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Dead-end filtration is a facile method to globally align single wall carbon nanotubes (SWCNTs) in large area films with a 2D order parameter, S2D , approaching unity. Uniaxial alignment has been achieved using pristine and hot-embossed membranes but more sophisticated geometries have yet to be investigated. In this work, three different patterns with radial symmetry and an area of 3.8 cm2 are created. Two of these patterns are replicated by the filtered SWCNTs and S2D values of ≈0.85 are obtained. Each of the radially aligned SWCNT films is characterized by scanning cross-polarized microscopy in reflectance and laser imaging in transmittance with linear, radial, and azimuthal polarized light fields. The former is used to define a novel indicator akin to the 2D order parameter using Malu's law, yielding 0.82 for the respective film. The films are then transferred to a flexible printed circuit board and terminal two-probe electrical measurements are conducted to explore the potential of those new alignment geometries.
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Dead-end filtration has proven to effectively prepare macroscopically (3.8 cm2 ) aligned thin films from solutionbased single-wall carbon nanotubes (SWCNTs). However, to make this technique broadly applicable, the role of SWCNT length and diameter must be understood. To date, most groups report the alignment of unsorted, large diameter (≈1.4 nm) SWCNTs, but systematic studies on their small diameter are rare (≈0.78 nm). In this work, films with an area of A = 3.81 cm2 and a thickness of ≈40 nm are prepared from length-sorted fractions comprising of small and large diameter SWCNTs, respectively. The alignment is characterized by cross-polarized microscopy, scanning electron microscopy, absorption and Raman spectroscopy. For the longest fractions (Lavg = 952 nm ± 431 nm, Δ = 1.58 and Lavg = 667 nm ± 246 nm, Δ = 1.55), the 2D order parameter, S2D, values of ≈0.6 and ≈0.76 are reported for the small and large diameter SWCNTs over an area of A = 625 µm2 , respectively. A comparison of Derjaguin, Landau, Verwey, and Overbeek (DLVO) theory calculations with the aligned domain size is then used to propose a law identifying the required length of a carbon nanotube with a given diameter and zeta potential.
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BACKGROUND: Although the number of lung transplantations (LTx) performed worldwide for COVID-19 induced acute respiratory distress syndrome (ARDS) is still low, there is general agreement that this treatment can save a subgroup of most severly ill patients with irreversible lung damage. However, the true proportion of patients eligible for LTx, the overall outcome and the impact of LTx to the pandemic are unknown. METHODS: A retrospective analysis was performed using a nationwide registry of hospitalised patients with confirmed severe acute respiratory syndrome coronavirus type 2 (SARS-Cov-2) infection admitted between January 1, 2020 and May 30, 2021 in Austria. Patients referred to one of the two Austrian LTx centers were analyzed and grouped into patients accepted and rejected for LTx. Detailed outcome analysis was performed for all patients who received a LTx for post-COVID-19 ARDS and compared to patients who underwent LTx for other indications. RESULTS: Between January 1, 2020 and May 30, 2021, 39.485 patients were hospitalised for COVID-19 in Austria. 2323 required mechanical ventilation, 183 received extra-corporeal membrane oxygenation (ECMO) support. 106 patients with severe COVID-19 ARDS were referred for LTx. Of these, 19 (18%) underwent LTx. 30-day mortality after LTx was 0% for COVID-19 ARDS transplant recipients. With a median follow-up of 134 (47-450) days, 14/19 patients are alive. CONCLUSIONS: Early referral of ECMO patients to a LTx center is pivotal in order to select patients eligible for LTx. Transplantation offers excellent midterm outcomes and should be incorporated in the treatment algorithm of post-COVID-19 ARDS.
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Plasmonic biosensors are a powerful tool for studying molecule adsorption label-free and with high sensitivity. Here, we present a systematic study on the optical properties of strictly regular nanostructures composed of metallodielectric cuboids with the aim to deliberately tune their optical response and improve their biosensing performance. In addition, the patterns were tested for their potential to eliminate spurious effects from sensor response, caused by refractive index changes in the bulk solution. Shifts in the plasmonic spectrum are exclusively caused by the adsorbing molecules. For this purpose, nanopatterns of interconnected and separated cubes with dimensions ranging from 150 to 600 nm have been fabricated from poly(methyl methacrylate) using electron-beam lithography followed by metallization with gold. It is shown that a small lateral pattern size, a high aspect ratio, and short connection lengths are favorable to generate extinction spectra with well-separated and pronounced peaks. Furthermore, for selected nanostructures, we have been able to identify reflection angles for which the influence of the bulk refractive index on the position of the plasmonic peaks is negligible. It is shown that sensor operation under these angles enables monitoring of in situ biomolecule adsorption with high sensitivity providing a promising tool for high-throughput applications.
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This paper studies numerically the solid phase of a system of particles interacting by the exponentially repulsive pair potential, which is a face-centered cubic (fcc) crystal at low densities and a body-centered cubic (bcc) crystal at higher densities [U. R. Pedersen et al., J. Chem. Phys. 150, 174501 (2019)]. Structure is studied via the pair-distribution function and dynamics via the velocity autocorrelation function and the phonon density of states. These quantities are evaluated along isotherms, isochores, and three isomorphs in both crystal phases. Isomorphs are traced out by integrating the density-temperature relation characterizing configurational adiabats, starting from state points in the middle of the fcc-bcc coexistence region. Good isomorph invariance of structure and dynamics is seen in both crystal phases, which is notable in view of the large density variations studied. This is consistent with the fact that the virial potential-energy correlation coefficient is close to unity in the entire fcc phase and in most of the bcc phase (basically below the re-entrant density). Our findings confirm that the isomorph theory, developed and primarily studied for liquids, applies equally well for solids.
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This paper determines the thermodynamic phase diagram of the EXP system of particles interacting by the purely repulsive exponential pair potential. The solid phase is face-centered cubic (fcc) at low densities and pressures. At higher densities and pressures, the solid phase is body-centered cubic (bcc) with a re-entrant liquid phase at the highest pressures simulated. The investigation first identifies the phase diagram at zero temperature at which the following four crystal structures are considered: fcc, bcc, hexagonal close packed, and cubic diamond. There is a T = 0 phase transition at pressure 2.651 × 10-3 with the thermodynamically stable structure being fcc below and bcc above this pressure. The densities of the two crystal structures at the phase transition are 1.7469 × 10-2 (fcc) and 1.7471 × 10-2 (bcc). At finite temperatures, the fcc-bcc, fcc-liquid, and bcc-liquid coexistence lines are determined by numerical integration of the Clausius-Clapeyron equation and validated by interface-pinning simulations at selected state points. The bcc-fcc phase transition is a weak first-order transition. The liquid-fcc-bcc triple point, which is determined by the interface-pinning method, has temperature 5.9 × 10-5 and pressure 2.5 × 10-6; the triple-point densities are 1.556 × 10-3 (liquid), 1.583 × 10-3 (bcc), and 1.587 × 10-3 (fcc).
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This report describes a case of invasive Exophiala dermatitidis infection after double lung transplantation in a 76-year-old man. After thoracotomy, the patient's wound showed dehiscence with purulent secretion. The black yeast was isolated from cultures taken from the wound, and species identification was confirmed by sequence analysis of the internal transcribed spacer (ITS-S2) region. The results of the susceptibility testing showed voriconazole as the most active drug. Despite adaptation of the antifungal therapy the clinical condition worsened, and the patient died. In addition, we evaluated the fungicidal activity of antiseptics towards E. dermatitidis and aimed to provide a brief literature review of previously reported infections caused by this rare fungus. To the best of our knowledge, this is the first report of a rapidly progressing invasive fungal infection with E. dermatitidis originating from a colonized wound after lung transplantation.
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Exophiala/isolamento & purificação , Hospedeiro Imunocomprometido , Infecções Fúngicas Invasivas/diagnóstico , Transplante de Pulmão , Feoifomicose/diagnóstico , Infecção da Ferida Cirúrgica/diagnóstico , Idoso , Antifúngicos/administração & dosagem , Antifúngicos/farmacologia , DNA Fúngico/química , DNA Fúngico/genética , DNA Espaçador Ribossômico/química , DNA Espaçador Ribossômico/genética , Exophiala/classificação , Exophiala/efeitos dos fármacos , Exophiala/genética , Evolução Fatal , Humanos , Infecções Fúngicas Invasivas/microbiologia , Infecções Fúngicas Invasivas/patologia , Masculino , Testes de Sensibilidade Microbiana , Feoifomicose/microbiologia , Feoifomicose/patologia , Análise de Sequência de DNA , Infecção da Ferida Cirúrgica/microbiologia , Infecção da Ferida Cirúrgica/patologia , Voriconazol/administração & dosagem , Voriconazol/farmacologiaRESUMO
This paper continues the investigation of the exponentially repulsive EXP pair-potential system of Paper I [A. K. Bacher et al., J. Chem. Phys. 149, 114501 (2018)] with a focus on isomorphs in the low-temperature gas and liquid phases. As expected from the EXP system's strong virial potential-energy correlations, the reduced-unit structure and dynamics are isomorph invariant to a good approximation. Three methods for generating isomorphs are compared: the small-step method that is exact in the limit of small density changes and two versions of the direct-isomorph-check method that allows for much larger density changes. Results from the latter two approximate methods are compared to those of the small-step method for each of the three isomorphs generated by 230 one percent density changes, covering one decade of density variation. Both approximate methods work well.
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It was recently shown that the exponentially repulsive EXP pair potential defines a system of particles in terms of which simple liquids' quasiuniversality may be explained [A. K. Bacher et al., Nat. Commun. 5, 5424 (2014); J. C. Dyre, J. Phys.: Condens. Matter 28, 323001 (2016)]. This paper and its companion [A. K. Bacher et al., J. Chem. Phys. 149, 114502 (2018)] present a detailed simulation study of the EXP system. Here we study how structure monitored by the radial distribution function and dynamics monitored by the mean-square displacement as a function of time evolve along the system's isotherms and isochores. The focus is on the gas and liquid phases, which are distinguished pragmatically by the absence or presence of a minimum in the radial distribution function above its first maximum. A constant-potential-energy (NVU)-based proof of quasiuniversality is presented, and quasiuniversality is illustrated by showing that the structure of the Lennard-Jones system at four state points is well approximated by those of EXP pair-potential systems with the same reduced diffusion constant. Paper II studies the EXP system's isomorphs, focusing also on the gas and liquid phases.
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OBJECTIVES: Lung transplantation for idiopathic pulmonary arterial hypertension has the highest reported postoperative mortality of all indications. Reasons lie in the complexity of treatment of these patients and the frequent occurrence of postoperative left ventricular failure. Transplantation on intraoperative extracorporeal membrane oxygenation support instead of cardiopulmonary bypass and even more the prolongation of extracorporeal membrane oxygenation into the postoperative period helps to overcome these problems. We reviewed our experience with this concept. METHODS: All patients undergoing bilateral lung transplantation for idiopathic pulmonary arterial hypertension on intraoperative extracorporeal membrane oxygenation with or without prophylactic extracorporeal membrane oxygenation prolongation into the postoperative period between January 2000 and December 2014 were retrospectively analysed. RESULTS: Forty-one patients entered the study. Venoarterial extracorporeal membrane oxygenation support was prolonged into the postoperative period for a median of 2.5 days (range 1-40). Ninety-day, 1-, 3- and 5-year survival rates for the patient collective were 92.7%, 90.2%, 87.4% and 87.4%, respectively. When compared with 31 patients with idiopathic pulmonary arterial hypertension transplanted in the same period of time without prolongation of extracorporeal membrane oxygenation into the postoperative period, the results compared favourably (83.9%, 77.4%, 77.4%, and 77.4%; P = 0.189). Furthermore, these results are among the best results ever reported for this particularly difficult patient population. CONCLUSIONS: Bilateral lung transplantation for idiopathic pulmonary arterial hypertension with intraoperative venoarterial extracorporeal membrane oxygenation support seems to provide superior outcome compared with the results reported about the use of cardiopulmonary bypass. Prophylactic prolongation of venoarterial extracorporeal membrane oxygenation into the early postoperative period provides stable postoperative conditions and seems to further improve the results.
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Oxigenação por Membrana Extracorpórea , Hipertensão Pulmonar Primária Familiar/cirurgia , Cuidados Intraoperatórios/métodos , Transplante de Pulmão , Cuidados Pós-Operatórios/métodos , Adulto , Hipertensão Pulmonar Primária Familiar/mortalidade , Feminino , Seguimentos , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do TratamentoRESUMO
When building spot array binary Fourier diffractive optical elements (DOEs) having feature sizes on the order of the wavelength, we noticed remarkable variations in the experimental diffraction efficiency compared to the simulation results. Even with the use of high-cost electron beam lithography and rigorous Fourier modal method simulations, there appear to be no publications, to the best of our knowledge, showing close agreement in diffraction efficiency between the simulation and experimental results. In this Letter, we show that the diffraction symmetry of binary Fourier DOEs can be an efficient and consistent metric for evaluating the limit of the thin-element approximation and the effects of fabrication errors.
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Lasing from whispering-gallery mode (WGM) resonators occurs omnidirectional in azimuthal plane. Most applications of WGM resonators require spectral analysis with off-chip detectors, where in-plane emission and beam divergence hinder efficient detection. We demonstrate redirecting WGM laser emission from all azimuthal angles using a circular micromirror placed around the cavity. By collecting reflections off the micromirror via free-space optics, read-out intensity improved by one order of magnitude. Blocking vertically emitted spontaneous emission and recording reflections off the micromirror only, signal-to-noise ratio improved from 4.6 dB to 15 dB. Our read-out concept may be applied to arbitrary WGM cavity geometries without deteriorating the cavity's quality factor.
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Herein we report the case of a 60-year-old female patient who developed severe respiratory failure after right-sided pneumonectomy starting 2 hours after uneventful surgery. A computed tomographic scan revealed a completely congested left lower lobe. The underlying pathomechanism of this unique finding was a kinking effect of the left lower lobe vein over the descending aorta, caused by the shifting of the heart toward the right side. Even with immediate reintubation and aggressive ventilation it was impossible to stabilize the patient and therefore an extracorporal membrane oxygenation (ECMO) had to be implanted. The ECMO support and right-lateral and prone positioning of the patient markedly improved oxygenation. After a stabilization period of 2 days the ECMO could be removed and the patient was extubated on the ninth postoperative day. To the best of our knowledge, this is the first reported case of a unilobar edema caused by a transiently impaired venous drainage after pneumonectomy. The combination of immediate ECMO support together with right-lateral and prone positioning resulted in restoration and stabilization of the patient's cardiorespiratory function.
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Pneumonectomia/efeitos adversos , Veias Pulmonares , Insuficiência Respiratória/etiologia , Feminino , Humanos , Pessoa de Meia-Idade , Pneumonectomia/métodosRESUMO
BACKGROUND: Endothelial glycocalyx participates in the maintenance of vascular integrity, and its perturbations cause capillary leakage, loss of vascular responsiveness, and enhanced adhesion of leukocytes and platelets. We hypothesized that marked shedding of the glycocalyx core protein, syndecan-1, occurs in end-stage liver disease (ESLD) and that it increases during orthotopic liver transplantation (OLT). We further evaluated the effects of general anesthesia on glycocalyx shedding and its association with acute kidney injury (AKI) after OLT. PATIENTS AND METHODS: Thirty consecutive liver transplant recipients were enrolled in this prospective study. Ten healthy volunteers served as a control. Acute kidney injury was defined by Acute Kidney Injury Network criteria. RESULTS: Plasma syndecan-1 was significantly higher in ESLD patients than in healthy volunteers (74.3 ± 59.9 vs 10.7 ± 9.4 ng/mL), and it further increased significantly after reperfusion (74.3 ± 59.9 vs 312.6 ± 114.8 ng/mL). The type of general anesthesia had no significant effect on syndecan-1. Syndecan-1 was significantly higher during the entire study in patients with posttransplant AKI stage 2 or 3 compared to patients with AKI stage 0 or 1. The area under the curve of the receiver operating characteristics curve of syndecane-1 to predict AKI stage 2 or 3 within 48 hours after reperfusion was 0.76 (95% confidence interval, 0.57-0.89, P = 0.005). CONCLUSIONS: Patients with ESLD suffer from glycocalyx alterations, and ischemia-reperfusion injury during OLT further exacerbates its damage. Despite a higher incidence of AKI in patients with elevated syndecan-1, it is not helpful to predict de novo AKI. Volatile anesthetics did not attenuate glycocalyx shedding in human OLT.
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Injúria Renal Aguda/patologia , Doença Hepática Terminal/cirurgia , Glicocálix/química , Transplante de Fígado , Adulto , Idoso , Anestesia , Área Sob a Curva , Endotélio/metabolismo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório , Estudos Prospectivos , Reperfusão , Traumatismo por Reperfusão , Sindecana-1/metabolismoRESUMO
It has been known for a long time that many simple liquids have surprisingly similar structure as quantified, for example, by the radial distribution function. A much more recent realization is that the dynamics are also very similar for a number of systems with quite different pair potentials. Systems with such non-trivial similarities are generally referred to as 'quasi-universal'. From the fact that the exponentially repulsive pair potential has strong virial potential-energy correlations in the low-temperature part of its thermodynamic phase diagram, we here show that a liquid is quasi-universal if its pair potential can be written approximately as a sum of exponential terms with numerically large prefactors. Based on evidence from the literature we moreover conjecture the converse, that is, that quasi-universality only applies for systems with this property.
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We propose an iterative algorithm based on our scalar nonparaxial propagator for the design of Fourier diffractive optical elements (DOEs) having features on the order of the illumination wavelength. The simulation results show that our algorithm, using iterative Fourier transform and iterative projection, obtains higher-performance DOEs than a purely scalar paraxial design with the same order of calculation time. Upon verification with the experimental results, we find that our scalar-based design method is valid for DOEs with surprisingly small feature sizes (about half the wavelength) and diffraction angles up to about 37°.
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Optically excited organic semiconductor distributed feedback (DFB) lasers enable efficient lasing in the visible spectrum. Here, we report on the rapid and parallel fabrication of DFB lasers via transferring a nanograting structure from a flexible mold onto an unstructured film of the organic gain material. This geometrically well-defined structure allows for a systematic investigation of the laser threshold behavior. The laser thresholds for these devices show a strong dependence on the pump spot diameter. This experimental finding is in good qualitative agreement with calculations based on coupled-wave theory. With further investigations on various DFB laser geometries prepared by different routes and based on different organic gain materials, we found that these findings are quite general. This is important for the comparison of threshold values of various devices characterized under different excitation areas.
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BACKGROUND: Hemodynamic monitoring using transesophageal echocardiography (TEE) in patients with signs of portal hypertension undergoing orthotopic liver transplantation (OLT) carries potential risk of esophageal and gastric variceal hemorrhage. The aim of our retrospective analysis was to evaluate the safety of intraoperative TEE monitoring during OLT in patients with esophagogastric varices. METHODS: A retrospective analysis of 396 liver transplant recipients was performed at the Medical University of Vienna monitored by TEE during OLT between 2003 and 2010. RESULTS: Varices were documented by esophagogastroduodenoscopy in 287 (72.5%) of 396 analyzed patients: 130 (32.8%) varices grade I (<5 mm under insufflation) and 157 (39.6%) varices grade II (>5 mm under insufflation). Red spot signs were identified in 40 patients (10.1%). Most varices (82.2%) were documented in the esophagus, 4.2% in the stomach, and 13.6% in both (esophagus and stomach). Only one major bleeding occurred, and it was only in a case of one patient with an esophageal varix, which was treated with a balloon tamponade during OLT. Although patients with varices demonstrated a significantly longer prothrombin time and lower platelet count, there was no significant difference in the requirement for blood products among patients with and without varices. CONCLUSIONS: TEE is a relatively safe method for monitoring cardiac performance with a low incidence of major hemorrhagic complications in patients with documented esophagogastric varices undergoing OLT.
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Ecocardiografia Transesofagiana , Doença Hepática Terminal/cirurgia , Varizes Esofágicas e Gástricas/diagnóstico por imagem , Transplante de Fígado , Ecocardiografia Transesofagiana/efeitos adversos , Doença Hepática Terminal/diagnóstico por imagem , Doença Hepática Terminal/fisiopatologia , Varizes Esofágicas e Gástricas/fisiopatologia , Feminino , Hemodinâmica , Humanos , Masculino , Pessoa de Meia-Idade , Monitorização Intraoperatória , Estudos RetrospectivosRESUMO
Acute liver failure is a very complex type of disease with a mortality of up to 90%, leading to numerous severe disturbances of the whole organism. Bleeding because of absent synthesis of various coagulation factors and disseminated intravascular coagulation, acute kidney failure, circulatory failure with vasopressor dependence, respiratory failure with adult respiratory distress syndrome, neurological failure up to coma because of hepatic encephalopathy, and a very high risk of infection and sepsis frequently result from the initial state of isolated liver failure. High urgency liver transplantation is a highly efficient therapy if performed in time. However, increasing the rate of spontaneous recovery of the patients' own liver, and reducing the need for liver transplantation is preferable and would further improve the outcome of acute liver failure. Extracorporeal liver support by multipass albumin dialysis or plasmapheresis and filtering systems may offer a possibility to fulfill these aims of therapy. A prospective study in 88 patients with acute liver failure has shown a nonsignificant trend in improvement of survival after acute liver failure by multipass albumin dialysis and filtering. Other retrospective studies have shown benefits in improving hepatic encephalopathy and brain oedema. Further, an increase in the rate of spontaneous recovery of liver function has been described. With regional citrate anticoagulation for multipass albumin dialysis and filtering, the need for systemic anticoagulation - a potentially very harmful measure in these patients - can be eliminated and the rate of filter clotting can extremely effectively be reduced.
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Hemofiltração/métodos , Falência Hepática Aguda/terapia , Plasmaferese/métodos , Diálise Renal/métodos , Albumina Sérica/isolamento & purificação , HumanosRESUMO
OBJECTIVE: Regional citrate anticoagulation has emerged as a promising method in critically ill patients at high risk of bleeding. However, in patients with liver failure, citrate accumulation may lead to acid-base and electrolyte imbalances, notably of calcium. The aim of this study was to evaluate the feasibility and safety of regional citrate anticoagulation during liver support using a molecular adsorbent recirculating system as well as its effects on electrolyte and acid-base balance in patients with liver failure. DESIGN: Prospective observational study. SETTING: University hospital. PATIENTS: Twenty critically ill patients supported by molecular adsorbent recirculating system resulting from liver failure between January 2007 and May 2009. MEASUREMENTS AND MAIN RESULTS: The median duration of molecular adsorbent recirculating system treatment was 20 hrs (interquartile range, 18-22 hrs). Two of 77 molecular adsorbent recirculating system treatments (2%) were prematurely discontinued as a result of filter clotting and bleeding, respectively. The median citrate infusion rate, necessary to maintain the postfilter ionized calcium between 0.2 and 0.4 mmol/L, was 3.1 mmol/L (interquartile range, 2.3-4 mmol/L) blood flow. The median calcium chloride substitution rate was 0.9 mmol/L (0.3-1.7 mmol/L) dialysate. Total serum calcium remained stable during molecular adsorbent recirculating system treatments. There was a statistically significant increase of the ratio of total calcium to systemic ionized calcium (2.04 ± 0.32 mmol/L to 2.17 ± 0.35; p = .01), which reflected citrate accumulation resulting from liver failure. Under close monitoring, no clinically relevant electrolytes or acid-base disorders were observed. CONCLUSIONS: Our results suggest that regional citrate anticoagulation is a safe and feasible method to maintain adequate circuit lifespan without increasing the risk of hemorrhagic complications while maintaining a normal acid-base as well as electrolyte balance in patients with liver failure supported by molecular adsorbent recirculating system.