Remimazolam Pilot for Office-Based Dental Sedation: Adverse Events, Awareness and Outcomes.

In recent years, remimazolam has gained approval for use in adult procedural sedation in both the United Kingdom and the United States, potentially offering an alternative to conventional sedatives like propofol and midazolam for procedural sedation. However, there is a limited body of literature that systematically reviews the outcomes of a remimazolam-alfentanil combination protocol for routine office-based dental procedures. The primary objective of this pilot study was to assess the occurrence of significant adverse events associated with the use of a remimazolam-alfentanil sedation protocol for adult dental procedures. Secondary outcomes included evaluating physiological responses, sedation effectiveness, patient and clinician satisfaction and the incidence of intraprocedural awareness. Notably, no significant adverse events were reported among the 25 adult subjects who received remimazolam and alfentanil, and all dental procedures were successfully completed. Patients and clinicians expressed high levels of satisfaction, and patients did not report any distressing memories associated with the dental procedure. These findings suggest that in a limited cohort, the remimazolam-alfentanil regimen appears to be well tolerated and effective for office-based dental procedures in adult patients, with a low risk of adverse events, acceptable hemodynamic effects, rapid onset and recovery and minimal intraoperative awareness. This study provides valuable insights into the potential use of the remimazolam-alfentanil combination in dental sedation practice.

Tree canopy arthropods have idiosyncratic responses to plant ecophysiological traits in a warm temperate forest complex.

Biodiversity studies on forest canopies often have narrow arthropod taxonomic focus, or refer to a single species of tree. In response, and to better understand the wide range of drivers of arthropod diversity in tree canopies, we conducted a large-scale, multi-taxon study which (a) included effect of immediate surroundings of an individual tree on plant physiological features, and (b), how these features affect compositional and functional arthropod diversity, in a warm, southern Afro-temperate forest. We found that tree species differed significantly in plant physiological features and arthropod diversity patterns. Surprisingly, we found negative correlation between surrounding canopy cover, and both foliar carbon and arthropod diversity in host trees, regardless of tree species. Subtle, tree intraspecific variation in physiological features correlated significantly with arthropod diversity measures, but direction and strength of correlations differed among tree species. These findings illustrate great complexity in how canopy arthropods respond to specific tree species, to immediate surroundings of host trees, and to tree physiological features. We conclude that in natural forests, loss of even one tree species, as well as homogenization of the crown layer and/or human-induced environmental change, could lead to profound and unpredictable canopy arthropod biodiversity responses, threatening forest integrity.