaneous articular pathology. Joint line tenderness, a positive McMurray test, and mechanical catching or locking can be highly suggestive of a meniscal source of knee pain and dysfunction. Radiographs and magnetic resonance imaging are frequently utilized to examine for osteoarthritis and to verify the presence of meniscal tears, in addition to ruling out other sources of pain. Non-operative therapy focused on non-steroidal anti-inflammatory drugs and physical therapy may be able to provide pain relief as well as improve mechanical function of the knee joint. For patients refractory to conservative therapy, arthroscopic partial meniscectomy can provide short-term gains regarding pain relief, especially when combined with an effective, regular physiotherapy program. Patients with clear mechanical symptoms and meniscal pathology may benefit from arthroscopic partial meniscectomy, but surgery is not a guaranteed success, especially with concomitant articular pathology. Ultimately, the long-term outcomes of either treatment arm provide similar results for most patients. Further study is needed regarding the short and long-term outcomes regarding conservative and surgical therapy, with a particular focus on the economic impact of treatment as well.

Anatomical considerations of the suprascapular nerve in rotator cuff repairs.

Introduction. When using the double interval slide technique for arthroscopic repair of chronic large or massive rotator cuff tears, the posterior interval release is directed toward the scapular spine until the fat pad that protects the suprascapular nerve is reached. Injury to the suprascapular nerve can occur due to the nerve's proximity to the operative field. This study aimed to identify safe margins for avoiding injury to the suprascapular nerve. Materials and Methods. For 20 shoulders in ten cadavers, the distance was measured from the suprascapular notch to the glenoid rim, the articular margin of the rotator cuff footprint, and the lateral border of the acromion. Results. From the suprascapular notch, the suprascapular nerve coursed an average of 3.42 cm to the glenoid rim, 5.34 cm to the articular margin of the rotator cuff footprint, and 6.09 cm to the lateral border of the acromion. Conclusions. The results of this study define a safe zone, using anatomic landmarks, to help surgeons avoid iatrogenic injury to the suprascapular nerve when employing the double interval slide technique in arthroscopic repair of the rotator cuff.

Subacute superior patellar pole sleeve fracture.

Patellar fractures are uncommon, representing 1% of pediatric fractures. Most of these injuries are sleeve avulsions of the inferior pole. Sleeve avulsion of the superior pole is rare, with only 14 cases reported in the English-language literature. These injuries occur in adolescents after forced knee flexion or direct anterior blow. Radiographs may reveal patella baja, anterior tilt, and suprapatellar calcifications. Ultrasound and magnetic resonance imaging (MRI) can confirm the diagnosis. We present a subacute superior pole sleeve fracture in a 15-year-old boy who sustained a left knee injury. Initial radiographs were negative. Ten days later, the patient returned with hemarthrosis and suprapatellar calcification. MRIs were read as "distal quadriceps tendon tear." Twenty-three days after the injury, the patient presented with a limp, palpable quadriceps tendon gap, and inability to maintain a straight leg raise. A superior pole sleeve fracture was repaired surgically the following day. An understanding of the injury demographics and radiological findings associated with superior pole sleeve fractures can prevent missed diagnosis of a rare injury. We review the literature for injury demographics, operative and nonoperative treatment methods, and outcomes.