Synthesis of Hybrid Tin-Based Perovskite Microcrystals for LED Applications.

Considerable focus on tin-based perovskites lies on substitution to leadhalide perovskites for the fabrication of eco-friendly optoelectronic devices.The major concern related to tin-based perovskite devices are mainly thestability and the efficiency. However, thinking on the final commercializationscope, other considerations such as precursor stability and cost are majorfactors to carry about. In this regard, this work presents a robust and facilesynthesis of 2D A2SnX4 (A = 4-fluorophenethylammonium(4-FPEA); X = I, Br, I/Br) and 3D FASnI3 perovskite microcrystals followinga developed synthesis strategy with low-cost starting materials. In thisdeveloped methodology, acetic acid is used as a solvent, which helps to protectfrom water by making a hydrophobic network over the perovskite surface, andhence provides sufficient ambient and long-term inert atmosphere stability ofthe microcrystals. Further, the microcrystals are recrystallized in thin filmsfor LED application, allowing the fabrication of orange, near-infrared and purered emitting LEDs. The two-step recrystallized devices show better performanceand stability in comparison to the reference devices made by using commercialprecursors. Importantly, the developed synthesis methodology is defined as ageneric method for the preparation of varieties of hybrid tin-based perovskitesmicrocrystals and application in optoelectronic devices.

Tailoring Single-Mode Random Lasing of Tin Halide Perovskites Integrated in a Vertical Cavity.

The development of random lasing (RL) with predictable and controlled properties is an important step to make these cheap optical sources stable and reliable. However, the design of tailored RL characteristics (emission energy, threshold, number of modes) is only obtained with complex photonic structures, while the simplest optical configurations able to tune the RL are still a challenge. This work demonstrates the tuning of the RL characteristics in spin-coated and inkjet-printed tin-based perovskites integrated into a vertical cavity with low quality factor. When the cavity mode is resonant with the photoluminescence (PL) peak energy, standard vertical lasing is observed. More importantly, single mode RL operation with the lowest threshold and a quality factor as high as 1 000 (twenty times the quality factor of the resonator) is obtained if the cavity mode lies above the PL peak energy due to higher gain. These results can have important technological implications toward the development of low-cost RL sources without chaotic behavior.

Large-Area, Flexible, Lead-Free Sn-Perovskite Solar Modules.

For the first time, large-area, flexible organic-inorganic tin perovskite solar modules are fabricated by means of an industry-compatible and scalable blade-coating technique. An 8-cell interconnected mini module with dimensions of 25 cm2 (active area = 8 × 1.5 cm2) reached 5.7% power conversion efficiency under 1000 W/m2 (AM 1.5G) and 9.4% under 2000 lx (white-LED).

Síndrome antifosfolípidos catastrófico en México. Revisión de la bibliografía / Catastrophic antiphospholipid syndrome in Mexico. Literature review

El síndrome antifosfolípidos catastrófico (SAFC) es una entidad rara. Se han reportado aproximadamente 600 casos en todo el mundo, y se desconoce la prevalencia en México. Objetivo: Conocer la prevalencia estimada de SAFC en México. Material y métodos: Se realizó una búsqueda bibliográfica de casos clínicos aislados o series de casos en los diversos buscadores, utilizando los términos «síndrome antifosfolípidos catastrófico» y «México», en mayo de 2022. Resultados: Encontramos una serie de casos retrospectivos en necropsias que incluyeron 12 casos, dos reportes que incluyeron 2 casos cada uno, y también se encontraron reportes de 11 casos clínicos aislados; estas publicaciones se generaron entre 2003 y 2020. En total, se tienen datos de 27 casos de SAFC, de los cuales 16 corresponden al síndrome antifosfolípidos primario, 10 en asociación con lupus eritematoso sistémico y 1 caso de esclerosis sistémica. La tasa de prevalencia estimada en la población mexicana en 2022 es de 2 casos por cada 10.000.000 de habitantes. La mortalidad estimada fue del 68% en esta serie de casos. Conclusión: Los casos de SAFC en México están subreportados; sin embargo, identificarlos ayudará a mejorar las estrategias diagnósticas y terapéuticas que se utilizan actualmente en el país, incentivando la implementación de la triple terapia y, en casos refractarios, el uso de eculizumab, para reducir la mortalidad actual. (AU)

Catastrophic antiphospholipid syndrome (CAPS) is a rare entity, approximately 600 cases have been reported around the world, and the prevalence in Mexico is unknown. Objective: To determine the estimated prevalence of CAPS in Mexico. Material and methods: A literature search of isolated clinical cases or case series was conducted in diverse search engines, using the terms: «catastrophic antiphospholipid syndrome» and «Mexico» in May 2022. Results: We found a series of retrospective cases in autopsies that included 12 cases, two reports that included 2 cases each, and reports of 11 isolated clinical cases; these publications were generated between 2003 and 2020. In total, we collected data on 27 cases of CAPS, of which 16 correspond to primary antiphospholipid syndrome, 10 are associated with systemic lupus erythematosus, and 1 case corresponds to systemic sclerosis. The estimated prevalence rate in the Mexican population in 2022 is 2 cases per 10,000,000 inhabitants. The estimated mortality was 68% in this case series. Conclusion: Cases of catastrophic antiphospholipid syndrome in Mexico are underreported; identifying them will help improve current diagnostic and therapeutic strategies used in the country, encouraging the implementation of triple therapy and, in refractory cases, the use of eculizumab, to reduce current mortality. (AU)

The ∆Pv-aCO2/∆Ca-vO2 ratio as a predictor of mortality in patients with severe acute respiratory distress syndrome related to COVID-19.

OBJECTIVE: To evaluate the central venous-to-arterial carbon dioxide difference combined with arterial-to-venous oxygen content difference (∆Pv-aCO2/∆Ca-vO2 ratio) as a predictor of mortality in patients with COVID-19-related severe acute respiratory distress syndrome (ARDS). METHODS: Patients admitted to the intensive care unit with severe ARDS secondary to SARS-CoV-2, and invasive mechanical ventilation were included in this single-center and retrospective cohort study performed between April 18, 2020, and January 18, 2022. The tissue perfusion indexes (lactate, central venous oxygen saturation [ScvO2], and venous-to-arterial carbon dioxide pressure difference [∆Pv-aCO2]), anaerobic metabolism index (∆Pv-aCO2/∆Ca-vO2 ratio), and severity index (Simplified Acute Physiology Score II [SAPSII]) were evaluated to determine its association with the mortality through Cox regression analysis, Kaplan-Meier curve and receiver operating characteristic (ROC) curve. RESULTS: One hundred fifteen patients were included in the study and classified into two groups, the survivor group (n = 54) and the non-survivor group (n = 61). The lactate, ScvO2, ∆Pv-aCO2, and ∆Pv-aCO2/∆Ca-vO2 ratio medians were 1.6 mEq/L, 75%, 5 mmHg, and 1.56 mmHg/mL, respectively. The ∆Pv-aCO2/∆Ca-vO2 ratio (Hazard Ratio (HR) = 1.17, 95% confidence interval (CI) = 1.06-1.29, p = 0.001) was identified as a mortality biomarker for patients with COVID-19-related severe ARDS. The area under the curve for ∆Pv-aCO2/∆Ca-vO2 ratio was 0.691 (95% CI 0.598-0.774, p = 0.0001). The best cut-off point for ∆Pv-aCO2/∆Ca-vO2 ratio was >2.14 mmHg/mL, with a sensitivity of 49.18%, specificity of 85.19%, a positive likelihood of 3.32, and a negative likelihood of 0.6. The Kaplan-Meier curve showed that survival rates were significantly worse in patients with values greater than this cut-off point. CONCLUSIONS: The ∆Pv-aCO2/∆Ca-vO2 ratio could be used as a predictor of mortality in patients with severe ARDS secondary to SARS-CoV-2.

Catastrophic antiphospholipid syndrome in Mexico. Literature review.

Catastrophic antiphospholipid syndrome (CAPS) is a rare entity, approximately 600 cases have been reported around the world, and the prevalence in Mexico is unknown. OBJECTIVE: To determine the estimated prevalence of CAPS in Mexico. MATERIAL AND METHODS: A literature search of isolated clinical cases or case series was conducted in diverse search engines, using the terms: "Catastrophic Antiphospholipid Syndrome" and "Mexico" in May 2022. RESULTS: We found a series of retrospective cases in autopsies that included 12 cases, two reports that included 2 cases each, and reports of 11 isolated clinical cases; these publications were generated between 2003 and 2020. In total, we collected data on 27 cases of CAPS, of which 16 correspond to primary antiphospholipid syndrome, 10 are associated with systemic lupus erythematosus, and 1 case corresponds to systemic sclerosis. The estimated prevalence rate in the Mexican population in 2022 is 2 cases per 10,000,000 inhabitants. The estimated mortality was 68% in this case series. CONCLUSION: Cases of catastrophic antiphospholipid syndrome in Mexico are underreported; identifying them will help improve current diagnostic and therapeutic strategies used in the country, encouraging the implementation of triple therapy and, in refractory cases, the use of eculizumab, to reduce current mortality.

Unusual Spectrally Reproducible and High Q-Factor Random Lasing in Polycrystalline Tin Perovskite Films.

An unusual spectrally reproducible near-IR random lasing (RL) with no fluctuation of lasing peak wavelength is disclosed in polycrystalline films of formamidinium tin triiodide perovskite, which have been chemically stabilized against Sn2+ to Sn4+ oxidation. Remarkably, a quality Q-factor as high as ≈104 with an amplified spontaneous emission (ASE) threshold as low as 2 µJ cm-2 (both at 20 K) are achieved. The observed spectral reproducibility is unprecedented for semiconductor thin film RL systems and cannot be explained by the strong spatial localization of lasing modes. Instead, it is suggested that the spectral stability is a result of such an unique property of Sn-based perovskites as a large inhomogeneous broadening of the emitting centers, which is a consequence of an intrinsic structural inhomogeneity of the material. Due to this, lasing can occur simultaneously in modes that are spatially strongly overlapped, as long as the spectral separation between the modes is larger than the homogeneous linewidth of the emitting centers. The discovered mechanism of RL spectral stability in semiconductor materials, possessing inhomogeneous broadening, opens up prospects for their practical use as cheap sources of narrow laser lines.

Índices de oxigenación como marcadores pronósticos en neumonía grave por SARS-CoV-2 / Oxygenation indices as prognostic marker in severe pneumonia due to SARS-CoV-2 / Índices de oxigenação como marcadores prognósticos na pneumonia grave por SARS-CoV-2

Resumen: Introducción: a través de los índices de oxigenación valoramos la función del sistema respiratorio de oxigenación y ventilación. Objetivo: determinar el valor de los índices de oxigenación como factor de pronóstico para el desenlace en neumonía grave por SARS-CoV-2. Material y métodos: estudio retrospectivo, longitudinal, descriptivo, analítico. Se incluyeron pacientes > 18 años con diagnóstico de neumonía por SARS-CoV-2 entre el 01 junio y el 31 de diciembre de 2020. Se clasificó a los pacientes de acuerdo al desenlace: sobreviviente o no sobreviviente. Se empleó estadística descriptiva y pruebas paramétricas y no paramétricas de acuerdo al caso, se construyeron curvas ROC (Receiver Operating Characteristic Curve) para determinar los puntos de corte de los gases arteriales con la mejor sensibilidad y especificidad y se determinó el área bajo la curva (ABC) para el desenlace fatal. Resultados: se incluyeron 175 pacientes, 70.3% correspondió al sexo masculino, la media de edad fue de 56 años (rango intercuartil 45-64). El grupo de sobrevivientes incluyó 51 pacientes y el grupo de no sobrevivientes 124 pacientes. Al analizar los gases arteriales al momento de ingresar a la unidad de cuidados intensivos sobresale la PaO2/FiO2 de 100 mmHg y el índice respiratorio (IR) > 2.4 con un ABC de 0.694 y 0.722 respectivamente. A las 96 horas de ingreso destaca PaO2/FiO2 de 145 mmHg, el IR >3 y la PaO2/PAO2 de 0.22 con un ABC de 0.846, 0.840 y 0.842 respectivamente. Conclusión: los gases arteriales medidos a las 96 horas de ingreso a la UCI son marcadores pronósticos para el desenlace fatal en la neumonía grave por SARS-CoV-2.

Abstract: Introduction: oxygenation indices we assess the function of the respiratory system of oxygenation and ventilation. Objective: to determine the value of arterial gases as a prognostic factor for the outcome of patients with severe SARS-CoV-2 pneumonia. Material and methods: retrospective, longitudinal, descriptive, analytical study. We included patients > 18 years with a diagnosis of SARS-CoV-2 pneumonia between 1 June and 31 December 2020. Patients were classified according to outcome: survivor or non-survivor. Descriptive statistics and parametric and non-parametric tests were used according to the case, ROC (Receiver Operating Characteristic Curve) curves were constructed to determine the cut-off points of arterial gases with the best sensitivity and specificity and the area under the curve (AUC) for the fatal outcome was determined. Results: we included 175 patients, 70.3% corresponded to the male sex, the mean age was 56 years (interquartile range 45-64). The survivor group included 51 patients and the non-survivor group 124 patients. When analyzing arterial gases at the time of admission to the ICU, paO2/FiO2 of 100 mmHg and respiratory index (RI) > 2.4 with ABC 0.694 and 0.722 respectively. At 96 hours of admission, PaO2/FiO2 of 145 mmHg stands out, the RI > 3 and the DA-aO2 of 0.22 with ABC 0.846, 0.840 and 0.842 respectively. Conclusion: arterial blood gases measured at 96 hours of ICU admission are prognostic markers for fatal outcome in severe SARS-CoV-2 pneumonia.

Resumo: Introdução: através dos índices de oxigenação avaliamos a função do sistema respiratório de oxigenação e ventilação. Objetivo: determinar o valor dos índices de oxigenação como fator prognóstico para o desfecho em pneumonia grave por SARS-CoV-2. Material e métodos: estudo retrospectivo, longitudinal, descritivo, analítico. Icluíram-se pacientes com mais de 18 anos de idade diagnosticados com pneumonia por SARS-CoV-2 entre 1º de junho e 31 de dezembro de 2020. Os pacientes foram classificados de acordo com o desfecho: sobreviventes ou não sobreviventes. Foram usadas estatística descritiva e testes paramétricos e não paramétricos de acordo com o caso, foram construídas curvas ROC (Receiver Operating Characteristic Curve) para determinar os pontos de corte da gasometria arterial com melhor sensibilidade e especificidade e determinou-se a área sob a curva (ABC) para o desfecho fatal. Resultados: incluíram-se 175 pacientes, 70.3% eram do sexo masculino, a média de idade foi de 56 anos (rango interquartil 45-64). O grupo sobrevivente incluiu 51 pacientes e o grupo não sobrevivente 124 pacientes. Na análise dos gases arteriais no momento da admissão na UTI, destacam-se a PaO2/FiO2 de 100 mmHg e o índice respiratório (IR) > 2.4 com AUC 0.694 e 0.722 respectivamente. Às 96 horas de internamento destaca-se PaO2/FiO2 145 mmHg, IR > 3 e PaO2/PAO2 de 0.22 com ABC 0.846, 0.840 e 0.842 respetivamente. Conclusão: os gases sanguíneos arteriais medidos 96 horas após a admissão na UTI são marcadores prognósticos para desfecho fatal em pneumonia grave por SARS-CoV-2.

Simplified acute physiology score II and Mannheim peritonitis index are associated with in-hospital mortality in patients with abdominal sepsis admitted to ICU.

OBJECTIVE: The objective of this study was to assess the association and interaction of laboratory parameters, Simplified Acute Physiology Score II (SAPSII), Modified Shock Index (MSI), and Mannheim Peritonitis Index (MPI) with in-hospital mortality. MATERIAL AND METHODS: We conducted a single-center case-control study. Adult patients with abdominal sepsis were included from May 2015 to May 2020. Baseline characteristics, laboratory parameters, SAPSII, MSI, and MPI scores at admission were collected. A principal component (PC) analysis was applied to evaluate variable interactions. In-hospital mortality risk was determined through logistic regression models. RESULTS: One hundred and twenty-seven patients were identified, 60 of which were included for analyses. Non-survivors (48.4%) had a higher frequency of hypertension, lactate and MPI, and lower BE and alactic BE levels. Eight PCs were obtained, PC1 being a linear combination of pH, AG, cAG, alactic BE, bicarbonate, and BE. MPI (OR = 9.87, 95% CI: 3.07-36.61, p = 0.0002), SAPSII (OR = 1.07, 95% CI: 1.01-1.14, p = 0.01), and PC1 (OR = 2.13, 95% CI: 1.12-4.76, p = 0.04) were significantly associated with mortality in univariate analysis, while MPI (OR = 10.1, 95% CI: 3.03-40.06, p = 0.0003) and SAPSII (OR = 1.07, CI95%: 1.01-1.14, p = 0.02) remained significant after adjusting for age and sex. CONCLUSION: MPI and SAPSII were associated with mortality, although the interaction of laboratory parameters was not.

OBJETIVO: Evaluar la asociación e interacción de los parámetros de laboratorio, SAPSII, MSI y MPI con la mortalidad intrahospitalaria. MATERIALES Y MÉTODOS: Nosotros realizamos un estudio de casos y controles de pacientes adultos con sepsis abdominal desde mayo 2015 a mayo 2020. Recolectamos las características basales, parámetros de laboratorio, SAPSII, MSI y MPI al ingreso. Se aplicó un Análisis de Componentes Principales. El riesgo de mortalidad intrahospitalaria se determinó mediante modelos de regresión logística. RESULTADOS: Identificamos 127 pacientes, 60 de los cuales se incluyeron. Los no supervivientes (48,4%) tuvieron mayor frecuencia de HAS, lactato y MPI, y menores niveles de EB y EB aláctico. Se obtuvieron ocho Componentes Principales (PC), siendo PC1 una combinación lineal de pH, AG, cAG, EB aláctico, bicarbonato y EB. MPI (OR = 9.87, IC95%: 3.07-36.61, p = 0.0002), SAPSII (OR = 1.07, IC95%: 1.01-1.14, p = 0.01) y PC1 (OR = 2.13, IC95%: 1.12-4.76, p = 0.04) se asociaron significativamente con la mortalidad en el análisis univariado, mientras que MPI (OR = 10.1, IC95%: 3.03-40.06, p = 0.0003) y SAPSII (OR = 1.07, IC 95%: 1.01-1.14, p = 0.02) permanecieron significativos después del ajuste por edad y sexo. CONCLUSIONES: MPI y SAPSII se asociaron con mortalidad, aunque la interacción de los parámetros de laboratorio no lo hizo.

2D PEA2SnI4 Inkjet-Printed Halide Perovskite LEDs on Rigid and Flexible Substrates.

Lead-free PEA2SnI4-based perovskite LEDs are successfully inkjet-printed on rigid and flexible substrates. Red-emitting devices (λmax = 633 nm) exhibit, under ambient conditions, a maximum external quantum efficiency (EQEmax) of 1% with a related brightness of 30 cd/m2 at 10 mA/cm2.

Decúbito prono prolongado: una estrategia no ventilatoria en neumonía grave por SARS-CoV-2 / Prono position: a non-ventilatory strategy in patients with severe pneumonia due to SARS-CoV-2 / Posição prona prolongada: uma estratégia não ventilatória em pneumonia grave devido a SARS-CoV-2

Resumen: Introducción: La neumonía grave por SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) ocasiona hipoxemia severa, por lo anterior, las guías para el manejo de pacientes adultos críticamente enfermos con COVID-19 recomiendan el uso de la posición decúbito prono para mejorar la oxigenación. Material y métodos: Estudio de cohorte, prospectivo, descriptivo y analítico. Pacientes ingresados a la unidad de cuidados intensivos en el periodo comprendido entre el 18 de abril de 2020 y el 18 de agosto de 2021 con ventilación mecánica invasiva (VMI) secundaria a neumonía grave por SARS-CoV-2 confirmados. Resultados: En el periodo comprendido se incluyeron 110 pacientes que cumplieron con los criterios de inclusión. Del total, 88 pacientes se incluyeron en el grupo de mejoría sostenida al retiro del prono y 22 en el grupo de mejoría no sostenida al retiro del prono. Se observó que la disminución del porcentaje de la PaO2/FiO2 al retiro del prono es útil para predecir mortalidad con ABC de 0.740 con IC95% de (0.646-0.834) y p = 0.001. Conclusión: La disminución > 50% de la PaO2/FiO2 al retiro de la posición decúbito prono prolongado o mejoría no sostenida es un predictor de mortalidad en los pacientes con neumonía grave por SARS-CoV-2.

Abstract: Introduction: Severe pneumonia due to SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) causes severe hypoxemia, therefore, the guidelines for the management of critically ill adult patients with COVID-19 recommend the use of the prone position to improve oxygenation. Material and methods: A prospective, descriptive and analytical cohort study. Patients admitted to the intensive care unit in the period from April 18, 2020 to August 18, 2021 with confirmed IMV secondary to severe SARS-CoV-2 pneumonia. Results: In the period covered, 110 patients who met the inclusion criteria were included. Of the total, 88 patients were included in the group with sustained improvement at prone withdrawal and 22 in the group with non-sustained improvement at prone withdrawal. It was observed that the% Decrease in PaO2/FiO2 upon prone removal is useful to predict mortality with AUC of 0.740 with 95% CI of (0.646-0.834) and p = 0.001. Conclusion: A > 50% decrease in PaO2/FiO2 upon removal from prolonged prone position or unsustained improvement is a predictor of mortality in patients with severe SARS-CoV-2 pneumonia.

Resumo: Introdução: A pneumonia grave por SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) causa hipoxemia grave, portanto, as diretrizes para o manejo de pacientes adultos criticamente doentes com COVID-19 recomendam o uso da posição prona para melhorar a oxigenação. Material e métodos: Estudo de coorte, prospectivo, descritivo e analítico. Pacientes admitidos na unidade de terapia intensiva no período entre 18 de abril de 2020 e 18 de agosto de 2021 com VMI secundária a pneumonia grave por SARS-CoV-2 confirmadas. Resultados: No período abrangido, incluíram-se 110 pacientes que atenderam aos critérios de inclusão. Do total, 88 pacientes foram incluídos no grupo melhora sustentada na retirada da posição prona e 22 no grupo melhora não sustentada na retirada da posição prona. Observou-se que a % de diminuição da PaO2/FiO2 na retirada da pronação é útil para predizer mortalidade com ABC de 0.740 com IC de 95% de (0.646-0.834) e p = 0.001. Conclusão: Uma diminuição > 50% na PaO2/FiO2 após a retirada da posição prona prolongada ou melhora não sustentada é um preditor de mortalidade em pacientes com pneumonia grave por SARS-CoV-2.

Monkeypox outbreak predominantly affecting men who have sex with men, Madrid, Spain, 26 April to 16 June 2022.

Up to 22 June 2022, 508 confirmed cases of monkeypox (MPX) have been reported in the Madrid region of Spain, 99% are men (n = 503) with a median age of 35 years (range: 18-67). In this ongoing outbreak, 427 cases (84.1%) reported condomless sex or sex with multiple partners within the 21 days before onset of symptoms, who were predominantly men who have sex with men (MSM) (n = 397; 93%). Both the location of the rash, mainly in the anogenital and perineal area, as well as the presence of inguinal lymphadenopathy suggest that close physical contact during sexual activity played a key role in transmission. Several cases reported being at a sauna in the city of Madrid (n = 34) or a mass event held on the Spanish island of Gran Canaria (n = 27), activities which may represent a conducive environment for MPX virus spread, with many private parties also playing an important role. Because of the rapid implementation of MPX surveillance in Madrid, one of the largest outbreaks reported outside Africa was identified. To minimise transmission, we continue to actively work with LGBTIQ+ groups and associations, with the aim of raising awareness among people at risk and encouraging them to adopt preventive measures.

Tin perovskite solar cells with >1,300 h of operational stability in N2 through a synergistic chemical engineering approach.

Despite the promising properties of tin-based halide perovskites, one clear limitation is the fast Sn+2 oxidation. Consequently, the preparation of long-lasting devices remains challenging. Here, we report a chemical engineering approach, based on adding Dipropylammonium iodide (DipI) together with a well-known reducing agent, sodium borohydride (NaBH4), aimed at preventing the premature degradation of Sn-HPs. This strategy allows for obtaining efficiencies (PCE) above 10% with enhanced stability. The initial PCE remained unchanged upon 5 h in air (60% RH) at maximum-power-point (MPP). Remarkably, 96% of the initial PCE was kept after 1,300 h at MPP in N2. To the best of our knowledge, these are the highest reported values for Sn-based solar cells. Our findings demonstrate a beneficial synergistic effect when additives are incorporated, highlight the important role of iodide in the performance upon light soaking, and, ultimately, unveil the relevance of controlling the halide chemistry for future improvement of Sn-based perovskite devices.

El índice de anaerobiosis predice mortalidad en neumonía grave por SARS-CoV-2 / The anaerobiosis index predicts mortality in patients with severe pneumonia due to SARS-CoV-2 / O índice de anaerobiose prevê a mortalidade em pneumonia grave devido a SARS-CoV-2

Resumen: Introducción: Detectar y corregir el metabolismo anaerobio es indispensable en el paciente críticamente enfermo; desafortunadamente, no existe un estándar de oro. Los pacientes con neumonía grave por SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) presentan hipoxemia severa, aumentando el metabolismo anaerobio. El lactato y la diferencia de presión venoarterial de dióxido de carbono/diferencia del contenido arteriovenoso de oxígeno (Δp(v-a)CO2/ΔC(a-v)O2) son útiles en este contexto. Material y métodos: Estudio de cohorte, prospectivo, descriptivo y analítico, que incluyó pacientes ingresados a la Unidad de Cuidados Intensivos (UCI) en el periodo comprendido entre el 18 de abril de 2020 al 18 de enero de 2021 con neumonía grave (definida por el inicio de ventilación mecánica invasiva) por SARS-CoV-2 confirmados. Resultados: En el periodo comprendido se incluyeron 91 pacientes que cumplieron con los criterios de inclusión. Del total, 39 pacientes se incluyeron en el grupo de supervivientes y 52 en el grupo de no supervivientes. Se puede observar que la Δp(v-a)CO2/ΔC(a-v)O2, o índice de anaerobiosis, tiene OR de 4.4, IC de 95% 1.51-13.04, p = 0.006 en el análisis multivariable. Conclusión: El incremento de la Δp(v-a)CO2/ΔC(a-v)O2, o índice de anaerobiosis, > 1.4 mmHg/mL está relacionado con 4.44 veces más riesgo de muerte en los pacientes con neumonía grave (intubados) por SARS-CoV-2.

Abstract: Introduction: Detecting and correcting anaerobic metabolism is essential in the critically ill patient, unfortunately, there is no gold standard. Patients with severe pneumonia due to SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) present severe hypoxemia, increasing anaerobic metabolism. Lactate and the venoarterial carbon dioxide pressure difference/arteriovenous oxygen content difference (Δp(v-a)CO2/ΔC(a-v)O2) are useful in this context. Material and methods: Prospective, descriptive and analytical cohort study that included patients admitted to the Intensive Care Unit (ICU) in the period from April 18, 2020 to January 18, 2021 with severe pneumonia (defined by the start of invasive mechanical ventilation) by SARS-CoV-2 confirmed. Results: In the period covered, 91 patients who met the inclusion criteria were included. Of the total, 39 patients were included in the survivors group and 52 in the non-survivors group. It can be seen that the Δp(v-a)CO2/ΔC(a-v)O2 also called anaerobiosis index has OR 4.4, 95% CI 1.51-13.04, p = 0.006 in the multivariate analysis. Conclusion: The increase in the Δp(v-a)CO2/ΔC(a-v)O2 also called anaerobiosis index > 1.4 mmHg/mL is associated with a 4.44 times higher risk of death in patients with severe pneumonia (intubated) due to SARS-CoV-2.

Resumo: Introdução: Detectar e corrigir o metabolismo anaeróbio é essencial no paciente crítico, infelizmente, não existe um «padrão ouro¼. Pacientes com pneumonia grave por SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) apresentam hipoxemia grave, aumentando o metabolismo anaeróbio. O lactato e a diferença de pressão venoarterial de dióxido de carbono/diferença do conteúdo arteriovenoso de oxigênio (Δp(v-a)CO2/ΔC(a-v)O2) são úteis neste cenário. Material e métodos: Estudo de coorte, prospectivo, descritivo e analítico que incluiu pacientes internados na Unidade de Terapia Intensiva (UTI) no período de 18 de abril de 2020 a 18 de janeiro de 2021 com pneumonia grave (definida pelo início da ventilação mecânica invasiva) por SARS-CoV-2 confirmados. Resultados: No período compreendido, foram incluídos 91 pacientes que atenderam aos critérios de inclusão. Do total, 39 pacientes foram incluídos no grupo sobrevivente e 52 no grupo não sobrevivente. Pode-se observar que o Δp(v-a)CO2/ΔC(a-v)O2 ou índice de anaerobiose tem OR 4.4, IC 95% 1.51-13.04, p = 0.006 na análise multivariada. Conclusão: Um aumento em Δp(v-a)CO2/ΔC(a-v)O2 ou índice de anaerobiose > 1.4 mmHg/mL está associado a um aumento de 4.44 vezes no risco de morte em pacientes com pneumonia grave (entubados) por SARS-CoV-2.

Awake prone positioning and oxygen therapy in patients with COVID-19: the APRONOX study.

BACKGROUND: The awake prone positioning strategy for patients with acute respiratory distress syndrome is a safe, simple and cost-effective technique used to improve hypoxaemia. We aimed to evaluate intubation and mortality risk in patients with coronavirus disease 2019 (COVID-19) who underwent awake prone positioning during hospitalisation. METHODS: In this retrospective, multicentre observational study conducted between 1 May 2020 and 12 June 2020 in 27 hospitals in Mexico and Ecuador, nonintubated patients with COVID-19 managed with awake prone or awake supine positioning were included to evaluate intubation and mortality risk through logistic regression models; multivariable and centre adjustment, propensity score analyses, and E-values were calculated to limit confounding. RESULTS: 827 nonintubated patients with COVID-19 in the awake prone (n=505) and awake supine (n=322) groups were included for analysis. Fewer patients in the awake prone group required endotracheal intubation (23.6% versus 40.4%) or died (19.8% versus 37.3%). Awake prone positioning was a protective factor for intubation even after multivariable adjustment (OR 0.35, 95% CI 0.24-0.52; p<0.0001, E=2.12), which prevailed after propensity score analysis (OR 0.41, 95% CI 0.27-0.62; p<0.0001, E=1.86) and mortality (adjusted OR 0.38, 95% CI 0.26-0.55; p<0.0001, E=2.03). The main variables associated with intubation among awake prone patients were increasing age, lower baseline peripheral arterial oxygen saturation/inspiratory oxygen fraction ratio (P aO2 /F IO2 ) and management with a nonrebreather mask. CONCLUSIONS: Awake prone positioning in hospitalised nonintubated patients with COVID-19 is associated with a lower risk of intubation and mortality.

Ultrasonido Point-Of-Care (POCUS) durante la reanimación cardiopulmonar para el diagnóstico de causas reversibles de arresto cardiaco / Point-Of-Care ultrasound (POCUS) during cardiopulmonary resuscitation for the diagnosis of reversible causes of cardiac arrest / Ultrassonografia Point-of-Care (POCUS) durante a reanimação cardiopulmonar para o diagnóstico de causas reversíveis de parada cardíaca

Resumen: La ultrasonografía enfocada al paciente crítico o «ultrasonido Point-Of-Care¼ (POCUS) es una herramienta utilizada en la cabecera del paciente en distintas áreas de la medicina crítica y servicios de emergencias debido a su practicidad y a que provee gran información de forma rápida y no invasiva para realizar diagnósticos y abordajes terapéuticos. El arresto cardiaco (AC) es una situación crítica que requiere una adecuada reanimación cardiopulmonar (RCP) y en la que es crucial la identificación de la etiología para realizar una intervención rápida y lograr la resolución de la misma, particularmente en el escenario de una actividad eléctrica sin pulso (AESP) en la que la ecografía cobra vital importancia. La implementación de protocolos de reanimación cardiopulmonar apoyados de un abordaje ultrasonográfico es factible y de gran utilidad para la identificación etiológica del AC y la resolución de causas específicas.

Abstract: Ultrasound focused on the critical patient or «Point-Of-Care ultrasound¼ (POCUS) is a tool used at the patient's bedside in different areas of critical medicine and emergency services due to its practicality as it provides great information quickly and non-invasive for diagnostic and therapeutic approaches. Cardiac arrest (CA) is a critical situation that requires adequate cardiopulmonary resuscitation (CPR), and in which the identification of the etiology is crucial to carry out a rapid intervention and achieve its resolution, particularly in the setting of a pulseless electrical activity (AESP) in which ultrasound is of vital importance. The implementation of cardiopulmonary resuscitation protocols supported by an ultrasound approach is feasible and of great utility for the etiological identification of CA and the resolution of specific causes.

Resumo: A ultrassonografia focada em pacientes críticos ou «Point-Of-Care ultra-som¼ (POCUS) é uma ferramenta utilizada à beira do leito do paciente em diferentes áreas da medicina crítica e serviços de emergência devido à sua praticidade e ao fato de fornecer uma grande quantidade de informações rapidamente e não invasivo para abordagens diagnósticas e terapêuticas. A parada cardíaca (PC) é uma situação crítica que requer uma adequada ressuscitação cardiopulmonar (RCP) e na qual a identificação da etiologia é crucial para a rápida intervenção e resolução, particularmente no cenário de uma atividade elétrica sem pulso (AESP) em qual o ultra-som é de vital importância. A implementação de protocolos de ressuscitação cardiopulmonar apoiados por uma abordagem ultrassonográfica é viável e muito útil para a identificação etiológica do RAC e resolução de causas específicas.