First-principles study of MXene properties with varying hydrofluoric acid concentration

With varying hydrofluoric acid (HF) concentrations under three etching conditions, we presented a comparative study of the effects of both the ordered and randomly ternary mixed terminated Ti3C2Tx surfaces with a wide variation of O/OH/F stoichiometry on the thermodynamic stability and electronic properties. Regardless of the HF concentration, an OH-rich surface is found to be thermodynamically stable and the electrical conductivity of Ti3C2Tx is substantially affected by the OH concentration. The charge density difference and electron localization function demonstrated a significant electron localization at the hydroxyl group on the O/OH/F mixed terminated surface, which could yield a locally induced dipole on the surface that renders favorable reaction sites on the functionalized surface. In addition, a large tunability in the work function (ΔΦ ∼ 3.5 eV) is predicted for Ti3C2Tx. These findings provide a pathway for strategically tuning the electronic and structural properties of Ti3C2 MXenes etched with HF.

Template assisted lithium superoxide growth for lithium-oxygen batteries

Developing batteries with energy densities comparable to internal combustion technology is essential for a worldwide transition to electrified transportation. Li-O2 batteries are seen as the 'holy grail' of battery technologies since they have the highest theoretical energy density of all battery technologies. Current lithium-oxygen (Li-O2) batteries suffer from large charge overpotentials related to the electronic resistivity of the insulating lithium peroxide (Li2O2) discharge product. One potential solution is the formation and stabilization of a lithium superoxide (LiO2) discharge intermediate that exhibits good electronic conductivity. However, LiO2 is reported to be unstable at ambient temperature despite its favorable formation energy at -1.0 eV per atom. In this paper - based on our recent work on the development of cathode materials for aprotic lithium oxygen batteries including two intermetallic compounds, LiIr3 and LiIr, that are found to form good template interfaces with LiO2 - a simple goodness of fit R factor to gauge how well a template surface structure can support LiO2 growth, is developed. The R factor is a quantitative measurement to calculate the geometric difference in the unit cells of specific Miller Index 2D planes of the template surface and LiO2. Using this as a guide, the R factors for LiIr3, LiIr, and La2NiO4+δ, are found to be good. This guide is attested by simple extension to other noble metal intermetallics with electrochemical cycling data including LiRh3, LiRh, and Li2Pd. Finally, the template concept is extended to main group elements and the R factors for LiO2 (111) and Li2Ca suggest that Li2Ca is a possible candidate for the template assisted LiO2 growth strategy.

Clinical Outcomes of Conservative Treatment for Low-Risk Ductal Carcinoma in Situ: A Systematic Review and Pooled Analysis

AIMS

The current gold standard of treatment for ductal carcinoma in situ (DCIS) is surgical resection with or without adjuvant radiotherapy. However, the increased detection and radical treatment of DCIS did not result in a declined incidence of invasive breast cancers, leading to the debate if DCIS has been overtreated. While ongoing randomised controlled trials on active surveillance of DCIS are still in progress, this systematic review aims to evaluate the best evidence on conservative treatment for DCIS from the literature.

MATERIALS AND METHODS

This systematic review was conducted in line with the PRISMA statement. We included all relevant studies published up to June 2022 for analysis. The primary outcomes were overall survival and breast cancer-specific survival (BCSS) of conservative treatment for DCIS.

RESULTS

Three studies, with a total of 34 007 women with low-risk DCIS, were included in the analysis. Active and conservative treatments both resulted in excellent 10-year BCSS, with no statistically insignificant difference (98.6% versus 96.0%, 31 478 women). One study comparing 5-year BCSS of active and conservative treatments only in subjects aged over 80 years also reported [AQ1]an insignificant difference (98.2% versus 96.0%, 2529 women). One study measuring 5- and 10-year overall survival between the treatment groups also reported [AQ1]an insignificant difference (5-year: 96.2% versus 92.4%; 10-year: 85.6% versus 86.7%, 31 106 women).

CONCLUSION

BCSS between active and conservative treatment for women with low-risk DCIS is both excellent and comparable, suggesting that conservative treatment is a possible alternative without compromising survival.

Unusual Melting Trend in an Alkali Asymmetric Sulfonamide Salt Series: Single-Crystal Analysis and Modeling

Developing low-melting alkali salts is of interest for both battery electrolytes and inorganic ionic liquids. In this study, we report a series of asymmetric alkali-metal sulfonamide salts based upon the (3-methoxypropyl)((trifluoromethyl)sulfonyl)amide (MPSA) anion. This family of salts features an unusual melting point trend, where the melting point of the salts decreases as the cation increases in size from Li to K but then the melting point increases as the cation further increases in size from K to Cs. Analyses of single crystals reveal that the unusual higher melting points of RbMPSA and CsMPSA in comparison to KMPSA can be attributed to the greater cation-cation distances as well as the increased rigidity of anion-cation coordination due to an increase in cyclic structures in comparison to KMPSA. Exceptionally, KMPSA features a very low melting point of only 50.79 ± 0.31 °C. This low melting point can be attributed to a relatively high degree of disorder, an unusual uncoordinated ether moiety, and a very short K-K distance of only 3.4348(7) Å among other factors, which is supported by the low cohesive energy and small elastic moduli among the rest according to density functional theory (DFT) calculations. The low melting point of KMPSA makes it interesting for low-temperature ionic liquids.

Structure-Property of Lithium-Sulfur Nanoparticles via Molecular Dynamics Simulation

Lithium-sulfur (Li-S) batteries offer higher energy densities than most reported lithium-ion batteries. However, our understanding of Li-S battery is still largely unknown at the level of the nanoscale. The structural properties of Li-S materials were investigated via molecular dynamics (MD) simulations using the ReaxFF force field. Several Li-S nanoparticles with different Li/S composition ratios (2:1 and 2:8) and various structures are studied. Our MD simulations show that among the four structures we constructed for Li₂S₈ nanoparticles, the core-shell structure is the most thermodynamically stable one during the charging (delithiation) process. In contrast to bulk crystal Li₂S, we find the presence of mixed lithium sulfide and polysulfide species are common features for these Li-S (Li₂S, Li₂S₈) nanoparticles. The complex distribution of these sulfide and polysulfide speciation are dictated by both stoichiometry and local atomic structures in the nanoparticle. These findings will provide insight into further development of functionalized lithium-sulfur cathodes.

Dendrite-Free Potassium-Oxygen Battery Based on a Liquid Alloy Anode

The safety issue caused by the dendrite growth is not only a key research problem in lithium-ion batteries but also a critical concern in alkali metal (i.e., Li, Na, and K)-oxygen batteries where a solid metal is usually used as the anode. Herein, we demonstrate the first dendrite-free K-O₂ battery at ambient temperature based on a liquid Na-K alloy anode. The unique liquid-liquid connection between the liquid alloy and the electrolyte in our alloy anode-based battery provides a homogeneous and robust anode-electrolyte interface. Meanwhile, we manage to show that the Na-K alloy is only compatible in K-O₂ batteries but not in Na-O₂ batteries, which is mainly attributed to the stronger reducibility of potassium and relatively more favorable thermodynamic formation of KO₂ over NaO₂ during the discharge process. It is observed that our K-O₂ battery based on a liquid alloy anode shows a long cycle life (over 620 h) and a low discharge-charge overpotential (about 0.05 V at initial cycles). Moreover, the mechanism investigation into the K-O₂ cell degradation shows that the O₂ crossover effect and the ether-electrolyte instability are the critical problems for K-O₂ batteries. In a word, this study provides a new route to solve the problems caused by the dendrite growth in alkali metal-oxygen batteries.

Effect of Hydrofluoroether Cosolvent Addition on Li Solvation in Acetonitrile-Based Solvate Electrolytes and Its Influence on S Reduction in a Li-S Battery

Li-S batteries are a promising next-generation battery technology. Due to the formation of soluble polysulfides during cell operation, the electrolyte composition of the cell plays an active role in directing the formation and speciation of the soluble lithium polysulfides. Recently, new classes of electrolytes termed "solvates" that contain stoichiometric quantities of salt and solvent and form a liquid at room temperature have been explored due to their sparingly solvating properties with respect to polysulfides. The viscosity of the solvate electrolytes is understandably high limiting their viability; however, hydrofluoroether cosolvents, thought to be inert to the solvate structure itself, can be introduced to reduce viscosity and enhance diffusion. Nazar and co-workers previously reported that addition of 1,1,2,2-tetrafluoroethyl 2,2,3,3-tetrafluoropropyl ether (TTE) to the LiTFSI in acetonitrile solvate, (MeCN)₂-LiTFSI, results in enhanced capacity retention compared to the neat solvate. Here, we evaluate the effect of TTE addition on both the electrochemical behavior of the Li-S cell and the solvation structure of the (MeCN)₂-LiTFSI electrolyte. Contrary to previous suggestions, Raman and NMR spectroscopy coupled with ab initio molecular dynamics simulations show that TTE coordinates to Li⁺ at the expense of MeCN coordination, thereby producing a higher content of free MeCN, a good polysulfide solvent, in the electrolyte. The electrolytes containing a higher free MeCN content facilitate faster polysulfide formation kinetics during the electrochemical reduction of S in a Li-S cell likely as a result of the solvation power of the free MeCN.

Electronic, structural and vibrational induced effects upon ionization of 2-quinolinone

Using first principle methodologies, we characterize the lowest electronic states of 2-quinolinone(+) cation. The ground state of this ion is of X˜(2)A(″) nature. We deduce the adiabatic ionization energy of 2-quinolinone to be equal 8.249eV using the explicitly correlated coupled cluster level and where zero point vibrational energy, core-valence and scalar relativistic effects are taken into account. We examine also the ionization induced structural changes and vibrational shifts and analyze the electron density differences between the neutral and ionic species. These data show that the formation of 2-quinolinone(+)X˜(2)A(″) from 2-quinolinone affects strongly the HNCO group, whereas the carbon skeletal is perturbed when the upper electronic cationic states are populated. The comparison to 2-pyridone allows the elucidation of the effect of benzene ring fused with this heterocyclic ring. Since quinolones and pyridones are both model systems of DNA bases, these findings might help in understanding the charge redistribution in these biological entities upon ionization.

An atomistically informed mesoscale model for growth and coarsening during discharge in lithium-oxygen batteries

An atomistically informed mesoscale model is developed for the deposition of a discharge product in a Li-O2 battery. This mescocale model includes particle growth and coarsening as well as a simplified nucleation model. The model involves LiO2 formation through reaction of O2(-) and Li(+) in the electrolyte, which deposits on the cathode surface when the LiO2 concentration reaches supersaturation in the electrolyte. A reaction-diffusion (rate-equation) model is used to describe the processes occurring in the electrolyte and a phase-field model is used to capture microstructural evolution. This model predicts that coarsening, in which large particles grow and small ones disappear, has a substantial effect on the size distribution of the LiO2 particles during the discharge process. The size evolution during discharge is the result of the interplay between this coarsening process and particle growth. The growth through continued deposition of LiO2 has the effect of causing large particles to grow ever faster while delaying the dissolution of small particles. The predicted size evolution is consistent with experimental results for a previously reported cathode material based on activated carbon during discharge and when it is at rest, although kinetic factors need to be included. The approach described in this paper synergistically combines models on different length scales with experimental observations and should have applications in studying other related discharge processes, such as Li2O2 deposition, in Li-O2 batteries and nucleation and growth in Li-S batteries.

Interstitial and Interlayer Ion Diffusion Geometry Extraction in Graphitic Nanosphere Battery Materials

Large-scale molecular dynamics (MD) simulations are commonly used for simulating the synthesis and ion diffusion of battery materials. A good battery anode material is determined by its capacity to store ion or other diffusers. However, modeling of ion diffusion dynamics and transport properties at large length and long time scales would be impossible with current MD codes. To analyze the fundamental properties of these materials, therefore, we turn to geometric and topological analysis of their structure. In this paper, we apply a novel technique inspired by discrete Morse theory to the Delaunay triangulation of the simulated geometry of a thermally annealed carbon nanosphere. We utilize our computed structures to drive further geometric analysis to extract the interstitial diffusion structure as a single mesh. Our results provide a new approach to analyze the geometry of the simulated carbon nanosphere, and new insights into the role of carbon defect size and distribution in determining the charge capacity and charge dynamics of these carbon based battery materials.

The Effect of Potassium Impurities Deliberately Introduced into Activated Carbon Cathodes on the Performance of Lithium-Oxygen Batteries

Rechargeable lithium-air (Li-O2) batteries have drawn much interest owing to their high energy density. We report on the effect of deliberately introducing potassium impurities into the cathode material on the electrochemical performance of a Li-O2 battery. Small amounts of potassium introduced into the activated carbon (AC) cathode material in the synthesis process are found to have a dramatic effect on the performance of the Li-O2 cell. An increased amount of potassium significantly increases capacity, cycle life, and round-trip efficiency. This improved performance is probably due to a larger amount of LiO2 in the discharge product, which is a mixture of LiO2 and Li2O2, resulting from the increase in the amount of potassium present. No substantial correlation with porosity or surface area in an AC cathode is found. Experimental and computational studies indicate that potassium can act as an oxygen reduction catalyst, which can account for the dependence of performance on the amount of potassium.

A Mo2C/Carbon Nanotube Composite Cathode for Lithium-Oxygen Batteries with High Energy Efficiency and Long Cycle Life

Although lithium-oxygen batteries are attracting considerable attention because of the potential for an extremely high energy density, their practical use has been restricted owing to a low energy efficiency and poor cycle life compared to lithium-ion batteries. Here we present a nanostructured cathode based on molybdenum carbide nanoparticles (Mo2C) dispersed on carbon nanotubes, which dramatically increase the electrical efficiency up to 88% with a cycle life of more than 100 cycles. We found that the Mo2C nanoparticle catalysts contribute to the formation of well-dispersed lithium peroxide nanolayers (Li2O2) on the Mo2C/carbon nanotubes with a large contact area during the oxygen reduction reaction (ORR). This Li2O2 structure can be decomposed at low potential upon the oxygen evolution reaction (OER) by avoiding the energy loss associated with the decomposition of the typical Li2O2 discharge products.

Interfacial effects on lithium superoxide disproportionation in Li-O₂ batteries

During the cycling of Li-O2 batteries the discharge process gives rise to dynamically evolving agglomerates composed of lithium-oxygen nanostructures; however, little is known about their composition. In this paper, we present results for a Li-O2 battery based on an activated carbon cathode that indicate interfacial effects can suppress disproportionation of a LiO2 component in the discharge product. High-intensity X-ray diffraction and transmission electron microscopy measurements are first used to show that there is a LiO2 component along with Li2O2 in the discharge product. The stability of the discharge product was then probed by investigating the dependence of the charge potential and Raman intensity of the superoxide peak with time. The results indicate that the LiO2 component can be stable for possibly up to days when an electrolyte is left on the surface of the discharged cathode. Density functional calculations on amorphous LiO2 reveal that the disproportionation process will be slower at an electrolyte/LiO2 interface compared to a vacuum/LiO2 interface. The combined experimental and theoretical results provide new insight into how interfacial effects can stabilize LiO2 and suggest that these interfacial effects may play an important role in the charge and discharge chemistries of a Li-O2 battery.

Understanding side reactions in K-O2 batteries for improved cycle life

Superoxide based metal-air (or metal-oxygen) batteries, including potassium and sodium-oxygen batteries, have emerged as promising alternative chemistries in the metal-air battery family because of much improved round-trip efficiencies (>90%). In order to improve the cycle life of these batteries, it is crucial to understand and control the side reactions between the electrodes and the electrolyte. For potassium-oxygen batteries using ether-based electrolytes, the side reactions on the potassium anode have been identified as the main cause of battery failure. The composition of the side products formed on the anode, including some reaction intermediates, have been identified and quantified. Combined experimental studies and density functional theory (DFT) calculations show the side reactions are likely driven by the interaction of potassium with ether molecules and the crossover of oxygen from the cathode. To inhibit these side reactions, the incorporation of a polymeric potassium ion selective membrane (Nafion-K(+)) as a battery separator is demonstrated that significantly improves the battery cycle life. The K-O2 battery with the Nafion-K(+) separator can be discharged and charged for more than 40 cycles without increases in charging overpotential.

Raman Evidence for Late Stage Disproportionation in a Li-O2 Battery

Raman spectroscopy is used to characterize the composition of toroids formed in an aprotic Li-O2 cell based on an activated carbon cathode. The trends in the Raman data as a function of discharge current density and charging cutoff voltage provide evidence that the toroids are made up of outer LiO2-like and inner Li2O2 regions, consistent with a disproportionation reaction occurring in the solid phase. The LiO2-like component is found to be associated with a new Raman peak identified in the carbon stretching region at ∼1505 cm(-1), which appears only when the LiO2 peak at 1123 cm(-1) is present. The new peak is assigned to distortion of the graphitic ring stretching due to coupling with the LiO2-like component based on density functional calculations. These new results on the LiO2-like component from Raman spectroscopy provide evidence that a late stage disproportionation mechanism can occur during discharge and add new understanding to the complexities of possible processes occurring in Li-O2 batteries.

Structure and Stability of Lithium Superoxide Clusters and Relevance to Li-O2 Batteries

The discharge mechanism of a Li-O2 battery involves lithium superoxide (LiO2) radicals. In this Letter, we have performed high-level quantum chemical calculations (G4MP2) to investigate the structure and stability of LiO2 clusters. The clusters have planar ring-shaped structures, high spins, and are thermodynamically more stable than LiO2 dimer. The computed energy barrier for disproportionation of the larger clusters is also significantly higher than the corresponding barrier in the LiO2 dimer (1.0 eV vs 0.5 eV). This means that disproportionation rate should be much slower if the reaction involves LiO2 clusters other than the dimer. As a result, the clusters may survive long enough to be incorporated into the growing discharge product. These results are discussed in terms of recent experimental studies of the electronic structure and morphology of the discharge products in Li-air batteries.

Magnetism in lithium-oxygen discharge product

Nonaqueous lithium-oxygen batteries have a much superior theoretical gravimetric energy density compared to conventional lithium-ion batteries, and thus could render long-range electric vehicles a reality. A molecular-level understanding of the reversible formation of lithium peroxide in these batteries, the properties of major/minor discharge products, and the stability of the nonaqueous electrolytes is required to achieve successful lithium-oxygen batteries. We demonstrate that the major discharge product formed in the lithium-oxygen cell, lithium peroxide, exhibits a magnetic moment. These results are based on dc-magnetization measurements and a lithium-oxygen cell containing an ether-based electrolyte. The results are unexpected because bulk lithium peroxide has a significant band gap. Density functional calculations predict that superoxide-type surface oxygen groups with unpaired electrons exist on stoichiometric lithium peroxide crystalline surfaces and on nanoparticle surfaces; these computational results are consistent with the magnetic measurement of the discharged lithium peroxide product as well as EPR measurements on commercial lithium peroxide. The presence of superoxide-type surface oxygen groups with spin can play a role in the reversible formation and decomposition of lithium peroxide as well as the reversible formation and decomposition of electrolyte molecules.

Molecular dynamics simulation of yttria-stabilized zirconia (YSZ) crystalline and amorphous solids

An empirically fitted atomic potential allows a classical molecular dynamics study of the static and dynamic properties of both crystalline and amorphous yttria-stabilized zirconia (YSZ) with typical dilute Y(2)O(3) concentrations (i.e. 3.0-12.0 mol% Y(2)O(3)) in the temperature range 300-1400 K. Based on the rigid ion model approximation, we find, regardless of the distinctly different geometries, that the oxygen ionic conductivity shows a maximum at ∼ 8.0 mol% Y(2)O(3), close to the experimental maximum. A lower absolute ionic conductivity is found for the high density YSZ amorphous solid, relative to crystalline YSZ, consistent with the trends observed in crystalline and stabilized amorphous thin films of YSZ reported in experiments. Different from YSZ crystals, intriguing features of mutual diffusion among the heavy cations and mobile anions are found in the amorphous phase.

Lattice dielectric and thermodynamic properties of yttria stabilized zirconia solids

A study of lattice dielectric and thermodynamic properties of yttria stabilized zirconia (YSZ) crystals as a function of yttria concentration is reported. This study is based on density functional perturbation theory, using ABINIT. Within the local density approximation and the harmonic approximation, we find excellent agreement between calculated and low temperature experimental specific heat and dielectric constants. From the variation of the specific heat of YSZ with the yttria composition, we propose a simple additivity rule that estimates the dependence of the specific heat of YSZ on the yttria concentration, whereas for the dielectric constants of YSZ, the values are bounded by the dielectric constants of cubic and amorphous zirconia.

Structure and stability of Mg-intercalated boron nanotubes and crystalline bundles

First principles calculations based on density functional theory predict a highly selective adsorption site for Mg atoms and negligible preference for the growth of Mg islands on the tubular surface of Mg-intercalated (small diameter) boron nanotubes, thereby establishing the criterion for understanding the growth mechanism of single-walled boron nanotubes (SWBNTs) supported by magnesium. On the other hand, the Mg-SWBNT bundles can be considered as an 'electrostatic' bound system consisting of partially ionized Mg and partially ionized tubules. The metallic character of the tubular Mg-B bundles is then attributed to boron atoms forming a metallic wire, while the role of Mg atoms is limited in enhancing the stability of the crystalline bundles.

Combined vacuum ultraviolet laser and synchrotron pulsed field ionization study of CH2BrCl

The pulsed field ionization-photoelectron (PFI-PE) spectrum of bromochloromethane (CH2BrCl) in the region of 85,320-88,200 cm-1 has been measured using vacuum ultraviolet laser. The vibrational structure resolved in the PFI-PE spectrum was assigned based on ab initio quantum chemical calculations and Franck-Condon factor predictions. At energies 0-1400 cm-1 above the adiabatic ionization energy (IE) of CH2BrCl, the Br-C-Cl bending vibration progression (nu1+=0-8) of CH2BrCl+ is well resolved and constitutes the major structure in the PFI-PE spectrum, whereas the spectrum at energies 1400-2600 cm-1 above the IE(CH2BrCl) is found to exhibit complex vibrational features, suggesting perturbation by the low lying excited CH2BrCl+(A 2A") state. The assignment of the PFI-PE vibrational bands gives the IE(CH2BrCl)=85,612.4+/-2.0 cm-1 (10.6146+/-0.0003 eV) and the bending frequencies nu1+(a1')=209.7+/-2.0 cm-1 for CH2BrCl+(X2A'). We have also examined the dissociative photoionization process, CH2BrCl+hnu-->CH2Cl++Br+e-, in the energy range of 11.36-11.57 eV using the synchrotron based PFI-PE-photoion coincidence method, yielding the 0 K threshold or appearance energy AE(CH2Cl+)=11.509+/-0.002 eV. Combining the 0 K AE(CH2Cl+) and IE(CH2BrCl) values obtained in this study, together with the known IE(CH2Cl), we have determined the 0 K bond dissociation energies (D0) for CH2Cl+-Br (0.894+/-0.002 eV) and CH2Cl-Br (2.76+/-0.01 eV). We have also performed CCSD(T, full)/complete basis set (CBS) calculations with high-level corrections for the predictions of the IE(CH2BrCl), AE(CH2Cl+), IE(CH2Cl), D0(CH2Cl+-Br), and D0(CH2Cl-Br). The comparison between the theoretical predictions and experimental determinations indicates that the CCSD(T, full)/CBS calculations with high-level corrections are highly reliable with estimated error limits of <17 meV.

The 2D-3D structural transition and chemical bonding in elemental boron nanoclusters

The rich chemistry of boron compounds are often found dominated by its structural dimensionality and chemical bonding from which some of the qualitative features of boron clusters can easily be extracted. In this article, we review such features to discuss structural properties of Bn clusters. In both small-cluster regime of n ≤ 20 and largecluster regime of n ≥ 20, the preferred topological structures are the result of the interplay between bonding factors related to the delocalized π bonds and the inter-icosahedral and intra-icosahedral bonds. The bulk fragments of boron are also expected to become a competitive isomeric configuration with the increase in the cluster-size, in contrast to 3D spherical cages observed in the large carbon clusters

A high-resolution pulsed field ionization-photoelectron-photoion coincidence study of vinyl bromide

By employing the high-resolution pulsed field ionization-photoelectron (PFI-PE)-photoion coincidence method, we have examined the unimolecular dissociation reaction of energy-selected C(2)H(3)Br(+) to form C(2)H(3) (+)+Br near its threshold. The analysis of the breakdown curves for C(2)H(3)Br(+) and C(2)H(3) (+) yields a value of 11.9010+/-0.0015 eV for the 0 K dissociative photoionization threshold or appearance energy (AE) for C(2)H(3) (+) from C(2)H(3)Br. This AE(C(2)H(3) (+)) value, together with the ionization energy (IE) for C(2)H(3)Br (9.8200+/-0.0015 eV) obtained by PFI-PE and threshold photoelectron (TPE) measurements, has allowed the determination of the 0 K dissociation energy (D(0)) for the C(2)H(3) (+)-Br bond to be 2.081+/-0.002 eV. The 0 K AE(C(2)H(3) (+)) from C(2)H(3)Br obtained in this study corresponds to DeltaH(f0) ( composite function )(C(2)H(3) (+))=1123.7+/-1.9 kJ/mol. Combining the latter value and the known DeltaH(f0) ( composite function )(C(2)H(3))=306.7+/-2.1 kJ/mol, we calculated a value of 8.468+/-0.029 eV for the IE(C(2)H(3)), which is in accord with the result obtained in the previous photoionization efficiency study. We have also carried out high-level ab initio calculations for the IE(C(2)H(3)) at the Gaussian-3 and the CCSD(T,full)/CBS level of theory. The CCSD(T,full)/CBS prediction of 8.487 eV for the IE(C(2)H(3)-->bridged-C(2)H(3) (+)) is in good agreement with the IE(C(2)H(3)) value derived in the present experiment. Combining the 0 K AE(C(2)H(3) (+))=11.9010+/-0.0015 eV and the IE(C(2)H(3))=8.468+/-0.029 eV yields the value of 3.433+/-0.029 eV for D(0)(C(2)H(3)-Br). We have also recorded the TPE spectrum of C(2)H(3)Br in the energy range of 9.80-12.20 eV. Members (n=5-14) of four autoionizing Rydberg series converging to the C(2)H(3)Br(+)(A (2)A(')) state are observed in the TPE spectrum. The analysis of the converging limit of these Rydberg series and the vibrational TPE bands for C(2)H(3)Br(+)(A (2)A(')) has provided more precise values for the nu(6) (+) (1217+/-10 cm(-1)) and nu(8) (+) (478+/-8 cm(-1)) modes and the IE (10.9156+/-0.0010 eV) for the formation of C(2)H(3)Br(+)(A (2)A(')) from C(2)H(3)Br.

Rovibrational-state-selected photoionization of acetylene by the two-color IR+VUV scheme: observation of rotationally resolved Rydberg transitions

We have demonstrated a rovibrational-state-selected photoionization experiment using an IR laser and high-resolution VUV-synchrotron radiation. The VUV photoionization of acetylene [C2H2(Xtilde; (1)Sigma(+)(g);nu(3)=1,J(')=8 or 10)] prepared by IR excitation reveals three strong autoionizing Rydberg series converging to C2H+2(Xtilde; (2)Pi(u);nu(+)(3)=1) with little ion background interference. Rotational transitions resolved for the Rydberg states provide an estimate of approximately 1.8 ps for their lifetimes. This experiment opens the way for state-selective photoionization studies of polyatomic molecules using VUV-synchrotron radiation.

Preliminary evaluation of "interpreter" role plays in teaching communication skills to medical undergraduates

RATIONALE AND OBJECTIVES

Multiculturalism presents linguistic obstacles to health care provision. We explored the early introduction of "interpreter" role-play exercises in teaching medical undergraduates communication skills. The interpreter role creates a natural barrier in communication providing an active prompt for recognizing learning needs in this area.

METHODS

Bilingual Cantonese first-year medical students (n=160) were randomly allocated to either "Observer" or "Interpreter" role plays at a small-group introductory communication skills workshop using a quasi experimental design, counterbalanced across tutors. Students assessed their own skill competence before and, together with their perceptions of the different role plays' effectiveness, again after the workshop, using an anonymous 16 item Likert-type scale, analysed using ANOVA and MANOVA.

RESULTS

Students' assessments of their skills improved significantly following the workshop (F=73.19 [1,156], P=0.0009). Students in the observer group reported greater changes in their scores following the workshop than did students in the interpreter group (F=4.84 [1,156], P=0.029), largely due to improvement in perceived skill (F=4.38 [1,156], P=0.038) rather than perceived programme effectiveness (F=3.13 [1,156], P > 0.05). Subsequent MANOVA indicated no main effect of observer/interpreter conditions, indicating these differences could be attributed to chance alone (F=1.41 [16 141], P > 0.05).

CONCLUSION

The workshop positively influenced students' perceived communication skills, but the "Interpreter" role was less effective than the "Observer" role in achieving this. Future studies should examine whether interpreter role plays introduced later in the medical programme are beneficial.

Successful radiofrequency ablation in an infant with drug-resistant permanent junctional reciprocating tachycardia

Over the past decade, the technique of radiofrequency ablation has evolved substantially. Currently, most forms of cardiac arrhythmias seen in children can be treated with good long-term results and low risk of adverse outcome. Curative arrhythmia treatment with this technique, however, is still uncommon in neonates and infants. Reported here is our experience in the management of an 8-week-old with drug-resistant permanent junctional reciprocating tachycardia.

Simplified single patch technique for the repair of atrioventricular septal defect

OBJECTIVE

Because of the complexity of traditional 1- and 2-patch techniques for the repair of complete atrioventricular septal defect, we modified our repair technique to avoid the use of any ventricular septal patch material. We report our prospective experience with this simplified 1-patch technique.

METHOD

Forty-seven consecutive patients between May 1995 and August 1998 underwent repair with the use of this technique without modification. Repair was done in all patients by direct suturing of the common atrioventricular valve leaflets to the crest of the ventricular septum. No division of valve leaflets was necessary. A single pericardial patch was used to close the defect in the atrial septal component. Follow-up included electrocardiography and echocardiographic assessment of ventricular function, atrioventricular valve function, and adequacy of the left ventricular outflow tract.

RESULTS

There were 2 deaths (4%), only 1 cardiac related, in the series. There were 17 male patients and 30 female patients. Mean age at repair was 5.6 months (median, 3.4 months). Associated lesions were repaired in 19 patients (40%). Mean follow-up was 1.85 years (median, 1.9 years). There was no heart block. There were no significant residual ventricular septal defects detected and no left ventricular outflow tract obstruction seen on echocardiography in any patient to date. Mitral valve status after operation was assessed as no incompetence in 13 patients (28%), minimal in 19 patients (40%), mild in 12 patients (26%), and moderate in 3 patients (6%).

CONCLUSION

The repair of complete atrioventricular septal defect by direct suturing of the atrioventricular valve leaflets to the crest of the ventricular septum with a single-patch technique greatly simplifies the repair and does not lead to left ventricular outflow tract obstruction nor interfere with valve function.

Supraventricular electrical interaction in conjoined twins with common coronary sinus

Conjoined twins with echocardiographic evidence of continuity of the coronary sinuses had identical heart rates on ECG. Both had broad, polyphasic QRS complexes, and various imaging modalities were unable to determine whether there was ventricular myocardial continuity. Administration of adenosine demonstrated that the broad polyphasic complexes were a "fusion" of the twins' individual QRS complexes, which could be clearly distinguished after administration of the drug. Ventricular pacing resulted in dissociation of the individual QRS complexes, thus demonstrating an absence of ventricular myocardial continuity. This was confirmed when the twins were successfully separated at the age of 10 months.

Radiofrequency catheter ablation in a haemodynamically compromised premature neonate with hydrops fetalis

A preterm infant was born at 35 weeks gestation after failed antenatal antiarrhythmic therapy. The infant had an incessant supraventricular tachycardia, impaired ventricular function and hypotension and failed to respond to adenosine, cardioversion and intravenous amiodarone. After resuscitation from cardiovascular collapse, a successful radiofrequency catheter ablation (RFA) of a left free wall atrioventricular pathway was performed at 24 h of age without extracorporeal support. The infant is normal on follow up at 12 months of age. Whilst most fetal and neonatal supraventricular tachyarrhythmias respond to antiarrhythmic medications and RFA is not required, this is the earliest RFA to be performed on a premature infant when antiarrhythmics have failed.

Radiofrequency catheter ablation of right ventricular outflow tract tachycardia in a preschooler

A 3-year-old girl presented with a febrile illness complicated by right ventricular outflow tract tachycardia, which persisted after resolution of the presumed viral infection. The tachycardia was intermittent, but was significantly exacerbated by exercise. Radiofrequency ablation (RFA) of the ectopic focus was successfully performed and the child remains free of tachycardia 12 months later. A review of the literature suggests that RFA in children is increasingly seen as a safe and convenient option for the treatment of supraventricular tachycardia, whereas the management of ectopic ventricular tachycardia in pediatric practice has not been well defined.

Adenosine in the management of supraventricular tachycardia in children

OBJECTIVE

To assess the efficacy and safety of adenosine in the management of supraventricular tachycardia in children.

METHODOLOGY

A review of 43 children with supraventricular tachycardia who received intravenous adenosine between June 1992 and July 1995.

RESULTS

Thirty-five patients had re-entrant supraventricular tachycardia and eight patients had atrial tachydysrhythmias. Reversion to sinus rhythm occurred in 75% of episodes in all patients treated for supraventricular tachycardia, and in 96% of episodes in patients with re-entrant supraventricular tachycardia. Early re-initiation of supraventricular tachycardia after reversion to sinus rhythm occurred in 25% of episodes. Sixteen percent of patients reverted with the recommended 0.05 mg/kg starting dose, and 35% reverted with a dose of 0.1 mg/kg. Four patients were given adenosine as a diagnostic procedure to elicit occult pre-excitation. The most common side effects were brief feelings of discomfort. No serious side effects occurred.

CONCLUSION

Adenosine is safe and effective in the management of supraventricular tachycardia in children. A commencing dose of 0.1 mg/kg is appropriate.