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The absolute vapor pressures for the series of [Cnmim][BF4] ionic liquids with (n = 2, 4, 6, 8, and 10) were measured over the temperature range 404–457 K by using the quartz-crystal microbalance. An absence of possible thermal decomposition was monitored by the ATR-IR spectroscopy. The molar enthalpies of vaporization of ionic liquids under study were derived from vapor pressure temperature dependences and adjusted to the reference temperature 298.15 K. The liquid phase molar enthalpy of formation of [C2mim][BF4] was derived from the solution calorimetry and combined with its molar vaporization enthalpy to get the first experimental gas-phase molar enthalpy of formation of the [BF4]− containing ionic liquid. A computational approach based on the DLPNO-CCSD(T) method was used to calculate the theoretical gas-phase molar enthalpy of formation of [C2mim][BF4]. The theoretical and experimental results were found to be in agreement within the combined uncertainties, providing the mutual validation of experimental and computational procedures used in the current study.

In this work supported ionic liquid membranes (SILMs) were developed via physical imbibition of 1-alkyl-3-methylimidazolium-based ionic liquids incorporating either the tricyanomethanide ([TCM]−) or the trifluoromethanesulfonate ([TfO]−) anion, into tubular composite ceramic substrates bearing a mesoporous separation layer. The developed SILMs were evaluated with respect to their efficiency for removal of CO2 and SO2 gases from mixtures simulating dry flue gas. In this context, the effect of temperature, feed composition and trans-membrane pressure gradient on CO2/N2 and SO2/CO2 separation performance was studied. For all SILMs, the highest CO2/N2 selectivity values (up to 47.6) were exhibited at ambient temperature unlike to CO2 permeance that was favored by elevation of temperature. The SO2 permeances varied over the range of 3–9.6·10−8 mol m2 s−1 Pa−1 being much higher than those determined for CO2 at comparable conditions whereas the permeances of the two gases exhibited opposite temperature dependence. The SO2/CO2 selectivity reached up to 30.7 even though it was markedly reduced with rising temperature and applied pressure gradient, in qualitative accordance to the behavior of CO2/N2 selectivity. Besides physical interaction, the embedded ionic liquid incorporating [TfO]− anions showed also weak chemical interaction with absorbed SO2, the contribution of the which resulted in enhanced SO2 permeation rates as compared to the ones through the embedded tricyanomethanide-based ionic liquids.

On the evening of June 23, 2016, a white powder advertised as cocaine was purchased off the streets from multiple sources and used by an unknown number of persons in New Haven, Connecticut. During a period of less than 8 hours, 12 patients were brought to the emergency department (ED) at Yale New Haven Hospital, experiencing signs and symptoms consistent with opioid overdose. The route of intoxication was not known, but presumed to be insufflation ("snorting") in most cases. Some patients required doses of the opioid antidote naloxone exceeding 4 mg (usual initial dose = 0.1-0.2 mg intravenously), and several patients who were alert after receiving naloxone subsequently developed respiratory failure. Nine patients were admitted to the hospital, including four to the intensive care unit (ICU); three required endotracheal intubation, and one required continuous naloxone infusion. Three patients died. The white powder was determined to be fentanyl, a drug 50 times more potent than heroin, and it included trace amounts of cocaine. The episode triggered rapid notification of public health and law enforcement agencies, interviews of patients and their family members to trace and limit further use or distribution of the fentanyl, immediate naloxone resupply and augmentation for emergency medical services (EMS) crews, public health alerts, and plans to accelerate naloxone distribution to opioid users and their friends and families. Effective communication and timely, coordinated, collaborative actions of community partners reduced the harm caused by this event and prevented potential subsequent episodes.

In this study, we report on the effects of three common transition metal ions, i.e., Ni2+, Cu2+ and Fe3+ on the electrodeposition of aluminum from a chloroaluminate ionic liquid, evaluated by means of electrochemical and morphological investigation. Aiming at the determination of the morphological and chemical effects on the aluminum coatings, variable amounts of ions were introduced into the electroplating bath. Thick (about 20 ?m) Al coatings were obtained by direct deposition (galvanostatic, 10 mA cm2, 2 h) on brass or carbon steel substrates (10 mm diameter disks), and their morphology was examined via rugosimetry, optical and electron microscopy. The chemical composition of the deposits was provided by EDX analysis. Nickel and iron resulted to have only moderate effects on the coatings properties, but copper affected the process even in tiny amounts being detected in the deposits for bath content as low as 10 ppm.

While the adoption of next generation sequencing has rapidly expanded, the informatics infrastructure used to manage the data generated by this technology has not kept pace. Historically, relational databases have provided much of the framework for data storage and retrieval. Newer technologies based on NoSQL architectures may provide significant advantages in storage and query efficiency, thereby reducing the cost of data management. But their relative advantage when applied to biomedical data sets, such as genetic data, has not been characterized. To this end, we compared the storage, indexing, and query efficiency of a common relational database (MySQL), a document-oriented NoSQL database (MongoDB), and a relational database with NoSQL support (PostgreSQL). When used to store genomic annotations from the dbSNP database, we found the NoSQL architectures to outperform traditional, relational models for speed of data storage, indexing, and query retrieval in nearly every operation. These findings strongly support the use of novel database technologies to improve the efficiency of data management within the biological sciences.

The use of some nucleic acid amplification tests (NAATs) for the diagnosis of group A Streptococcus (GAS) pharyngitis allows laboratories to adopt single-tiered testing without reflex culture. However, centralization may delay the delivery of actionable information to the bedside, particularly in the outpatient setting. We describe two novel workflows at our institution and their effect on in-lab turnaround time (TAT) at a tertiary care microbiology lab. Laboratory records were extracted, and relevant data were analyzed after the implementation of qualitative in vitro diagnostic testing for GAS with the Xpert Xpress Strep A assay, performed using the GeneXpert Infinity-48s. Workflow optimization steps studied included: (i) direct specimen submission to the microbiology laboratory via the pneumatic tube system and (ii) autoverification of GAS NAAT results in the laboratory information system. Between April 2018 and October 2018, 2,595 unique specimens were tested for GAS by PCR. Of these, 2,523 were included in the final analysis. Linear regression established that the total in-lab TAT was significantly reduced by direct specimen submission to the microbiology laboratory, autoverification, and processing during the night shift. We describe two workflow optimization methods that reduced the in-lab TAT for GAS NAAT. Although microbiology labs historically use manual processes, the advent of total laboratory automation and the adoption of on-demand NAATs will allow for more streamlined processing of microbiology specimens. It may be beneficial to consider instrument interfacing and specimen processing optimization during the early phases of implementation planning for NAATs in the microbiology laboratory.

The use of some nucleic acid amplification tests (NAATs) for the diagnosis of group A Streptococcus (GAS) pharyngitis allows laboratories to adopt single-tiered testing without reflex culture. However, centralization may delay the delivery of actionable information to the bedside, particularly in the outpatient setting. We describe two novel workflows at our institution and their effect on in-lab turnaround time (TAT) at a tertiary care microbiology lab. Laboratory records were extracted, and relevant data were analyzed after the implementation of qualitative in vitro diagnostic testing for GAS with the Xpert Xpress Strep A assay, performed using the GeneXpert Infinity-48s. Workflow optimization steps studied included: (i) direct specimen submission to the microbiology laboratory via the pneumatic tube system and (ii) autoverification of GAS NAAT results in the laboratory information system. Between April 2018 and October 2018, 2,595 unique specimens were tested for GAS by PCR. Of these, 2,523 were included in the final analysis. Linear regression established that the total in-lab TAT was significantly reduced by direct specimen submission to the microbiology laboratory, autoverification, and processing during the night shift. We describe two workflow optimization methods that reduced the in-lab TAT for GAS NAAT. Although microbiology labs historically use manual processes, the advent of total laboratory automation and the adoption of on-demand NAATs will allow for more streamlined processing of microbiology specimens. It may be beneficial to consider instrument interfacing and specimen processing optimization during the early phases of implementation planning for NAATs in the microbiology laboratory.

EgeUn###, Marie Sktodowska-Curie Individual Fellowship [H2020-MSCA-IF] [658170]; Welcome Trust Institutional Fund (ISSF3); Breast Cancer Now, This work was supported by Marie Sktodowska-Curie Individual Fellowship [H2020-MSCA-IF, 658170] and Welcome Trust Institutional Fund (ISSF3) to CS and AHS, Breast Cancer Now to AHS.

Background: Health care data are increasing in volume and complexity. Storing and analyzing these data to implement precision medicine initiatives and data-driven research has exceeded the capabilities of traditional computer systems. Modern big data platforms must be adapted to the specific demands of health care and designed for scalability and growth. Objective: The objectives of our study were to (1) demonstrate the implementation of a data science platform built on open source technology within a large, academic health care system and (2) describe 2 computational health care applications built on such a platform. Methods: We deployed a data science platform based on several open source technologies to support real-time, big data workloads. We developed data-acquisition workflows for Apache Storm and NiFi in Java and Python to capture patient monitoring and laboratory data for downstream analytics. Results: Emerging data management approaches, along with open source technologies such as Hadoop, can be used to create integrated data lakes to store large, real-time datasets. This infrastructure also provides a robust analytics platform where health care and biomedical research data can be analyzed in near real time for precision medicine and computational health care use cases. Conclusions: The implementation and use of integrated data science platforms offer organizations the opportunity to combine traditional datasets, including data from the electronic health record, with emerging big data sources, such as continuous patient monitoring and real-time laboratory results. These platforms can enable cost-effective and scalable analytics for the information that will be key to the delivery of precision medicine initiatives. Organizations that can take advantage of the technical advances found in data science platforms will have the opportunity to provide comprehensive access to health care data for computational health care and precision medicine research.

Silicon nanowires (SiNWs) were successfully coated by uniform, adherent and homogenous ultra-thin crystalline diamond films through microwave enhanced chemical vapor deposition (MWCVD). The as-grown functionalized nanowires were employed as electrodes in a symmetric micro-supercapacitor (MSC) using a protic ionic liquid electrolyte [triethylammonium bis(trifluoromethylsulfonyl)imide; Et3NH TFSI]. The electrochemical performance of the device delivered a specific capacitance of 1.5 mF cm−2 and a power density of 25 mW cm−2 using an enlarged cell voltage of 4 V. Furthermore, a remarkable cycling stability was evaluated after 1 · 106 galvanostatic cycles at a high current density of 10 mA cm−2 with an excellent capacitive behavior. These results confirm that diamond-coated SiNW micro-supercapacitors exhibit very promising performances dealing with MSCs based on CVD-grown SiNWs. Keywords: Supercapacitors, Ionic liquid, Diamond, Silicon nanowires

Introduction: Biomedical and translational research often relies on the evaluation of patients or specimens that meet specific clinical or laboratory criteria. The typical approach used to identify biospecimens is a manual, retrospective process that exists outside the clinical workflow. This often makes biospecimen collection cost prohibitive and prevents the collection of analytes with short stability times. Emerging data architectures offer novel approaches to enhance specimen-identification practices. To this end, we present a new tool that can be deployed in a real-time environment to automate the identification and notification of available biospecimens for biomedical research. Methods: Real-time clinical and laboratory data from Cloverleaf (Infor, NY, NY) were acquired within our computational health platform, which is built on open-source applications. Study-specific filters were developed in NiFi (Apache Software Foundation, Wakefield, MA, USA) to identify the study-appropriate specimens in real time. Specimen metadata were stored in Elasticsearch (Elastic N. V., Mountain View, CA, USA) for visualization and automated alerting. Results: Between June 2018 and December 2018, we identified 2992 unique specimens belonging to 2815 unique patients, split between two different use cases. Based on laboratory policy for specimen retention and study-specific stability requirements, secure E-mail notifications were sent to investigators to automatically notify of availability. The assessment of throughput on commodity hardware demonstrates the ability to scale to approximately 2000 results per second. Conclusion: This work demonstrates that real-world clinical data can be analyzed in real time to increase the efficiency of biospecimen identification with minimal overhead for the clinical laboratory. Future work will integrate additional data types, including the analysis of unstructured data, to enable more complex cases and biospecimen identification.

The N‐iodosuccinimide‐mediated spirocyclization of tryptamine‐derived isocyanides to generate spiroindolenines is reported. The products contain both an imine and an imidoyl iodide as flexible handles for follow‐up chemistry. Nucleophilic addition typically occurs chemoselectively on the imine moiety with complete diastereoselectivity, providing opportunities for the construction of complex molecular frameworks. The synthetic potential of the method was showcased in the formal total synthesis of (±)‐aspidofractinine.

International audience; In this work, we propose a new eutectic ionic liquid mixture based on 1-ethyl-3-methylimidazolium bis(trifluoromethylsulfonyl)imide and 1-propyl-3-methylpyrrolidinium bis(trifluoromethylsulfonyl)imide to be employed as electrolyte in large temperature range supercapacitor applications. The electrolyte exhibited excellent thermal properties in terms of high temperature decomposition (440 °C), a very low melting temperature (no phase transition up to −70 °C) as well as a wide electrochemical window (4.4 V vs Pt). Accordingly, a symmetric coin cell supercapacitor device was performed using porous Ni-foam electrodes in presence of the corresponding mixture at an extended working temperature range from −70 °C to 80 °C. The electrochemical performance of the device was characterised by a wide electrochemical window of 3.5 V maintaining an excellent electrochemical double layer capacitive behavior in all the range. In addition, areal capacitance values between 5 μF cm−2 (−70 °C) and 100 μF cm−2 (80 °C) were obtained at a high scan rate of 20 V s−1, evidencing the rapid and extraordinary electrochemical response even at such extreme temperatures with an excellent cycling stability.

The digital transformation of healthcare has generated a wealth of new information, ranging from electronic health records to patient-generated data. The availability of these data has led to the rapid adoption of artificial intelligence in medicine. Although these algorithms have the potential to guide precision therapies, improve efficiency, and achieve better outcomes, there has been limited regulatory oversight to assess the quality and efficacy of predictive algorithms in the clinical setting. Recent articles by Parikh et al. in Science and Collins and Moons in The Lancet and draft guidance from the Food and Drug Administration have started to explore reporting and regulatory frameworks for predictive algorithms (1–3). Recent draft guidance from the Food and Drug Administration on clinical decision support systems and artificial intelligence in software as a medical device has started …

Despite variability in disease surveillance statistics, malaria is widely considered a global public health concern because it causes high rates of morbidity and death, particularly in populations from developing or low- to middle-income countries. In recent years, substantial effort has been made through international collaborations to reduce the global burden and ultimately eradicate the presence of malaria. Optimization of diagnostic assays for malaria remains central to this effort and may help address the need for improved epidemiologic surveillance, population-based screening, and targeted antimalarial treatment campaigns. A recent article published in Science Translational Medicine (1) describes a novel biomarker present in human saliva that detects Plasmodium falciparum gametocytes. The authors report on the discovery of 35 parasite biomarkers by leveraging mass spectrometry and proteomic profiling. Following …

The crystal structure of 5-iodouracil, C4H3IN2O2, has been determined in the noncentrosymmetric space groupP21on a nonmerohedrally twinned crystal. Both twin components are enantiomorphically pure, but the twin element is a mirror plane perpendicular toc*. The molecular structure is discussed and stacking faults in the two-dimensional packing are proposed as a reason for the twinning.

Aim To identify whether patients with congestive cardiac failure have a higher prevalence of inaccurately documented medications on general practice referral letters to emergency departments than other polypharmacy patients. Method A prospective case-control study was undertaken in two urban emergency departments. Patients with a general practitioner referral letter and a history of congestive cardiac failure were recruited as the study group, while patients with a general practitioner referral letter and a history of polypharmacy were recruited as controls. Medications on the referral letter were compared with those dispensed by the patient's usual pharmacist (gold standard) and emergency clinician documentation. Discrepancies were analysed by number, type and potential severity. Results A total of 205 patients were recruited: 69 patients with heart failure in the study group and 136 patients in the control group. The proportion of letters with at least one discrepancy was high in both groups (91 vs 88%, p = 0.57). On average, heart failure patients had more discrepancies per letter (4.8 vs 3.8, p = 0.05). The most common discrepancy in all groups was over-inclusion of medications (68% heart failure and 64% control). Heart failure patients had more discrepancies judged likely to be harmful (24 vs 14%, p < 0.001). Discussion The prevalence of medication discrepancies in referral letters to the emergency department is very high. The overall prevalence of a discrepancy was not higher in heart failure patients compared with other polypharmacy patients, but there were more discrepancies per letter and these discrepancies were potentially more serious. Extra vigilance is required when reconciling medications for patients with heart failure because of higher numbers and greater potential severity of medication discrepancies.

Ionic liquids (ILs) are promising solvents for carbon capture because of their high sorption capacity and low regeneration energy compared to conventional amine-based solvents. Previously, tetracyanoborate-based ILs have shown enhanced carbon dioxide (CO2) absorption capacity and absorption kinetics due to their low viscosity.1 In this work, the related IL 1-butyl-3-methylimidazolium tricyanomethanide ([bmim][tcm]) is studied for the first time as a solvent for CO2 capture. The physicochemical properties (e.g., density, viscosity, electrical conductivity, surface tension, thermal decomposition temperature, glass transition point) of pure [bmim][tcm] were experimentally determined and successfully described using appropriate correlations. [Bmim][tcm] was found to be a low-viscous IL with a relatively high thermal stability (Tdecomp = 473.15 K). The solubilities of CO2 in [bmim][tcm] were measured at temperatures ranging from (288.15 to 363.15) K and a pressure range of (0.01 to 10) MPa using two different methods (volumetric vs gravimetric), which show good agreement with each other. [Bmim][tcm] shows higher solubilities and therefore, higher sorption capacity compared to other nonfluorous ILs. The Peng–Robinson equation of state was applied to correlate the experimental data. Henry’s law constants (4 MPa to 13 MPa) and partial molar enthalpies of absorption (-14 kJ·mol–1) at different temperatures were also calculated from the measured solubility data. The diffusion coefficients of CO2 in [bmim][tcm] were determined at temperatures ranging from (308.15 to 353.15) K using the gravimetric method only. The diffusivity data of CO2 in [bmim][tcm] (~5·10–10 m2·s–1) are comparable to those in other low-viscous ILs, and show that high rates of absorption are possible. Therefore, it can be concluded that [bmim][tcm] is a promising candidate for carbon capture.

Approximately 30 ionic liquids with different cations and anions were manufactured and tested for their thermal stability. In addition to common cations (e.g., imidazolium and ammonium), novel cations such as several dications, a bicyclic amine, a benzimimidazolium, and an inorganic cation were applied. All liquids were heated to the desired temperature by applying a constant heating rate of 3 K/min. After the heating period, the temperature was held for at least 6 h in a nitrogen-atmosphere. Some ionic liquids based on the [NTf 2 ]-anion tend to be stable up to 250 °C or even 300 °C in N 2 atmosphere. In particular, imidazolium and pyrrolidinium dicationic ionic liquids show a high thermal stability. The salt [Li][NTf 2 ], which provides an inorganic cation, decomposes at temperatures between 250 and 300 °C. Additionally and with respect to technical application, the effect of hydrogen and nickel on the thermal stability of ILs was studied. Both nickel and hydrogen reduce the thermal stability, whereas the effect of hydrogen on the thermal stability of ILs is drastic.

BACKGROUND Morphologic profiling of the erythrocyte population is a widely used and clinically valuable diagnostic modality, but one that relies on a slow manual process associated with significant labor cost and limited reproducibility. Automated profiling of erythrocytes from digital images by capable machine learning approaches would augment the throughput and value of morphologic analysis. To this end, we sought to evaluate the performance of leading implementation strategies for convolutional neural networks (CNNs) when applied to classification of erythrocytes based on morphology. METHODS Erythrocytes were manually classified into 1 of 10 classes using a custom-developed Web application. Using recent literature to guide architectural considerations for neural network design, we implemented a “very deep” CNN, consisting of >150 layers, with dense shortcut connections. RESULTS The final database comprised 3737 labeled cells. Ensemble model predictions on unseen data demonstrated a harmonic mean of recall and precision metrics of 92.70% and 89.39%, respectively. Of the 748 cells in the test set, 23 misclassification errors were made, with a correct classification frequency of 90.60%, represented as a harmonic mean across the 10 morphologic classes. CONCLUSIONS These findings indicate that erythrocyte morphology profiles could be measured with a high degree of accuracy with “very deep” CNNs. Further, these data support future efforts to expand classes and optimize practical performance in a clinical environment as a prelude to full implementation as a clinical tool.

Introduction SUPREMO is a phase 3 randomised trial evaluating radiotherapy post-mastectomy for intermediate-risk breast cancer. 1688 patients were enrolled from 16 countries between 2006 and 2013. We report the results of central pathology review carried out for quality assurance. Patients and methods A single recut haematoxylin and eosin (H&E) tumour section was assessed by one of two reviewing pathologists, blinded to the originally reported pathology and patient data. Tumour type, grade and lymphovascular invasion were reviewed to assess if they met the inclusion criteria. Slides from potentially ineligible patients on central review were scanned and reviewed online together by the two pathologists and a consensus reached. A subset of 25 of these cases was double-reported independently by the pathologists prior to the online assessment. Results The major contributors to the trial were the UK (75%) and the Netherlands (10%). There is a striking difference in lymphovascular invasion (LVi) rates (41.6 vs. 15.1% (UK); p =

The rearrangements of protons and neutrons amongst the valence single-particle orbitals during double �� decay of 100Mo have been determined by measuring cross sections in (d,p), (p,d), (3He,��) and (3He,d) reactions on 98,100Mo and 100,102Ru targets. The deduced nucleon occupancies reveal significant discrepancies when compared with theoretical calculations; the same calculations have previously been used to determine the nuclear matrix element associated with the decay probability of double �� decay of the 100Mo system., 18 pages, 13 figures, 37 pages of supplemental information