Effect of Different Administration Routes of Dexmedetomidine on Postoperative Delirium in Elderly Patients Undergoing Elective Spinal Surgery: A Prospective Randomized Double-Blinded Controlled Trial.

BACKGROUND: Intravenous dexmedetomidine has been reported to decrease the occurrence of postoperative delirium (POD) in elderly patients. Nevertheless, some previous studies have indicated that intratracheal dexmedetomidine and intranasal dexmedetomidine are also effective and convenient. The current study aimed to compare the effect of different administration routes of dexmedetomidine on POD in elderly patients. METHODS: We randomly allocated 150 patients (aged 60 years or more) scheduled for spinal surgery to receive intravenous dexmedetomidine (0.6 µg/kg), intranasal dexmedetomidine (1 µg/kg) before anesthesia induction, or intratracheal dexmedetomidine (0.6 µg/kg) after anesthesia induction. The primary outcome was the frequency of delirium during the first 3 postoperative days. The secondary outcomes were the incidence of postoperative sore throat (POST) and sleep quality. Adverse events were recorded, and routine treatment was performed. RESULTS: Compared with the intranasal group, the intravenous group had a significantly lower occurrence of POD within 3 days (3 of 49 [6.1%] vs 14 of 50 [28.0%]; odds ratio [OR], 0.17; 95% confidence intervals [CIs], 0.05-0.63; P < .017). Meanwhile, patients in the intratracheal group had a lower incidence of POD than those in the intranasal group (5 of 49 [10.2%] vs 14 of 50 [28.0%]; OR, 0.29; 95% CI, 0.10-0.89; P < .017). Whereas, there was no difference between the intratracheal and intravenous groups (5 of 49 [10.2%] vs 3 of 49 [6.1%]; OR, 1.74; 95% CI, 0.40-7.73; P > .017). The rate of POST was lower in the intratracheal group than that in the other 2 groups at 2 hours after surgery (7 of 49 [14.3%] vs 12 of 49 [24.5%] vs 18 of 50 [36.0%], P < .017, respectively). Intravenous dexmedetomidine had the lowest Pittsburgh Sleep Quality Index score on the second morning after surgery (median [interquartile range {IQR}]: 4 [3-5] vs 6 [4-7] vs 6 [4-7], P < .017, respectively). Compared with the intranasal group, the intravenous group had a higher rate of bradycardia and a lower incidence of postoperative nausea and vomiting ( P < .017). The intranasal group was associated with the highest incidence of hypertension ( P < .017). CONCLUSIONS: For patients aged ≥60 years undergoing spinal surgery, compared with the intranasal route of dexmedetomidine, intravenous and intratracheal dexmedetomidine reduced the incidence of early POD. Meanwhile, intravenous dexmedetomidine was associated with better sleep quality after surgery, and intratracheal dexmedetomidine resulted in a lower incidence of POST. Adverse events were mild in all 3 administration routes of dexmedetomidine.

Ischemic-Preconditioning Induced Serum Exosomal miR-133a-3p Improved Post-Myocardial Infarction Repair via Targeting LTBP1 and PPP2CA.

Background: Ischemic preconditioning-induced serum exosomes (IPC-exo) protected rat heart against myocardial ischemia/reperfusion injury. However, whether IPC-exo regulate replacement fibrosis after myocardial infarction (MI) and the underlying mechanisms remain unclear. MicroRNAs (miRs) are important cargos of exosomes and play an essential role in cardioprotection. We aim to investigate whether IPC-exo regulate post-MI replacement fibrosis by transferring cardioprotective miRs and its action mechanism. Methods: Exosomes obtained from serum of adult rats in control (Con-exo) and IPC groups were identified and analyzed, subsequently intracardially injected into MI rats following ligation. Their miRs profiles were identified using high-throughput miR sequencing to identify target miRs for bioinformatics analysis. Luciferase reporter assays confirmed target genes of selected miRs. IPC-exo transfected with selected miRs antagomir or NC were intracardially administered to MI rats post-ligation. Cardiac function and degree of replacement fibrosis were detected 4 weeks post-MI. Results: IPC-exo exerted cardioprotective effects against excessive replacement fibrosis. MiR sequencing and RT-qPCR identified miR-133a-3p as most significantly different between IPC-exo and Con-exo. MiR-133a-3p directly targeted latent transforming growth factor beta binding protein 1 (LTBP1) and protein phosphatase 2, catalytic subunit, alpha isozyme (PPP2CA). KEGG analysis showed that transforming growth factor-ß (TGF-ß) was one of the most enriched signaling pathways with miR-133a-3p. Comparing to injection of IPC-exo transfected with miR-133a-3p antagomir NC, injecting IPC-exo transfected with miR-133a-3p antagomir abolished protective effects of IPC-exo on declining excessive replacement fibrosis and cardiac function enhancement, while increasing the messenger RNA and protein expression of LTBP1, PPP2CA, and TGF-ß1in MI rats. Conclusion: IPC-exo inhibit excessive replacement fibrosis and improve cardiac function post-MI by transferring miR-133a-3p, the mechanism is associated with directly targeting LTBP1 and PPP2CA, and indirectly regulating TGF-ß pathway in rats. Our finding provides potential therapeutic effect of IPC-induced exosomal miR-133a-3p for cardiac repair.

Design and synthesis of one-dimensional magnetic composites with Co nanoparticles encapsulated in carbon nanofibers for enhanced microwave absorption.

With the increased usage of electromagnetic microwaves (EM) in wireless communication technology, the problem of electromagnetic radiation pollution has grown dramatically. This study successfully prepared novel Co/C magnetic nanocomposite fibers for EM absorption using the electrospinning and carbonization methods. The morphology, composition, magnetic properties, and EM absorption performance were extensively characterized. This material shows exceptional EM absorption performance, achieving -72.01 dB (at 2.08 mm) for minimum reflection loss (RLmin) and 5.4 GHz (at 1.68 mm) for effective absorption bandwidth (EAB). The performance surpasses not only any single precursor but also stands as the best in similar investigations. It can be attributed to the microstructure of magnetic Co nanoparticles encapsulated in carbon nanofibers and the macrostructure of cross-linked three-dimensional (3D) conductive networks. The combination of these structures resulted in excellent dielectric loss, magnetic loss, and impedance matching. This research offers new insights into the production of one-dimensional (1D) carbon-based absorbers, while also establishing a theoretical foundation for exploring the application potential of this material. These findings may contribute to the development of more efficient and practical EM absorption materials in the future.

Simple fabrication of cobalt-nickel alloy/carbon nanocomposite fibers for tunable microwave absorption.

A series of CoNi/C nanocomposite fibers with different Co and Ni ratios were successfully prepared by electrospinning and carbonization techniques for the study of electromagnetic microwave (EMW) absorbing materials. We systematically studied the influence of Co and Ni content on the microstructure, chemical composition, magnetic properties, and EMW absorption characteristics of the samples. The results showed that CoNi/C nanocomposite fibers obtained excellent EMW absorption ability through the reasonable design of the composition, and the Co/Ni ratio significantly affected the microstructure and EMW absorption performance. When the Co/Ni ratio was 1/3, the minimum reflection loss (RLmin) is -71.2 dB (2.4 mm, 13.4 GHz), and the maximum effective absorption bandwidth (EAB, RL＜-10 dB) is up to 5.9 GHz (2.2 mm, 12.1-18 GHz), covering almost the entire Ku band. This study demonstrated the enormous potential of one-dimensional structure in the field of EMW absorption. In addition, the CoNi/C nanocomposite fiber synthesized using a straightforward and low-cost method not only has excellent EMW absorption performance but also has the potential for practical application. The results of this study provide a simple and effective approach for designing high-performance EMW absorbing materials.

Effect of a Local Anesthetic Injection Kit on Pain Relief and Postoperative Recovery After Transumbilical Single-Incision Laparoscopic Cholecystectomy.

Purpose: This study was conducted to explore whether incisional infiltration using a local anesthetic injection kit could better relieve postoperative pain and enhance the quality of recovery compared with ultrasound-guided rectus sheath block (RSB) or conventional local anesthetic infiltration in patients undergoing transumbilical single-incision laparoscopic cholecystectomy (SILC). Patients and Methods: A total of 60 patients undergoing SILC with American Society of Anesthesiology functional status scores of I-II were randomized into the rectus sheath block group (RSB group), conventional local wound infiltration group (LAI-I group) and incisional infiltration using a local anesthetic injection kit group (LAI-II group). The primary outcomes were the patient-controlled intravenous analgesia (PCIA) demand frequency within 48 hours after the operation and postoperative pain measured by a visual analog scale (VAS) at 2 h, 4 h, 8 h, 24 h, and 48 h after surgery. Secondary outcomes were the total procedure times, cumulative consumption of anesthetic drugs, duration of surgery, duration and awaking time of anesthesia, early recovery indicator and side effects. Results: The PCIA demand frequency in LAI-II group was significantly lower compared with patients in the RSB and LAI-I group (both P < 0.001). Moreover, the total procedure times in LAI-I and LAI-II group was significantly shorter than that in the RSB group (P < 0.001, respectively), but it was comparable between LAI-I and LAI-II group (P = 0.471). Though lower at 2h and 4h postoperative in LAI-II group, pain scores at each time point had no statistical differences among three groups. There were no significant differences among three groups for other outcomes as well. Conclusion: The effect of ultrasound-guided RSB and conventional local anesthetic infiltration in SILC patients were found to be similar in terms of relieving postoperative pain and promoting recovery. Incisional infiltration using a local anesthetic injection kit can significantly reduce the demand frequency of PCIA, which serves as a rescue analgesic.

Transplantation of microencapsulated Schwann cells and mesenchymal stem cells augment angiogenesis and improve heart function.

Because of their plasticity and availability, bone-marrow-derived mesenchymal stem cells (MSC) are a potential cell source for treating ischemic heart disease. Schwann cells (SC) play a critical role in neural remodeling and angiogenesis because of their secretion of cytokines such as vascular endothelial growth factor (VEGF). Cell microencapsulation, surrounding cells with a semipermeable polymeric membrane, is a promising tool to shelter cells from the recipient's immune system. We investigated whether transplantation of microencapsulated SC (MC-SC) and MSC together could improve heart function by augmenting angiogenesis in acute myocardial infarction (AMI). Sprague-Dawley rats with ligation of the left anterior descending artery to induce AMI were randomly divided for cell transplantation into four groups-MC-SC+MSC, MC+MSC, MSC, MC-SC, and controls. Echocardiography was performed at 3 days and 2 and 4 weeks after AMI. Rat hearts were harvested on day 28 after transplantation and examined by immunohistochemistry and western blot analysis. Echocardiography revealed differences among the groups in fractional shortening and end-systolic and end-diastolic dimensions (P < 0.05). The number of BrdU-positive cells was greater with MC-SC+MSC transplantation than the other groups (P < 0.01). The vessel density and VEGF level in the infarcted zone was significantly increased with MC-SC+MSC transplantation (P < 0.05). These results show that transplanting a combination of MC-SC and MSC could augment angiogenesis and improve heart function in AMI.

Synthesis of sugar gourd-like metal organic framework-derived hollow nanocages nickel molybdate@cobalt-nickel layered double hydroxide for flame retardant polyurea.

Transition metals with catalytic properties were expected to improve the fire resistance of the polymer. In this work, NiMoO4 nanorods decorated with Co-Ni layered double hydroxide (LDH) were fabricated and incorporated into polyurea (PUA) to improve the flame retardancy during combustion. Thermogravimetric analysis (TGA) showed that the addition of NiMoO4@Co-Ni LDH slightly decreased the initial degradation and the maximum degradation temperature. With increasing loading of NiMoO4@Co-Ni LDH, the char residue increased obviously. The combustion performance of PUA with 3.0 wt% NiMoO4@Co-Ni LDH investigated by cone calorimeter (CCT) showed that the peak heat release rate (PHRR), total heat release (THR) and smoke factor (SF) decreased by 34.41%, 12.68% and 48.65%, respectively. The existence of well-dispersed NiMoO4@Co-Ni LDH effectively enhanced the mechanical properties and flame retardant performances of PUA.

Constructing 3D magnetic flower-like Fe3O4@SiO2@Co3O4@BiOCl heterojunction photocatalyst for degrading rhodamine B.

In this work, the 3D magnetic flower-like Fe3O4@SiO2@Co3O4@BiOCl heterojunction photocatalyst was successfully prepared. The combination of BiOCl with Co3O4 favored to increase specific surface area and separate photo-generated carriers of the resulting composite, resulting in the improvement of catalytic efficiency. The photocatalytic activities of Fe3O4@SiO2@Co3O4@BiOCl were researched in details. In 50 min of visible light, the degradation efficiency for rhodamine B (RhB) of Fe3O4@SiO2@Co3O4@BiOCl was 98.41%. It still maintained 94.22% even after three tests. Furthermore, the photodegradation mechanisms were also investigated, indicating that the improved efficiency was ascribed to the superior separation of photo-induced electron-hole pairs. This study supplies a new perception to fabricate photocatalysts for actual uses.

Composites Filled with Metal Organic Frameworks and Their Derivatives: Recent Developments in Flame Retardants.

Polymer matrix is vulnerable to fire hazards and needs to add flame retardants to enhance its performance and make its application scenarios more extensive. At this stage, it is more necessary to add multiple flame-retardant elements and build a multi-component synergistic system. Metal organic frameworks (MOFs) have been studied for nearly three decades since their introduction. MOFs are known for their structural advantages but have only been applied to flame-retardant polymers for a relatively short period of time. In this paper, we review the development of MOFs utilized as flame retardants and analyze the flame-retardant mechanisms in the gas phase and condensed phase from the original MOF materials, modified MOF composites, and MOF-derived composites as flame retardants, respectively. The effects of carbon-based materials, phosphorus-based materials, nitrogen-based materials, and biomass on the flame-retardant properties of polymers are discussed in the context of MOFs. The construction of MOF multi-structured flame retardants is also introduced, and a variety of MOF-based flame retardants with different morphologies are shown to broaden the ideas for subsequent research.

Significance of TP53 Mutation in Cellular Process and Disease Progression in Lung Adenocarcinoma.

Introduction: TP53 (tumor protein p53) is one of the most commonly mutanted genes in lung adenocarcinoma (LUAD). Materials and Methods: In this study, we used data from The Cancer Genome Atlas (TCGA) to evaluate the importance of TP53 mutations in cellular processes, disease progression, the prognosis in LUAD, and to identify critical hub genes and pathways associated with oncogenesis. Results: Analysis of the TCGA data showed TP53 mutations in 22% of LUAD patients. Clinicopathological analyses demonstrated that TP53 mutation was correlated with the disease progression but not prognosis. We identified 1935 differentially expressed genes (DEGs). Functional enrichment analysis showed that the DEGs were mainly concentrated in metabolism, cell differentiation, and cancer-related pathways. The top hub genes were identified and disease analysis revealed the most critical genes related to disease progression and prognosis. The expression levels of several of these genes were then tested in tumor tissues. Conclusion: Our results showed that TP53 mutation plays a critical role in cellular process and the clinicopathological findings in LUAD. We also identified potential key genes, which could provide novel evidence for individualized treatment.

Self-calibration of catadioptric camera with two planar mirrors from silhouettes.

If an object is interreflected between two planar mirrors, we may take an image containing both the object and its multiple reflections, i.e., simultaneously imaging multiple views of an object by a single pinhole camera. This paper emphasizes the problem of recovering both the intrinsic and extrinsic parameters of the camera using multiple silhouettes from one single image. View pairs among views in a single image can be divided into two kinds by the relationship between the two views in the pair: reflected by some mirror (real or virtual) and in a circular motion. Epipoles in the first kind of pairs can be easily determined from intersections of common tangent lines of silhouettes. Based on the projective properties of these epipoles, efficient methods are proposed to recover both the imaged circular points and the included angle between two mirrors. Epipoles in the second kind of pairs can be recovered simultaneously with the projection of intersection line between two mirrors by solving a simple 1D optimization problem using the consistency constraint of epipolar tangent lines. Fundamental matrices among views in a single image are all recovered. Using the estimated intrinsic and extrinsic parameters of the camera, a euclidean reconstruction can be obtained. Experiments validate the proposed approach.