Author Contributions: Drs Mortus and Rosengart had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Excessive inflammatory responses in the surgical patient may result in cellular hypo-responsiveness, which is associated with an increased risk of secondary infection and death. microRNAs (miRNAs), such as miR-155, are powerful regulators of inflammatory signalling pathways including nuclear factor κB (NFκB). Our objective was to determine the effect of IκK-16, a selective blocker of inhibitor of kappa-B kinase (IκK), on miRNA expression and the monocyte inflammatory response. In a model of endotoxin tolerance using primary human monocytes, impaired monocytes had decreased p65 expression with suppressed TNF-α and IL-10 production (P < 0.05). miR-155 and miR-138 levels were significantly upregulated at 17 h in the impaired monocyte (P < 0.05). Notably, IκK-16 decreased miR-155 expression with a corresponding dose-dependent decrease in TNF-α and IL-10 production (P < 0.05), and impaired monocyte function was associated with increased miR-155 and miR-138 expression. In the context of IκK-16 inhibition, miR-155 mimics increased TNF-α production, while miR-155 antagomirs decreased both TNF-α and IL-10 production. These data demonstrate that IκK-16 treatment attenuates the monocyte inflammatory response, which may occur through a miR-155-mediated mechanism, and that IκK-16 is a promising approach to limit the magnitude of an excessive innate inflammatory response to LPS.

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SUMMARYAn electrochemical cell utilizing a molten salt eutectic electrolyte (ZnCl 2 -KCl) is investigated as a new low-cost energy storage technology. Using Zn as the anode, a broad range of candidate cathode materials (Al, Ag, Bi, C, Cu, a Ni alloy, Sn, and Pb) are characterized by open-circuit potential, chronoamperometry, and electrochemical impedance spectroscopy methods. Cells employing the molten metal cathodes Sn, Bi, and Pb deliver markedly high current densities independent of their standard reduction potentials. Molten Pb (at 330°C), for example, gave 25 times higher current density than solid Pb (at 315°C). Additionally, ZnCl 2 -KCl is employed for the first time in an energy storage application and it affords an operating temperature >100°C lower than other liquid metal battery technologies. Thermal properties of this relatively air-stable molten salt electrolyte allow for a second mode of energy storage, that is, thermal. The combination of an inexpensive Zn anode, low-temperature eutectic electrolyte, and a molten metal cathode offers a simple and promising electrochemical system for dual-mode (thermal-electrochemical) large-scale energy storage.

(1 of 9) 1600035 wileyonlinelibrary.com grid storage. To date, much research in EES has focused on batteries with lithium as a charge carrier, spurred by success in portable electronics, but high costs, short lifetimes, and safety issues make lithium technology less than ideal for grid storage. [4][5][6][7] The chemistry of all-vanadium redox fl ow batteries has yielded promising cycle lifetimes, but this technology is hindered by the high cost of vanadium and low energy densities and round-trip efficiencies. [8][9][10] For EES technologies to be practical for grid storage, systems must utilize low-cost, abundant, and safe materials.Liquid metal batteries (LMBs), which contain molten metal electrodes and molten salt electrolytes, have recently re-emerged as candidates for grid storage technologies. [ 11,12 ] These batteries, which contain socalled "structureless" electrodes, are not susceptible to mechanical degradation inherent with intercalation-type electrochemistry. Until now LMB technologies have featured a design in which the immiscible molten materials naturally stratify into three layers, where the density of the electrolyte lies between that of the two electrodes. While this design simplifi es battery fabrication, the relative density requirement (i) limits materials choices, precluding the use of many low-cost materials, (ii) necessitates exceedingly high operating temperatures, and/or (iii) compromises on safety due to material reactivity. [ 13,14 ] Recently reported LMBs contain highly reactive metals such as Ca, Mg, or Li and operate at high temperatures (450-700 °C). Furthermore, the stratifi ed LMB design is susceptible to electrode dissolution and magnetohydrodynamic instabilities at high current densities, which could lead to cell shorting and thermal runaway. [ 11 ] Other recent examples of batteries containing a liquid metal electrode include Na-NiCl 2 batteries and Na-S batteries; these electrodes are separated by a ceramic membrane and do not have the strict requirements of relative densities and immiscibility and can reach lower operating temperatures. However, the performance of these batteries is limited by the inclusion of nonconducting materials in the electrode (NiCl 2 or S), and the batteries still pose dangers because they contain corrosive liquids and brittle membranes. [15][16][17] In the present work, we sought to address the shortcomings of the above technologies while keeping material and energy costs low by creating a zinc-based LMB. Zinc (Zn), an inexpensive multivalent energy carrier, has a high theoretical energy density of 820 mAh g −1 , and, in an all-molten cell design, Molten Zinc Alloys for Lower

Molten salts at moderate temperatures (ca. 460-690 K) are investigated as electrolytes in two different electrochemical cells employing Zn and Sn electrodes. The thermodynamics and kinetics are explored in an H-cell design, as an analogue to the conventional galvanic cell, and in a one pot, membrane-free system. Emf-temperature measurements reveal opposing trends between the two designs owing to different redox chemistry at the cathode. The potential of these systems for electrochemical energy storage applications are considered. The simpler, membrane-free design is able to deliver the highest short-circuit current densities due to lower Zn activity in a molten ZnSn alloy.

BACKGROUND: Opioid use has grown exponentially over the last decade. The effect of preoperative opioid prescription in patients with Crohn’s disease undergoing surgery is unknown. OBJECTIVE: The purpose of this study was to identify whether preoperative opioid prescription is associated with adverse postoperative outcomes in Crohn’s disease. DESIGN: This is a single-institution retrospective observational study. SETTINGS: This study was performed at an academic tertiary care center. Details of preoperative opioid prescription were collected from the Kentucky All-Schedule Prescription Electronic Reporting database and the electronic databases of bordering states. PATIENTS: Consecutive patients undergoing ileocolic resection for Crohn’s disease from 2014 to 2018 were included. MAIN OUTCOME MEASURES: The outcomes examined were major complications (Clavien–Dindo ≥3a), length of stay, and 30-day hospital readmission. RESULTS: Fifty one of 118 patients were prescribed opioids within 6 months preoperatively (range, 0–33,760 morphine milligram equivalents). Patients with preoperative opioid prescription compared with no preoperative opioid prescription required more daily opioids during hospital admission (p = 0.024). Nineteen patients had a major postoperative complication (preoperative opioid prescription: 26% (13/51) vs no preoperative opioid prescription: 9% (6/67)). On multivariable analysis, preoperative opioid prescription (OR = 2.994 (95% CI, 1.024–8.751); p = 0.045) was a significant risk factor for a major complication. Preoperative opioid prescription was associated with increased length of stay (p < 0.001) and was a risk factor for readmission (OR = 2.978 (95% CI, 1.075–8.246); p = 0.036). Twenty-four patients were readmitted. Using a cutoff for higher opioid prescription of 300 morphine milligram equivalents within 6 months preoperation (eg, 60 tablets of hydrocodone/acetaminophen 5/325), preoperative opioid prescription remained a risk factor for major postoperative complications (OR = 3.148 (95% CI, 1.110–8.928); p = 0.031). LIMITATIONS: This was a retrospective study and could not assess nonprescribed opioid use. CONCLUSIONS: Preoperative opioid prescription was a significant risk factor for adverse outcomes in patients with Crohn’s disease undergoing elective ileocolic resection. See Video Abstract at http://links.lww.com/DCR/B113. LA PRESCRIPCIÓN PREOPERATORIA DE OPIOIDES SE ASOCIA CON COMPLICACIONES MAYORES EN PACIENTES CON ENFERMEDAD DE CROHN SOMETIDOS A RESECCIÓN ILEOCÓLICA ELECTIVA ANTECEDENTES: El uso de opioides ha crecido exponencialmente en la última década. Se desconoce el efecto de la prescripción preoperatoria de opioides en pacientes con enfermedad de Crohn sometidos a cirugía. OBJETIVO: Identificar si la prescripción preoperatoria de opioides está asociada con resultados postoperatorios adversos en la enfermedad de Crohn. DISEÑO. Este es un estudio observacional retrospectivo de una sola institución. AJUSTES: Este estudio se realizó en un centro académico de atención terciaria. Los detalles de la prescripción preoperatoria de opiáceos se recopilaron de la base de datos de “Kentucky All-Schedule Prescription Electronic Reporting” y de las bases de datos electrónicas de los estados fronterizos. PACIENTES: Pacientes consecutivos sometidos a resección ileocólica por enfermedad de Crohn entre 2014-2018. PRINCIPALES MEDIDAS DE RESULTADO: Los resultados examinados fueron complicaciones mayores (Clavien-Dindo ≥3a), duración de la estancia y el reingreso hospitalario de 30 días. RESULTADOS: A cincuenta y uno de 118 pacientes se le recetaron opioides dentro de los 6 meses preoperatorios (rango, 0 a 33,760 equivalentes de miligramos de morfina). Los pacientes con prescripción preoperatoria de opioides en comparación con ninguna prescripción preoperatoria de opioides requirieron más opioides diarios durante el ingreso hospitalario (p = 0,024). Diecinueve pacientes tuvieron una complicación postoperatoria importante (prescripción preoperatoria de opioides: 26% [13/51] frente a ninguna prescripción preoperatoria de opioides: 9% [6/67]). En el análisis multivariable, la prescripción de opioides preoperatorios (OR = 2.994, IC 95%: 1.024-8.751, p = 0.045) fueron factores de riesgo significativos para una complicación mayor. La prescripción preoperatoria de opioides se asoció con un aumento de la duración de la estadía (p <0.001) y fue un factor de riesgo para el reingreso (OR = 2.978, IC 95%: 1.075-8.246, p = 0.036). Veinticuatro pacientes fueron readmitidos. Utilizando un límite para una mayor prescripción de opioides de 300 miligramos equivalentes de morfina dentro de los 6 meses previos a la operación (p. Ej., 60 tabletas de hidrocodona / acetaminofén 5/325), la prescripción preoperatoria de opioides siguió siendo un factor de riesgo para complicaciones postoperatorias mayores (OR = 3.148 IC 95%: 1.110-8.928, p = 0.031). LIMITACIONES: Este fue un estudio retrospectivo y no pudo evaluar el uso de opioides no prescritos. CONCLUSIÓN: La prescripción preoperatoria de opioides fue un factor de riesgo significativo para los resultados adversos en pacientes con enfermedad de Crohn sometidos a resección ileocólica electiva. Consulte Video Resumen en http://links.lww.com/DCR/B113.