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High-efficiency energy transfer (ET) from Sm3+ to Eu3+ leads to dominant red emission in Sm3+, Eu3+ co-doped single-phase cubic CeO2 phosphors. In this work, a series of Sm3+ singly and Sm3+/Eu3+ co-doped CeO2 cubic phosphors was successfully synthesized by solution combustion followed by heat treatment at 800 °C in air. The crystal structure, morphology, chemical element composition, and luminescence properties of the obtained phosphors were investigated using X-ray diffraction, scanning electron microscopy, energy-dispersive X-ray spectroscopy, and photoluminescence analysis. Under 360 nm excitation, the Sm3+ singly doped CeO2 phosphor emitted strong yellow-red light at 573 nm (4G5/2-6H5/2) and 615 nm (4G5/2-6H7/2). Meanwhile, the CeO2:Sm3+, Eu3+ phosphors showed the emission characteristic of both Sm3+ and Eu3+, with the highest emission intensity at 631 nm. The emission intensity of Sm3+ decreased with increasing Eu3+ content, suggesting the ET from Sm3+ to Eu3+ in the CeO2:Sm3+, Eu3+ phosphors. The decay kinetics of the 4G5/2-6H5/2 transition of Sm3+ in the CeO2:Sm3+, Eu3+ phosphors were investigated, confirming the high-efficiency ET from Sm3+ to Eu3+ (reached 84%). The critical distance of energy transfer (RC = 13.7 Å) and the Dexter theory analysis confirmed the ET mechanism corresponding to the quadrupole-quadrupole interaction. These results indicate that the high-efficiency ET from Sm3+ to Eu3+ in CeO2:Sm3+, Eu3+ phosphors is an excellent strategy to improve the emission efficiency of Eu3+.
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The weak emission intensity of rare-earth element-doped dual-mode materials leads to low-sensor sensitivity, which is a challenge in optical sensor applications. The present work achieved high-sensor sensitivity and high green color purity based on the intense green dual-mode emission of Er/Yb/Mo-doped CaZrO3 perovskite phosphors. Their structure, morphology, luminescent properties, and optical temperature sensing properties have been investigated in detail. Phosphor shows a uniform cubic morphology with an average size of approximately 1 µm. Rietveld refinement confirms the formation of single-phase orthorhombic CaZrO3. Under the excitation of 975 and 379 nm, the phosphor emits pure green up and down-conversion (UC and DC) emission at 525/546 nm corresponding to 2H11/2/4S3/2-4I15/2 transitions of Er3+ ions, respectively. Intense green UC emissions were achieved because of energy transfer (ET) from the high-energy excited state of Yb3+-MoO42- dimer to the 4F7/2 level of Er3+ ion. Furthermore, the decay kinetics of all obtained phosphors confirmed ET efficiency from Yb3+-MoO42- dimer to Er3+ ions, leading to strong green DC emission. Moreover, the DC of the obtained phosphor shows that a sensor sensitivity value of 0.697% K-1 at 303 K is higher than the UC (0.667% K-1 at 313 K) because the thermal effect generated by the DC excitation source light is ignored compared with UC luminescence. CaZrO3:Er-Yb-Mo phosphor shows intense green dual-mode emission with high green color purity, 96.50% of DC and 98% of UC emissions, and high sensitivity, making it suitable for optoelectronic devices and thermal sensor applications.
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BACKGROUND: Incisional hernia (IH) can be treated with an intraperitoneal on-lay mesh (IPOM). This study aimed to evaluate the surgical outcomes, recurrence rates, and chronic pain after laparoscopic IH repair. METHOD: The data of 50 patients who underwent laparoscopic IPOM repair between March 2018 and May 2021 were prospectively collected. RESULTS: The standard IPOM technique was used on 41 patients (82%), whereas the IPOM-plus technique was used on nine patients (18%). There was a history of IH repair for 12 patients (24%), and two of them recurrent hernias. The average body mass index was 24.7, and the average defect size was 17.6 cm2 . The mean operative time was 145.7 minutes, and the mean hospital stay was 3.5 days. There were minor complications in nine patients (18%), a case of bowel injury (2%), and a case of bladder injury (2%). Recurrent hernias were observed in three patients (6%) over a mean follow-up period of 17.9 months (4-36 months). One patient had postoperative chronic pain lasting 3 months. The width and size of the hernia were risk factors for recurrence. CONCLUSION: Laparoscopic IPOM repair was a safe and effective method of treating IH, with a low incidence of postoperative complications, chronic pain, and recurrence.
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Dolor Crónico , Hernia Ventral , Hernia Incisional , Laparoscopía , Dolor Crónico/etiología , Hernia Ventral/etiología , Hernia Ventral/cirugía , Herniorrafia/métodos , Humanos , Hernia Incisional/etiología , Hernia Incisional/cirugía , Laparoscopía/métodos , Dolor Postoperatorio/etiología , Dolor Postoperatorio/cirugía , Estudios Prospectivos , Recurrencia , Mallas QuirúrgicasRESUMEN
BACKGROUND: Right-sided colonic diverticulitis (RCD) is an Asian-centric disease. The optimal treatment for acute uncomplicated RCD remains a controversial area. This study aimed to compare the safety and efficacy of laparoscopic diverticulectomy (LD) with non-operative treatment (NT) in patients with uncomplicated RCD. METHODS: A single-center, prospective, non-randomized controlled study ran from 2009 to 2017. Patients with first episode of uncomplicated RCD were divided into two treatment arms, LD or NT with bowel rest and broad-spectrum antibiotics, based on their choice. The primary outcome was recurrent diverticulitis during follow-up. Secondary outcomes were treatment success and complications. RESULTS: A total of 155 patients were enrolled, with 81 in the NT arm and 74 in the LD arm. Mean follow-up was 49 months. The treatment success rate for the NT arm was 90.1% and for the LD arm, 86.5% (P = 0.480). There was no significant difference in the complication rate between the LD arm, 12.2% and the NT arm, 8.6% (P = 0.472). LD was better than NT in preventing recurrent diverticulitis. Nine patients in the NT arm and none in the LD arm had recurrence (P = 0.003). The number needed to treat to prevent recurrence was nine. CONCLUSION: Non-operative management with bowel rest and antibiotics for uncomplicated RCD is safe and effective. Alternatively, LD is also safe and effective, with the added benefit of preventing recurrences. While both treatments could be reasonably offered for uncomplicated RCD, LD is an appealing option when recurrence is a concern.
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Diverticulitis del Colon/cirugía , Diverticulitis del Colon/terapia , Laparoscopía/métodos , Adulto , Femenino , Humanos , Masculino , Estudios Prospectivos , Resultado del TratamientoRESUMEN
PURPOSE: The purpose of this article is to assess the quality of care and economic benefits of a shared care model managing patients with stable glaucoma in a primary eye care (PEC) clinic compared with a tertiary specialist outpatient clinic (SOC) in Singapore. PATIENTS AND METHODS: A randomized equivalence feasibility trial was preformed comparing the PEC with SOC models. Participants recruited from the SOC had no visual field progression or change in management for at least 3 years, were on a maximum of a single glaucoma medication, had no previous tube-shunt implant and were at least 3-year posttrabeculectomy surgery.Primary outcomes were clinical assessment and management, economic benefits, and patient satisfaction. Differences were analyzed using equivalence testing and generalized odds ratios. RESULTS: The trial included 233 patients, consisting of 42.1% glaucoma disc suspects (PEC: 47.4%; SOC: 36.8%), 27.5% primary angle closure suspects (PEC: 25.0%; SOC: 29.9%), 13.7% with ocular hypertension (PEC: 13.8%; SOC: 13.7%), 3.9% with primary angle closure glaucoma (PEC: 4.3%; SOC: 3.4%), and 3.0% with primary open angle glaucoma (PEC: 1.7%; SOC: 4.3%). Glaucoma clinical care for patients at PEC was as good as SOC [rate difference, 6.83%; 95% confidence interval (CI), 2.84-11.12) and management (rate difference, 7.69%; 95% CI, 3.21-12.17). In 23 cases (9.9%), 5.2% at PEC and 14.5% at SOC, there was disconcordance with the gold standard of senior consultant. Patient satisfaction at the PEC was equally high when compared with SOC (generalized odds ratio, 1.43; CI, 0.50-2.00). Direct costs per patient visit were 43% lower at PEC compared with SOC. CONCLUSION: Managing stable glaucoma patients at a primary care setting is a cost saving, safe, and effective shared care while enhancing professional collaboration between hospital and community settings.
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Toma de Decisiones Clínicas/métodos , Análisis Costo-Beneficio , Glaucoma de Ángulo Cerrado/terapia , Glaucoma de Ángulo Abierto/terapia , Evaluación del Resultado de la Atención al Paciente , Adulto , Anciano , Estudios de Factibilidad , Femenino , Glaucoma de Ángulo Cerrado/economía , Glaucoma de Ángulo Abierto/economía , Humanos , Presión Intraocular/fisiología , Persona de Mediana Edad , Hipertensión Ocular/economía , Hipertensión Ocular/terapia , Satisfacción del Paciente , Atención Dirigida al Paciente , Calidad de la Atención de Salud , Singapur , Campos Visuales/fisiologíaRESUMEN
PROBLEM: The paper tools used to monitor outreach work in all major cities in Viet Nam had substantial writing requirements for each contact with difficulty maintaining confidentiality. ACTION: This paper describes the development of a Unique Identifier Code (UIC), a field data collection notebook (databook) and a computer data entry system in Viet Nam. The databook can document 40 individual clients and has space for commodity distribution, group contacts and needles/syringe collection for each month. OUTCOME: Field implementation trials of the UIC and databook have been undertaken by more than 160 peer outreach workers to document their work with people who inject drugs (PWID) and sex workers (SW). Following an expanded trial in Hai Phong province, there have been requests for national circulation of the databook to be used by peer educators documenting outreach to PWID, SW and men who have sex with men. The standardized UIC and databook, in a variety of locally adapted formats, have now been introduced in more than 40 of the 63 provinces in Viet Nam. DISCUSSION: This development in Viet Nam is, to our knowledge, the first example of the combination of a confidential UIC and an innovative, simple pocket-sized paper instrument with associated customized data-entry software for documenting outreach.
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Problem: The paper tools used to monitor outreach work in all major cities in Viet Nam had substantial writing requirements for each contact with difficulty maintaining confidentiality. Action: This paper describes the development of a Unique Identifier Code (UIC), a field data collection notebook (databook)and a computer data entry system in Viet Nam. The databook can document 40 individual clients and has space forcommodity distribution, group contacts and needles/syringe collection for each month. Outcome: Field implementation trials of the UIC and databook have been undertaken by more than 160 peer outreachworkers to document their work with people who inject drugs (PWID) and sex workers (SW). Following an expanded trialin Hai Phong province, there have been requests for national circulation of the databook to be used by peer educators documenting outreach to PWID, SW and men who have sex with men. The standardized UIC and databook, in a variety of locally adapted formats, have now been introduced in more than 40 of the 63 provinces in Viet Nam. Discussion: This development in Viet Nam is, to our knowledge, the first example of the combination of a confidential UIC and an innovative, simple pocket-sized paper instrument with associated customized data-entry software for documenting outreach.