New test can ID patients at risk of severe COVID-19, study finds

Peer-Reviewed Publication

UNIVERSITY OF VIRGINIA HEALTH SYSTEM

 

IMAGE: UVA HEALTH'S ALEXANDRA KADL, MD, EXAMINED THE ABILITY OF A TEST TO PREDICT OUTCOMES FOR PATIENTS WITH COVID-19. view more 

CREDIT: DAN ADDISON | UVA COMMUNICATIONS

A genomic test being developed by a Charlottesville, Va., company can predict a patient’s risk of developing severe COVID-19, new research from UVA Health suggests. That information could help doctors identify patients at high risk for poor outcomes and quickly begin tailored treatment. 

The approach proved more than 90% accurate at predicting outcomes among more than two dozen patients in the intensive care unit at UVA and 100 patients from publicly available data generated at Duke and Harvard. The test, called CovGENE, analyzes genes expressed in a person’s blood to determine whether they may experience a severe disease course with increased risk of death.

“We have come far in the prevention and treatment of COVID-19 in the past two years. Regardless, we still struggle to identify patients at highest risk for severe disease. Our study uses a gene-analysis approach to identify an immune cell signature, distinct from other respiratory illnesses, that correlates with worse outcomes,” said researcher Alexandra Kadl, MD, of UVA Health’s Division of Pulmonary and Critical Care Medicine. “This knowledge has the potential to help evaluate patients’ immune profile with commonly, readily available assays to identify patients at risk for bad outcomes who would benefit from closer monitoring and advanced therapies to aid their recovery.” 

Predicting COVID-19 Severity

Based on the promising results of the UVA research, CovGENE’s developer, AMPEL Biosolutions, is seeking to partner with a diagnostic testing company or pharmaceutical company to bring the approach to market as a simple PCR-based blood test.

“This unique collaboration with our colleagues from the University of Virginia has provided an easy and novel means to assess an individual patient's response to the SARS-CoV-2 virus and predict the clinical outcome,” said Peter Lipsky, MD, AMPEL’s CEO, chief medical officer and co-founder. “Now that this unique approach has been validated, we look forward to its rapid development as a precision-medicine tool that can improve the outcome of patients with COVID-19 and reduce the number of hospitalizations, especially the most vulnerable.”

AMPEL Biosolutions aims to use genomic data to improve healthcare for patients. The company develops gene expression tests for blood or tissue samples to assist doctors in clinical decision-making. 

Company co-founder Amrie Grammer, PhD, is an alumna of UVA, having received both her bachelor’s and master’s degree there.

Findings Published

The researchers have published their findings in the journal Frontiers in Immunology. The team consisted of Andrea R. Daamen, Prathyusha Bachali, Catherine A. Bonham, Lindsay Somerville, Jeffrey M. Sturek, Amrie Grammer, Alexandra Kadl and Peter Lipsky. Daamen, Bachali, Grammer and Lipsky are employed by AMPEL BioSolutions.

The work was supported by the National Institutes of Health’s National Heart Lung Blood Institute, grant K23 HL143135; the National Institute of Allergy and Infectious Diseases, grant 1R21AI160334; the COVID-19 Rapid Response Initiative by UVA’s Global Infectious Disease Institute; and The RILITE Foundation.

To keep up with the latest medical research news from UVA, subscribe to the Making of Medicine blog at http://makingofmedicine.virginia.edu.

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DOI

10.3389/fimmu.2022.989556 

COI STATEMENT

Daamen, Bachali, Grammer and Lipsky are employed by AMPEL BioSolutions.

Excess weight, not high blood sugar, associated with increased risk of COVID-19 infection and long COVID

Analyses of over 30,000 UK adults from nine prospective cohort studies finds a high pre-pandemic BMI was associated with a higher risk of COVID-19 infection and long COVID

Reports and Proceedings

DIABETOLOGIA

High body mass index (BMI), rather than high blood sugar levels, are associated with excess risks of COVID-19 infection and long COVID, according to a meta-analysis of over 30,000 UK adults from nine large prospective cohort studies.

The findings by Dr Anika Knuppel from the MRC Unit for Lifelong Health and Ageing, University College London, UK, and colleagues are being presented at this year’s European Association for the Study of Diabetes (EASD) Annual Meeting in Stockholm, Sweden (19-23 Sept).

“Early in the pandemic research identified diabetes and obesity as risk factors for becoming severely ill with COVID-19. And we know that many people living with type 2 diabetes are also carrying excess weight. Our early findings support the idea that obesity-related mechanisms may be responsible for the excess risks of COVID-19 associated with diabetes, rather than high blood sugar per se,” says Dr Knuppel.

Previous research showed that people with diabetes and obesity are more likely to become severely ill and die if they catch COVID-19, but are no more likely to contract it. However, the underlying mechanisms, and their role in prolonged post-COVID-19 symptoms (long COVID), remains unclear.

To find out more, researchers looked for associations between a range of clinical characteristics measured before the pandemic—HbA1c (average blood sugar level), self-reported or medication-based diabetes, body mass index (BMI) and waist-to-hip ratio (WHR)—and self-reported COVID-19 infection and long COVID in nine ongoing UK cohort studies [1].

The analyses included the most recent measurements (taken between 2002 and 2019) of HbA1c, weight, height, waist and hip circumference from each study as well as information from questionnaires on health and lifestyle.

All eligible participants (maximum 31,252, aged 19-75 years old, 57% female) had data on previous measurements and completed at least one questionnaire during the COVID-19 pandemic (May 2020 to September 2021) covering questions on COVID-19 and, where possible, questions on the length of ongoing COVID-19-related symptoms.

Participants reported having COVID-19 based on a positive test or strong suspicion. Long COVID was defined as symptoms that went on or affected functioning for longer than four weeks post-infection and was compared to those reporting symptoms for less than four weeks.

Where possible, associations were adjusted for sex, smoking, ethnicity, income, and education at the time of measurement.

Between May 2020 and September 2021, 5,806 participants reported ever having COVID-19, and 584 reported having long COVID (around 7% of COVID-19 cases with information on symptoms length).

Analysis of data from 31,252 participants in nine studies found higher BMI was associated with greater odds of COVID-19 infection—with the risk 7% higher for each 5kg/m2 increase in BMI. People with overweight (BMI 25-29.9kg/m2) and obesity (30 kg/m2 or greater) had 10% and 16% greater odds of COVID-19 infection, respectively, than healthy weight individuals (less than 25 kg/m2; see figure in notes to editors).

Similar results were observed for long COVID (4,243 participants, six studies)—with the risk 20% higher for each 5kg/m2 increase in BMI. People with overweight and obesity had 20% and 36% greater odds of long COVID, respectively. However, for both COVID infection and long COVID associations with categories of BMI were not all statistically significant (so we cannot be sure they are not due to chance).

Analysis investigating the association with WHR were inconclusive.

Notably, studies focusing on average blood sugar level (HbA1c) and diabetes (15,795 participants and 1,917 for long COVID) revealed no association with COVID-19 or long-COVID (see figure in notes to editors).

The researchers stress the need for further research to explore the mechanisms underpinning these associations and to reduce the excess risk associated with high BMI. “Our early findings suggest a link of adiposity with COVID-19 infection and long COVID-19 even after taking into account socio-demographic factors and smoking. We need to further explore what makes people with overweight and obesity at risk of worse outcomes and how this relates to severe cases”, says Knuppel.

The authors acknowledge that the study was observational and cannot prove that higher BMI increases the risk of COVID-19 infection, and they cannot rule out the possibility that other unmeasured factors (e.g., underlying conditions) or missing data may have affected the results. They also point out that COVID-19 was based on suspicion rather than a positive test, and clinical measurements taken before the pandemic could be outdated for some of the included studies. Finally, they note that study participants were healthier than the general population which may limit the conclusions that may be drawn.

For interviews with the report authors, please contact Dr Anika Knuppel, MRC Unit for Lifelong Health and Ageing, University College London, UK E) anika.knuppel@ucl.ac.uk T) +44(0)2076705719 or +44(0)7474873564

Alternative contact in the EASD Press Room: Tony Kirby T) + 44(0)7834 385827 E) tony@tonykirby.com

Notes to editors:

[1] The preliminary analyses included data from up to 9 UK prospective cohort studies:

• The 1970 British Cohort Study (BCS70)
• Born in Bradford (BiB)*
• The English Longitudinal Study of Ageing (ELSA)*
• Generation Scotland (GS)
• The Millennium Cohort Study (MCS)
• The National Child and Development Study (NCDS)
• The MRC National Survey of Health and Development (NSHD)*
• Avon Longitudinal Study of Parents and Children (ALSPAC G1)
• Understanding Society (USoc), the UK Household Longitudinal Study.

*Not included in analyses of long COVID.

The study was funded by Characterisation, determinants, mechanisms and consequences of the long-term effects of COVID-19: providing the evidence base for health care services (CONVALESCENCE) funded by the National Institute for Health and Care Research.

The authors declare no conflicts of interest.

For Figure see full abstract

This press release is based on abstract 363 at annual meeting of The European Association for the Study of Diabetes (EASD). All accepted abstracts have been extensively peer reviewed by the congress selection committee. There is no full paper at this stage, but the authors are happy to answer your questions. No poster is available with this presentation.

 

 

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COI STATEMENT

The authors declare no conflicts of interest

Disease spillover risk poorly communicated, oversimplified during COVID-19 pandemic

Peer-Reviewed Publication

AMERICAN INSTITUTE OF BIOLOGICAL SCIENCES

COVID-19 has been the first pandemic that has taken place alongside the interconnectivity of the Internet. Consequently, the spread of ideas and information about the disease has been unprecedented—but not always accurate.. One of the widely circulated headlines was that of the relationship between land change and the spillover of diseases from wildlife to humans. Writing in BioScience, Andre D. Mader of the Institute for Global Environmental Strategies and colleagues survey primary and secondary literature, as well as webpage content on the subject of land change and zoonotic disease risk. Based on the patterns picked up from this literature and media coverage, Mader and colleagues describe what amounts to a case study in improper science communication and its possible consequences.

According to the authors, media messaging consistently described direct causality between zoonotic disease spread and land use change, despite the fact that only 53% of the surveyed peer-reviewed literature made this association. The authors delve into theoretical scenarios that would demonstrate the difficulty of tracing the real risk of zoonotic spillover, emphasizing that the “complexity of pathogen responses to land change cannot be reduced to one-size-fits-all proclamations.”

The authors found that as the literature moves from primary research to review articles and commentaries, and finally to webpages, the “overstating of the evidence” increases, with 78% of secondary papers implying the land use–zoonotic spillover association and all but one of the sampled webpages making this association. The authors also noted that secondary sources and webpages often failed to mention the uncertainty associated with their conclusions.

The potential consequences of simplistic messaging and a lack of proper communication regarding zoonotic spillover can erode credibility, neglect local community’s specific needs when it comes to policy making, and detract attention from other factors that can lead to zoonotic spillover, say Mader and colleagues. The authors recommend more accurate, nuanced, and explanatory dissemination of the studies on zoonotic spillover risk, arguing that such an approach would also benefit science more broadly. As the authors conclude, “if the goal of science communication is to improve understanding, it must strike a balance: sufficient simplicity to be grasped by as broad an audience as possible but sufficient nuance to capture the complexity of an issue and contribute meaningfully to the discussion around it, especially when it goes viral.”

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JOURNAL

BioScience

DOI

10.1093/biosci/biac075 

METHOD OF RESEARCH

Literature review

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

Messaging Should Reflect the Nuanced Relationship between Land Change and Zoonotic Disease Risk

ARTICLE PUBLICATION DATE

16-Sep-2022

COVID-19 took serious toll on Native Hawaiian/Pacific Islander mental and physical health

Two UC Riverside-led studies found concerning psychological and physical health problems among more than 300 NH/PIs in five US states

Peer-Reviewed Publication

UNIVERSITY OF CALIFORNIA - RIVERSIDE

RIVERSIDE, Calif. -- Native Hawaiians/Pacific Islanders, or NH/PIs, comprising more than 20 ethnic groups hailing from Polynesia, Micronesia, and Melanesia, are understudied despite being the third fastest growing racial group in the United States. Two studies now report that NH/PIs have been deeply affected by the COVID-19 pandemic.

Andrew Subica at the University of California, Riverside, led research groups that surveyed more than 300 NH/PIs from April-November 2021 in Washington, Utah, Oregon, California, and Arkansas — states with large NH/PI populations. Their findings are published in two journals.

Described in the first paper, published in Public Health Reports, the researchers found 30% of the NH/PI participants reported being diagnosed with COVID-19 and approximately 50% of the participants reported having a close family member with COVID-19.

Further, nearly 1 out of 5 NH/PIs reported the death of a close family member due to COVID-19 infection; the overall U.S. COVID-19 mortality rate was 1 death per 400 persons at the end of 2021.

“NH/PIs may carry the highest rates of COVID-19 infections and deaths of any U.S. racial/ethnic minority group during the pandemic,” said Subica, an associate professor in the School of Medicine’s Department of Social Medicine, Population, and Public Health. “For example, an earlier report found NH/PIs possessed the highest per capita death rate in 90% of states reporting NH/PI COVID-19 deaths.”

According to Subica, several factors increase NH/PIs’ risk for exposure to SARS-CoV-2, the virus that spreads COVID-19. These factors include employment in essential frontline positions, dwelling in dense households and neighborhoods, and traditional sociocultural practices and obligations that result in large in-person group contact.

“Our findings call for greater attention and funding of NH/PI research to prevent and reduce NH/PIs’ glaring health disparities associated with COVID-19,” Subica said. “Due to their high rates of comorbidities such as obesity, cancer, heart disease, and smoking that increase their risk of severe COVID-19 outcomes, it is crucial that future studies monitor and evaluate long-term COVID-19-related health issues facing NH/PI communities.”

The research paper is titled “Assessing the Health and Impact of COVID-19 on Native Hawaiians/Pacific Islanders.”

Substance use patterns and treatment needs

In the second paper, published in Drug and Alcohol Review, Subica and his team share their findings after conducting a large-scale investigation of NH/PI substance use, mental health, and treatment need during COVID-19.

The research team found NH/PI communities experienced high levels of alcohol, tobacco, and other drug use, depression, anxiety, and unmet treatment need during COVID-19; 47% and 22% of NH/PI adults reported current alcohol and cigarette use, respectively, while 35% reported lifetime illicit substance use. The national smoking rate during COVID-19 is 13%.

Further, more than 1 in 4 NH/PI adults, or 27%, screened positive for alcohol use disorder, a rate that is more than 2.6 times the national alcohol use disorder rate during the pandemic. 

Participants also reported heightened depression, anxiety, and psychological distress during COVID-19 with 27% of NH/PIs screening positive for major depressive disorder and 20% for generalized anxiety disorder, vastly exceeding the general population rates for these disorders.

“What our work makes clear is that we need targeted research and treatment services to mitigate COVID-19’s negative behavioral health impact on NH/PI communities,” Subica said. 

The researchers also found that approximately 50% of non-binary NH/PIs in the sample screened positive for probable alcohol use disorder and more than 50% reported needing mental health treatment during COVID-19.

“This illuminates the need for further research exploring the behavioral health needs of these at-risk individuals,” Subica said. “We need to develop and implement culturally responsive prevention, intervention, and recovery programs to reduce NH/PI substance use and mental health disparities during and after the COVID-19 pandemic.”

The research paper is titled “Native Hawaiian/Pacific Islander alcohol, tobacco, and other drug use, mental health, and treatment need in the United States during COVID-19.”
 
Subica was joined in the first study by Dr. Howard B. Moss of UCR; Nia Aitaoto of Pacific Islander Center of Primary Care Excellence; Quixi Li of Special Services for Groups; Brittany N. Morey of UCI; Li-Tzy Wu of Duke University; Derek K. Iwamoto of the University of Maryland; and Erick G. Guerrero of I-Lead Institute.

Subica, Moss, Guerrero, Aitaoto, Morey, and Wu were joined in the second study by Tammy K. K. Martin and Scott K. Okamoto of Hawaii Pacific University.

Both projects were supported by the National Institute of Drug Abuse and National Institute of Alcohol Abuse and Alcoholism of the National Institutes of Health. None of the content of this news release represents the official views of these institutes.

The University of California, Riverside is a doctoral research university, a living laboratory for groundbreaking exploration of issues critical to Inland Southern California, the state and communities around the world. Reflecting California's diverse culture, UCR's enrollment is more than 26,000 students. The campus opened a medical school in 2013 and has reached the heart of the Coachella Valley by way of the UCR Palm Desert Center. The campus has an annual impact of more than $2.7 billion on the U.S. economy. To learn more, visit www.ucr.edu.

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JOURNAL

Public Health Reports

DOI

10.1177/00333549221123579 

METHOD OF RESEARCH

Survey

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Assessing the Health and Impact of COVID-19 on Native Hawaiians/Pacific Islanders.

ARTICLE PUBLICATION DATE

16-Sep-2022

The building blocks for exploring new exotic states of matter

Combining synthesis, characterization, and theory confirmed the exotic properties and structure of a new intrinsic ferromagnetic topological material.

DOE/US DEPARTMENT OF ENERGY

Using the High Flux Isotope Reactor’s DEMAND instrument, neutron scattering studies identified the crystal & magnetic structure of an intrinsic ferromagnetic topological insulator MnBi8Te13. The last column of inset shows its crystal & magnetic structures view more
Credit: Image courtesy Oak Ridge National Laboratory.

The Science

Topological insulators act as electrical insulators on the inside but conduct electricity along their surfaces. Researchers study some of these insulators’ exotic behavior using an external magnetic field to force the ion spins within a topological insulator to be parallel to each other. This process is known as breaking time-reversal symmetry. Now, a research team has created an intrinsic ferromagnetic topological insulator. This means the time-reversal symmetry is broken without applying a magnetic field. The team employed a combination of synthesis, characterization tools, and theory to confirm the structure and properties of new magnetic topological materials. In the process, they discovered an exotic axion insulator in MnBi8Te13.

The Impact

Researchers can use magnetic topological materials to realize exotic forms of matter that are not seen in other types of material. Scientists believe that the phenomena these materials exhibit could help advance quantum technology and increase the energy efficiency of future electronic devices. Researchers believe that a topological insulator that is inherently ferromagnetic, rather than gaining its properties by adding small numbers of magnetic atoms, is ideal for studying novel topological behaviors. This is because no external magnetic field is needed to study the material’s properties. It also means the material’s magnetism is more uniformly distributed. However, scientists have previously faced challenges in creating this kind of material. This new material consists of layers of manganese, bismuth, and tellurium atoms. It could provide opportunities for exploring novel phases of matter and developing new technologies. It also helps researchers study basic scientific questions about quantum materials.

Summary

The research team, led by scientists from the University of California, Los Angeles, developed the intrinsic ferromagnetic topological insulator by making a compound with alternating layers of MnBi2Te4 and Bi2Te3, bonded by weak interlayer forces of attraction between molecules. Scientists recently discovered that MnBi2Te4 is a naturally magnetic topological material. However, when layers of magnetic MnBi2Te4 are directly stacked on one another, the magnetic moments within neighboring layers point in opposite directions, making the material antiferromagnetic as a whole – losing the topological aspects of the properties that are important for technologies. The researchers solved this problem by making a new compound with three nonmagnetic layers of Bi2Te3 between layers of MnBi2Te4, which, combined, creates MnBi8Te13. This material design increases the distance between the MnBi2Te4 layers, which successfully eliminates the antiferromagnetic effect, leading to long-range ferromagnetism below 10.5 K with strong coupling between magnetism and charge carriers.

Important aspects of this research were neutron scattering experiments through the DEMAND instrument at the High Flux Isotope Reactor (HFIR) that pinpointed how atoms are arranged within the MnBi8Te13 material and confirmed its ferromagnetic state. Because neutrons have their own magnetic moment, they can be used to determine the magnetic structure inside a material. The scientists additionally used angle resolved photoemission spectroscopy experiments at the Stanford Synchrotron Radiation Lightsource, a Department of Energy user facility, and first-principles, density functional theory calculations to investigate the material’s electronic and topological state. Combining the assessments from all of these methods, the researchers were able to validate the ferromagnetic and topological properties consistent with an axion insulator with sizable surface hybridization gaps and a nontrivial Chern number.

 

Funding

The research was supported by the DOE Office of Science, Basic Energy Sciences, Materials Sciences and Engineering Division and the Scientific User Facilities Division, the National Science Foundation, the Indian Institute of Technology Kanpur, the Council for Scientific and Industrial Research in India, the Ministry of Science and Technology in Taiwan, the National Cheng Kung University, the National Center for Theoretical Sciences in Taiwan, and the Ministry of Education in Taiwan. Research was performed at three DOE Office of Science user facilities: the High Flux Isotope Reactor at Oak Ridge National Laboratory, the Stanford Synchrotron Radiation Lightsource at SLAC National Accelerator Laboratory, and the National Energy Research Scientific Computing Center at Lawrence Berkeley National Laboratory. 

World Patient Safety Day 2022 –improving medication safety and other safety initiatives

European Society of Anaesthesiology and Intensive Care (ESAIC) fully supports WHO’s Medication without Harm campaign; other society initiatives present a broad response and include the key patient safety education program Safer Care to Save Lives

Reports and Proceedings

THE EUROPEAN SOCIETY OF ANAESTHESIOLOGY AND INTENSIVE CARE (ESAIC)

• European Society of Anaesthesiology and Intensive Care (ESAIC) fully supports WHO’s Medication without Harm campaign

 

• Recommendations to reduce medication-related harm formed part of the 2010 ESAIC global patient safety project ‘Helsinki Declaration on Patient Safety in Anaesthesiology’ since signed by 94 countries

 

• Other society initiatives present a broad response and include the key patient safety education programme Safer Care to Save Lives

 

• ESAIC is also creating ‘peer networks’ connecting anaesthesiologists and critical care physicians to allow them to share vital patient safety knowledge and experience

WHO’s World Patient Safety Day in 2022 (Saturday, 17 September) will focus on improving medication safety. The European Society of Anaesthesiology and Intensive Care (ESAIC) fully endorses this initiative and highlights that it first promoted medication safety back in 2010 as part of its ‘Helsinki Declaration on Patient Safety in Anaesthesiology’, signed by all anaesthesiology national societies in Europe and many countries beyond Europe’s borders.

Initiatives to further promote medication safety have been made since the Helsinki Declaration by ESAIC and its sister organisation, the European Board of Anaesthesiology, including through publications in the European Journal of Anaesthesiology.

According to WHO, medication harm accounts for 50% of the overall preventable harm in medical care. Furthermore, US$ 42 billion of global total health expenditure worldwide can be avoided if medication errors are prevented.

Dr David Whitaker, European Board of Anaesthesiology (EBA) representative in ESAIC’s Patient Safety and Quality Committee, and Chair the EBA Patient Safety Committee, Manchester UK, commenting on the WHO initiative, said: “Great opportunities exist to reduce and remove human factor errors in medication safety through better pharmacy procurement of safer, end-user friendly medicine preparations, avoiding preparations that look and sound alike, can easily be confused with others, using ready-to-administer prefilled syringes and standardisation of work surfaces and medication processes.”

He adds: “Key factors around this that ESAIC would like to emphasise are that the manipulation of medicines in clinical areas should be minimised to avoid errors – ideally medications should already be prepared and require no further staff interventions. Injectable medicines should be presented as prefilled syringes, already labelled or as other ‘ready-to-administer’ preparations wherever possible.”

“All medications prepared for routine use in anaesthesia, intensive care, critical emergency medicine and pain medicine should be clearly labelled. In addition, when drawing up medicines into syringes they should always be labelled immediately after filling before they leave the operator’s hand. Empty syringes should never be labelled. In combination, these interventions would reduce much of the avoidable medication harm we regrettably still see with injectable medicines today.”

While ESAIC welcomes the WHO project on patient safety, the society highlights that this is only one part of the overall patient safety picture and points to several other initiatives it has launched to improve all aspects of the patient safety continuum. Patient Safety is central to ESAIC’s core strategy: the society is dedicated to improving patients' experience as they undergo care and reducing unnecessary harm wherever it occurs.

ESAIC’s Safer Care to Save Lives project is a comprehensive package of Patient Safety education for anaesthesiologists, healthcare professionals, hospital management and patients, driven by the society’s Patient Safety and Quality Committee working with industry partners. The project was born out of extensive research. It is built on the principles laid out by the Helsinki Declaration, the Consensus Statement of the multi-Society Patient Safety Summit at the European Parliament in 2020, and the WHO Multi-professional Patient Safety Curriculum.

ESAIC’s Dr Jannicke Mellin-Olsen (ESAIC Patient Safety and Quality Committee Member and Past President, World Federation of Societies of Anaesthesiologists) said: “Education in patient safety will empower all those involved in healthcare to contribute with their knowledge and experience. This will ensure that no patient is harmed when they trust their medical team to safeguard their life and health when they are at their most vulnerable during our care.”

Recommendations for this new safety project also came from the ESAIC-convened Patient Safety Summit in 2020. The summit saw ESAIC leading a collaboration with the major medical societies in Europe to bring Patient Safety to the EU parliament. The result of the was “Multi-disciplinary and patient-centred approaches to perioperative patient safety: A European consensus statement”.

Safer Care to Save Lives includes a series of eLearning modules for the beginner. Another component is the Advanced Patient Safety Course, a unique course to earn a qualification in Patient Safety, which takes place in Amsterdam on September 19 and 20, the days immediately following World Patient Safety Day (the course is completely sold out). There will also be an annual Patient Safety and Quality Masterclass - a deeper, interactive experience covering 3 days; and an annual Anaesthesia and Intensive Care Crisis Simulation Masterclass, which helps improve the practice of key requirements of the Helsinki Declaration through high fidelity simulation scenarios.

The COVID-19 pandemic also thrust anaesthesiologists and intensive care specialists into the headlines as never before, with every part of their work, mostly previously unseen by and unknown to the public, suddenly part of the daily news agenda. This, along with the research as mentioned above on the implementation of the Helsinki Declaration, was the inspiration for another ESAIC project:  Peer Review in Patient Safety in Anaesthesiology and Intensive Care (PRiPSAIC).

PRiPSAIC will create networks of anaesthesiologists and intensive care physicians both within and between countries and give them the tools and support they need to examine their own practice and those of their peers and provide solutions for the future.

ESAIC will work with industry partners, national societies of anaesthesiology and intensive care to find and network ‘change champions’ and ambassadors for patient safety in hospitals in selected European countries; the project will be run in four countries: Lithuania, Finland, Republic of Moldova and the Czech Republic.

PRiPSAIC will involve training participants in evaluating patient safety using the implementation methodology and the site visit process used in the Helsinki Declaration Follow-Up research project; allow international exchange of knowledge and experience in patient safety and provide a practical ‘toolkit’ for the self-assessment of patient safety by departments of anaesthesiology to support further implementation of the Helsinki Declaration. One site visit has already been completed, in which doctors from Lithuania visited Glasgow Royal Infirmary in Scotland.

Prof Andrew Smith (Lancaster Patient Safety and Health Services Research Unit and representative in ESAIC’s Patient Safety and Quality Committee) said: “Every anaesthesiologist and every department they work in have skills, knowledge, and experience in patient safety. Unfortunately, too often, anaesthesiologists work in isolation. This new project is about bringing people together in the name of sharing our knowledge on patient safety.”

Ultimately, ESAIC joins other organisations worldwide to mark #WPSD and help raise awareness of medication-safety harm due to medication errors and unsafe practices, as well as of ways to improve safety standards and is dedicated to leading the way in patient safety and ensuring the best care for every patient.

 

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Note to Editors

About ESAIC

The European Association of Anaesthesiology and Intensive Care (ESAIC) is the leading European organisation for members and national societies for Anaesthesia, Intensive Care, Pain and Perioperative Medicine. ESAIC aims to: promote the exchange of information between European anaesthesiologists; it serves as the hub to disseminate information in regard to anaesthesiology. The Society helps raise the standards of the speciality by fostering and encouraging education, research, scientific progress and exchange of information while promoting improvements in the safety and quality of care of patients who are under the care of anaesthesiologists inside and outside the operating room by facilitating and harmonising the activities of national and international societies of anaesthesiologists in Europe. Furthermore, ESAIC promotes the professional role of anaesthesiologists to improve the care of patients in the fields of anaesthesiology, intensive care, perioperative medicine, emergency medicine, and pain medicine.

For more information, please visit:  https://www.esaic.org/patient-safety/

About the KOLs quoted on this PR

• Dr David Whitaker, ESAIC Patient Safety and Quality Committee (Chair the EBA Patient Safety Committee, Manchester UK. Please e-mail to arrange interview. E) whitaker2000@gmail.com
• Dr Jannicke Mellin-Olsen, ESAIC Patient Safety and Quality Committee; Trondheim University, Norway; and Immediate Past-President of World Federation of Societies of Anaesthesiologists. Please e-mail to arrange interview. E) jannicke@mellin.no / mellinolsen@gmail.com
• Professor Andrew Smith, ESAIC Patient Safety and Quality Committee; consultant anaesthetist at the University Hospitals of Morecambe Bay NHS Foundation Trust and Director of the Lancaster Patient Safety Research Unit, Lancaster University, not available for interview as currently on holiday.

For further information, please contact:

Tony Kirby of Tony Kirby PR T) +44 7834 385827 E) tony@tonykirby.com

Sources:

1. WHO Patient Safety pages and WHO World Patient Safety Day campaign Medication without Harm https://www.who.int/campaigns/world-patient-safety-day/2022
2. Recommendations for safe medication practice from European Board of Anaesthesiology, as published in EJA
3. European Consensus Statement (note, ESAIC was formerly known as ESA, until 2020)
4. The Helsinki Declaration on Patient Safety in Anaesthesiology and country signatories
5. Safer Care to Save Lives
6. PRiPSAIC
7. The WHO Multi-professional Patient Safety Curriculum

Damage-free way to gauge the health of next-gen batteries for electric vehicles

Electrochemical impedance spectroscopy shows how solid-state lithium metal batteries degrade

Peer-Reviewed Publication

TOKYO METROPOLITAN UNIVERSITY

 

IMAGE: AEROSOL DEPOSITION OF CATHODE MATERIAL INVOLVES ACCELERATING MICROSCOPIC CHUNKS AND COLLIDING THEM WITH AN ELECTROLYTE SURFACE TO FORM A DENSE FILM. TO UNDERSTAND THE STRENGTHS AND WEAKNESSES OF THEIR NEW BATTERY DESIGN, THE TEAM USED ELECTROCHEMICAL IMPEDANCE SPECTROSCOPY, APPLYING ELECTRICAL SIGNALS TO MEASURE THE EFFECTIVE RESISTANCES OF THE RANGE OF INTERFACES PRESENT IN THE BATTERY. view more 

CREDIT: TOKYO METROPOLITAN UNIVERSITY

Tokyo, Japan – Researchers from Tokyo Metropolitan University have demonstrated that electrochemical impedance spectroscopy (EIS) can be a powerful non-destructive tool to study the degradation mechanisms of all-solid-state lithium metal batteries. They studied ceramic-based all-solid-state Li metal batteries prepared by aerosol deposition and heating, identifying the specific interface responsible for the drop in performance. Their work accurately highlights the engineering hurdles that need to be overcome to bring these top-in-class batteries to the market.

Electric vehicles (EVs) are a crucial part of efforts worldwide to cut carbon emissions. And at the heart of every EV is its battery. Battery design remains a key bottleneck when it comes to maximizing driving range and improving vehicle safety. One of the proposed solutions, all-solid-state lithium metal batteries, has the potential to provide higher energy density, safety, and lower complexity, but technical issues continue to hamper their transition into everyday vehicles.

A major problem is the large interfacial resistance between electrodes and solid electrolytes. In many battery designs, both cathode and electrolyte materials are brittle ceramics; this makes it difficult to have good contact between them. There is also the challenge of diagnosing which interface is actually causing problems. Studying degradation in all-solid-state lithium metal batteries generally requires cutting them open: this makes it impossible to find out what is happening while the battery is operating.

A team led by Professor Kiyoshi Kanamura at Tokyo Metropolitan University have been developing all-solid-state Li metal batteries with lower interfacial resistance using a technique called aerosol deposition. Microscopic chunks of cathode material are accelerated towards a layer of ceramic electrolyte material where they collide and form a dense layer. To overcome the issue of cracks forming on collision, the team coated the chunks of cathode material with a “solder” material, that is, a softer, low melting point material which can be heat treated to generate excellent contact between the newly formed cathode and electrolyte. Their final all-solid-state Li/Li7La3Zr2O12/LiCoO2 cell delivers a high initial discharge capacity of 128 mAh g-1 at both 0.2 and 60 °C and maintains a high-capacity retention of 87% after 30 charge/discharge cycles. This is a best-in-class result for all-solid-state Li metal batteries with ceramic oxide electrolytes, making it all the more important to really get to grips with how they might degrade.

Here, the team used electrochemical impedance spectroscopy (EIS), a widely used diagnostic tool in electrochemistry. By interpreting how the cell responds to electrical signals of different frequency, they could separate out the resistances of the range of different interfaces in their battery. In the case of their new cell, they found that a resistance increase between the cathode material and the solder was the main reason for cell capacity decay. Importantly, they achieved this without tearing the cell apart. They were also able to back this up using in-situ electron microscopy, clearly identifying interface cracking during cycling.

The team’s innovations have not only realized a cutting-edge battery design but highlighted the next steps for making further improvements using a damage-free, widely available method. Their new paradigm promises exciting new advances for batteries in the next generation of EVs.

This work was supported by the Advanced Low Carbon Technology Research and Development Program (ALCA)—Specially Promoted Research for Innovative Next Generation Batteries (SPRING) (Grant No. JPMJAL1301) from the Japan Science and Technology Agency (JST).

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DOI

10.1021/acsami.2c09841 

ARTICLE TITLE

Degradation Mechanism of All-Solid-State Li-Metal Batteries Studied by Electrochemical Impedance Spectroscopy

Lithium-ion batteries: One size does not fit all in application or in assessment

Electron microscopy reveals molecular mechanisms of lithium-ion batteries

Peer-Reviewed Publication

TSINGHUA UNIVERSITY PRESS

 

IMAGE: A REVIEW PAPER BY A TIANJIN UNIVERSITY OF TECHNOLOGY RESEARCH TEAM USED VARIOUS ADVANCED ELECTRON MICROSCOPY AND ASSOCIATE CHARACTERIZATION TECHNIQUES TO CLARIFY TWO STRUCTURE-BASED MECHANISMS OF LITHIUM-ION BATTERIES. view more 

CREDIT: NANO RESEARCH ENERGY, TSINGHUA UNIVERSITY PRESS

Seeing is believing — or, rather, seeing can aid in understanding, especially when it comes to the mechanisms underpinning lithium-ion batteries. Despite near-ubiquitous use in cell phones, computers and more, the complex electrochemical environments of lithium-ion batteries remain murky. To better understand and to improve battery performance, researchers examined the current scientific literature and used electron microscopy to take a closer look at the charge-transfer and lithium-ion migration mechanisms that produce power.

 

This study was publicly available online on Sept. 6 in Nano Research Energy.

 

“Commercial lithium-ion batteries are widely used as energy storage devices, including electric vehicles, portable electronics and grid energy storage,” said Yi Ding, a professor of Tianjin University of Technology. “Energy, power, charge-discharge rate, cost, cycle life, safety and environmental impact are to be considered while adopting lithium-ion batteries for a suitable application, but each specific application faces a variety of different challenges.”

 

The amount of energy stored is important for portable electronics, while cost and safety are more important for electric vehicles, for example. Cost and safety are also important for energy grid needs, but energy density becomes less so than for electric vehicles. The trade-off between these elements shift based on need, but the ability to tune performance is limited by incomplete understanding of the materials used in batteries.

 

“The active electrode materials are the main portion responsible for the cell chemistry and performance and, ultimately, affect the commercialization of the constructed battery,” Ding said. “The performances, such as cycle life and energy density, of existing commercial electrode material systems still need to be improved, so it is important to understand the inherent physical and chemical properties, such as structural evolution/kinetics during lithium de-embedding and the effect of electrode-electrolyte interface on the performance of lithium-ion batteries.”

 

The researchers reviewed recent advances in electron microscopy to see how traditional characterization techniques measure up when it comes to understanding the structure-activity relationships of commercial lithium-ion batteries.

 

“By comparing with the characterization content obtained by traditional characterization techniques, such as X-ray diffraction and X-ray photoelectron spectroscopy, we illustrate the advantages and limitations of common electronic microscopes and recently developed advanced electronic microscopic characterization techniques, such as in situ electron microscopy technology, in this critical research,” Ding said.

 

The researchers examined how advanced electron microscopy and the associated characterization techniques can provide different insights into how, for example, lithium ions migrate in the battery to produce charge or how charge transfer can trigger energy use. They specifically focused on transition metal dissolution and charge transfer mechanism in the charging-discharging process of lithium-ion battery positive electrodes; the structure and evolution of cathode-electrode interfaces and solid electrolyte interphase during long-term cycling; and the effect of electrode structure and interface on lithium-ion migration.  

 

The conclusion, according to Ding, is that next-generation lithium-ion battery technologies with better cost and performance benefits are needed.  

 

“We propose the possibility of combining electron microscopy with other techniques to obtain more comprehensive information,” Ding said, noting that electron microscopy has three common limitations in battery assessment. These include inconsistent electrochemical environments between electron microscopy fields and actual batteries; unstable time windows that can skew data related to evolution of the sample; and certain batteries cannot be quantitatively assessed at the nanoscale. “Even with limitations, these discussions allow researchers to gain a deeper understanding of how commercial lithium-ion batteries operate at the microscale and provide guidance for design strategies for high-performance practical batteries.”

 

Other contributors include Chao Li, Bowen Liu and co-corresponding author Ningyi Jiang, Tianjin Key Laboratory of Advanced Functional Porous Materials, Institute for New Energy Materials and Low-Carbon Technology, School of Materials Science and Engineering, Tianjin University of Technology. Jiang is also affiliated with Tianjin University’s School of Chemical Engineering and Technology.

 

The National Key Research and Development Program of China, the National Natural Science Foundation of China and the National Science Fund for Distinguished Young Scholars funded this work.

 

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About Nano Research Energy 

 

Nano Research Energy is launched by Tsinghua University Press, aiming at being an international, open-access and interdisciplinary journal. We will publish research on cutting-edge advanced nanomaterials and nanotechnology for energy. It is dedicated to exploring various aspects of energy-related research that utilizes nanomaterials and nanotechnology, including but not limited to energy generation, conversion, storage, conservation, clean energy, etc. Nano Research Energy will publish four types of manuscripts, that is, Communications, Research Articles, Reviews, and Perspectives in an open-access form.

 

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JOURNAL

Nano Research Energy

DOI

10.26599/NRE.2022.9120032 

ARTICLE TITLE

Elucidating the charge-transfer and Li-ion-migration mechanisms in commercial lithium-ion batteries with advanced electron microscopy