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Phase Behavior during Electrochemical Cycling of Ni-Rich Cathode Materials for Li-Ion Batteries
Although layered lithium nickel-rich oxides have become the state-of-the-art cathode materials for lithium-ion batteries in EV applications, they can suffer from rapid performance failure – particularly when operated under conditions of stress (temperature, high voltage), the underlying mechanisms of which are not fully understood. In this essay, we aim to connect the electrochemical performance with changes in structure during cycling. First, we compare the structural properties of LiNiO2, to the substituted Ni-rich compounds NMCs (LiNixMnyCo1-x-yO2) and NCAs (LiNixCoyAl1-x-yO2). Particular emphasis is placed on decoupling intrinsic behaviour and extrinsic “two-phases” reactions observed during initial cycles, as well as after extensive cycling for NMC and NCA cathodes. We highlight the need to revisit the various high-voltage structural change processes that occur in LiNiO2 with modern characterization tools to aid the understanding of the accelerated degradation for Ni- rich cathodes at high voltages
Findings of the International Subarachnoid Aneurysm Trial and the National Study of Subarachnoid Haemorrhage in context.
Concern has been expressed about the applicability of the findings of the International Subarachnoid Aneurysm Trial (ISAT) with respect to the relative effects on outcome of coiling and clipping. It has been suggested that the findings of the National Study of Subarachnoid Haemorrhage may have greater relevance for neurosurgical practice. The objective of this paper was to interpret the findings of these two studies in the context of differences in their study populations, design, execution and analysis. Because of differences in design and analysis, the findings of the two studies are not directly comparable. The ISAT analysed all randomized patients by intention-to-treat, including some who did not undergo a repair, and obtained the primary outcome for 99% of participants. The National Study only analysed participants who underwent clipping or coiling, according to the method of repair, and obtained the primary outcome for 91% of participants. Time to repair was also considered differently in the two studies. The comparison between coiling and clipping was susceptible to confounding in the National Study, but not in the ISAT. The two study populations differed to some extent, but inspection of these differences does not support the view that coiling was applied inappropriately in the National Study. Therefore, there are many reasons why the two studies estimated different sizes of effect. The possibility that there were real, systematic differences in practice between the ISAT and the National Study cannot be ruled out, but such explanations must be seen in the context of other explanations relating to chance, differences in design or analysis, or confounding
Interprofessional communication with hospitalist and consultant physicians in general internal medicine : a qualitative study
This study helps to improve our understanding of the collaborative environment in GIM, comparing the communication styles and strategies of hospitalist and consultant physicians, as well as the experiences of providers working with them. The implications of this research are globally important for understanding how to create opportunities for physicians and their colleagues to meaningfully and consistently participate in interprofessional communication which has been shown to improve patient, provider, and organizational outcomes
Representation of Women in Stroke Clinical Trials: A Review of 281 Trials Involving More Than 500,000 Participants
Background and ObjectivesWomen have been underrepresented in cardiovascular disease clinical trials but there is less certainty over the level of disparity specifically in stroke. We examined the participation of women in trials according to stroke prevalence in the population.MethodsPublished randomized controlled trials with ≥100 participants enrolled between 1990 and 2020 were identified from ClinicalTrials.gov. To quantify sex disparities in enrollment, we calculated the participation to prevalence ratio (PPR), defined as the percentage of women participating in a trial vs the prevalence of women in the disease population.ResultsThere were 281 stroke trials eligible for analyses with a total of 588,887 participants, of whom 37.4% were women. Overall, women were represented at a lower proportion relative to their prevalence in the underlying population (mean PPR 0.84; 95% confidence interval [CI] 0.81-0.87). The greatest differences were observed in trials of intracerebral hemorrhage (PPR 0.73; 95% CI 0.71-0.74), trials with a mean age of participants <70 years (PPR 0.81; 95% CI 0.78-0.84), nonacute interventions (PPR 0.80; 95% CI 0.76-0.84), and rehabilitation trials (PPR 0.77; 95% CI 0.71-0.83). These findings did not significantly change over the period from 1990 to 2020 (p for trend = 0.201).DiscussionWomen are disproportionately underrepresented in stroke trials relative to the burden of disease in the population. Clear guidance and effective implementation strategies are required to improve the inclusion of women and thus broader knowledge of the impact of interventions in clinical trials
How large should whales be?
The evolution and distribution of species body sizes for terrestrial mammals
is well-explained by a macroevolutionary tradeoff between short-term selective
advantages and long-term extinction risks from increased species body size,
unfolding above the 2g minimum size induced by thermoregulation in air. Here,
we consider whether this same tradeoff, formalized as a constrained
convection-reaction-diffusion system, can also explain the sizes of fully
aquatic mammals, which have not previously been considered. By replacing the
terrestrial minimum with a pelagic one, at roughly 7000g, the terrestrial
mammal tradeoff model accurately predicts, with no tunable parameters, the
observed body masses of all extant cetacean species, including the 175,000,000g
Blue Whale. This strong agreement between theory and data suggests that a
universal macroevolutionary tradeoff governs body size evolution for all
mammals, regardless of their habitat. The dramatic sizes of cetaceans can thus
be attributed mainly to the increased convective heat loss is water, which
shifts the species size distribution upward and pushes its right tail into
ranges inaccessible to terrestrial mammals. Under this macroevolutionary
tradeoff, the largest expected species occurs where the rate at which
smaller-bodied species move up into large-bodied niches approximately equals
the rate at which extinction removes them.Comment: 7 pages, 3 figures, 2 data table
The molecular and cellular basis of rhodopsin retinitis pigmentosa reveals potential strategies for therapy
Inherited mutations in the rod visual pigment, rhodopsin, cause the degenerative blinding condition, retinitis pigmentosa (RP). Over 150 different mutations in rhodopsin have been identified and, collectively, they are the most common cause of autosomal dominant RP (adRP). Mutations in rhodopsin are also associated with dominant congenital stationary night blindness (adCSNB) and, less frequently, recessive RP (arRP). Recessive RP is usually associated with loss of rhodopsin function, whereas the dominant conditions are a consequence of gain of function and/or dominant negative activity. The in-depth characterisation of many rhodopsin mutations has revealed that there are distinct consequences on the protein structure and function associated with different mutations. Here we categorise rhodopsin mutations into seven discrete classes; with defects ranging from misfolding and disruption of proteostasis, through mislocalisation and disrupted intracellular traffic to instability and altered function. Rhodopsin adRP offers a unique paradigm to understand how disturbances in photoreceptor homeostasis can lead to neuronal cell death. Furthermore, a wide range of therapies have been tested in rhodopsin RP, from gene therapy and gene editing to pharmacological interventions. The understanding of the disease mechanisms associated with rhodopsin RP and the development of targeted therapies offer the potential of treatment for this currently untreatable neurodegeneration
The Microanatomic Location of Metastatic Breast Cancer in Sentinel Lymph Nodes Predicts Nonsentinel Lymph Node Involvement
Background: The majority of sentinel node (SN) positive breast cancer patients do not have
additional non-SN involvement and may not benefit from axillary lymph node dissection
(ALND). Previous studies in melanoma have suggested that microanatomic localization of SN
metastases may predict non-SN involvement. The present study was designed to assess whether
these criteria might also be used to be more restrictive in selecting breast cancer patients
who would benefit from an ALND.
Methods: A consecutive series of 357 patients with invasive breast cancer and a tumorpositive
axillary SN, followed by an ALND, was reviewed. Microanatomic SN tumor features
(subcapsular, combined subcapsular and parenchymal, parenchymal, extensive localization,
multifocality, and the penetrative depth from the SN capsule) were evaluated for their predictive
value for non-SN involvement.
Results: Non-SN metastases were found in 136/357 cases (38%). Microanatomic location
and penetrative depth of SN metastases were significant predictors for non-SN involvement
(<0.001); limited penetrative depth was associated with a low frequency of non-SN
involvement with a minimal of 10%.
Conclusions: Microanatomic location and penetrative depth of breast cancer SN metastases
predict non-SN involvement. However, based on these features no subgroup of patients could
be selected with less than 10% non-SN involvement
Relations Among Anhedonia, Reinforcement Learning, and Global Functioning in Help-seeking Youth
Dysfunction in the neural circuits underlying salience signaling is implicated in symptoms of psychosis and may predict conversion to a psychotic disorder in youth at clinical high risk (CHR) for psychosis. Additionally, negative symptom severity, including consummatory and anticipatory aspects of anhedonia, may predict functional outcome in individuals with schizophrenia-spectrum disorders. However, it is unclear whether anhedonia is related to the ability to attribute incentive salience to stimuli (through reinforcement learning [RL]) and whether measures of anhedonia and RL predict functional outcome in a younger, help-seeking population. We administered the Salience Attribution Test (SAT) to 33 participants who met criteria for either CHR or a recent-onset psychotic disorder and 29 help-seeking youth with nonpsychotic disorders. In the SAT, participants must identify relevant and irrelevant stimulus dimensions and be sensitive to different reinforcement probabilities for the 2 levels of the relevant dimension ("adaptive salience"). Adaptive salience attribution was positively related to both consummatory pleasure and functioning in the full sample. Analyses also revealed an indirect effect of adaptive salience on the relation between consummatory pleasure and both role (αβ = .22, 95% CI = 0.02, 0.48) and social functioning (αβ = .14, 95% CI = 0.02, 0.30). These findings suggest a distinct pathway to poor global functioning in help-seeking youth, via impaired reward sensitivity and RL
Rescue of mutant rhodopsin traffic by metformin-induced AMPK activation accelerates photoreceptor degeneration
Protein misfolding caused by inherited mutations leads to loss of protein function and potentially toxic 'gain of function', such as the dominant P23H rhodopsin mutation that causes retinitis pigmentosa (RP). Here, we tested whether the AMPK activator metformin could affect the P23H rhodopsin synthesis and folding. In cell models, metformin treatment improved P23H rhodopsin folding and traffic. In animal models of P23H RP, metformin treatment successfully enhanced P23H traffic to the rod outer segment, but this led to reduced photoreceptor function and increased photoreceptor cell death. The metformin-rescued P23H rhodopsin was still intrinsically unstable and led to increased structural instability of the rod outer segments. These data suggest that improving the traffic of misfolding rhodopsin mutants is unlikely to be a practical therapy, because of their intrinsic instability and long half-life in the outer segment, but also highlights the potential of altering translation through AMPK to improve protein function in other protein misfolding diseases
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