The feasibility of dexmedetomidine-led anesthesia maintenance strategy during major abdominal surgery.

Background: Dexmedetomidine is known for its selective action on α2-adrenoceptor sites and is recognized for its neuroprotective capabilities. It can improve postoperative cognitive function. Commonly used anesthetics, such as sevoflurane and propofol, have been reported to affect postoperative cognitive function. Therefore, it could be valuable to explore dexmedetomidine-led anesthesia strategy. This study was designed to assess the performance, safety, and effective infusion rate in anesthesia maintenance, to explore a feasible dexmedetomidine-led anesthesia maintenance protocol, and to provide a foundation for potential combined anesthesia. Methods: Thirty patients aged 18-60 years, classified as ASA I or II, undergoing abdominal surgery were involved. The anesthesia maintenance was achieved with dexmedetomidine, remifentanil and rocuronium. Dixon up-and-down sequential methodology was utilized to ascertain the ED50 of dexmedetomidine for maintaining Patient State Index (PSI) 25-40 (depth of stage III anesthesia). Intraoperative HR, BP and depth of anesthesia were monitored and controlled. The wake-up time from anesthesia, the incidence of intraoperative awareness and postoperative delirium, and the patients' satisfaction were assessed. Results: The results indicated that dexmedetomidine-led anesthesia could maintain the depth of stage III anesthesia during abdominal surgery. The ED50 and ED95 of dexmedetomidine infusion rates during anesthesia maintenance were 2.298 µg/kg·h (95%CI: 2.190-2.404 µg/kg·h) and 3.765 µg/kg·h (95%CI: 3.550-4.050 µg/kg·h). Continuous infusion of dexmedetomidine and 0.1-0.3 µg/kg·min remifentanil could maintain PSI 25-40, and provide appropriate anesthesia depth for abdominal surgery. Perioperative bradycardia and hypertension could be rapidly corrected with atropine and nitroglycerin. The median wake-up time after anesthesia was 4.8 min, the perioperative maximum HR had significant correlation with wake-up time and intraoperative dexmedetomidine dose. No intraoperative awareness and postoperative delirium occurred; the patients were satisfied with dexmedetomidine-led anesthesia. Conclusions: dexmedetomidine-led strategy could maintain stable depth of anesthesia throughout surgery, and the ED50 of dexmedetomidine infusion rates was 2.298 µg/kg·h. Intraoperative HR, BP and depth of anesthesia require monitoring, the bradycardia and hypertension could be rapidly corrected.

Impact of film thickness in laser-induced periodic structures on amorphous Si films.

We report self-organized periodic nanostructures on amorphous silicon thin films by femtosecond laser-induced oxidation. The dependence of structural periodicity on the thickness of silicon films and the substrate materials is investigated. The results reveal that when silicon film is 200 nm, the period of self-organized nanostructures is close to the laser wavelength and is insensitive to the substrates. In contrast, when the silicon film is 50 nm, the period of nanostructures is much shorter than the laser wavelength, and is dependent on the substrates. Furthermore, we demonstrate that, for the thick silicon films, quasi-cylindrical waves dominate the formation of periodic nanostructures, while for the thin silicon films, the formation originates from slab waveguide modes. Finite-difference time-domain method-based numerical simulations support the experimental discoveries.

Reaction and separation system for CO2 hydrogenation to formic acid catalyzed by iridium immobilized on solid phosphines under base-free condition.

Hydrogenation of carbon dioxide (CO2) to produce formic acid (HCOOH) in base-free condition can avoid waste producing and simplify product separation process. However, it remains a big challenge because of the unfavorable energy in both thermodynamics and dynamics. Herein, we report the selective and efficient hydrogenation of CO2 to HCOOH under neutral conditions with imidazolium chloride ionic liquid as the solvent, catalyzed by a heterogeneous Ir/PPh3 compound. The heterogeneous catalyst is more effective than the homogeneous one because it is inert in catalyzing the decomposition of product. A turnover number (TON) of 12700 can be achieved, and HCOOH with a purity of 99.5% can be isolated by distillation because of the non-volatility of the solvent. Both the catalyst and imidazolium chloride can be recycled at least 5 times with stable reactivity.

High-speed laser writing of structural colors for full-color inkless printing.

It is a formidable challenge to simultaneously achieve wide-gamut, high-resolution, high-speed while low-cost manufacturability, long-term stability, and viewing-angle independence in structural colors for practical applications. The conventional nanofabrication techniques fail to match the requirement in low-cost, large-scale and flexible manufacturing. Processing by pulsed lasers can achieve high throughput while suffering from a narrow gamut of ~15% sRGB or angle-dependent colors. Here, we demonstrate an all-in-one solution for ultrafast laser-produced structural colors on ultrathin hybrid films that comprise an absorbent dielectric TiAlN layer coating on a metallic TiN layer. Under laser irradiation, the absorption behaviours of the TiAlN-TiN hybrid films are tailored by photothermal-induced oxidation on the topmost TiAlN. The oxidized films exhibit double-resonance absorption, which is due to the non-trivial phase shifts both at the oxide-TiAlN interface, and at the TiAlN-TiN interface. By varying the accumulated laser fluence to modulate the oxidation depth, angle-robust structural colors with unprecedented large-gamut of ~90% sRGB are obtained. The highest printing speed reaches 10 cm2/s and the highest resolution exceeds 10000 dpi. The durability of the laser-printed colors is confirmed by fastness examination, including salt spray, double-85, light bleaching, and adhesion tests. These features render our technique to be competitive for industrial applications.

Thoracic Paravertebral Block Decreased Body Temperature in Thoracoscopic Lobectomy Patients: A Randomized Controlled Trial.

Purpose: Thoracic paravertebral block (TPVB) may be highly beneficial for thoracoscopic lobectomy patients, but it may increase the risk of hypothermia. Apart from its anesthetic-reducing effects, this randomized controlled trial aimed to investigate the hypothermic effect of TPVB, and thus optimize its clinical use. Patients and methods: Adult patients were randomly allocated to two groups: TPVB + general anesthesia (GA) group or GA group. In the TPVB+GA group, the block was performed after GA induction by an experienced but unrelated anesthesiologist. Both the lower esophageal and axillary temperature were recorded at the beginning of surgery (T0) and every 15 min thereafter (T1-T8), and the end of surgery (Tp). The primary outcome was the lower esophageal temperature at Tp. The secondary outcomes included lower esophageal temperature from T0-T8 and axillary temperature from T0-Tp. The total propofol, analgesics, and norepinephrine consumption and the incidence of adverse events were also recorded. Results: Forty-eight patients were randomly allocated to the TPVB+GA (n=24) and GA (n=24) groups. The core temperature at the end of the surgery was lower in the TPVB+GA group than the GA group (35.90±0.30°C vs 36.35±0.33°C, P<0.001), with a significant difference from 45 min after the surgery began until the end of the surgery (P<0.05). In contrast, the peripheral temperature showed a significant difference at 60 min after the surgery began till the end (P<0.05). TPVB+GA exhibited excellent analgesic and sedative-sparing effects compared to GA alone (P<0.001), though it increased norepinephrine consumption due to hypotension (P<0.001). Conclusion: Although thorough warming strategies were used, TPVB combined with GA remarkably reduced the body temperature, which is an easily neglected side effect. Further studies on the most effective precautions are needed to optimize the clinical use of TPVB.

Tomography of a Number-Resolving Detector by Reconstruction of an Atomic Many-Body Quantum State.

The high-fidelity analysis of many-body quantum states of indistinguishable atoms requires the accurate counting of atoms. Here we report the tomographic reconstruction of an atom-number-resolving detector. The tomography is performed with an ultracold rubidium ensemble that is prepared in a coherent spin state by driving a Rabi coupling between the two hyperfine clock levels. The coupling is followed by counting the occupation number in one level. We characterize the fidelity of our detector and show that a negative-valued Wigner function is associated with it. Our results offer an exciting perspective for the high-fidelity reconstruction of entangled states and can be applied for a future demonstration of Heisenberg-limited atom interferometry.

Tunable Construction of Sandwich-Type Double-[1 + 1] and Half-Folded [2 + 2] Schiff-Base Complexes Controlled by the Combination of Primary and Secondary Template Effects.

The first-row transition-metal ions Mn2+-Cu2+ could serve as effective templates to construct three types of double-[1 + 1], [2 + 2], and [1 + 1] Schiff-base dinuclear macrocyclic complexes in the presence of dialdehydes with different pendant arms and a common 1,8-diamine. The extremely flexible nature of macrocyclic ligands allows for the multiple template-directed syntheses, but the final products could be finely tuned by the subtle variations of Mn2+-Cu2+ ions in a 3d-electronic configuration, radius, and coordination number/geometry as well as the auxiliary (pendant-armed and anionic) template effect at the same time. Two borderlines are observed at the Co2+ ion for forming double-[1 + 1] and [2 + 2] metallacycles involving the H2pdd precursor and the [1 + 1] Cu2+ complex for double-[1 + 1] and [2 + 2] macrocycles containing the H2hpdd unit, respectively. The structural diversity is originated from the non-perfect match between [1 + 1]/[2 + 2] Schiff-base macrocycles and dinuclear metal centers; hence, a compromise between the metal coordination modes and alterations of the ligand conformation takes place.

Quasicylindrical Waves for Ordered Nanostructuring.

Laser-induced self-organization of periodic nanostructures on highly absorbing materials is widely understood to be due to interference between laser and surface plasmon polaritons (SPPs) that are excited by initial surface roughness. The structure order naturally emerges from the propagation phase of SPPs. Here, we reveal an unexplored mechanism that is predominantly induced by quasicylindrical waves (QCWs) with negligible contributions from SPPs. This mechanism features a new principle of order emergence in growth of periodic nanostructures through short-range electromagnetic interactions between QCWs and marginal nanofringes. In this scenario, the periodicity of nanostructures is not simply determined by the electromagnetic wavelength. With suppressed long-range interactions, the formation of nanostructures shows a domino-like growth process, thus significantly improving structure uniformity. An in situ microscopic observation is performed to characterize the temporal dynamics of structural growth and verify the new mechanism. Further, the QCWs are directly observed in experiments, which are theoretically supported by a scattering model.

Surface plasmons interference nanogratings: wafer-scale laser direct structuring in seconds.

It is always a great challenge to bridge the nano- and macro-worlds in nanoscience, for instance, manufacturing uniform nanogratings on a whole wafer in seconds instead of hours even days. Here, we demonstrate a single-step while extremely high-throughput femtosecond laser scanning technique to obtain wafer-scale, highly regular nanogratings on semiconductor-on-metal thin films. Our technique takes advantage of long-range surface plasmons-laser interference, which is regulated by a self-initiated seed. By controlling the scanning speed, two types of nanogratings are readily manufactured, which are produced by either oxidation or ablation. We achieve a record manufacturing speed (>1 cm2 s-1), with tunable periodicity of Λ < 1 µm. The fractional variation of their periodicity is evaluated to be as low as ∆Λ/Λ ≈ 0.5%. Furthermore, by utilizing the semiconductor-on-metal film-endowed interference effects, an extremely high energy efficiency is achieved via suppressing light reflection during femtosecond laser nano-processing. As the fabricated nanogratings exhibit multi-functionality, we exemplify their practical applications in highly sensitive refractive index sensing, vivid structural colors, and durable superhydrophilicity.

Self-assembly and luminescence of trinuclear lanthanide based supramolecular circular helicates.

A series of trinuclear lanthanide circular helicates [Ln3L3]Cl3 have been synthesized via supramolecular subcomponent self-assembly. Photophysical studies demonstrate that the unique helical bis-tetradentate 1,29-dialdehyde ligand L2- could serve as an effective sensitizer for SmIII, EuIII, NdIII and YbIII ions exhibiting efficient characteristic fluorescence emission because of the shell-type blocking of the ligand, which makes them the first circular helicates exhibiting near-infrared lanthanide fluorescence.

Controlling the Lewis Acidity and Polymerizing Effectively Prevent Frustrated Lewis Pairs from Deactivation in the Hydrogenation of Terminal Alkynes.

Two strategies were reported to prevent the deactivation of Frustrated Lewis pairs (FLPs) in the hydrogenation of terminal alkynes: reducing the Lewis acidity and polymerizing the Lewis acid. A polymeric Lewis acid (P-BPh3) with high stability was designed and synthesized. Excellent conversion (up to 99%) and selectivity can be achieved in the hydrogenation of terminal alkynes catalyzed by P-BPh3. This catalytic system works quite well for different substrates. In addition, the P-BPh3 can be easily recycled.

DNA Methylation Manipulation of Memory Genes Is Involved in Sevoflurane Induced Cognitive Impairments in Aged Rats.

DNA methylation is an essential epigenetic mechanism involving in gene transcription modulation. An age-related increase in promoter methylation has been observed for neuronal activity and memory genes, and participates in neurological disorders. However, the position and precise mechanism of DNA methylation for memory gene modulation in anesthesia related cognitive impairment remained to be determined. Here, we studied the effects of sevoflurane anesthesia on the transcription of memory genes in the aged rat hippocampus. Then, we investigated changes in DNA methylation of involved genes and verified whether dysregulated DNA methylation would contribute to anesthesia induced cognitive impairment. The results indicated that sevoflurane anesthesia down-regulated the mRNA and protein levels of three memory genes, Arc, Bdnf, and Reln, which were accompanied with promoter hypermethylation and increased Dnmt1, Dnmt3a, and Mecp2 expression, and finally impaired hippocampus dependent memory. Furthermore, inhibition of DNA hypermethylation by 5-Aza rescued sevoflurane induced memory gene expression decrease and cognitive impairment. These findings provide an epigenetic understanding for the pathophysiology of cognitive impairment induced by general anesthesia in aged brain.

Solvent-controlled self-assembly of tetrapodal [4 + 4] phosphate organic molecular cage.

Two flexible subcomponents, namely tris(4-formylphenyl)phosphate and tris(2-aminoethyl)amine, are assembled into a tetrapodal [4 + 4] cage depending on the solvent effect. Single-crystal structure analysis reveals that the caivity is surrounded by four phosphate uints. Good selectivity of CO2 adsorption over CH4 is demonstrated by the gas adsorption experiment.

A systematic review and meta-analysis of the associations of vitamin D receptor genetic variants with two types of most common neurodegenerative disorders.

BACKGROUND: Whether vitamin D receptor (VDR) genetic variants influence individual susceptibility to neurodegenerative disorders remains controversial. AIMS: This meta-analysis was conducted to analyze correlations of VDR genetic variants with two types of most common neurodegenerative disorders, Parkinson's disease (PD) and Alzheimer's disease (AD). METHODS: Systematic literature research of PubMed and Embase was performed to identify eligible articles. Q test and I2 statistic were employed to decide whether pooled analyses would be performed with random-effect models (REMs) or fixed-effect models (FEMs). All statistical analyses were conducted with Review Manager. RESULTS: Totally sixteen studies were enrolled for analyses. Among these eligible studies, ten studies were about PD (2356 cases and 2815 controls) and six studies were about AD (1256 cases and 1205 controls). Pooled overall analyses suggested that VDR rs7975232 (additive model: p = 0.03, OR = 1.19, 95% CI 1.01-1.39) and rs2228570 (recessive model: p < 0.008, OR = 1.26, 95% CI 1.06-1.50; allele model: p < 0.001, OR = 0.80, 95% CI 0.71-0.91) variants were significantly correlated with PD, and VDR rs731236 (dominant model: p = 0.003, OR = 0.70, 95% CI 0.56-0.89; additive model: p = 0.02, OR = 1.32, 95% CI 1.06-1.66; allele model: p = 0.02, OR = 0.82, 95% CI 0.69-0.96) variant was significantly correlated with AD. Further subgroup analyses by ethnicity revealed that the positive results were mainly driven by the Asians, whereas no significant associations were observed in Caucasians. CONCLUSION: Our meta-analysis suggested that VDR rs7975232 and rs2228570 variants might serve as genetic biomarkers of PD, whereas VDR rs731236 variant might serve as a genetic biomarker of AD.

Generating Ultrabroadband Deep-UV Radiation and Sub-10 nm Gap by Hybrid-Morphology Gold Antennas.

We experimentally investigate the interaction between hybrid-morphology gold optical antennas and a few-cycle Ti:sapphire laser up to ablative intensities, demonstrating rich nonlinear plasmonic effects and promising applications in coherent frequency upconversion and nanofabrication technology. The two-dimensional array of hybrid antennas consists of elliptical apertures combined with bowties in its minor axis. The plasmonic resonance frequency of the bowties is red-shifted with respect to the laser central frequency and thus mainly enhances the third harmonic spectrum at long wavelengths. The gold film between two neighboring elliptical apertures forms an hourglass-shaped structure, which acts as a "plasmonic lens" and thus strongly reinforces surface currents into a small area. This enhanced surface current produces a rotating magnetic field that deeply penetrates into the substrate. At resonant frequency, the magnetic field is further intensified by the bowties. The resonant frequency of the hourglass is blueshifted with respect to the laser central frequency. Consequently, it spectacularly extends the third harmonic spectrum toward short wavelengths. The resultant third harmonic signal ranges from 230 to 300 nm, much broader than the emission from a sapphire crystal. In addition, the concentration of surface current within the neck of the hourglass antenna results in a structural modification through laser ablation, producing sub-10 nm sharp metallic gaps. Moreover, after laser illumination the optical field hotspots are imprinted around the antennas, allowing us to confirm the subwavelength enhancement of the electric near-field intensity.

Determining correct tracheal tube insertion depth by measuring distance between endotracheal tube cuff and vocal cords by ultrasound in Chinese adults: a prospective case-control study.

OBJECTIVES: Unrecognised malposition of the endotracheal tube can lead to severe complications in patients under general anaesthesia. The purpose of this study was to verify the feasibility of using ultrasound to measure the distance between the upper edge of saline-inflated cuff and the vocal cords. DESIGN: Prospective case-control study. SETTING: A tertiary hospital in Beijing, China. METHODS: In this prospective study, 105 adult patients who required general anaesthesia were enrolled. Prior to induction, ultrasound was used to identify the position of the vocal cords. After intubation, the endotracheal tube (ETT) was fixed at a depth of 23 cm at the upper incisors in men and 21 cm in women. The depth of intubation was verified by video-assisted laryngoscopy. The distance between the upper edge of the saline-inflated cuff and the vocal cords was measured by ultrasound; the ideal distance was considered to be 1.9-4.1 cm. RESULTS: Among the 105 cases, two cuffs were too close to the vocal cords and one too far away from the vocal cords. These diagnoses were made by ultrasound and were in agreement with results from direct laryngoscopy. The overall accuracy of ultrasound in identifying malposition of the cuff was 100.0% (95% CI: 96.6% to 100%). The sensitivity, specificity, positive predictive value and negative predictive value of ultrasound were, respectively, 100% (95% CI: 96.5% to 100%), 100% (95% CI: 29.2% to 100%), 100% (95% CI: 96.5% to 100%) and 100% (95% CI: 29.2% to 100%). CONCLUSION: Identification of the upper edge of the saline-inflated cuff and the vocal cords by ultrasound to assess the location of the ETT is a reliable method. It can be used to avoid malposition of the ETT cuff and reduce the incidence of vocal cords injury after intubation. TRIAL REGISTRATION NUMBER: ChiCTR-DDD-17011048.

Isolation of ripening-related genes from ethylene/1-MCP treated papaya through RNA-seq.

BACKGROUND: Since papaya is a typical climacteric fruit, exogenous ethylene (ETH) applications can induce premature and quicker ripening, while 1-methylcyclopropene (1-MCP) slows down the ripening processes. Differential gene expression in ETH or 1-MCP-treated papaya fruits accounts for the ripening processes. To isolate the key ripening-related genes and better understand fruit ripening mechanisms, transcriptomes of ETH or 1-MCP-treated, and non-treated (Control Group, CG) papaya fruits were sequenced using Illumina Hiseq2500. RESULTS: A total of 18,648 (1-MCP), 19,093 (CG), and 15,321 (ETH) genes were detected, with the genes detected in the ETH-treatment being the least. This suggests that ETH may inhibit the expression of some genes. Based on the differential gene expression (DGE) and the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment, 53 fruit ripening-related genes were selected: 20 cell wall-related genes, 18 chlorophyll and carotenoid metabolism-related genes, four proteinases and their inhibitors, six plant hormone signal transduction pathway genes, four transcription factors, and one senescence-associated gene. Reverse transcription quantitative PCR (RT-qPCR) analyses confirmed the results of RNA-seq and verified that the expression pattern of six genes is consistent with the fruit senescence process. Based on the expression profiling of genes in carbohydrate metabolic process, chlorophyll metabolism pathway, and carotenoid metabolism pathway, the mechanism of pulp softening and coloration of papaya was deduced and discussed. We illustrate that papaya fruit softening is a complex process with significant cell wall hydrolases, such as pectinases, cellulases, and hemicellulases involved in the process. Exogenous ethylene accelerates the coloration of papaya changing from green to yellow. This is likely due to the inhibition of chlorophyll biosynthesis and the α-branch of carotenoid metabolism. Chy-b may play an important role in the yellow color of papaya fruit. CONCLUSIONS: Comparing the differential gene expression in ETH/1-MCP-treated papaya using RNA-seq is a sound approach to isolate ripening-related genes. The results of this study can improve our understanding of papaya fruit ripening molecular mechanism and reveal candidate fruit ripening-related genes for further research.

Distinguishable Zn(II) and Pb(II) template effects on forming pendant-armed Schiff-base macrocyclic complexes including a remarkable Pb(II)-π macrocyclic complex.

36-Membered [2 + 2] half-fold Schiff-base macrocyclic dinuclear Zn(II) complexes (1a and 1b) and 18-membered [1 + 1] Schiff-base macrocyclic mononuclear Pb(II) complexes (2 and 3) are produced from the condensation between 1,3-propanediamine and a pair of extended dialdehydes with different functional pendant arms (H2hpdd and H2pdd) because of the distinguishable cationic template effects. It is very interesting to mention that a unique intramolecular Pb(II)-π macrocyclic complex 2 with an uncommon η(3)-coordination type is achieved under ambient conditions and it can remain stable both in the solid state and in solution. The subtle variations of pendant-arms in the macrocyclic ligands H2hpdd and H2pdd yield different Pb(II) complexes, where the competition between Pb(II)-π and Pb(II)-NO3(-) electrostatic interactions as well as the combination of steric and electronic effects of pendant arms are believed to play important roles.

Dinuclear Cu(II) complexes based on two flexible Schiff-base ligands and one unusual in situ formed diphenolate 2,6-piperidin-4-one derivative.

A dinuclear Cu(ii) complex [Cu2(L3)2]·2H2O, having an unprecedented in situ formed diphenolate 2,6-piperidin-4-one derived ligand produced from the flexible Schiff-base ligand HL1, can be yielded as a side product in the presence of Cu(OAc)2·H2O-NH3·H2O dissolved in methanol and acetone in addition to the expected dinuclear Cu(ii) complex [Cu2(L1)4].

Dipyrido[3,2-a:2',3'-c]phenazine-based donor-acceptor aromatic heterocyclic compounds with thienyl and triphenylamino chromophores at the 2,7- and/or 10,13-positions.

A series of T- and H-shaped donor-acceptor (D-A) types of dipyrido[3,2-a:2',3'-c]phenazine (DPPZ)-based molecules, extended by thienyl and triphenylamino chromophores at the 2,7-(bottom) and/or 10,13-positions (top), have been designed and prepared successfully. Synthetic, structural, thermal, spectral, and computational comparisons have been carried out for related compounds because of their adjustable intramolecular charge-transfer properties. It is noted that a pair of structural isomers (5 and 6) has been obtained, respectively, where distinguishable UV/Vis and fluorescence spectra, electrochemical activity, thermal stability, and bandgaps are observed. Furthermore, compounds 6, 8, 10, 11, 13, and 15 exhibit excellent thermal stability, and the Td10 values for them are found to range from 524 to 646 °C, which can be regarded as one of the best groups of thermally stable compounds among organic small molecules. In addition, theoretical calculations were performed, and the structure-property relationships were examined to reveal the effects of the position and number of donor arms on the DPPZ acceptor core.