Upconversion Material-Plasmonic Metal-Semiconductor Ternary Heteronanostructures for Wide-Range Solar-to-Chemical Energy Conversion.

Harvesting full-spectrum solar energy is a critical issue for developing high-performance photocatalysts. Here, we report a hierarchical heteronanostructure consisting of upconverting, plasmonic, and semiconducting materials as a solar-to-chemical energy conversion platform that can exploit a wide range of sunlight (from ultraviolet (UV) to near-infrared). Lanthanide-doped NaYF4 nanorod-spherical Au nanocrystals-TiO2 ternary hybrid nanostructures with a well-controlled configuration and intimate contact between the constituent materials could be synthesized by a wet-chemical method. Notably, the prepared ternary hybrids exhibited high photocatalytic activity for the H2 evolution reaction under simulated solar and near-infrared light irradiation due to their broadband photoresponsivity and strong optical interaction between the constituents. Through systematic studies on the mechanism of energy transfer during the photocatalysis of the ternary hybrids, we revealed that upconverted photon energy from the upconversion domain transfers to the Au and TiO2 domains primarily through the Förster resonance energy transfer process, resulting in enhanced photocatalysis.

Effects of dexmedetomidine on the ratio of T helper 1 to T helper 2 cytokines in patients undergoing laparoscopic cholecystectomy.

STUDY OBJECTIVES: To investigate the effect of dexmedetomidine on T helper 1 (Th1) and T helper 2 (Th2) cytokines and their ratio during and after surgery. DESIGN: Single-blinded, randomized, placebo-controlled clinical comparison study. SETTING: Academic medical center. PATIENTS: 46 adult, ASA physical status 1 and 2 patients scheduled for laparoscopic cholecystectomy. INTERVENTIONS: Patients were randomized to two groups: the dexmedetomidine group (n = 23), in which dexmedetomidine was infused with a 1.0 µg/kg loading dose followed by infusion of 0.5 µg/kg/h; or the saline group (n = 23). MEASUREMENTS: Interferon-gamma (IFN-gamma) and interleukin-4 (IL-4) as Th1 and Th2 cytokines, respectively, were quantified three times: after induction of anesthesia (T0), at the end of peritoneal closure (T1), and 60 minutes after surgery (T2). The IFN-gamma/IL-4 ratio was then calculated. MAIN RESULTS: The dexmedetomidine group displayed higher levels of IFN-gamma at T1 and T2 (42.30 pg/dL vs 6.91 pg/dL at T1 [P = 0.025]; 40.51 pg/dL vs 8.29 pg/dL at T2 [P = 0.030]) than the saline group. The dexmedetomidine group was also associated with higher ratios of IFN-gamma/IL-4 (1.22 vs 0.32, respectively, at T1 [P = 0.012]; 1.53 vs 0.13, respectively, at T2 [P = 0.012]). CONCLUSIONS: Dexmedetomidine plays an immunomodulatory role, shifting the Th1/Th2 cytokine balance toward Th1 in patients with surgical and anesthetic stress.

Zoster-associated segmental paresis in a patient with cervical spinal stenosis.

Segmental zoster paresis is a rare complication of herpes zoster, characterized by focal motor weakness that does not always present simultaneously with skin lesions. Zoster paresis can be easily confused with other neuromuscular or spinal diseases. This case report describes the case of a 72-year-old woman with herpes zoster and cervical spinal stenosis at the same spinal level, where it was difficult to distinguish segmental zoster paresis from cervical radiculopathy combined with motor neuropathy. Although segmental zoster paresis in the upper extremity is rare, it should be included in the differential diagnosis of segmental pain and weakness in the extremities, especially in older or immunocompromised patients. Correct diagnosis is required, to avoid unnecessary surgery and allow timely antiviral treatment.

Left atrial volume measured by real-time 3-dimensional echocardiography predicts clinical outcomes in patients with severe left ventricular dysfunction and in sinus rhythm.

BACKGROUND: The clinical value of real-time 3-dimensional echocardiography assessments of left atrial volume in patients with left ventricular dysfunction has not been determined. METHODS: Real-time 3-dimensional echocardiography and 2-dimensional Doppler echocardiography were performed on the same day in 108 patients with severe left ventricular dysfunction and in sinus rhythm. End-systolic left atrial volumes were measured using real-time 3-dimensional echocardiography images (LAV-3D) and end-systolic left atrial volumes were calculated by the biplane area-length formula using 2-dimensional echocardiography (LAV-2D). Patients were observed clinically over 10 +/- 7 months. RESULTS: LAV-2D showed excellent correlation with LAV-3D (r = 0.88, P < .001), but the former was significantly smaller than the latter (-12 +/- 21 mL, P < .001). During follow-up, 31 patients (29%) showed clinical events, including 3 cardiac deaths and 28 hospitalizations as a result of heart failure. Patients with clinical events had larger initial LAV-3D (P < .05) and LAV-2D (P = .05), higher transmitral E velocity, higher E/E' ratio, more severe mitral and tricuspid regurgitation, and higher maximal velocity of tricuspid regurgitation than the 77 patients without events. LAV-3D (P < .001) and age (P < .05) were independent predictors of cardiac events by Cox proportional hazard model, whereas LAV-2D was negatively involved. Patients with initial LAV-3D less than 100 mL had a significantly higher 1-year event-free survival than those with LAV-3D greater than or equal to 100 mL (80 +/- 7 vs 48 +/- 10%, P < .001). CONCLUSIONS: LAV-3D is a major predictor of clinical events in patients with severe left ventricular dysfunction and in sinus rhythm. The clinical value of LAV-3D seems to be superior to that of LAV-2D.