Lithium-ion coin cells containing electrolytes with and without 1,3-propane sultone (PS) and vinylene carbonate (VC) were prepared and investigated. The electrochemical performance of the cells is correlated with ex situ surface analysis of the electrodes conducted by Fourier transform infrared and X-ray photoelectron spectroscopies and in situ gas analysis by online electrochemical mass spectrometry (OEMS). The results suggest that incorporation of both PS and VC results in improved capacity retention upon cycling at 55 °C and lower impedance. Ex situ surface analysis and OEMS confirm that incorporation of PS and VC alter the reduction reactions on the anode inhibiting ethylene generation and changing the structure of the solid electrolyte interface. Incorporation of VC results in CO2 evolution, formation of poly­(VC), and inhibition of ethylene generation. Incorporation of PS results in generation of lithium alkylsulfonate (RSO2Li) and inhibition of ethylene generation. The combination of PS and VC reduces the ethylene gassing during formation by more than 60%.

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The results suggest that PPT is adequately reliable and that 3 measurements should be taken to maximize measurement properties. The variance explained by the psychological variables was small but significant for 3 constructs related to catastrophizing, depression, and fear of movement. Clinical implications for application and interpretation of PPT are discussed.

Abstract. Objective: To evaluate the utility of bilevel positive airway pressure (BiPAP) in the out-of-hospital treatment of patients with presumed congestive heart failure (CHF). Methods: This was a prospective, sequential, parallel trial in an urban setting served by a single emergency medical services (EMS) system between January 4 and April 15, 1999. A convenience sampling of adults who were transported by rescue units judged to be in CHF by treating emergency medical technicians trained in advanced life support (ALS EMTs) was included. Rescue squads were divided into demographically matched pairs, and one of each was equipped with a BiPAP ventilatory support unit. Bilevel positive airway pressure therapy was added to the existing treatment protocols for eligible study patients. Main outcome measures were out-of-hospital treatment time, oxygen saturation changes, hospitalization length, need for endotracheal intubation, mortality rate, and ease of use of the device by EMS personnel. Results: Sixtytwo of 71 enrolled patients completed the study. Out-of-hospital treatment times did not differ between groups (31.2 minutes vs 31.4 minutes; p = 0.931). The difference between pre-and post-treatment oxygen saturation levels was greater for the BiPAP group (13.71%) than the control group (6.69%) (p < 0.05). There was no statistical difference between groups in the length of hospital stay [control: 7.63 days, vs BiPAP: 6.33 days, p = 0.48], the intubation rate [control: 7 of 25 (28%) vs BiPAP: 4 of 37 (11%), p = 0.10], or death rate [control: 2 of 24, vs BiPAP: 6 of 37, p = 0.46]. All of the ALS EMTs who used BiPAP thought that it was safe to use, and 97% thought it was easy and appeared to improve patients' dyspnea and respiratory distress. Conclusions: ALS EMTs can be trained to deliver noninvasive ventilation with BiPAP, find it easy to apply, and believe that it helps relieve dyspnea in patients with suspected CHF.

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