The complex three-phase composition of lithium-ion battery electrodes, containing an ion-conducting pore phase, a nanoporous electron-conducting carbon binder domain (CBD) phase, and an active material (AM) phase, provides several avenues of mesostructural engineering to enhance battery performance. We demonstrate a promising strategy for engineering electrode mesostructures by controlling the strength of adhesion between the AM and CBD phases. Using high-fidelity, physics-based colloidal and granular dynamics simulations, we predict that this strategy can provide significant control over electrochemical transport-relevant properties such as ionic conductivity, electronic conductivity, and available AM-electrolyte interface area. Importantly, the proposed strategy could be experimentally realized through surface functionalization of the AM and CBD phases and would be compatible with traditional electrode manufacturing methods.

By generalizing a geometric argument for frictionless spheres, a model is proposed for the jamming density φJ of mechanically stable packings of bidisperse, frictional spheres. The monodisperse, μs-dependent jamming density φJmono(μs) is the only input required in the model, where μs is the coefficient of friction. The predictions of the model are validated by robust estimates of φJ obtained from computer simulations of up to 107 particles for a wide range of μs, and size ratios up to 40:1. Although φJ varies nonmonotonically with the volume fraction of small spheres fs for all μs, its maximum value φJ,max at an optimal fmaxs are both μs dependent. The optimal fmaxs is characterized by a sharp transition in the fraction of small rattler particles.

Background

Paradoxical embolization through a right-to-left shunt (RLS), often from a patent foramen ovale (PFO), has been associated with cryptogenic stroke. While transesophageal echo (TEE) bubble study is the current standard reference for diagnosing PFO, transthoracic echo (TTE) remains the most commonly used screening test for RLS due to its noninvasiveness and easy availability. The aim of this meta-analysis was to determine the accuracy of TTE compared to TEE as the reference.

Methods and results

A systematic review of Medline, Cochrane, and Embase was done to look for all the prospective studies assessing for intracardiac RLS using conventional TTE compared to TEE as the reference; both TTE and TEE were performed with a contrast agent and a maneuver to provoke RLS in all studies. A total of 13 studies with 1436 patients fulfilled the inclusion criteria. The weighted mean sensitivity and specificity for TTE were 46% and 99%, respectively. Likewise, the positive likelihood ratio and negative likelihood ratio were 20.85 and 0.57, respectively. Using different contrast agents, different microbubble cutoffs for a positive TTE/TEE, and different cardiac cycle cutoffs for a positive TTE/TEE did not affect the accuracy of TTE. In a population of patients with cryptogenic stroke, a TTE that tests positive for RLS has a 95% probability of being a true positive.

Conclusion

Transthoracic echocardiogram has a low sensitivity and extremely high specificity, making it a poor rule out test but an excellent rule in test for the detection of intracardiac RLS.

Background: Right-to-left shunting (RLS), usually through a patent foramen ovale (PFO), has been associated with cryptogenic stroke, migraine with aura, and hypoxemia. With emerging observational studies and clinical trials on the subject of PFO and its association with these clinical syndromes, there is a need for accurate diagnosis of PFO in patients being considered for transcatheter closure. While transesophageal echo (TEE) bubble study is the current standard reference for diagnosing PFO, transcranial Doppler (TCD) bubble study may be a preferable screening test for RLS due to its high sensitivity, non-invasiveness and low cost. The aim of this meta-analysis was to determine the accuracy of TCD compared to TEE as the reference. Methods: A systematic review of Medline, Cochrane and Embase was done to look for all the prospective studies assessing for intracardiac RLS using TCD compared to TEE as the reference; both TCD and TEE were performed with a contrast agent and a maneuver to provoke RLS in all studies. Results: A total of twenty-seven studies with 1910 patients (mean age 48 ± 5.6, 58% male) fulfilled the inclusion criteria. The weighted mean sensitivity and specificity for TCD were 96% (95% CI 90-100) and 88% (95% CI 82-94) respectively. The PPV and NPV were 87% (95% CI 81-93) and NPV: 96% (95% CI 92-100) respectively. Overall diagnostic accuracy was 91% (95% CI 87-94). Conclusion: TCD is a reliable, non-invasive alternative diagnostic modality to TEE with an excellent sensitivity and NPV, making it a reliable screening tool for detecting RLS. TEE is limited by patient tolerance. If the precise anatomy is required, then TEE can be obtained before scheduling a patient for transcatheter PFO closure.

Background: Right-to-left shunting (RLS), often through a patent foramen ovale (PFO), has been associated with cryptogenic stroke, migraine with aura, and hypoxemia. With emerging observational studies and clinical trials on the subject of PFO and its association with stroke and migraine, there is a need for accurate diagnosis of PFO in patients being considered for transcatheter closure. While transesophageal echo (TEE) bubble study is the current standard reference for diagnosing PFO, transthoracic echo bubble study with second harmonic imaging (TTE-HI) may be a preferable screening test for RLS as it is a non-invasive and low cost technique. The aim of this meta-analysis was to determine the accuracy of TTE-HI compared to TEE used as the reference test. Methods: A systematic review of Medline, Cochrane and Embase was done to look for all the prospective studies assessing for intracardiac RLS using TTE-HI compared to TEE as the reference; both TTE-HI and TEE were performed with a contrast agent and a maneuver to provoke RLS in all studies. Results: A total of fifteen studies with 1995 patients (mean age 53.6 ± 6.1; 43% male) fulfilled the inclusion criteria. The weighted mean sensitivity and specificity for TTE-HI were 90.5% (95% CI: 88.1 to 92.6%) and 92.6% (95% CI: 91.0 to 94.0%) respectively. The overall positive likelihood ratio (LR+) was 13.52 (95% CI: 6.99 to 26.12) and the overall negative likelihood ratio (LR-) was 0.13 (95% CI: 0.07 to 0.24). Conclusion: TTE-HI is a reliable, non-invasive alternative diagnostic modality to TEE which is highly sensitive and specific for detecting RLS. TEE is limited by patient tolerance. If delineation of the precise anatomy is required, then TEE can be obtained before scheduling a patient for transcatheter PFO closure.

Objectives

The aim of this meta-analysis was to determine the accuracy of transcranial Doppler (TCD) compared with transesophageal echocardiography (TEE) as the reference.

Background

Right-to-left shunting (RLS), usually through a patent foramen ovale (PFO), has been associated with migraine, cryptogenic stroke, and hypoxemia. With emerging observational studies and clinical trials on the subject of PFO, there is a need for accurate diagnosis of PFO in patients with these conditions, and those being considered for transcatheter closure. Although a TEE bubble study is the current standard reference for diagnosing PFO, the TCD bubble study may be a preferable alternative test for RLS because of its high sensitivity and specificity, noninvasive nature, and low cost.

Methods

A systematic review of Medline, the Cochrane Library, and Embase was done to look for all the prospective studies assessing intracardiac RLS using TCD compared with TEE as the reference; both tests were performed with a contrast agent and a maneuver to provoke RLS in all studies.

Results

A total of 27 studies (29 comparisons) with 1,968 patients (mean age 47.8 ± 5.7 years; 51% male) fulfilled the inclusion criteria. The weighted mean sensitivity and specificity for TCD were 97% and 93%, respectively. Likewise, the positive and negative likelihood ratios were 13.51 and 0.04, respectively. When 10 microbubbles was used as the embolic cutoff for a positive TCD study, TCD produced a higher specificity compared with when 1 microbubble was used as the cutoff (p = 0.04); there was, however, no significant change in sensitivity (p = 0.29).

Conclusions

TCD is a reliable, noninvasive test with excellent diagnostic accuracies, making it a proficient test for detecting RLS. TCD can be used as a part of the stroke workup and for patients being considered for PFO closure. If knowledge of the precise anatomy is required, then TEE can be obtained before scheduling a patient for transcatheter PFO closure.

BACKGROUND: The rapid spread of SARS-CoV-2, the causative agent of Coronavirus disease 2019 (COVID-19), has been accompanied by the emergence of distinct viral clades, though their clinical significance remains unclear. Here, we aimed to investigate the phylogenetic characteristics of SARS-CoV-2 infections in Chicago, Illinois, and assess their relationship to clinical parameters. METHODS: We performed whole-genome sequencing of SARS-CoV-2 isolates collected from COVID-19 patients in Chicago in mid-March, 2020. Using these and other publicly available sequences, we performed phylogenetic, phylogeographic, and phylodynamic analyses. Patient data was assessed for correlations between demographic or clinical characteristics and virologic features. FINDINGS: The 88 SARS-CoV-2 genome sequences in our study separated into three distinct phylogenetic clades. Clades 1 and 3 were most closely related to viral sequences from New York and Washington state, respectively, with relatively broad distributions across the US. Clade 2 was primarily found in the Chicago area with limited distribution elsewhere. At the time of diagnosis, patients infected with Clade 1 viruses had significantly higher average viral loads in their upper airways relative to patients infected with Clade 2 viruses, independent of disease severity. INTERPRETATION: These results show that multiple variants of SARS-CoV-2 were circulating in the Chicago area in mid-March 2020 that differed in their relative viral loads in patient upper airways. These data suggest that differences in virus genotype can impact viral load and may influence viral spread. FUNDING: Dixon Family Translational Research Award, Northwestern University Clinical and Translational Sciences Institute (NUCATS), National Institute of Allergy and Infectious Diseases (NIAID), Lurie Comprehensive Cancer Center, Northwestern University Emerging and Re-emerging Pathogens Program.

We offer an explanation for how dendrite growth can be inhibited when Li metal pouch cells are subjected to external loads, even for cells using soft, thin separators. We develop a contact mechanics model for tracking Li surface and sub-surface stresses where electrodes have realistically (micron-scale) rough surfaces. Existing models examine a single, micron-scale Li metal protrusion under a fixed local current density that presses more or less conformally against a separator or stiff electrolyte. At the larger, sub-mm scales studied here, contact between the Li metal and the separator is heterogeneous and far from conformal for surfaces with realistic roughness: the load is carried at just the tallest asperities, where stresses reach tens of MPa, while most of the Li surface feels no force at all. Yet, dendrite growth is suppressed over the entire Li surface. To explain this dendrite suppression, our electrochemical/mechanics model suggests that Li avoids plating at the tips of growing Li dendrites if there is sufficient local stress; that local contact stresses there may be high enough to close separator pores so that incremental Li+ ions plate elsewhere; and that creep ensures that Li protrusions are gradually flattened. These mechanisms cannot be captured by single-dendrite-scale analyses.

Li metal anodes are enticing for batteries due to high theoretical charge storage capacity, but commercialization is plagued by dendritic Li growth and short circuits when cycled at high currents. Applied pressure has been suggested to improve morphology, and therefore performance. We hypothesized that increasing pressure would suppress dendritic growth at high currents. To test this hypothesis, here, we extensively use cryogenic scanning electron microscopy to show that varying the applied pressure from 0.01 to 1 MPa has little impact on Li morphology after one deposition. We show that pressure improves Li density and preserves Li inventory after 50 cycles. However, contrary to our hypothesis, pressure exacerbates dendritic growth through the separator, promoting short circuits. Therefore, we suspect Li inventory is better preserved in cells cycled at high pressure only because the shorts carry a larger portion of the current, with less being carried by electrochemical reactions that slowly consume Li inventory.

Plant traits-the morphological, anatomical, physiological, biochemical and phenological characteristics of plants-determine how plants respond to environmental factors, affect other trophic levels, and influence ecosystem properties and their benefits and detriments to people. Plant trait data thus represent the basis for a vast area of research spanning from evolutionary biology, community and functional ecology, to biodiversity conservation, ecosystem and landscape management, restoration, biogeography and earth system modelling. Since its foundation in 2007, the TRY database of plant traits has grown continuously. It now provides unprecedented data coverage under an open access data policy and is the main plant trait database used by the research community worldwide. Increasingly, the TRY database also supports new frontiers of trait-based plant research, including the identification of data gaps and the subsequent mobilization or measurement of new data. To support this development, in this article we evaluate the extent of the trait data compiled in TRY and analyse emerging patterns of data coverage and representativeness. Best species coverage is achieved for categorical traits-almost complete coverage for 'plant growth form'. However, most traits relevant for ecology and vegetation modelling are characterized by continuous intraspecific variation and trait-environmental relationships. These traits have to be measured on individual plants in their respective environment. Despite unprecedented data coverage, we observe a humbling lack of completeness and representativeness of these continuous traits in many aspects. We, therefore, conclude that reducing data gaps and biases in the TRY database remains a key challenge and requires a coordinated approach to data mobilization and trait measurements. This can only be achieved in collaboration with other initiatives.