Effects of Chinese traditional five-element music intervention on postoperative delirium and sleep quality in elderly patients after non-cardiac surgery: a randomized controlled trial.

BACKGROUND: Postoperative delirium (POD) is a common neurologic disorder among elderly patients after non-cardiac surgery, which leads to various negative outcomes. Sleep disorder is considered an important cause of POD. The objective of this study was to investigate whether the Chinese traditional five-element music intervention could reduce POD by improving sleep quality in elderly patients undergoing non-cardiac surgery. METHODS: A total of 132 patients aged 65 to 90 years who underwent non-cardiac surgery were randomized to two groups: the intervention (n = 60) and the control group (n = 63). Patients in the intervention group were subjected to the Chinese traditional five-element music intervention during the perioperative, while patients in the control group had no music intervention. POD was evaluated using the Confusion Assessment Method (CAM) in the first 5 days after surgery. The Richards‒Campbell Sleep Questionnaire (RCSQ) was used to assess subjective sleep quality. The levels of nocturnal melatonin and cortisol in saliva were measured on the preoperative and the first 2 postoperative days. RESULTS: The incidence of POD within 5 days was 27.0% in the control group and 11.7% in the intervention group. Preoperative PSQI and MMSE scores were associated with POD. The RCSQ scores on the first postoperative day were significantly decreased in the two groups compared to the preoperative day. Compared to the control group, the RCSQ scores showed a significant improvement in the intervention group on the first postoperative day. Compared to the control group, the level of saliva melatonin in the intervention group showed a significant increase on the first postoperative day. However, there was no statistical difference in cortisol levels between the two groups. CONCLUSIONS: Chinese traditional five-element music intervention decreased the incidence of POD in elderly patients who underwent noncardiac surgery via improving sleep quality, which may be associated with increased levels of melatonin.

Middle ear cholesteatoma resection under general anesthesia in patients with congenital methemoglobinemia: A case report.

RATIONALE: Congenital methemoglobinemia is a rare cyanosis cause that can be manifested in affected individuals. We report a case of congenital methemoglobinemia after middle ear cholesteatoma resection under general anesthesia. PATIENT CONCERNS: The primary concern of the patient is to safely perform cholesteatoma resection of the middle ear to reduce the pain associated with years of surgery and to survive the perioperative period. DIAGNOSES: Congenital methemoglobinemia type 1. INTERVENTIONS: The patient underwent general anesthesia and cholesteatoma resection of the middle ear. OUTCOMES: The patient successfully underwent cholesteatoma resection in the middle ear under general anesthesia and went through the perioperative period smoothly, and successfully returned to society. LESSONS: For patients requiring general anesthesia complicated with rare methemoglobinemia, we improve the awareness of crisis and make comprehensive preparation and monitoring, learn the pathophysiological mechanism related to the disease, so as to protect the operation of methemoglobin patients under general anesthesia.

Defect MoS Misidentified as MoS2 in Monolayer MoS2 by Scanning Transmission Electron Microscopy: A First-Principles Prediction.

The defect types in layered semiconductors can be identified by matching the scanning transmission electron microscopy (STEM) images with the structures from first-principles simulations. In a PVD-grown MoS2 monolayer, the MoS2 antisite (one Mo replaces two S) is recognized as being dominant, because its calculated structure matches the distortive structure in STEM images. Therefore, MoS2 has received much attention in MoS2-related defect engineering. We reveal that MoS (one Mo replaces one S) may be mistaken for MoS2, because ionized MoS also has similar structural distortion and can easily be ionized under electron irradiation. Unfortunately, the radiation-induced ionization and associated structural distortion of MoS were overlooked in previous studies. Because the formation energy of MoS is much lower than that of MoS2, it is more likely to exist as the dominant defect in MoS2. Our results highlight the necessity of considering the defect ionization and associated structural distortion in STEM identification of defects in layered semiconductors.

An adult female patient with single atrium and single ventricle undergoing appendectomy: A case report.

Appendicitis is one of the common diseases, and appendectomy is one of the most commonly performed procedures. Single atrium and single ventricle are rare heart diseases, and very few patients survive to adulthood. We report a patient with single atrial and single ventricles undergoing appendectomy with transverse abdominis plane block and dexmedetomidine sedation anesthesia with smooth postoperative appendectomy.

Impact of intravenous dexmedetomidine on gastrointestinal function recovery after laparoscopic hysteromyomectomy: a randomized clinical trial.

Postoperative intestinal ileus is common after laparoscopic surgery, the incidence of those after hysterectomy was 9.2%. Anesthesia is one of the independent risk factors of postoperative ileus. Dexmedetomidine has been widely used in perioperative anesthesia and previous reports suggested that intraoperative dexmedetomidine may be associated with the improvement of gastrointestinal function recovery after abdominal surgery. We hypothesized that dexmedetomidine could improve gastrointestinal function recovery after laparoscopic hysteromyomectomy. Participants in elective laparoscopic hysteromyomectomy were enrolled with a single dose of 0.5 µg kg-1 dexmedetomidine or the same volume of placebo intravenously administered for 15 min, followed by continuous pumping of 0.2 µg kg-1 h-1 of corresponding drugs until 30 min before the end of surgery. The primary outcome was the time to first flatus. Secondary outcomes were the time to first oral feeding and the first defecation, the occurrence of flatulence, pain score and postoperative nausea and vomiting until 48 h after the surgery. Eventually, 106 participants (54 in dexmedetomidine group and 52 in placebo group) were included for final analysis. The time to first flatus (SD, 25.83 [4.18] vs 27.67 [3.77], P = 0.019), oral feeding time (SD, 27.29 [4.40] vs 28.92 [3.82], P = 0.044), the time to first defecation (SD, 59.82 [10.49] vs 63.89 [7.71], P = 0.025), abdominal distension (n%, 12 (22.2) vs 21 (40.4), P = 0.044), PONV at 24 h (n%, 10 (18.5) vs 19 (36.5), P = 0.037), NRS 6 h (3.15(0.68) vs 3.46 (0.87), P = 0.043) and NRS 12 h (3.43 (0.88) vs 3.85 (0.85), P = 0.014) of dexmedetomidine group were significantly shorter than those of the placebo group. Intraoperative dexmedetomidine reduced the time to first flatus, first oral feeding, and first defecation. These results suggested that this treatment may be a feasible strategy for improving postoperative gastrointestinal function recovery in patients undergoing laparoscopic hysteromyomectomy.

Effect of ketorolac tromethamine combined with dezocine prior administration on hemodynamics and postoperative analgesia in patients undergoing laparoscopic hernia repair.

OBJECTIVE: To observe the effect of Ketorolac tromethamine combined with dezocine prior administration on hemodynamics and postoperative sedation in patients undergoing laparoscopic hernia repair. METHODS: 100 male patients aged 60 to 80 years old, a line to elective laparoscopic inguinal hernia repair, were randomly divided into four groups: control group (Group A) and dezocine group (Group B), ketorolac tromethamine group (Group C), ketorolac tromethamine combined with dezocine group (Group D). Patients were administrated with 0.1 mg/kg dezocine in Group B, 0.5 mg/kg ketorolac in Group C, 0.1 mg/kg dezocine, and 0.5 mg/kg ketorolac in Group D, and with an equal dose of normal saline in group A. The heart rate (HR) and mean arterial pressure (MAP) of patients in 4 groups were recorded at each time point as follows, T0 (enter the operating room), T1 (before skin resection), 10 min after pneumoperitoneum (T2), mesh placement (T3), and laryngeal mask extraction (T4). Operation time, awakening time (time from drug withdrawal to consciousness recovery), the dosage of propofol, sufentanil, remifentanil, and intraoperative vasoactive drug dosage were recorded to compare. Visual analog scale score and sedation Ramsay score were evaluated 1, 6, 12, and 24 hours after extubation. RESULTS: There was no significant difference in operation time, anesthesia recovery time, sufentanil dosage, and vasoactive drugs among all groups. The amount of propofol in Group B and D was less than that in Group A and C (P < .05), and there was no difference between Group B and D, A and C (P > .05). The amount of remifentanil in Group B, C, and D was less than that in Group A (P < .05), and Group D was less than B and C (P < .05). After extubation, HR and MAP were significantly higher than before (P < .05). Compared with T0, HR and MAP increased in each group at T4, but MAP and HR in Group D increased the least (P < .05). There were significant differences between Group B, C, D, and A, MAP and HR fluctuated little during extubation (P < .05), but there was a significant difference between Group D and B, C (P < .05). Visual analog scale scores of Group B, C, and D were lower than those of A at 1, 6, and 12 hours after surgery (P < .05), and there was a significant difference between Group D, and B, C (P < .05). Ramsay scores in Group B and D were higher than those in A and C at 1 and 6 hours after the operation (P < .05). There was no difference in the incidence of adverse reactions among groups. CONCLUSION: The prophylactic use of ketorolac tromethamine and dezocine before laparoscopic inguinal hernia repair can reduce hemodynamic disorder during anesthesia recovery, increase postoperative sedative and analgesic effects.

First-principles identification of VI + Cuidefect cluster in cuprous iodide: origin of red light photoluminescence.

Theγ-phase cuprous iodide (CuI) emerges as a promising transparent p-type semiconductor for next-generation display technology because of its wide direct band gap, intrinsic p-type conductivity, and high carrier mobility. Two main peaks are observed in its photoluminescence (PL). One is short wavelength (410-430 nm) emission, which is well attributed to the electronic transitions at Cu vacancy, whereas the other long wavelength emission (680-720 nm) has not been fully understood. In this paper, through first-principles simulations, we investigate the formation energies and emission line shapes for various defects, and discover that the intrinsic point defect clusterVI+Cui2+is the source of the long wavelength emission. Our finding is further supported by the prediction that the defect concentration decreases dramatically as the chemical condition changes from Cu-rich to I-rich, explaining the significant reduction in the red light emission if CuI is annealed in abundant I environment.

The effect of ultrasound-guided low serratus anterior plane block on laparoscopic cholecystectomy postoperative analgesia: A randomized clinical trial.

BACKGROUND: Anterior serratus plane block for analgesia in many procedures, but there have been no reports of analgesia undergoing laparoscopic cholecystectomy (LC). We investigated the effects of ultrasonic-guided low serratory anterior block on patients undergoing LC. METHODS: One hundred patients who undergo LC were selected and randomly divided into 2 groups: Patients in group C with routine general anesthesia and patients in group S treat low anterior serratus block combined with general anesthesia. The serratus anterior block was performed at the T8 to T9 point after anesthesia induction, before cutting leather (T0), stamp card placement (T1), 2 groups of patients' heart rate (HR), blood pressure were recorded, at the same time dosage of analgesic drugs and postoperative 0.5, 6, 12, 24 hours when resting visual analogue scale (VAS) scores were recorded in 2 groups of patients. RESULTS: The T0 point, patients' HR, blood pressure had significant difference (P > .05), the T1 point, patients' HR, mean arterial pressure in group S lower than group C (P < .05), the amount of intra-operative propofol and remifentanil, patients in group S were less than in group C (P < .05), and resting VAS pain score at the 0.5, 6, 12 hours after operation patients in group S were lower than group C also (P < .05), resting VAS pain had no significant difference at postoperative 24 hours between 2 groups (P > .05). CONCLUSION: Low serratus anterior plane block in LC can provide safe and effective analgesia for patients.

More Se Vacancies in Sb2 Se3 under Se-Rich Conditions: An Abnormal Behavior Induced by Defect-Correlation in Compensated Compound Semiconductors.

It was believed that the Se-rich synthesis condition can suppress the formation of deep-level donor defect VSe (selenium vacancy) in Sb2 Se3 and is thus critical for fabricating high-efficiency Sb2 Se3 solar cells. However, here it is shown that by first-principles calculations the density of VSe increases unexpectedly to 1016 cm-3 when the Se chemical potential increases, so Se-rich condition promotes rather than suppresses the formation of VSe . Therefore, high density of VSe is thermodynamically inevitable, no matter under Se-poor or Se-rich conditions. This abnormal behavior can be explained by a physical concept "defect-correlation", i.e., when donor and acceptor defects compensate each other, all defects become correlated with each other due to the formation energy dependence on Fermi level which is determined by densities of all ionized defects. In quasi-1D Sb2 Se3 , there are many defects and the complicated defect-correlation can give rise to abnormal behaviors, e.g., lowering Fermi level and thus decreasing the formation energy of ionized donor VSe 2+ in Se-rich Sb2 Se3 . Such behavior exists also in Sb2 S3 . It explains the recent experiments that the extremely Se-rich condition causes the efficiency drop of Sb2 Se3 solar cells, and demonstrates that the common chemical intuition and defect engineering strategies may be invalid in compensated semiconductors.

Quasi-one-dimensional Sb2(S,Se)3 alloys as bandgap-tunable and defect-tolerant photocatalytic semiconductors.

Both Sb2S3 and Sb2Se3 have been studied as promising photocatalytic and photovoltaic semiconductors because of their suitable bandgaps, high light absorption coefficients and good stability. Through forming the mixed-anion Sb2(S,Se)3 alloys, the bandgaps and lattice parameters can be tuned and a band structure engineering design of semiconductor heterostructures becomes possible. However, the properties of the disordered Sb2(S,Se)3 alloys are currently not clear. Using first-principles calculations, we show that the alloys are highly miscible with low formation enthalpies, so composition-variable and uniform alloys can be fabricated under room temperature. The bandgaps of the alloys change almost linearly as the alloy composition (S/Se ratio) varies, indicating that the bandgap engineering can be quite flexible. The calculations of the defect properties show that there are dozens of detrimental defects producing deep levels in the bandgap of the alloy under the Sb-rich (Se-poor) condition, which can cause serious electron-hole non-radiative recombination and limit the minority carrier lifetime. The formation of these detrimental defects can be largely suppressed under the Sb-poor condition, so we propose that the Sb-poor (Se-rich) condition should be adopted for fabricating Sb2(S,Se)3 alloys as photocatalytic and photovoltaic light-absorber semiconductors with long minority carrier lifetimes.

Chemical Trends in the Thermodynamic Stability and Band Gaps of 980 Halide Double Perovskites: A High-Throughput First-Principles Study.

The chemical trends in the thermodynamic stability and band gaps of 980 A2B+B3+X6 halide double perovskites are revealed based on high-throughput first-principles calculations. To accurately predict the stability with respect to phase decomposition, all known metal halides in the Materials Project database are considered as the competing compounds. The energies above the convex hull show that only 112 of 980 double perovskites are stable and 27 double perovskites that had been predicted to be stable in the literature are actually unstable after considering more competing compounds. The stability of these double perovskites is determined mainly by A, X, and B+ elements and increases gradually as A becomes heavier (from Li to Cs) and X becomes lighter (from I to F). The band gaps are determined mainly by X, B+, and B3+ elements, decreasing monotonically as X becomes heavier while changing nonmonotonically as B+ and B3+ change. These chemical trends provide clear instructions for the design of double perovskites with good stability and suitable band gaps for various applications, i.e., through choosing heavier A cations (e.g., large organic cations), stable double perovskites can be designed with band gaps tunable in a wide range of 0-7 eV (infrared to ultraviolet); however, through choosing light X anions, stable double perovskites can be designed with only wide band gaps.

Dissociation path competition of radiolysis ionization-induced molecule damage under electron beam illumination.

Radiolysis ionization under electron beam illumination induces dissociation and damage of organic and biological molecules; thus, it is impossible to image the related materials by transmission electron microscopy (TEM). To understand the atomistic mechanism of radiolysis damage, we developed a systematical procedure based on real-time time-dependent density functional theory (rt-TDDFT) for simulating the radiolysis damage processes of molecules; this procedure can describe the ionization cross sections of the electronic states and the fast dissociation processes caused by hot carrier cooling and the Auger decay on deep levels. For the radiolysis damage of C2H6O2, our simulation unexpectedly showed that there is strong competition among three different dissociation paths, including fast dissociation caused by nonadiabatic cooling of the hot carrier; fast dissociation caused by Auger decay, which induces double ionization and Coulomb explosion; and slow dissociation caused by increased kinetic energy. As the energy of the incident electron beam changes, the time scales of these dissociation paths and their relative contributions to the molecule damage change significantly. These simulation results explain the measured mass spectra of the C2H6O2 dissociation fragments and also provide clear competition mechanisms for blocking these dissociation paths in the TEM imaging of organic and biological materials.

Natural Intermediate Band in I 2 -II-IV-VI4 Quaternary Chalcogenide Semiconductors.

An intermediate band in the band gap of semiconductors is fundamental to the development of the intermediate band solar cells, but it is usually produced artificially, which imposes technical challenges on the experimental realization. Here we found that there are natural intermediate bands in the band gaps of the I2-II-IV-VI4 quaternary chalcogenide semiconductors such as Cu2ZnSnS4 and Ag2ZnSnSe4, which had been proposed as promising light-absorber semiconductors in thin film solar cells. By first-principles calculations, we found the lowest conduction band of these I2-II-IV-VI4 semiconductors in the kesterite structure is isolated (a lone band, resulting from the energy separation between Sn 5s and 5p states), which can be viewed as a natural intermediate band. The gap between the intermediate band and higher-energy conduction band can be increased through changing the crystal structure from the zincblende-derived kesterite structure to the wurtzite-derived wurtzite-kesterite structure. In contrast, the intermediate-conduction band gap shrinks when the component element Sn is replaced by Ge (Cu2ZnGeS4), and the gap even disappears (intermediate band disappear) when Sn is replaced by Si (Cu2ZnSiS4). Through tuning the intermediate-conduction and intermediate-valence band gaps, we show that the wurtzite-kesterite structured Ag2ZnSnSe4 may be a potential light-absorber semiconductor in intermediate band solar cells.