Efficacy and safety of fibrin sealant application in patients undergoing thyroidectomy: a systematic review and meta-analysis.

Various studies have focused on the application of fibrin sealants (FS) in thyroid surgery. Utilizing a meta-analysis, this systematic review analyzed the findings of recent randomized controlled trials on the safety and efficacy of FS in patients who underwent thyroidectomy. The Cochrane Library, Web of Science, Embase, PubMed, and Medline databases were searched for relevant studies, without any language restrictions. Seven randomized controlled trials were included in the originally identified 69 studies. Overall, 652 patients received FS during thyroid surgery; their outcomes were compared with those of conventionally treated patients. The primary outcomes were total volume of wound drainage, length of hospitalization, and operative time. Significant differences were observed in the total volume of wound drainage (mean deviation (MD): -29.75, 95% confidence interval (CI): -55.39 to -4.11, P = 0.02), length of hospitalization (MD: -0.84, 95% CI: -1.02 to -0.66, P < 0.00001), and surgery duration (MD: -7.60, 95% CI: -14.75 to -0.45, P = 0.04). Secondary outcomes were seroma and hypoparathyroidism development. The risk of hypoparathyroidism did not differ between the FS and conventional groups (I = 0%, relative risk = 1.31, P = 0.38). Analysis of "seroma formation that required invasive treatment" indicated that FS showed some benefit (I2 = 8%, relative risk 0.44, P = 0.15). Heterogeneity among the different trials limited their conclusions. The meta-analysis showed that although FS use did not significantly reduce seroma or hypoparathyroidism incidence in patients after thyroidectomy, it significantly reduced the total drainage volume, length of hospitalization, and duration of surgery.

The Impact of Glucocorticoid Treatment on Hypocalcemia Following Thyroid Surgery: A Systematic Review and Meta-Analysis.

Patients undergoing thyroidectomy often develop hypocalcemia. While there is evidence suggesting that the prophylactic administration of dexamethasone in patients undergoing thyroidectomy can reduce the risk of postoperative complications including nausea, vomiting, and pain, it remains uncertain as to whether such treatment has a similar impact on hypocalcemia risk. Here, randomized controlled trials (RCTs) focused on comparing the risk of postoperative hypocalcemia in thyroidectomy patients that either were or were not administered a single preoperative dose of dexamethasone were systematically evaluated. These RCTs were identified by searching the Medline, PubMed, Embase, and Cochrane Library for all relevant publications as of April 2023. Primary study outcomes included biochemical hypocalcemia and symptomatic hypocalcemia incidence within 24 h after thyroidectomy, while the incidence of permanent hypocalcemia was a secondary outcome in this analysis. Random-effects models were used for all comparisons in this meta-analysis. In total, 8 RCTs enrolling 1666 patients were incorporated when conducting this meta-analysis. Relative to placebo control treatment, dexamethasone administration was associated with significant reductions in the rates of postoperative symptomatic hypocalcemia (OR = 0.40; 95%CI 0.16-1.00; p = 0.050) and biochemical hypocalcemia (OR = 0.34;95%CI 0.14-0.83; p = 0.020 (p < 0.05). No differences were detected between these groups with respect to the incidence of permanent hypocalcemia, and no trials revealed any evidence of glucocorticoid-associated complications. Significant heterogeneity was detected among studies, but the exclusion of any single study did not significantly alter study outcomes. The present pooled analyses suggested that one preoperative dexamethasone dose was sufficient to reduce the odds of thyroidectomy patients developing biochemical or symptomatic hypocalcemia within 24 h after the procedure. The prophylactic administration of steroids was both safe and effective, suggesting that it warrants consideration as a component of routine clinical care. However, additional prospective work will be vital to validate the efficacy of dexamethasone as a means of preventing objective hypocalcemia in this patient population.

A CuI/CuIII prototypical organometallic mechanism for the deactivation of an active pincer-like CuI catalyst in Ullmann-type couplings.

Unraveling the mechanistic details of copper-catalyzed arylation of nucleophiles (Ullmann-type couplings) is a very challenging task. It is a matter of intense debate whether it is a radical-based process or an organometallic redox-based process. The ancillary ligand choice in Ullmann-type couplings plays a key role in such transformations and can strongly influence the catalytic efficiency as well as the mechanism. Here, we show how a predesigned tridentate pincer-like catalyst undergoes a deactivation pathway through a CuI/CuIII prototypical mechanism as demonstrated by helium-tagging infrared photodissociation (IRPD) spectroscopy and DFT studies, lending a strong support to the existence of an aryl-CuIII species in the Ullmann couplings using this tridentate ligand.

Orthogonal Discrimination among Functional Groups in Ullmann-Type C-O and C-N Couplings.

The copper-catalyzed arylation of nucleophiles has been established as an efficient methodology for the formation of C-C and C-heteroatom bonds. Considering the advances during the last two decades, the ligand choice plays a key role in such transformations and can strongly influence the catalytic efficiency. The applicability of these Ullmann-type coupling reactions regarding the orthogonal selectivity of different functional groups constitutes a challenging subject for current synthetic strategies. Herein, we report a useful toolkit of Cu-based catalysts for the chemoselective arylation of a wide-range of nucleophiles in competitive reactions using aryl iodides and bromides. We show in this work that the arylation of all kinds of amides can be orthogonal to that of amines (aliphatic or aromatic) and phenol derivatives. This high chemoselectivity can be governed by the use of different ligands, yielding the desired coupling products under mild conditions. The selectivity trends are maintained for electronically biased iodobenzene and bromobenzene electrophiles. Radical clock experiments discard the occurrence of radical-based mechanisms.

Core-shell heterojunction of silicon nanowire arrays and carbon quantum dots for photovoltaic devices and self-driven photodetectors.

Silicon nanostructure-based solar cells have lately intrigued intensive interest because of their promising potential in next-generation solar energy conversion devices. Herein, we report a silicon nanowire (SiNW) array/carbon quantum dot (CQD) core-shell heterojunction photovoltaic device by directly coating Ag-assisted chemical-etched SiNW arrays with CQDs. The heterojunction with a barrier height of 0.75 eV exhibited excellent rectifying behavior with a rectification ratio of 10(3) at ±0.8 V in the dark and power conversion efficiency (PCE) as high as 9.10% under AM 1.5G irradiation. It is believed that such a high PCE comes from the improved optical absorption as well as the optimized carrier transfer and collection capability. Furthermore, the heterojunction could function as a high-performance self-driven visible light photodetector operating in a wide switching wavelength with good stability, high sensitivity, and fast response speed. It is expected that the present SiNW array/CQD core-shell heterojunction device could find potential applications in future high-performance optoelectronic devices.

The effect of plasmonic nanoparticles on the optoelectronic characteristics of CdTe nanowires.

In this work, a simple strategy is proposed to improve the device performance of photodetector by modifying plasmonic nanoparticles onto the surface of semiconductors nanostructure. Both experimental analysis and theoretical simulation show that the plasmonic metal nanoparticles (AuNPs) exhibits obvious localized surface plasmon resonance (LSPR) which can trap incident light efficiently, leading to enhanced photocurrents and improved performance of photoelectronic devices. It is also observed that the AuNPs modified CdTeNW photodetector exhibit apparent sensitivity to 510 nm light, to which pure CdTeNWs is virtually blind. What is more, after AuNPs decoration, the response speed of the photodetector is increased substantially from 6.12 to 1.92 s. It is believed that this result will open up new doors for manipulating light and further improving the efficiency of semiconductor nanostructures based optoelectronic devices.

Monolayer graphene/germanium Schottky junction as high-performance self-driven infrared light photodetector.

We report on the simple fabrication of monolayer graphene (MLG)/germanium (Ge) heterojunction for infrared (IR) light sensing. It is found that the as-fabricated Schottky junction detector exhibits obvious photovoltaic characteristics, and is sensitive to IR light with high Ilight/Idark ratio of 2 × 10(4) at zero bias voltage. The responsivity and detectivity are as high as 51.8 mA W(-1) and 1.38 × 10(10) cm Hz(1/2) W(-1), respectively. Further photoresponse study reveals that the photovoltaic IR detector displays excellent spectral selectivity with peak sensitivity at 1400 nm, and a fast light response speed of microsecond rise/fall time with good reproducibility and long-term stability. The generality of the above results suggests that the present MLG/Ge IR photodetector would have great potential for future optoelectronic device applications.

Silicon powder: the first nonmetal elemental catalyst for aminobromination of olefins with TsNH(2) and NBS.

Silicon powder was found, for the first time, to be an efficient alternative to transition metal catalysts for aminobromination of alpha,beta-unsaturated carbonyl compounds and simple olefins with p-toluenesulfonamide (4-TsNH(2)) and NBS, affording the aminobrominated products in high yields and regio- and stereoselectivity. The high reactivity of electron-rich substrates reveals that the reaction has the electrophilic addition feature.

Combination of carbamazepine and valproate in different dose proportions in maximal electroshock seizure model in mice.

Rational polypharmacy of antiepileptic drugs is one of the treatment strategies for refractory epilepsy. To investigate whether it may be rational to combine carbamazepine (CBZ) and valproate (VPA), we tested both the anti-convulsant effect and the toxicity of combinations of CBZ and VPA in different dose proportions. CBZ/VPA dose ratios were, respectively, 1:6.66, 1:10, 1:13.3 and 1:20. The median effect doses of monotherapy and polytherapy in maximal electroshock seizure test and the median lethal (within 3 days after administration) doses were determined. These parameters were analyzed with the isobologram method. We found that the anti-convulsant effect of all combinations was additive. The toxicity of combination 1, 2 and 3 (CBZ/VPA, 1:6.66, 1:10, 1:13.3) was additive, but the toxicity of combination 4 (CBZ/VPA, 1:20) was infra-additive. Thus, in mice, using this model, a combination of CBZ/VPA 1:20 has an advantage over each of the drugs alone.