MIL-88A Metal-Organic Framework as a Stable Sulfur-Host Cathode for Long-Cycle Li-S Batteries

Lithium-sulfur (Li-S) batteries have received enormous interest as a promising energy storage system to compete against limited, non-renewable, energy sources due to their high energy density, sustainability, and low cost. Among the main challenges of this technology, researchers are concentrating on reducing the well-known “shuttle effect” that generates the loss and corrosion of the active material during cycling. To tackle this issue, metal-organic frameworks (MOF) are considered excellent sulfur host materials to be part of the cathode in Li-S batteries, showing efficient confinement of undesirable polysulfides. In this study, MIL-88A, based on iron fumarate, was synthesised by a simple and fast ultrasonic-assisted probe method. Techniques such as X-ray diffraction (XRD), Raman spectroscopy, Thermogravimetric Analysis (TGA), Scanning Electron Microscopy (SEM), and N2 adsorption/desorption isotherms were used to characterise structural, morphological, and textural properties. The synthesis process led to MIL-88A particles with a central prismatic portion and pyramidal terminal portions, which exhibited a dual micro-mesoporous MOF system. The composite MIL-88A@S was prepared, by a typical melt-diffusion method at 155 °C, as a cathodic material for Li-S cells. MIL-88A@S electrodes were tested under several rates, exhibiting stable specific capacity values above 400 mAh g−1 at 0.1 C (1C = 1675 mA g−1). This polyhedral and porous MIL-88A was found to be an effective cathode material for long cycling in Li-S cells, retaining a reversible capacity above 300 mAh g−1 at 0.5 C for more than 1000 cycles, and exhibiting excellent coulombic efficiency

Una ictericia de causa avergonzante

We present the case of a 63-year-old man who went to the Emergency Department complaining of jaundice, choluria, and generalised pruritus for several days. He was admitted to the General Surgery department with the initial diagnosis of obstructive jaundice and incipient cholecystitis. After being ruled out, the patient was referred to Internal Medicine for further investigation. Test results were consistent with acute cholestatic hepatitis of probable toxic origin. Although he had initially denied taking medication or other products, he eventually confessed to taking sildenafil purchased over the Internet.Presentamos el caso de un varón de 63 años que acudió a Urgencias por un cuadro de ictericia, coluria y prurito generalizado de varios días de evolución. Con el diagnóstico inicial de ictericia obstructiva y colecistitis incipiente ingresó en el servicio de Cirugía General. Tras descartarse, el paciente pasó a cargo de Medicina Interna para continuar el estudio. Los resultados de las pruebas fueron consistentes con una hepatitis colestásica aguda de probable origen tóxico. A pesar de que inicialmente había negado la ingesta de medicamentos u otros productos, finalmente reconoció la ingesta de sildenafilo comprado a través de Internet

Healthcare failure mode and effects analysis and cost‑minimization analysis of three pharmaceutical services

Objetivo: El objetivo principal fue evaluar y comparar tres programas de entrega de medicamentos requeridos por los pacientes atendidos en las consultas externas de farmacia hospitalaria: mediante centros de salud, empresa de mensajería externa y oficinas de farmacia. El objetivo secundario fue analizar el coste económico desde la perspectiva del sistema público de salud. Método: Se utilizó el análisis modal de fallos y efectos para el objetivo principal. El análisis económico se realizó mediante un estudio de mini mización de costes. Resultados: Los resultados en índice de probabilidad de riesgo fueron 184 puntos para la entrega mediante centros de salud, 170 mediante mensajería y 126 mediante oficina de farmacia. El estudio económico mostró que actualmente el programa con menor coste económico fue la dispensación mediante oficina de farmacia respecto a mensajería y centros de salud (7.986,52 € versus 18.434,52 € y 11.417,08 €). Conclusiones: La entrega mediante oficina de farmacia tiene el menor índice de probabilidad de riesgo debido en gran parte al papel del farmacéutico en la custodia y conservación del medicamento. Respecto al estudio económico, también la dispensación mediante oficina de farmacia obtuvo el menor coste pero con una importante limitación: fue asignado un coste cero relativo a la empresa distribuidora y a la entrega del medicamento en las oficinas de farmacia por la colaboración altruista durante la pandemia. Si el coste fuese distinto de cero, serán necesarios nuevos estudios para evaluar el impacto económico el sistema público de salud. Objective: The main purpose of this study was to analyze and compare three different medication delivery methods used by the outpatient care unit of a hospital pharmacy, namely health center collection, community pharmacy collection and home delivery. The secondary purpose was to compare the economic cost of those methods for the Spanish health service. Method: A failure mode and effects analysis was carried out to attain the primary objective. For the secondary objective, an in-depth analysis was performed of the economic costs associated with each program using a cost-minimization analysis. Results: The failure mode and effects analysis resulted in scores of 184, 170 and 126 points for the health center collection, home delivery and community pharmacy collection programs, respectively. The eco nomic evaluation, for its part, rendered estimated costs of €18,434.52, €11,417.08 and €7,986.52 for home delivery, health center collection and community pharmacy collection services, respectively. Conclusions: The results of the study indicated that collection at the commu nity pharmacy was the program associated to the lowest risk, most likely due to the crucial role of the pharmacist regarding the custody and preservation of medicines. As regards cost, dispensation at the community pharmacy was also associated with the lowest cost. Nevertheless, this finding was biased by the fact that, given the generous collaboration of pharmaceutical distributors during the COVID-19 pandemic, the cost of transport and delivery to the pharmacy during the study period was zero. Further economic analyses are required to evaluate the costs of community pharmacy delivery and determine their impact on the public health system in cases where transport costs are different from zero

Results of Nurse Case Management in Primary Heath Care: Bibliographic Review

Background: The new characteristics of today’s population, together with the presence of chronic diseases in the elderly, require a new approach to care, promoting coordination between different levels of care. In this sense, we find the figure of the nurse case manager (NCM) in primary health care mainly responsible for ensuring continuity of care in complex patients with chronic diseases. Objective: to describe the role of the NCM in care management, determining its effectiveness in addressing chronic disease (health outcomes and quality of life) and its efficiency in the health system. Methods: Bibliographic review of scientific evidence on case management applied to nursing. Between March and April 2020 a bibliographic search was carried out in the Dialnet, Scielo, Scopus and Pubmed databases. Inclusion criteria: articles written in the last 5 years, which analyze how this nursing rol influences the care and health of patients. Results: A total of 16 articles were selected. The NCM reduced the use of the emergency department, hospital admissions, readmissions, and the duration of these in the patients studied. Conclusion: The NCM is effective and efficient for both patients and health institutions, and a common practice model is needed that includes standardized protocols and evidence-based practices

Genome of the Avirulent Human-Infective Trypanosome—Trypanosoma rangeli

Background: Trypanosoma rangeli is a hemoflagellate protozoan parasite infecting humans and other wild and domestic mammals across Central and South America. It does not cause human disease, but it can be mistaken for the etiologic agent of Chagas disease, Trypanosoma cruzi. We have sequenced the T. rangeli genome to provide new tools for elucidating the distinct and intriguing biology of this species and the key pathways related to interaction with its arthropod and mammalian hosts.  Methodology/Principal Findings: The T. rangeli haploid genome is ,24 Mb in length, and is the smallest and least repetitive trypanosomatid genome sequenced thus far. This parasite genome has shorter subtelomeric sequences compared to those of T. cruzi and T. brucei; displays intraspecific karyotype variability and lacks minichromosomes. Of the predicted 7,613 protein coding sequences, functional annotations could be determined for 2,415, while 5,043 are hypothetical proteins, some with evidence of protein expression. 7,101 genes (93%) are shared with other trypanosomatids that infect humans. An ortholog of the dcl2 gene involved in the T. brucei RNAi pathway was found in T. rangeli, but the RNAi machinery is non-functional since the other genes in this pathway are pseudogenized. T. rangeli is highly susceptible to oxidative stress, a phenotype that may be explained by a smaller number of anti-oxidant defense enzymes and heatshock proteins.  Conclusions/Significance: Phylogenetic comparison of nuclear and mitochondrial genes indicates that T. rangeli and T. cruzi are equidistant from T. brucei. In addition to revealing new aspects of trypanosome co-evolution within the vertebrate and invertebrate hosts, comparative genomic analysis with pathogenic trypanosomatids provides valuable new information that can be further explored with the aim of developing better diagnostic tools and/or therapeutic targets

Impact of the first wave of the SARS-CoV-2 pandemic on the outcome of neurosurgical patients: A nationwide study in Spain

Objective To assess the effect of the first wave of the SARS-CoV-2 pandemic on the outcome of neurosurgical patients in Spain. Settings The initial flood of COVID-19 patients overwhelmed an unprepared healthcare system. Different measures were taken to deal with this overburden. The effect of these measures on neurosurgical patients, as well as the effect of COVID-19 itself, has not been thoroughly studied. Participants This was a multicentre, nationwide, observational retrospective study of patients who underwent any neurosurgical operation from March to July 2020. Interventions An exploratory factorial analysis was performed to select the most relevant variables of the sample. Primary and secondary outcome measures Univariate and multivariate analyses were performed to identify independent predictors of mortality and postoperative SARS-CoV-2 infection. Results Sixteen hospitals registered 1677 operated patients. The overall mortality was 6.4%, and 2.9% (44 patients) suffered a perioperative SARS-CoV-2 infection. Of those infections, 24 were diagnosed postoperatively. Age (OR 1.05), perioperative SARS-CoV-2 infection (OR 4.7), community COVID-19 incidence (cases/10 5 people/week) (OR 1.006), postoperative neurological worsening (OR 5.9), postoperative need for airway support (OR 5.38), ASA grade =3 (OR 2.5) and preoperative GCS 3-8 (OR 2.82) were independently associated with mortality. For SARS-CoV-2 postoperative infection, screening swab test <72 hours preoperatively (OR 0.76), community COVID-19 incidence (cases/10 5 people/week) (OR 1.011), preoperative cognitive impairment (OR 2.784), postoperative sepsis (OR 3.807) and an absence of postoperative complications (OR 0.188) were independently associated. Conclusions Perioperative SARS-CoV-2 infection in neurosurgical patients was associated with an increase in mortality by almost fivefold. Community COVID-19 incidence (cases/10 5 people/week) was a statistically independent predictor of mortality. Trial registration number CEIM 20/217

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

Measurement of the top quark forward-backward production asymmetry and the anomalous chromoelectric and chromomagnetic moments in pp collisions at √s = 13 TeV

Abstract The parton-level top quark (t) forward-backward asymmetry and the anomalous chromoelectric (d̂ t) and chromomagnetic (μ̂ t) moments have been measured using LHC pp collisions at a center-of-mass energy of 13 TeV, collected in the CMS detector in a data sample corresponding to an integrated luminosity of 35.9 fb−1. The linearized variable AFB(1) is used to approximate the asymmetry. Candidate t t ¯ events decaying to a muon or electron and jets in final states with low and high Lorentz boosts are selected and reconstructed using a fit of the kinematic distributions of the decay products to those expected for t t ¯ final states. The values found for the parameters are AFB(1)=0.048−0.087+0.095(stat)−0.029+0.020(syst),μ̂t=−0.024−0.009+0.013(stat)−0.011+0.016(syst), and a limit is placed on the magnitude of | d̂ t| &lt; 0.03 at 95% confidence level. [Figure not available: see fulltext.