Assessment and management of statin-associated muscle symptoms (SAMS): A clinical perspective from the National Lipid Association.

Statin-associated muscle symptoms (SAMS) are the most common form of statin intolerance and are associated with increased risk of cardiovascular events that manifest from statin underutilization and discontinuation. The reported frequencies of SAMS are divergent in the literature. The writing group estimates the prevalence of SAMS, namely all muscle symptoms temporally related to statin use but without regard to causality, to be about 10% (range 5% to 25%), and the prevalence of pharmacological SAMS, specifically muscle symptoms resulting from pharmacological properties of the statin, to be about 1-2% (range 0.5% to 4%). In clinical practice, SAMS are likely to result from a combination of pharmacological and nonpharmacological effects, however this does not make the symptoms any less clinically relevant. Regardless of the etiology, SAMS need to be addressed in accordance with patients' preferences and experiences. This clinical perspective reviews the epidemiology and underlying pathophysiology of SAMS, and the cardiovascular consequences resulting from statin discontinuation. We present patient-centered clinical and communication strategies to mitigate SAMS and improve medication adherence and outcomes among statin users. Treatment strategies include 1) optimizing lifestyle interventions, 2) modulating risk factors that may contribute to muscle symptoms, 3) optimizing statin tolerability by dose reduction, decreased dosing frequency, or use of an alternate statin with more favorable pharmacokinetic properties, and 4) use of non-statins, emphasizing those with evidence for atherosclerotic risk reduction, either in combination with or in place of statin therapy depending on the patient's circumstances. The focus of this clinical perspective is sustainable lipoprotein goal achievement, which is important for cardiovascular risk reduction.

Improving the Thermal Stability of NMC 622 Li-Ion Battery Cathodes through Doping During Coprecipitation.

Increasing the Ni content of LiNixMnyCo1-x-yO2 (NMC) cathodes can increase the capacity, but additional stability is needed to improve safety and longevity characteristics. In order to achieve this improved stability, Mg and Zr were added during the coprecipitation to uniformly dope the final cathode material. These dopants reduced the capacity of the material to some extent, depending on the concentration and calcination temperature. However, these dopants can impart substantial stabilization. It was found that the degree of stabilization is strongly dependent on the calcination temperature of the material. In addition, we used synchrotron X-ray diffraction during thermal breakdown to better understand why the different dopants impact the thermal stability and confirm the stabilization effects of the dopants.

Celiac Disease in the Pediatric Population.

Celiac disease is an autoimmune disorder in which the lining of the gastrointestinal tract is damaged by an immune-mediated response to gluten proteins (Allen, 2015). It is a polygenetic disease that only appears in genetically susceptible individuals (Newton & Singer, 2012). It is a worldwide concern, with North America having a high prevalence rate (Liu et al., 2017). Celiac disease can present in a spectrum of manifestations, making it difficult to identify and diagnosis (Reilly & Green, 2012). High-risk populations include those with a positive family history as well as individuals with other autoimmune disorders (Newton & Singer, 2012). Screening and diagnosis are completed with a blood test followed by a biopsy of the small intestinal lining (Zevit & Shamir, 2014). Currently, the only treatment for celiac disease is a strict, gluten-free diet. Further research is warranted in areas of environmental risk factors and treatments (Allen, 2015; Newton & Singer, 2012).

Electrochemical (de)lithiation of silver ferrite and composites: mechanistic insights from ex situ, in situ, and operando X-ray techniques.

The structure of pristine AgFeO2 and phase makeup of Ag0.2FeO1.6 (a one-pot composite comprised of nanocrystalline stoichiometric AgFeO2 and amorphous γ-Fe2O3 phases) was investigated using synchrotron X-ray diffraction. A new stacking-fault model was proposed for AgFeO2 powder synthesized using the co-precipitation method. The lithiation/de-lithiation mechanisms of silver ferrite, AgFeO2 and Ag0.2FeO1.6 were investigated using ex situ, in situ, and operando characterization techniques. An amorphous γ-Fe2O3 component in the Ag0.2FeO1.6 sample is quantified. Operando XRD of electrochemically reduced AgFeO2 and Ag0.2FeO1.6 composites demonstrated differences in the structural evolution of the nanocrystalline AgFeO2 component. As complimentary techniques to XRD, ex situ X-ray Absorption Spectroscopy (XAS) provided insight into the short-range structure of the (de)lithiated nanocrystalline electrodes, and a novel in situ high energy X-ray fluorescence nanoprobe (HXN) mapping measurement was applied to spatially resolve the progression of discharge. Based on the results, a redox mechanism is proposed where the full reduction of Ag+ to Ag0 and partial reduction of Fe3+ to Fe2+ occur on reduction to 1.0 V, resulting in a Li1+yFeIIIFeIIyO2 phase. The Li1+yFeIIIFeIIyO2 phase can then reversibly cycle between Fe3+ and Fe2+ oxidation states, permitting good capacity retention over 50 cycles. In the Ag0.2FeO1.6 composite, a substantial amorphous γ-Fe2O3 component is observed which discharges to rock salt LiFe2O3 and Fe0 metal phase in the 3.5-1.0 V voltage range (in parallel with the AgFeO2 mechanism), and reversibly reoxidizes to a nanocrystalline iron oxide phase.

Visualization of lithium-ion transport and phase evolution within and between manganese oxide nanorods.

Multiple lithium-ion transport pathways and local phase changes upon lithiation in silver hollandite are revealed via in situ microscopy including electron diffraction, imaging and spectroscopy, coupled with density functional theory and phase field calculations. We report unexpected inter-nanorod lithium-ion transport, where the reaction fronts and kinetics are maintained within the neighbouring nanorod. Notably, this is the first time-resolved visualization of lithium-ion transport within and between individual nanorods, where the impact of oxygen deficiencies is delineated. Initially, fast lithium-ion transport is observed along the long axis with small net volume change, resulting in two lithiated silver hollandite phases distinguishable by orthorhombic distortion. Subsequently, a slower reaction front is observed, with formation of polyphase lithiated silver hollandite and face-centred-cubic silver metal with substantial volume expansion. These results indicate lithium-ion transport is not confined within a single nanorod and may provide a paradigm shift for one-dimensional tunnelled materials, particularly towards achieving high-rate capability.

Impact of Multifunctional Bimetallic Materials on Lithium Battery Electrochemistry.

Electric energy storage devices such as batteries are complex systems comprised of a variety of materials with each playing separate yet interactive roles, complicated by length scale interactions occurring from the molecular to the mesoscale. Thus, addressing specific battery issues such as functional capacity requires a comprehensive perspective initiating with atomic level concepts. For example, the electroactive materials which contribute to the functional capacity in a battery comprise approximately 30% or less of the total device mass. Thus, the design and implementation of multifunctional materials can conceptually reduce or eliminate the contribution of passive materials to the size and mass of the final system. Material multifunctionality can be achieved through appropriate material design on the atomic level resulting in bimetallic electroactive materials where one metal cation forms mesoscale conductive networks upon discharge while the other metal cations can contribute to atomic level structure and net functional secondary capacity, a device level issue. Specifically, this Account provides insight into the multimechanism electrochemical redox processes of bimetallic cathode materials based on transition metal oxides (MM'O) or phosphorus oxides (MM'PO) where M = Ag and M' = V or Fe. One discharge process can be described as reduction-displacement where Ag(+) is reduced to Ag(0) and displaced from the parent structure. This reduction-displacement reaction in silver-containing bimetallic electrodes allows for the in situ formation of a conductive network, enhancing the electrochemical performance of the electrode and reducing or eliminating the need for conductive additives. A second discharge process occurs through the reduction of the second transition metal, V or Fe, where the oxidation state of the metal center is reduced and lithium cations are inserted into the structure. As both metal centers contribute to the functional capacity, determining the kinetically and thermodynamically preferred reduction processes at various states of discharge is critical to elucidating the mechanism. Specific advanced in situ and ex situ characterization techniques are conducive to gaining insight regarding the electrochemical behavior of these multifunctional materials over multiple length scales. At the material level, optical microscopy, scanning electron microscopy, and local conductivity measurement via a nanoprobe can track the discharge mechanism of an isolated single particle. At the mesoscale electrode level, in situ data from synchrotron based energy dispersive X-ray diffraction (EDXRD) within fully intact steel batteries can be used to spatially map the distribution of silver metal generated through reduction displacement as a function of discharge depth and discharge rate. As illustrated here, appropriate design of materials with multiple electrochemically active metal centers and properties tuned through strategically conceptualized materials synthesis may provide a path toward the next generation of high energy content electroactive materials and systems. Full understanding of the multiple electrochemical mechanisms can be achieved only by utilizing advanced characterization tools over multiple length scales.

Structural Defects of Silver Hollandite, Ag(x)Mn8O(y), Nanorods: Dramatic Impact on Electrochemistry.

Hollandites (OMS-2) are an intriguing class of sorbents, catalysts, and energy storage materials with a tunnel structure permitting one-dimensional insertion and deinsertion of ions and small molecules along the c direction. A 7-fold increase in delivered capacity for Li/AgxMn8O16 electrochemical cells (160 versus 23 mAh/g) observed upon a seemingly small change in silver content (x ∼1.1 (L-Ag-OMS-2) and 1.6 (H-Ag-OMS-2)) led us to characterize the structure and defects of the silver hollandite material. Herein, Ag hollandite nanorods are studied through the combined use of local (atomic imaging, electron diffraction, electron energy-loss spectroscopy) and bulk (synchrotron based X-ray diffraction, thermogravimetric analysis) techniques. Selected area diffraction and high resolution transmission electron microscopy show a structure consistent with that refined by XRD; however, the Ag occupancy varies significantly even within neighboring channels. Both local and bulk measurements indicate a greater quantity of oxygen vacancies in L-Ag-OMS-2, resulting in lower average Mn valence relative to H-Ag-OMS-2. Electron energy loss spectroscopy shows a lower Mn oxidation state on the surface relative to the interior of the nanorods, where the average Mn valence is approximately Mn(3.7+) for H-Ag-OMS-2 and Mn(3.5+) for L-Ag-OMS-2 nanorods, respectively. The higher delivered capacity of L-Ag-OMS-2 may be related to more oxygen vacancies compared to H-Ag-OMS-2. Thus, the oxygen vacancies and MnO6 octahedra distortion are assumed to open the MnO6 octahedra walls, facilitating Li diffusion in the ab plane. These results indicate crystallite size and surface defects are significant factors affecting battery performance.

Organometallic rhenium(III) chalcogenide clusters: coordination of N-heterocyclic carbenes.

The preparation of rhenium based octahedral clusters containing N-heterocyclic carbenes is described. These represent the first examples of [M6(µ3-Q)8](n+) or [M6(µ3-X)8](n+) clusters to contain a carbene ligand of any type (NHC, Fischer or Schrock). Surprisingly, the NHC ligands attenuate their luminescent properties.

Synthetic control of composition and crystallite size of silver ferrite composites: profound electrochemistry impacts.

A paradigm for concomitant control of crystallite size and composition of bimetallic composites via co-precipitation is introduced. Direct preparation of composites of silver ferrite and amorphous maghemite via nonstoichiometric synthesis was demonstrated. Notable impact on electrochemistry was observed, with ∼200% increase in reversible capacity for the small crystallite material.

Azide alkyne cycloaddition facilitated by hexanuclear rhenium chalcogenide cluster complexes.

Two hexanuclear rhenium clusters containing azide ligands, [Re6Se8(PEt3)5(N3)]BF4 and [Re6Se8(PEt3)4(N3)2], were synthesized from the analogous pyridine complexes and fully characterized. Studies show that [Re6Se8(PEt3)5(N3)]BF4 reacts with activated alkynes, dimethyl acetylenedicarboxylate and methyl 4-hydroxyhex-2-yneoate, to form the triazolate cluster complexes [Re6Se8(PEt3)5(L1 or L2)]BF4 (where L1 = 4,5-bis(methoxycarbonyl)-1,2,3-triazol-2-yl and L2 = 4-methoxycarbonyl-5-(1-propanol)-1,2,3-triazol-2-yl). The bis-triazolato complex, cis-[Re6Se8(PEt3)4(L1)2] was also prepared via a similar reaction starting with cis-[Re6Se8(PEt3)4(N3)2] demonstrating that these clusters can promote two azide moieties to undergo heterocyclic ring formation. The structures of [Re6Se8(PEt3)5(N3)]BF4, [Re6Se8(PEt3)4(N3)2], and [Re6Se8(PEt3)5(L1)](BF4), were determined by single-crystal X-ray diffraction analysis. In addition, studies involving the alkylation of [Re6Se8(PEt3)5(L1)]BF4 with benzyl bromide and methyl iodide are reported.

Preparation of a family of hexanuclear rhenium cluster complexes containing 5-(phenyl)tetrazol-2-yl ligands and alkylation of 5-substituted tetrazolate ligands.

The preparation of two new families of hexanuclear rhenium cluster complexes containing benzonitrile and phenyl-substituted tetrazolate ligands is described. Specifically, we report the preparation of a series of cluster complexes with the formula [Re(6)Se(8)(PEt(3))(5)L](2+) where L = benzonitrile, p-aminobenzonitrile, p-methoxybenzonitrile, p-acetylbenzonitrile, or p-nitrobenzonitrile. All of these complexes undergo a [2 + 3] cycloaddition with N(3)(-) to generate the corresponding [Re(6)Se(8)(PEt(3))(5)(5-(p-X-phenyl)tetrazol-2-yl)](+) (or [Re(6)Se(8)(PEt(3))(5)(2,5-p-X-phenyltetrazolate)](+)) cluster complexes, where X = NH(2), OMe, H, COCH(3), or NO(2). Crystal structure data are reported for three compounds: [Re(6)Se(8)(PEt(3))(5)(p-acetylbenzonitrile)](BF(4))(2)•MeCN, [Re(6)Se(8)(PEt(3))(5)(2,5-phenyltetrazolate)](BF(4))•CH(2)Cl(2), and [Re(6)Se(8)(PEt(3))(5)(2,5-p-aminophenyltetrazolate)](BF(4)). Treatment of [Re(6)Se(8)(PEt(3))(5)(2,5-phenyltetrazolate)](BF(4)) with HBF(4) in CD(3)CN at 100 °C leads to protonation of the tetrazolate ring and formation of [Re(6)Se(8)(PEt(3))(5)(CD(3)CN)](2+). Surprisingly, alkylation of the phenyl and methyl tetrazolate complexes ([Re(6)Se(8)(PEt(3))(5)(2,5-N(4)CPh)](BF(4)) and [Re(6)Se(8)(PEt(3))(5)(1,5-N(4)CMe)](BF(4))) with methyl iodide and benzyl bromide, leads to the formation of mixtures of 1,5- and 2,5-disubstituted tetrazoles.

Substitution of the terminal chloride ligands of [Re(6)S(8)Cl(6)](4-) with triethylphosphine: photophysical and electrochemical properties of a new series of [Re(6)S(8)](2+) based clusters.

A systematic substitution of the terminal chlorides coordinated to the hexanuclear cluster [Re(6)S(8)Cl(6)](4-) has been conducted. The following complexes: [Re(6)S(8)(PEt(3))Cl(5)](3-) (1), cis- (cis-2) and trans-[Re(6)S(8)(PEt(3))(2)Cl(4)](2-) (trans-2), mer- (mer-3) and fac-[Re(6)S(8)(PEt(3))(3)Cl(3)](-) (fac-3), and cis- (cis-4) and trans-[Re(6)S(8)(PEt(3))(4)Cl(2)] (trans-4) were synthesized and fully characterized. Compared to the substitution of the halide ligands of the related [Re(6)S(8)Br(6)](4-) and [Re(6)Se(8)I(6)](3-) clusters, the chloride ligands are slower to substitute which allowed us to prepare the first monophosphine cluster (1). In addition, the synthesis of fac-3 was optimized by using cis-2 as the starting material, which led to a significant increase in the overall yield of this isomer. Notably, we observed evidence of phosphine isomerization taking place during the preparation of the facial isomer; this was unexpected based on the relatively inert nature of the Re-P bond. The structures of Bu(4)N(+) salts of trans-2, mer-3, and fac-3 were determined using X-ray crystallography. All compounds display luminescent behavior. A study of the photophysical properties of these complexes includes measurement of the excited state lifetimes (which ranged from 4.1-7.1 µs), the emission quantum yields, the rates of radiative and non-radiative decay, and the rate of quenching with O(2). Quenching studies verify the triplet state nature of the excited state.