Identifying risk factors for hypoxemia during emergence from anesthesia in patients undergoing robot-assisted laparoscopic radical prostatectomy.

Robot-assisted laparoscopic radical prostatectomy (RALP) has emerged as an effective treatment for prostate cancer with obvious advantages. This study aims to identify risk factors related to hypoxemia during the emergence from anesthesia in patients undergoing RALP. A cohort of 316 patients undergoing RALP was divided into two groups: the hypoxemia group (N = 134) and the non-hypoxemia group (N = 182), based on their postoperative oxygen fraction. Comprehensive data were collected from the hospital information system, including preoperative baseline parameters, intraoperative data, and postoperative recovery profiles. Risk factors were examined using multiple logistic regression analysis. The study showed that 38.9% of patients had low preoperative partial pressure of oxygen (PaO2) levels. Several clinical parameters showed significant differences between the hypoxemia group and the non-hypoxemia group, including weight (P < 0.0001), BMI (P < 0.0001), diabetes mellitus (P = 0.044), history of emphysema and pulmonary alveoli (P < 0.0001), low preoperative PaO2 (P < 0.0001), preoperative white blood cell count (P = 0.012), preoperative albumin (P = 0.048), intraoperative bleeding (P = 0.043), intraoperative CO2 accumulation (P = 0.001), duration of surgery (P = 0.046), postoperative hemoglobin level (P = 0.002), postoperative hypoxemia (P = 0.002), and early postoperative fever (P = 0.006). Multiple logistic regression analysis revealed BMI (adjusted odds ratio = 0.696, 95% confidence interval 0.612-0.719), low preoperative PaO2 (adjusted odds ratio = 9.119, 95% confidence interval 4.834-17.203), and history of emphysema and pulmonary alveoli (adjusted odds ratio = 2.804, 95% confidence interval 1.432-5.491) as independent factors significantly associated with hypoxemia on emergence from anesthesia in patients undergoing RALP. Our results demonstrate that BMI, lower preoperative PaO2, and a history of emphysema and pulmonary alveolar disease are independent risk factors associated with hypoxemia on emergence from anesthesia in patients undergoing RALP. These findings provide a theoretical framework for surgeons and anesthesiologists to facilitate strategies to mitigate postoperative hypoxemia in this unique patient population.

Segmented Control of Selenization Environment for High-Quality Cu2ZnSn(S,Se)4 Films Toward Efficient Kesterite Solar Cells.

High-crystalline-quality absorbers with fewer defects are crucial for further improvement of open-circuit voltage (VOC) and efficiency of Cu2ZnSn(S,Se)4 (CZTSSe) solar cells. However, the preparation of high-quality CZTSSe absorbers remains challenging due to the uncontrollability of the selenization reaction and the complexity of the required selenization environment for film growth. Herein, a novel segmented control strategy for the selenization environment, specifically targeting the evaporation area of Se, to regulate the selenization reactions and improve the absorber quality is proposed. The large evaporation area of Se in the initial stage of the selenization provides a great evaporation and diffusion flux for Se, which facilitates rapid phase transition reactions and enables the attainment of a single-layer thin film. The reduced evaporation area of Se in the later stage creates a soft-selenization environment for grain growth, effectively suppressing the loss of Sn and promoting element homogenization. Consequently, the mitigation of Sn-related deep-level defects on the surface and in the bulk induced by element imbalance is simultaneously achieved. This leads to a significant improvement in nonradiative recombination suppression and carrier collection enhancement, thereby enhancing the VOC. As a result, the CZTSSe device delivers an impressive efficiency of 13.77% with a low VOC deficit.

Passivating Grain Boundaries via Graphene Additive for Efficient Kesterite Solar Cells.

Grain boundaries (GBs)-triggered severe non-radiative recombination is recently recognized as the main culprits for carrier loss in polycrystalline kesterite photovoltaic devices. Accordingly, further optimization of kesterite-based thin film solar cells critically depends on passivating the grain interfaces of polycrystalline Cu2 ZnSn(S,Se)4 (CZTSSe) thin films. Herein, 2D material of graphene is first chosen as a passivator to improve the detrimental GBs. By adding graphene dispersion to the CZTSSe precursor solution, single-layer graphene is successfully introduced into the GBs of CZTSSe absorber. Due to the high carrier mobility and electrical conductivity of graphene, GBs in the CZTSSe films are transforming into electrically benign and do not act as high recombination sites for carrier. Consequently, benefitting from the significant passivation effect of GBs, the use of 0.05 wt% graphene additives increases the efficiency of CZTSSe solar cells from 10.40% to 12.90%, one of the highest for this type of cells. These results demonstrate a new route to further increase kesterite-based solar cell efficiency by additive engineering.

2D Ti3C2-MXene Serving as Intermediate Layer between Absorber and Back Contact for Efficient CZTSSe Solar Cells.

Kesterite Cu2ZnSn(S,Se)4 (CZTSSe) has been considered as the most promising absorber material for inorganic thin-film solar cells. Among the three main interfaces in CZTSSe-based solar cells, the CZTSSe/Mo back interface plays an essential role in hole extraction as well as device performance. During the selenization process, the reaction between CZTSSe and Mo is one of the main reasons that lead to a large open circuit voltage (VOC) deficit, low short circuit current (Jsc), and fill factor. In this study, 2D Ti3C2-MXene was introduced as an intermediate layer to optimize the interface between the CZTSSe absorber layer and Mo back contact. Benefiting from the 2D Ti3C2-MXene intermediate layer, the reaction between CZTSSe and Mo was effectually suppressed, thus, significantly reducing the thickness of the detrimental Mo(S,Se)2 layer as well as interface recombination at the CZTSSe/Mo back interface. As a result, the power conversion efficiency of the champion device fabricated with the 2D Ti3C2-MXene intermediate layer was improved from 10.89 to 13.14% (active-area efficiency). This study demonstrates the potential use of the 2D Ti3C2-MXene intermediate layer for efficient CZTSSe solar cells and promotes a deeper understanding of the back interface in CZTSSe solar cells.

Progress and prospectives of solution-processed kesterite absorbers for photovoltaic applications.

Solar cells based on emerging kesterite Cu2ZnSn(S,Se)4 (CZTSSe) materials have reached certified power conversion efficiency (PCE) as high as 13.6%, showing great potential in the next generation of photovoltaic technologies because of their earth-abundant, tunable direct bandgap, high optical absorption coefficient, environment-friendly, and low-cost properties. The predecessor of CZTSSe is Cu(In,Ga) Se2 (CIGS), and the highest PCE of CIGS fabricated by the vacuum method is 23.35%. However, the recorded PCE of CZTSSe devices are fabricated by a low-cost solution method. The characteristics of the solvent play a key role in determining the crystallization kinetics, crystal growth quality, and optoelectronic properties of the CZTSSe thin films in the solution method. It is still challenging to improve the efficiency of CZTSSe solar cells for future commercialization and applications. This review describes the current status of CZTSSe solar cell absorbers fabricated by protic solvents with NH (hydrazine), protic solvents with SH (amine-thiol), aprotic solvents (DMSO and DMF), ethylene glycol methyl ether-based precursor solution method (EGME), and thioglycolic acid (TGA)-ammonia solution (NH3H2O) deposition methods. Furthermore, the performances of vacuum-deposited devices and solution-based processed devices are compared. Finally, the challenges and outlooks of CZTSSe solar cells are discussed for further performance improvement.

Suppressing interface recombination in CZTSSe solar cells by simple selenization with synchronous interface gradient doping.

The main bottleneck in the development of kesterite Cu2ZnSn(S,Se)4 (CZTSSe) solar cells is their very low VOC due to severe carrier recombination. Specifically, due to the poor defect environment and unfavorable band structure, carrier recombination at the front interface is considered to be one of the most serious issues. Thus, to reduce the interface recombination and VOC deficit, we propose a convenient and effective strategy for Cd gradient doping near the front interface during selenization. The formed Cd gradient significantly reduced the CuZn defects and related [2CuZn + SnZn] defect clusters near the CZTSSe-CdS heterojunction, thus significantly suppressing the interface recombination near the heterojunction. Benefitting from the formed Cd gradient, a champion device with 12.14% PCE was achieved with the VOC significantly improved from 432 mV to 486 mV. The proposed element gradient doping strategy can offer a new idea for selenization and element gradient doping in other photoelectric devices.

Over 16% Efficient Solution-Processed Cu(In,Ga)Se2 Solar Cells via Incorporation of Copper-Rich Precursor Film.

Solution processing of Cu(In,Ga)Se2 (CIGS) absorber is a highly promising strategy for a cost-effective CIGS photovoltaic device. However, the device performance of solution-processed CIGS solar cells is still hindered by the severe non-radiative recombination resulting from deep defects and poor crystal quality. Here, a simple and effective precursor film engineering strategy is reported, where Cu-rich (CGI >1) CIGS layer is incorporated into the bottom of the CIGS precursor film. It has been discovered that the incorporation of the Cu-rich CIGS layer greatly improves the absorber crystallinity and reduces the trap state density. Accordingly, more efficient charge generation and charge transfer are realized. As a result of systematic processing optimization, the champion solution-processed CIGS device delivers an improved open-circuit voltage of 656 mV, current density of 33.15 mA cm-2 , and fill factor of 73.78%, leading to the high efficiency of 16.05%.

Postoperative Cognitive Dysfunction and Alzheimer's Disease: A Transcriptome-Based Comparison of Animal Models.

Background: Postoperative cognitive dysfunction (POCD) is a common complication characterized by a significant cognitive decline. Increasing evidence suggests an association between the pathogenesis of POCD and Alzheimer's disease (AD). However, a comprehensive understanding of their relationships is still lacking. Methods: First, related databases were obtained from GEO, ArrayExpress, CNGB, and DDBJ repositories. De novo analysis was performed on the raw data using a uniform bioinformatics workflow. Then, macro- and micro-level comparisons were conducted between the transcriptomic changes associated with AD and POCD. Lastly, POCD was induced in male C57BL/6j mice and the hippocampal expression levels of mRNAs of interest were verified by PCR and compared to those in AD congenic models. Results: There was a very weak correlation in the fold-changes in protein-coding transcripts between AD and POCD. Overall pathway-level comparison suggested that AD and POCD are two disease entities. Consistently, in the classical AD pathway, the mitochondrial complex and tubulin mRNAs were downregulated in both the POCD hippocampus and cortex. POCD and AD hippocampi might share the same pathways, such as tryptophan metabolism, but undergo different pathological changes in phagosome and transferrin endocytosis pathways. The core cluster in the hippocampal network was mainly enriched in mitosis-related pathways. The hippocampal expression levels of genes of interest detected by PCR showed good consistency with those generated by high throughput platforms. Conclusion: POCD and AD are associated with different transcriptomic changes despite their similar clinical manifestations. This study provides a valuable resource for identifying biomarkers and therapeutic targets for POCD.

Plasmonic Local Electric Field-Enhanced Interface toward High-Efficiency Cu2ZnSn(S,Se)4 Thin-Film Solar Cells.

The kesterite Cu2ZnSn(S,Se)4 (CZTSSe) solar cells have shown a continuous rise in power conversion efficiencies in the past years. However, the encountered interfacial problems with respect to charge recombination and extraction losses at the CdS/CZTSSe heterojunction still hinder their further development. In this work, an additional plasmonic local electric field is imposed into the CdS/CZTSSe interface through the electrostatic assembly of a two-dimensional (2D) ordered Au@SiO2 NP array onto an aminosilane-modified surface absorber. The interfacial electric properties are tuned by controlling the coverage particle distance, and the finite-difference time domain (FDTD) simulation demonstrates that the strong near-field enhancement mainly occurs near the p-n junction interface. It is shown that the imposed local electric field leads to interfacial electrostatic potential (Velec) augmentation and improves the charge extraction and recombination processes. These electric benefits enable remarkable improvements in open-circuit voltage (Voc) and short-circuit current (Jsc), leading to the cell efficiency being increased from 10.19 to 11.50%. This work highlights the dramatic role of the plasmonic local electric field and the use of the 2D Au@SiO2 NP array to modify a surface absorber instead of the extensively used ion passivation, providing a new strategy for p-n junction engineering in kesterite photovoltaics.

Interface Engineering for High-Efficiency Solution-Processed Cu(In,Ga)(S,Se)2 Solar Cells via a Novel Indium-Doped CdS Strategy.

Indium doping of cadmium sulfide (CdS) by chemical bath deposition (CBD) can be an efficient strategy to boost the CIGSSe efficiency. However, limited by the extremely low solubility of In2S3, it is difficult to increase the In doping contents and inhibit the band energy-level regulation for CdS through the traditional CBD process. In this work, we perform a novel CBD method to prepare an indium-doped CdS (In:CdS) buffer, in which the indium source is sequentially slowly added in the growing aqueous solution. In this process, the In ion concentration involved in the real-time deposition is significantly reduced. Thus, compact and uniform In:CdS with higher indium doping content is obtained. Indium doping can elevate the CdS conduction band edge and construct a more favorable spike band alignment with a CIGSSe absorber. Moreover, it introduces efficient carrier transport and reduced interface defect density. As a result, improved CIGSSe heterojunction quality is realized by utilizing In:CdS. Also, the solution-processed CIGSSe device with In:CdS as a buffer yields a high efficiency of 16.4%, with a high VOC of 670 mV and an FF of 75.3%.

Local Cu Component Engineering to Achieve Continuous Carrier Transport for Enhanced Kesterite Solar Cells.

Although the traditional Cu-poor architecture addresses many limitations for Cu2ZnSn(S,Se)4 solar cells, its further development still encounters a bottleneck in terms of efficiency, primarily arising from the inferior charge transport within the quasineutral region and enlarged recombination at back contact. On the contrary, the electrical benign kesterite compound with higher Cu content may compensate for these shortages, but it will degrade device performance more pronouncedly at front contact because of the Fermi level pinning and more electric shunts. Based on the electric disparities on their independent side, in this work, we propose a new status of Cu component by exploring a large grain/fine grain/large grain trilayer architecture with higher Cu content near back contact and lower Cu content near front contact. The benefits of this bottom Cu-higher strategy are that it imposes a concentration gradient to drive carrier diffusion toward front contact and decreases the valence band edge offset in the rear of the device to aid in hole extraction. Also, it maintains the Cu-poor architecture at the near surface to facilitate hole quasi-Fermi level splitting. In return, the local Cu component engineering-mediated electric advances contribute to the highest efficiency of 12.54% for kesterite solar cells using amine-thiol solution systems so far.

Quasi-Vertically-Orientated Antimony Sulfide Inorganic Thin-Film Solar Cells Achieved by Vapor Transport Deposition.

The one-dimensional photovoltaic absorber material Sb2S3 requires crystal orientation engineering to enable efficient carrier transport. In this work, we adopted the vapor transport deposition (VTD) method to fabricate vertically aligned Sb2S3 on a CdS buffer layer. Our work shows that such a preferential vertical orientation arises from the sulfur deficit of the CdS surface, which creates a beneficial bonding environment between exposed Cd2+ dangling bonds and S atoms in the Sb2S3 molecules. The CdS/VTD-Sb2S3 interface recombination is suppressed by such properly aligned ribbons at the interface. Compared to typical [120]-oriented Sb2S3 films deposited on CdS by the rapid thermal evaporation (RTE) method, the VTD-Sb2S3 thin film is highly [211]- and [121]-oriented and the performance of the solar cell is increased considerably. Without using any hole transportation layer, a conversion efficiency of 4.73% is achieved with device structure of indium tin oxide (ITO)/CdS/Sb2S3/Au. This work provides a potential way to obtain vertically aligned thin films on different buffer layers.

Enhancing Grain Growth for Efficient Solution-Processed (Cu,Ag)2ZnSn(S,Se)4 Solar Cells Based on Acetate Precursor.

Material crystallinity is the overriding factor in the determination of the photoelectric properties of absorber materials and the overall performance of the photovoltaic device. Nevertheless, in the Cu2ZnSn(S,Se)4 (CZTSSe) photovoltaic device, the bilayer or trilayer structure for the absorber has been broadly observed, which is generally harmful to the cell performance because the probability of photogenerated carrier recombination at grain boundaries significantly increased. Herein, our experiment reveals that the application of anions to a new family of (Cu,Ag)2ZnSn(S,Se)4 (CAZTSSe) materials leads to an increase in grain size and crystallinity. It is inspiring that using acetate starting materials in the precursor solution, a uniform, compact, and pinhole-free CAZTS precursor film was obtained, and the smoothness of the films surpassed that of films fabricated from the oxide route. More importantly, the crystallization of the CAZTSSe film has been considerably enhanced after selenization, and large grains going through the entire absorber layer was successfully obtained. Additionally, it is observed that the Voc accompanied by excellent crystallinity improved significantly due to the pronouncedly reduced carrier recombination loss at grain boundaries. As a consequence, the power conversion efficiency (PCE) of the CAZTSSe photovoltaic device is successfully increased from 10.35% (oxide route) to 11.32% (acetate route). Importantly, our work attests to the feasibility of tuning the crystallization of the CZTSSe film by simple chemistry.

High Efficiency CIGS Solar Cells by Bulk Defect Passivation through Ag Substituting Strategy.

Cu(In,Ga)Se2 (CIGS) is considered a promising photovoltaics material due to its excellent properties and high efficiency. However, the complicated deep defects (such as InCu or GaCu) in the CIGS layer hamper the development of polycrystalline CIGS solar cells. Numerous efforts have been employed to passivate these defects which distributed in the grain boundary and the CIGS/CdS interface. In this work, we implemented an effective Ag substituting approach to passivate bulk defects in CIGS absorber. The composition and phase characterizations revealed that Ag was successfully incorporated in the CIGS lattice. The substituting of Ag could boost the crystallization without obviously changing the band gap. The C-V and EIS results demonstrated that the device showed enlarged Wd and beneficial carrier transport dynamics after Ag incorporation. The DLTS result revealed that the deep InCu defect density was dramatically decreased after Ag substituting for Cu. A champion Ag-substituted CIGS device exhibited a remarkable efficiency of 15.82%, with improved VOC of 630 mV, JSC of 34.44 mA/cm2, and FF of 72.90%. Comparing with the efficiency of an unsubstituted CIGS device (12.18%), a Ag-substituted CIGS device exhibited 30% enhancement.

Hydroiodic Acid Additive Enhanced the Performance and Stability of PbS-QDs Solar Cells via Suppressing Hydroxyl Ligand.

The recent emerging progress of quantum dot ink (QD-ink) has overcome the complexity of multiple-step colloidal QD (CQD) film preparation and pronouncedly promoted the device performance. However, the detrimental hydroxyl (OH) ligands induced from synthesis procedure have not been completely removed. Here, a halide ligand additive strategy was devised to optimize QD-ink process. It simultaneously reduced sub-bandgap states and converted them into iodide-passivated surface, which increase carrier mobility of the QDs films and achieve thicker absorber with improved performances. The corresponding power conversion efficiency of this optimized device reached 10.78%. (The control device was 9.56%.) Therefore, this stratege can support as a candidate strategy to solve the QD original limitation caused by hydroxyl ligands, which is also compatible with other CQD-based optoelectronic devices.

The prognostic value of peak arterial lactate levels within 72 h of lung transplantation in identifying patient outcome.

BACKGROUND: Lactic acidosis is often seen in lung transplantation (LTx). Postoperative lactate is frequently associated with poor outcome in postoperative and critically ill patients. Our aim was to evaluate the predictive value of postoperative peak lactate levels within 72 h of LTx for 30-day and late mortality. METHODS: We evaluated patients who underwent LTx from January 2015 to September 2017. All admitted patients were classified according to the peak lactate level (PL) within 72 h of surgery: PL <5 mmol/L (Group 1); PL =5-10 mmol/L (Group 2), and PL >10 mmol/L (Group 3). We performed logistic regression analysis and used Cox regression models to identify the peak lactate level as a predictive factor for 30-day and late mortality, respectively. RESULTS: Of 255 eligible patients, mean age 55.61±12.16, mean lactate 4.99±2.93 and 80% male, and 40% had hyperlactatemia (PL >5 mmol/L) after LTx. The 30-day mortality rate was 17.9%, 28.9% and 68.8% in the three groups, respectively (P<0.05). Multivariate regression analyses revealed postoperative PL as a notable predictor of 30-day mortality [odds ratio =2.62 (1.42-4.84), P=0.002] as well as for late mortality [hazard ratio =2.70 (1.13-6.42), P=0.025]. CONCLUSIONS: The postoperative peak lactate level within 72 h of surgery was an independent predictor for 30-day and late mortality in LTx patients.

Improving the Performance of PbS Quantum Dot Solar Cells by Optimizing ZnO Window Layer.

Comparing with hot researches in absorber layer, window layer has attracted less attention in PbS quantum dot solar cells (QD SCs). Actually, the window layer plays a key role in exciton separation, charge drifting, and so on. Herein, ZnO window layer was systematically investigated for its roles in QD SCs performance. The physical mechanism of improved performance was also explored. It was found that the optimized ZnO films with appropriate thickness and doping concentration can balance the optical and electrical properties, and its energy band align well with the absorber layer for efficient charge extraction. Further characterizations demonstrated that the window layer optimization can help to reduce the surface defects, improve the heterojunction quality, as well as extend the depletion width. Compared with the control devices, the optimized devices have obtained an efficiency of 6.7% with an enhanced V oc of 18%, J sc of 21%, FF of 10%, and power conversion efficiency of 58%. The present work suggests a useful strategy to improve the device performance by optimizing the window layer besides the absorber layer.

Flexible and Semitransparent Organolead Triiodide Perovskite Network Photodetector Arrays with High Stability.

Organolead triiodide perovskite (CH3NH3PbI3) as a light-sensitive material has attracted extensive attention in optoelectronics. The reported perovskite photodetectors (PDs) mainly focus on the individual, which limits their spatial imaging applications. Uniform perovskite networks combining transparency and device performance were synthesized on poly(ethylene terephthalate) (PET) by controlling perovskite crystallization. Photodetector arrays based on above network were fabricated to demonstrate the potential for image mapping. The trade-off between the PD performance and transparency was systematically investigated and the optimal device was obtained from 30 wt % precursor concentration. The switching ratio, normalized detectivity, and equivalent dark current derived shot noise as the critical parameters of PD arrays reached 300, 1.02 × 10(12) Jones, and 4.73 × 10(-15)A Hz(-1/2), respectively. Furthermore, the PD arrays could clearly detect spatial light intensity distribution, thus demonstrating its preliminary imaging function. The perovskite network PD arrays fabricated on PET substrates could also conduct superior flexibility under wide angle and large number of bending. For the common problem of perovskite optoelectronics in stability, the perovskite networks sheathed with hydrophobic polymers greatly enhanced the device stability due to the improved interface contacts, surface passivation, and moisture isolation. Taking into consideration transparency, flexibility, imaging and stability, the present PD arrays were expected to be widely applied in visualized portable optoelectronic system.

Wurtzite copper-zinc-tin sulfide as a superior counter electrode material for dye-sensitized solar cells.

Wurtzite and kesterite Cu2ZnSnS4 (CZTS) nanocrystals were employed as counter electrode (CE) materials for dye-sensitized solar cells (DSSCs). Compared to kesterite CZTS, the wurtzite CZTS exhibited higher electrocatalytic activity for catalyzing reduction of iodide electrolyte and better conductivity. Accordingly, the DSSC with wurtzite CZTS CE generated higher power conversion efficiency (6.89%) than that of Pt (6.23%) and kesterite CZTS (4.89%) CEs.

Enhanced performance of dye-sensitized solar cells using solution-based in situ synthesis and fabrication of Cu2ZnSnSe4 nanocrystal counter electrode.

On the bright side: A solution-based strategy was developed for in situ synthesis and film deposition of Cu2ZnSnSe4 nanocrystal films (samples a-d). The obtained Cu2ZnSnSe4 nanocrystal films can be used as an effective counter-electrode (CE) material to replace Pt, and yield low-cost, high-efficiency dye-sensitized solar cells (DSSCs). The assembled solar cell devices exhibit an efficiency of 7.82 % under 1 sun irradiation (see figure).