Radial Alignment of Carbon Nanotubes via Dead-End Filtration.

Dead-end filtration is a facile method to globally align single wall carbon nanotubes (SWCNTs) in large area films with a 2D order parameter, S2D , approaching unity. Uniaxial alignment has been achieved using pristine and hot-embossed membranes but more sophisticated geometries have yet to be investigated. In this work, three different patterns with radial symmetry and an area of 3.8 cm2 are created. Two of these patterns are replicated by the filtered SWCNTs and S2D values of ≈0.85 are obtained. Each of the radially aligned SWCNT films is characterized by scanning cross-polarized microscopy in reflectance and laser imaging in transmittance with linear, radial, and azimuthal polarized light fields. The former is used to define a novel indicator akin to the 2D order parameter using Malu's law, yielding 0.82 for the respective film. The films are then transferred to a flexible printed circuit board and terminal two-probe electrical measurements are conducted to explore the potential of those new alignment geometries.

The Impact of Carbon Nanotube Length and Diameter on their Global Alignment by Dead-End Filtration.

Dead-end filtration has proven to effectively prepare macroscopically (3.8 cm2 ) aligned thin films from solutionbased single-wall carbon nanotubes (SWCNTs). However, to make this technique broadly applicable, the role of SWCNT length and diameter must be understood. To date, most groups report the alignment of unsorted, large diameter (≈1.4 nm) SWCNTs, but systematic studies on their small diameter are rare (≈0.78 nm). In this work, films with an area of A = 3.81 cm2 and a thickness of ≈40 nm are prepared from length-sorted fractions comprising of small and large diameter SWCNTs, respectively. The alignment is characterized by cross-polarized microscopy, scanning electron microscopy, absorption and Raman spectroscopy. For the longest fractions (Lavg = 952 nm ± 431 nm, Δ = 1.58 and Lavg = 667 nm ± 246 nm, Δ = 1.55), the 2D order parameter, S2D, values of ≈0.6 and ≈0.76 are reported for the small and large diameter SWCNTs over an area of A = 625 µm2 , respectively. A comparison of Derjaguin, Landau, Verwey, and Overbeek (DLVO) theory calculations with the aligned domain size is then used to propose a law identifying the required length of a carbon nanotube with a given diameter and zeta potential.

Clinical relevance of lung transplantation for COVID-19 ARDS: a nationwide study.

BACKGROUND: Although the number of lung transplantations (LTx) performed worldwide for COVID-19 induced acute respiratory distress syndrome (ARDS) is still low, there is general agreement that this treatment can save a subgroup of most severly ill patients with irreversible lung damage. However, the true proportion of patients eligible for LTx, the overall outcome and the impact of LTx to the pandemic are unknown. METHODS: A retrospective analysis was performed using a nationwide registry of hospitalised patients with confirmed severe acute respiratory syndrome coronavirus type 2 (SARS-Cov-2) infection admitted between January 1, 2020 and May 30, 2021 in Austria. Patients referred to one of the two Austrian LTx centers were analyzed and grouped into patients accepted and rejected for LTx. Detailed outcome analysis was performed for all patients who received a LTx for post-COVID-19 ARDS and compared to patients who underwent LTx for other indications. RESULTS: Between January 1, 2020 and May 30, 2021, 39.485 patients were hospitalised for COVID-19 in Austria. 2323 required mechanical ventilation, 183 received extra-corporeal membrane oxygenation (ECMO) support. 106 patients with severe COVID-19 ARDS were referred for LTx. Of these, 19 (18%) underwent LTx. 30-day mortality after LTx was 0% for COVID-19 ARDS transplant recipients. With a median follow-up of 134 (47-450) days, 14/19 patients are alive. CONCLUSIONS: Early referral of ECMO patients to a LTx center is pivotal in order to select patients eligible for LTx. Transplantation offers excellent midterm outcomes and should be incorporated in the treatment algorithm of post-COVID-19 ARDS.

The EXP pair-potential system. IV. Isotherms, isochores, and isomorphs in the two crystalline phases.

This paper studies numerically the solid phase of a system of particles interacting by the exponentially repulsive pair potential, which is a face-centered cubic (fcc) crystal at low densities and a body-centered cubic (bcc) crystal at higher densities [U. R. Pedersen et al., J. Chem. Phys. 150, 174501 (2019)]. Structure is studied via the pair-distribution function and dynamics via the velocity autocorrelation function and the phonon density of states. These quantities are evaluated along isotherms, isochores, and three isomorphs in both crystal phases. Isomorphs are traced out by integrating the density-temperature relation characterizing configurational adiabats, starting from state points in the middle of the fcc-bcc coexistence region. Good isomorph invariance of structure and dynamics is seen in both crystal phases, which is notable in view of the large density variations studied. This is consistent with the fact that the virial potential-energy correlation coefficient is close to unity in the entire fcc phase and in most of the bcc phase (basically below the re-entrant density). Our findings confirm that the isomorph theory, developed and primarily studied for liquids, applies equally well for solids.

The EXP pair-potential system. III. Thermodynamic phase diagram.

This paper determines the thermodynamic phase diagram of the EXP system of particles interacting by the purely repulsive exponential pair potential. The solid phase is face-centered cubic (fcc) at low densities and pressures. At higher densities and pressures, the solid phase is body-centered cubic (bcc) with a re-entrant liquid phase at the highest pressures simulated. The investigation first identifies the phase diagram at zero temperature at which the following four crystal structures are considered: fcc, bcc, hexagonal close packed, and cubic diamond. There is a T = 0 phase transition at pressure 2.651 × 10-3 with the thermodynamically stable structure being fcc below and bcc above this pressure. The densities of the two crystal structures at the phase transition are 1.7469 × 10-2 (fcc) and 1.7471 × 10-2 (bcc). At finite temperatures, the fcc-bcc, fcc-liquid, and bcc-liquid coexistence lines are determined by numerical integration of the Clausius-Clapeyron equation and validated by interface-pinning simulations at selected state points. The bcc-fcc phase transition is a weak first-order transition. The liquid-fcc-bcc triple point, which is determined by the interface-pinning method, has temperature 5.9 × 10-5 and pressure 2.5 × 10-6; the triple-point densities are 1.556 × 10-3 (liquid), 1.583 × 10-3 (bcc), and 1.587 × 10-3 (fcc).

Invasive Fungal Infection Caused by Exophiala dermatitidis in a Patient After Lung Transplantation: Case Report and Literature Review.

This report describes a case of invasive Exophiala dermatitidis infection after double lung transplantation in a 76-year-old man. After thoracotomy, the patient's wound showed dehiscence with purulent secretion. The black yeast was isolated from cultures taken from the wound, and species identification was confirmed by sequence analysis of the internal transcribed spacer (ITS-S2) region. The results of the susceptibility testing showed voriconazole as the most active drug. Despite adaptation of the antifungal therapy the clinical condition worsened, and the patient died. In addition, we evaluated the fungicidal activity of antiseptics towards E. dermatitidis and aimed to provide a brief literature review of previously reported infections caused by this rare fungus. To the best of our knowledge, this is the first report of a rapidly progressing invasive fungal infection with E. dermatitidis originating from a colonized wound after lung transplantation.

The EXP pair-potential system. II. Fluid phase isomorphs.

This paper continues the investigation of the exponentially repulsive EXP pair-potential system of Paper I [A. K. Bacher et al., J. Chem. Phys. 149, 114501 (2018)] with a focus on isomorphs in the low-temperature gas and liquid phases. As expected from the EXP system's strong virial potential-energy correlations, the reduced-unit structure and dynamics are isomorph invariant to a good approximation. Three methods for generating isomorphs are compared: the small-step method that is exact in the limit of small density changes and two versions of the direct-isomorph-check method that allows for much larger density changes. Results from the latter two approximate methods are compared to those of the small-step method for each of the three isomorphs generated by 230 one percent density changes, covering one decade of density variation. Both approximate methods work well.

The EXP pair-potential system. I. Fluid phase isotherms, isochores, and quasiuniversality.

It was recently shown that the exponentially repulsive EXP pair potential defines a system of particles in terms of which simple liquids' quasiuniversality may be explained [A. K. Bacher et al., Nat. Commun. 5, 5424 (2014); J. C. Dyre, J. Phys.: Condens. Matter 28, 323001 (2016)]. This paper and its companion [A. K. Bacher et al., J. Chem. Phys. 149, 114502 (2018)] present a detailed simulation study of the EXP system. Here we study how structure monitored by the radial distribution function and dynamics monitored by the mean-square displacement as a function of time evolve along the system's isotherms and isochores. The focus is on the gas and liquid phases, which are distinguished pragmatically by the absence or presence of a minimum in the radial distribution function above its first maximum. A constant-potential-energy (NVU)-based proof of quasiuniversality is presented, and quasiuniversality is illustrated by showing that the structure of the Lennard-Jones system at four state points is well approximated by those of EXP pair-potential systems with the same reduced diffusion constant. Paper II studies the EXP system's isomorphs, focusing also on the gas and liquid phases.

Diffraction symmetry of binary Fourier elements with feature sizes on the order of the illumination wavelength and effects of fabrication errors.

When building spot array binary Fourier diffractive optical elements (DOEs) having feature sizes on the order of the wavelength, we noticed remarkable variations in the experimental diffraction efficiency compared to the simulation results. Even with the use of high-cost electron beam lithography and rigorous Fourier modal method simulations, there appear to be no publications, to the best of our knowledge, showing close agreement in diffraction efficiency between the simulation and experimental results. In this Letter, we show that the diffraction symmetry of binary Fourier DOEs can be an efficient and consistent metric for evaluating the limit of the thin-element approximation and the effects of fabrication errors.

Efficient free-space read-out of WGM lasers using circular micromirrors.

Lasing from whispering-gallery mode (WGM) resonators occurs omnidirectional in azimuthal plane. Most applications of WGM resonators require spectral analysis with off-chip detectors, where in-plane emission and beam divergence hinder efficient detection. We demonstrate redirecting WGM laser emission from all azimuthal angles using a circular micromirror placed around the cavity. By collecting reflections off the micromirror via free-space optics, read-out intensity improved by one order of magnitude. Blocking vertically emitted spontaneous emission and recording reflections off the micromirror only, signal-to-noise ratio improved from 4.6 dB to 15 dB. Our read-out concept may be applied to arbitrary WGM cavity geometries without deteriorating the cavity's quality factor.

Iterative scalar nonparaxial algorithm for the design of Fourier phase elements.

We propose an iterative algorithm based on our scalar nonparaxial propagator for the design of Fourier diffractive optical elements (DOEs) having features on the order of the illumination wavelength. The simulation results show that our algorithm, using iterative Fourier transform and iterative projection, obtains higher-performance DOEs than a purely scalar paraxial design with the same order of calculation time. Upon verification with the experimental results, we find that our scalar-based design method is valid for DOEs with surprisingly small feature sizes (about half the wavelength) and diffraction angles up to about 37°.

Pump spot size dependent lasing threshold in organic semiconductor DFB lasers fabricated via nanograting transfer.

Optically excited organic semiconductor distributed feedback (DFB) lasers enable efficient lasing in the visible spectrum. Here, we report on the rapid and parallel fabrication of DFB lasers via transferring a nanograting structure from a flexible mold onto an unstructured film of the organic gain material. This geometrically well-defined structure allows for a systematic investigation of the laser threshold behavior. The laser thresholds for these devices show a strong dependence on the pump spot diameter. This experimental finding is in good qualitative agreement with calculations based on coupled-wave theory. With further investigations on various DFB laser geometries prepared by different routes and based on different organic gain materials, we found that these findings are quite general. This is important for the comparison of threshold values of various devices characterized under different excitation areas.

Design Strategy for Nanostructured Arrays of Metallodielectric Cuboids to Systematically Tune the Optical Response and Eliminate Spurious Bulk Effects in Plasmonic Biosensors.

Plasmonic biosensors are a powerful tool for studying molecule adsorption label-free and with high sensitivity. Here, we present a systematic study on the optical properties of strictly regular nanostructures composed of metallodielectric cuboids with the aim to deliberately tune their optical response and improve their biosensing performance. In addition, the patterns were tested for their potential to eliminate spurious effects from sensor response, caused by refractive index changes in the bulk solution. Shifts in the plasmonic spectrum are exclusively caused by the adsorbing molecules. For this purpose, nanopatterns of interconnected and separated cubes with dimensions ranging from 150 to 600 nm have been fabricated from poly(methyl methacrylate) using electron-beam lithography followed by metallization with gold. It is shown that a small lateral pattern size, a high aspect ratio, and short connection lengths are favorable to generate extinction spectra with well-separated and pronounced peaks. Furthermore, for selected nanostructures, we have been able to identify reflection angles for which the influence of the bulk refractive index on the position of the plasmonic peaks is negligible. It is shown that sensor operation under these angles enables monitoring of in situ biomolecule adsorption with high sensitivity providing a promising tool for high-throughput applications.

Regional citrate anticoagulation in patients with liver failure supported by a molecular adsorbent recirculating system.

OBJECTIVE: Regional citrate anticoagulation has emerged as a promising method in critically ill patients at high risk of bleeding. However, in patients with liver failure, citrate accumulation may lead to acid-base and electrolyte imbalances, notably of calcium. The aim of this study was to evaluate the feasibility and safety of regional citrate anticoagulation during liver support using a molecular adsorbent recirculating system as well as its effects on electrolyte and acid-base balance in patients with liver failure. DESIGN: Prospective observational study. SETTING: University hospital. PATIENTS: Twenty critically ill patients supported by molecular adsorbent recirculating system resulting from liver failure between January 2007 and May 2009. MEASUREMENTS AND MAIN RESULTS: The median duration of molecular adsorbent recirculating system treatment was 20 hrs (interquartile range, 18-22 hrs). Two of 77 molecular adsorbent recirculating system treatments (2%) were prematurely discontinued as a result of filter clotting and bleeding, respectively. The median citrate infusion rate, necessary to maintain the postfilter ionized calcium between 0.2 and 0.4 mmol/L, was 3.1 mmol/L (interquartile range, 2.3-4 mmol/L) blood flow. The median calcium chloride substitution rate was 0.9 mmol/L (0.3-1.7 mmol/L) dialysate. Total serum calcium remained stable during molecular adsorbent recirculating system treatments. There was a statistically significant increase of the ratio of total calcium to systemic ionized calcium (2.04 ± 0.32 mmol/L to 2.17 ± 0.35; p = .01), which reflected citrate accumulation resulting from liver failure. Under close monitoring, no clinically relevant electrolytes or acid-base disorders were observed. CONCLUSIONS: Our results suggest that regional citrate anticoagulation is a safe and feasible method to maintain adequate circuit lifespan without increasing the risk of hemorrhagic complications while maintaining a normal acid-base as well as electrolyte balance in patients with liver failure supported by molecular adsorbent recirculating system.

Extracorporeal liver support with multipass albumin dialysis or plasmapheresis and filtering systems in acute liver failure.

Acute liver failure is a very complex type of disease with a mortality of up to 90%, leading to numerous severe disturbances of the whole organism. Bleeding because of absent synthesis of various coagulation factors and disseminated intravascular coagulation, acute kidney failure, circulatory failure with vasopressor dependence, respiratory failure with adult respiratory distress syndrome, neurological failure up to coma because of hepatic encephalopathy, and a very high risk of infection and sepsis frequently result from the initial state of isolated liver failure. High urgency liver transplantation is a highly efficient therapy if performed in time. However, increasing the rate of spontaneous recovery of the patients' own liver, and reducing the need for liver transplantation is preferable and would further improve the outcome of acute liver failure. Extracorporeal liver support by multipass albumin dialysis or plasmapheresis and filtering systems may offer a possibility to fulfill these aims of therapy. A prospective study in 88 patients with acute liver failure has shown a nonsignificant trend in improvement of survival after acute liver failure by multipass albumin dialysis and filtering. Other retrospective studies have shown benefits in improving hepatic encephalopathy and brain oedema. Further, an increase in the rate of spontaneous recovery of liver function has been described. With regional citrate anticoagulation for multipass albumin dialysis and filtering, the need for systemic anticoagulation - a potentially very harmful measure in these patients - can be eliminated and the rate of filter clotting can extremely effectively be reduced.

Up-regulation of interleukin 33 and soluble ST2 serum levels in liver failure.

BACKGROUND: IL-33, a member of the IL-1 family, induces the production of pro-inflammatory and Th2-associated cytokines and may also serve as an 'alarmin' similar to HMGB1. Soluble ST2 has been implicated as a decoy receptor, to attenuate Th2 inflammatory responses. The relevance of both molecules in hepatic failure is unknown. MATERIALS AND METHODS: The trial was a prospective preliminary study in a university hospital surgical ICU; 11 patients with acute liver failure (ALF) and 12 patients with acute-on-chronic liver failure (ACLF), who were admitted to the ICU; 14 patients with chronic hepatic failure (CHF) awaiting liver transplantation; 13 healthy individuals served as controls. IL-33 and soluble ST2 concentrations were determined by enzyme linked immunosorbent assay (ELISA). RESULTS: The concentration of IL-33 and soluble ST2 was significantly higher in ALF, ACLF, and CHF patients compared with the controls. Soluble ST2 serum concentration was significantly elevated in ALF and ACLF compared with CHF; moreover, soluble ST2 was significantly higher in CHF compared with healthy controls. IL-33 and soluble ST2 serum levels correlated significantly (r = 0.6117, P < 0.0001). Moreover, there was a correlation between IL-33 serum levels and alanine aminotransferase (ALT) activity in CHF, ALF, and ACLF patients (r = 0.4321, P = 0.0171). CONCLUSION: Our data provide evidence for elevated levels of IL-33 and soluble ST2 in liver failure, which could a sign of immune hyperactivation, and/or a mechanism to down-regulate inflammation. Especially, soluble ST2 maybe useful to discern acute from chronic hepatic failure or to monitor the course and the severity of the disease.

MCP-1 and MIP3-alpha serum levels in acute liver failure and molecular adsorbent recirculating system (MARS) treatment: a pilot study.

OBJECTIVE: The CC chemokines monocyte chemoattractant protein-1 (MCP-1) and macrophage inflammatory protein-3 alpha (MIP3-alpha) may be involved in the pathogenesis of acute liver failure (ALF) and acute-on-chronic liver failure (ACLF). In ALF and ACLF, the molecular adsorbent recirculating system (MARS) has been used to support liver function. Enhancement of MCP-1, as seen in other extracorporeal support systems such as haemodialysis, might thus have mitigated the beneficial effects of the MARS system in acute hepatic failure. MATERIAL AND METHODS: Serum concentrations of MCP-1 and MIP3-alpha were measured in 10 patients with ALF or ACLF treated with MARS. Thirteen patients suffering from chronic hepatic failure (CHF) and 15 healthy individuals served as controls. RESULTS: Baseline MCP-1 serum concentrations were significantly increased in ALF and ACLF patients as compared to patients with CHF (p=0.0027 and p=0.0046, respectively) and controls (p=0.0006 and p=0.0012, respectively). MIP3-alpha serum concentrations were also significantly enhanced in the ALF and ACLF groups as compared with those in CHF patients (p=0.0002 and p=0.0003, respectively) and controls (p<0.0001 and p<0.0001, respectively). Moreover, MIP3-alpha levels were significantly increased in CHF patients as compared to controls (p=0.0002). MCP-1 and MIP3-alpha concentrations did not change significantly during MARS treatment in ALF and ACLF patients. CONCLUSIONS: The CC chemokines MCP-1 and MIP3-alpha are increased in ALF and ACLF patients. MARS had no effect on MCP-1 and MIP3-alpha serum concentrations in patients with ALF and ACLF, and yielded no evidence of any harmful effects of the increase of these potentially hepatocidal chemokines.

Lung transplantation for idiopathic pulmonary arterial hypertension on intraoperative and postoperatively prolonged extracorporeal membrane oxygenation provides optimally controlled reperfusion and excellent outcome.

OBJECTIVES: Lung transplantation for idiopathic pulmonary arterial hypertension has the highest reported postoperative mortality of all indications. Reasons lie in the complexity of treatment of these patients and the frequent occurrence of postoperative left ventricular failure. Transplantation on intraoperative extracorporeal membrane oxygenation support instead of cardiopulmonary bypass and even more the prolongation of extracorporeal membrane oxygenation into the postoperative period helps to overcome these problems. We reviewed our experience with this concept. METHODS: All patients undergoing bilateral lung transplantation for idiopathic pulmonary arterial hypertension on intraoperative extracorporeal membrane oxygenation with or without prophylactic extracorporeal membrane oxygenation prolongation into the postoperative period between January 2000 and December 2014 were retrospectively analysed. RESULTS: Forty-one patients entered the study. Venoarterial extracorporeal membrane oxygenation support was prolonged into the postoperative period for a median of 2.5 days (range 1-40). Ninety-day, 1-, 3- and 5-year survival rates for the patient collective were 92.7%, 90.2%, 87.4% and 87.4%, respectively. When compared with 31 patients with idiopathic pulmonary arterial hypertension transplanted in the same period of time without prolongation of extracorporeal membrane oxygenation into the postoperative period, the results compared favourably (83.9%, 77.4%, 77.4%, and 77.4%; P = 0.189). Furthermore, these results are among the best results ever reported for this particularly difficult patient population. CONCLUSIONS: Bilateral lung transplantation for idiopathic pulmonary arterial hypertension with intraoperative venoarterial extracorporeal membrane oxygenation support seems to provide superior outcome compared with the results reported about the use of cardiopulmonary bypass. Prophylactic prolongation of venoarterial extracorporeal membrane oxygenation into the early postoperative period provides stable postoperative conditions and seems to further improve the results.

Molecular adsorbent recirculating system and hemostasis in patients at high risk of bleeding: an observational study.

INTRODUCTION: Liver failure is associated with reduced synthesis of clotting factors, consumptive coagulopathy, and platelet dysfunction. The aim of the study was to evaluate the effects of liver support using a molecular adsorbent recirculating system (MARS) on the coagulation system in patients at high risk of bleeding. METHODS: We studied 61 MARS treatments in 33 patients with acute liver failure (n = 15), acute-on-chronic liver failure (n = 8), sepsis (n = 5), liver graft dysfunction (n = 3), and cholestasis (n = 2). Standard coagulation tests, standard thromboelastography (TEG), and heparinase-modified and abciximab-fab-modified TEG were performed immediately before and 30 minutes after commencement of MARS, and after the end of MARS treatment. Prostaglandin I2 was administered extracorporeally to all patients; 17 patients additionally received unfractioned heparin. RESULTS: Three moderate bleeding complications in three patients, requiring three to four units of packed red blood cells, were observed. All were sufficiently managed without interrupting MARS treatment. Although there was a significant decrease in platelet counts (median, 9 G/l; range, -40 to 145 G/l) and fibrinogen concentration (median, 15 mg/dl; range, -119 to 185 mg/dl) with a consecutive increase in thrombin time, the platelet function, as assessed by abciximab-fab-modified TEG, remained stable. MARS did not enhance fibrinolysis. CONCLUSION: MARS treatment appears to be well tolerated during marked coagulopathy due to liver failure. Although MARS leads to a further decrease in platelet count and fibrinogen concentration, platelet function, measured as the contribution of the platelets to the clot firmness in TEG, remains stable. According to TEG-based results, MARS does not enhance fibrinolysis.

Effects of body temperature on blood gases.

BACKGROUND: Changes in body temperature have important impact on measurements of blood gases. In blood gas analyzers the samples are always kept constant at a temperature of exactly 37 degrees C during the measurements, and therefore results are not correct if body temperature differs from 37 degrees C. OBJECTIVE: Lack of knowledge of the effects of body temperature on results of blood gas monitoring may lead to wrong and potentially harmful interpretations and decisions in the clinical setting. The following article elucidates alterations in monitoring of blood gases and oxyhemoglobin saturation (SO(2)) that occur during changes in body temperature.