Olanzapine for the prevention of postoperative nausea and vomiting after gynecologic laparoscopic surgery: a randomized controlled trial.

Purpose: This study was designed to investigate the prophylactic effect of oral olanzapine in postoperative nausea and vomiting after gynecologic laparoscopic surgery. Methods: ASA I-II, aged 18-75 years, planned to undergo gynecologic laparoscopic surgery with general anesthesia in adult female patients. Using the randomized numbers table, the patients were placed in two groups. Oral olanzapine 5 mg or placebo was given 1 h before anesthesia. All patients received standard antiemetic prophylaxis with dexamethasone and granisetron. The primary outcome was nausea and/or vomiting in the 24 h after the postoperative. Results: A total of 250 patients were randomized, and 241 were analyzed. The primary outcome occurred in 10 of 120 patients (8.3%) in the olanzapine group and 23 of 121 patients (19.2%) in the placebo group (p = 0.014). According to Kaplan-Meier analysis, the probabilities of nausea and/or vomiting in the 24 h after the postoperative in the olanzapine group were lower than in the placebo group (log-rank p = 0.014). In a multivariate Cox analysis, the variables of use of olanzapine [hazard ratio (HR): 0.35, 95% confidence interval (CI): 0.16-0.79; p = 0.012] and use of vasoactive drugs (HR: 2.48, 95% CI: 1.07-5.75; p = 0.034) were independently associated with nausea and/or vomiting in the 24 h after the postoperative. Conclusion: Our data suggest that olanzapine relative to placebo decreased the risk of nausea and/or vomiting in the 24 h after gynecologic laparoscopic surgery. Trial registration: The trial was registered prior to patient enrollment at The Chinese Clinical Trial Registry (https://www.chictr.org.cn/showproj.html?proj=166900, link to registry page, Principal investigator: Nanjin Chen, Date of registration: 25 April 2022).

Preventing nausea and vomiting after laparoscopic gynecological surgery: the benefits of using olanzapine Why was this study done? Despite the use of antiemetics, postoperative nausea and vomiting remain prevalent. Furthermore, patients who undergo gynecological laparoscopic surgery are at an increased risk. Therefore, this study investigated whether oral Olanzapine could reduce the incidence of nausea and vomiting after gynaecological Laparoscopy? What did the researchers do? The research team examined patients who underwent gynecological laparoscopic surgery under general anesthesia. They observed the occurrence of nausea and vomiting within 24 hours after surgery in patients who either received or did not receive Olanzapine treatment. The goal was to assess the effectiveness of Olanzapine in reducing postoperative nausea and vomiting. What did the researchers find? The addition of Olanzapine, when combined with granisetron and dexamethasone, resulted in a decreased risk of nausea and/or vomiting within the 24 hours following gynecologic laparoscopic surgery, as compared to the placebo. Administering oral Olanzapine at a dosage of 5 mg reduced the incidence of nausea and vomiting after gynecological laparoscopy from 19.2% to 8.3%. What do the findings mean? This study has identified a safe and effective medication for preventing postoperative nausea and vomiting. Implementing Olanzapine as a preventive measure can significantly reduce the incidence of nausea and vomiting following surgery, thereby enhancing the overall medical experience for patients.

Ultrauniform Plating of Lithium on 10-nm-Scale Ordered Carbon Grids for Long Lifespan Lithium Metal Batteries.

Tailorable lithium (Li) nucleation and uniform early-stage plating is essential for long-lifespan Li metal batteries. Among factors influencing the early plating of Li anode, the substrate is critical, but a fine control of the substrate structure on a scale of ≈10 nm has been rarely achieved. Herein, a carbon consisting of ordered grids is prepared, as a model to investigate the effect of substrate structure on the Li nucleation. In contrast to the individual spherical Li nuclei formed on the flat graphene, an ultrauniform and nuclei-free Li plating is obtained on the ordered carbon with a grid size smaller than the thermodynamical critical radius of Li nucleation (≈26 nm). Simultaneously, an inorganic-rich solid-electrolyte-interphase is promoted by the cross-sectional carbon layers of such ordered grids which are exposed to the electrolyte. Consequently, the carbon grids with a grid size of ≈10 nm show a favorable cycling stability for more than 1100 cycles measured at 2 mA cm-2 in a half cell. With LiNi0.8Co0.1Mn0.1O2 as cathode, the assembled full cell with a cathode capacity of 3 mAh cm-2 and a negative/positive ratio of 1.67 demonstrates a stable cycling for over 130 cycles with a capacity retention of 88%.

Rapid Yet Efficient Reduction of Graphene Oxide Triggered by Semi-Molten Metals.

Reduced graphene oxide (rGO) has garnered extensive attention as electrodes, sensors, and membranes, necessitating the efficient reduction of graphene oxide (GO) for optimal performance. In this work, a swift reduction of GO that involves bringing GO foam in contact with semi-molten metals like tin (Sn) and lithium (Li) is presented. These findings reveal that the electrical resistance of GO foam is significantly diminished by its interaction with these metals, even in dry air. Taking inspiration from this technique, Sn foil is employed to encase the GO foam, followed by a calcination in 15 vol% H2 /Ar environment at 235 °C to fabricate the rGO, which demonstrates a remarkably lower electrical resistivity of 0.42 Ω cm when compared to the chemically reduced GO via hydrazine hydrate (650 Ω cm). The reduction mechanism entails the migration of Sn on GO and its subsequent reaction with oxygen functional groups. SnO/Sn(OH)2 formed from the reaction can be subsequently reversed through reduction by H2 to Sn. Utilizing this rGO as the host material for a sulfur cathode, a lithium-sulfur battery is constructed that displays a specific capacity of 1146 mAh g-1 and maintains a capacity retention of 68.4% after 300 cycles at a rate of 0.2 C.

Synthesis of α-Trifluoromethyl Alkynes through Fluoroalkynylation of gem-Difluoroalkenes.

A trifluoromethylalkynylation reaction of gem-difluoroalkenes with alkynyl sulfoxide by photoredox radical addition with good functional group tolerance in moderate to high yields, is developed for the synthesis of α-trifluoromethyl alkyne. This reaction features simple operation and inexpensive raw materials and provides an expeditious route to synthesize biologically relevant fluorine-containing alkynyl compounds with diverse structural skeletons.

Hierarchical palladium catalyst for highly active and stable water oxidation in acidic media.

Acidic water electrolysis is of great importance for boosting the development of renewable energy. However, it severely suffers from the trade-off between high activity and long lifespan for oxygen evolution catalysts on the anode side. This is because the sluggish kinetics of oxygen evolution reaction necessitates the application of a high overpotential to achieve considerable current, which inevitably drives the catalysts far away from their thermodynamic equilibrium states. Here we demonstrate a new oxygen evolution model catalyst-hierarchical palladium (Pd) whose performance even surpasses the benchmark Ir- and Ru-based materials. The Pd catalyst displays an ultralow overpotential (196 mV), excellent durability and mitigated degradation (66 µV h-1) at 10 mA cm-2 in 1 M HClO4. Tensile strain on Pd (111) facets weakens the binding of oxygen species on electrochemical etching-derived hierarchical Pd and thereby leads to two orders of magnitudes of enhancement of mass activity in comparison to the parent Pd bulk materials. Furthermore, the Pd catalyst displays the bifunctional catalytic properties for both oxygen and hydrogen evolutions and can deliver a current density of 2 A cm-2 at a low cell voltage of 1.771 V when fabricated into polymer electrolyte membrane electrolyser.

Long-range ordered porous carbons produced from C60.

Carbon structures with covalent bonds connecting C60 molecules have been reported1-3, but their production methods typically result in very small amounts of sample, which restrict the detailed characterization and exploration necessary for potential applications. We report the gram-scale preparation of a new type of carbon, long-range ordered porous carbon (LOPC), from C60 powder catalysed by α-Li3N at ambient pressure. LOPC consists of connected broken C60 cages that maintain long-range periodicity, and has been characterized by X-ray diffraction, Raman spectroscopy, magic-angle spinning solid-state nuclear magnetic resonance spectroscopy, aberration-corrected transmission electron microscopy and neutron scattering. Numerical simulations based on a neural network show that LOPC is a metastable structure produced during the transformation from fullerene-type to graphene-type carbons. At a lower temperature, shorter annealing time or by using less α-Li3N, a well-known polymerized C60 crystal forms owing to the electron transfer from α-Li3N to C60. The carbon K-edge near-edge X-ray absorption fine structure shows a higher degree of delocalization of electrons in LOPC than in C60(s). The electrical conductivity is 1.17 × 10-2 S cm-1 at room temperature, and conduction at T < 30 K appears to result from a combination of metallic-like transport over short distances punctuated by carrier hopping. The preparation of LOPC enables the discovery of other crystalline carbons starting from C60(s).

A survey on the safety of the SARS-CoV-2 vaccine among a population with stroke risk in China.

Background: The safety of the COVID-19 vaccine in patients at stroke risk is poorly understood. Methods: A survey was conducted on risk factors related to stroke and adverse reactions to vaccines. The participants were divided into low-, medium-, and high-risk groups, according to the stroke risk scorecard recommended by the Stroke Prevention and Control Engineering Committee of the National Health and Family Planning Commission. Factors associated with adverse reactions were analyzed. Reasons for non-vaccination and the aggravation of underlying diseases after vaccination were investigated. Results: 1747 participants participated (138 unvaccinated) and 36.8, 22.1, 41.1% of the vaccinated participants had low, medium, high risk of stroke, respectively. The incidence of adverse reactions after the first and second injection was 16.6, 13.7%, respectively. There was no difference in the incidence of adverse reactions among different risk groups. Sex, vaccine type, sleep quality, worry of adverse reactions, age, and education level were significantly related to adverse reactions to vaccination. The most popular reason for non-vaccination for medium- or high risk-participants was the aggravation of the existing disease. Only 0.3% of vaccinated participants reported slight changes in blood pressure, sugar levels, and lipid levels. No aggravation of stroke sequelae, atrial fibrillation, or transient ischemic attack was reported. Conclusions: Vaccination against COVID-19 (inactive virus) is safe for people at risk of stroke when the existing disease condition is stable. It is suggested to strengthen vaccine knowledge and ensure good sleep before vaccination.

Identification of misdiagnosis by deep neural networks on a histopathologic review of breast cancer lymph node metastases.

The frozen section (FS) diagnoses of pathology experts are used in China to determine whether sentinel lymph nodes of breast cancer have metastasis during operation. Direct implementation of a deep neural network (DNN) in clinical practice may be hindered by misdiagnosis of the algorithm, which affects a patient's treatment decision. In this study, we first obtained the prediction result of the commonly used patch-DNN, then we present a relative risk classification and regression tree (RRCART) to identify the misdiagnosed whole-slide images (WSIs) and recommend them to be reviewed by pathologists. Applying this framework to 2362 WSIs of breast cancer lymph node metastasis, test on frozen section results in the mean area under the curve (AUC) reached 0.9851. However, the mean misdiagnosis rate (0.0248), was significantly higher than the pathologists' misdiagnosis rate (p < 0.01). The RRCART distinguished more than 80% of the WSIs as a high-accuracy group with an average accuracy reached to 0.995, but the difference with the pathologists' performance was not significant (p > 0.01). However, the other low-accuracy group included most of the misdiagnoses of DNN models. Our research shows that the misdiagnosis from deep learning model can be further enriched by our method, and that the low-accuracy WSIs must be selected for pathologists to review and the high-accuracy ones may be ready for pathologists to give diagnostic reports.

Erratum: Stronger Interlayer Interactions Contribute to Faster Hot Carrier Cooling of Bilayer Graphene under Pressure [Phys. Rev. Lett. 126, 027402 (2021)].

This corrects the article DOI: 10.1103/PhysRevLett.126.027402.

Microfluidic Oxidation of Graphite in Two Minutes with Capability of Real-Time Monitoring.

Graphite oxide and its exfoliated counterpart, graphene oxide, are important precursors for the large-scale production of graphene-based materials and many relevant applications. The current batch-style preparation of graphite oxide suffers from safety concern, long reaction time, and nonuniform product quality, due to the large volume of reactors and slow energy exchange. Reaction in microchannels can largely enhance the oxidization efficiency of graphite due to the enhanced mass transfer and extremely quick energy exchange, by which the controllable oxidization of graphite is achieved in ≈2 min. Comprehensive characterizations show that the graphene oxide obtained through the microfluidic strategy has features like those prepared in laboratory beakers and industrial reactors, yet with the higher oxidization degree and more epoxy groups. More importantly, the microfluidic preparation allows for on-line monitoring of the oxidization by Raman spectroscopy, ready for the dynamical control of reaction condition and product quality. The capability of continuous preparation is also demonstrated by showing the assembly of fibers and reduction of graphene oxide in microfluidic channels, and the applicability of graphene oxide prepared from the microfluidic strategy for thermally and electrically conductive films.

Anisotropic conductive networks for multidimensional sensing.

In the past decade, flexible physical sensors have attracted great attention due to their wide applications in many emerging areas including health-monitoring, human-machine interfaces, smart robots, and entertainment. However, conventional sensors are typically designed to respond to a specific stimulus or a deformation along only one single axis, while directional tracking and accurate monitoring of complex multi-axis stimuli is more critical in practical applications. Multidimensional sensors with distinguishable signals for simultaneous detection of complex postures and movements in multiple directions are highly demanded for the development of wearable electronics. Recently, many efforts have been devoted to the design and fabrication of multidimensional sensors that are capable of distinguishing stimuli from different directions accurately. Benefiting from their unique decoupling mechanisms, anisotropic architectures have been proved to be promising structures for multidimensional sensing. This review summarizes the present state and advances of the design and preparation strategies for fabricating multidimensional sensors based on anisotropic conducting networks. The fabrication strategies of different anisotropic structures, the working mechanism of various types of multidimensional sensing and their corresponding unique applications are presented and discussed. The potential challenges faced by multidimensional sensors are revealed to provide an insightful outlook for the future development.

Phase-Changing in Graphite Assisted by Interface Charge Injection.

Among many phase-changing materials, graphite is probably the most studied and interesting: the rhombohedral (3R) and hexagonal (2H) phases exhibit dramatically different electronic properties. However, up to now the only way to promote 3R to 2H phase transition is through exposure to elevated temperatures (above 1000 °C); thus, it is not feasible for modern technology. In this work, we demonstrate that 3R to 2H phase transition can be promoted by changing the charged state of 3D graphite, which promotes the repulsion between the layers and significantly reduces the energy barrier between the 3R and 2H phases. In particular, we show that charge transfer from lithium nitride (α-Li3N) to graphite can lower the transition temperature down to 350 °C. The proposed interlayer slipping model potentially offers the control over topological states at the interfaces between different phases, making this system even more attractive for future electronic applications.

Emerging flat bands in large-angle twisted bi-layer graphene under pressure.

Recent experiments on magic-angle twisted bi-layer graphene have attracted intensive attention due to exotic properties such as unconventional superconductivity and correlated insulation. These phenomena were often found at a magic angle less than 1.1°. However, the preparation of precisely controlled bi-layer graphene with a small magic angle is challenging. In this work, electronic properties of large-angle twisted bi-layer graphene (TBG) under pressure are investigated with density functional theory. We demonstrate that large-angle TBG can display flat bands nearby the Fermi level under pressure, which may also induce interesting properties such as superconductivity which have only been found in small-angle TBG at ambient pressure. The Fermi velocity is found to decrease monotonously with pressure for large twisted angles, e.g., 21.8°. Our work indicates that applying pressure provides opportunities for flat-band engineering in larger angle TBG and supports further exploration in related investigations.

Electrochemical Characterization of Single Layer Graphene/Electrolyte Interface: Effect of Solvent on the Interfacial Capacitance.

The development of the basic understanding of the charge storage mechanisms in electrodes for energy storage applications needs deep characterization of the electrode/electrolyte interface. In this work, we studied the charge of the double layer capacitance at single layer graphene (SLG) electrode used as a model material, in neat (EMIm-TFSI) and solvated (with acetonitrile) ionic liquid electrodes. The combination of electrochemical impedance spectroscopy and gravimetric electrochemical quartz crystal microbalance (EQCM) measurements evidence that the presence of solvent drastically increases the charge carrier density at the SLG/ionic liquid interface. The capacitance is thus governed not only by the electronic properties of the graphene, but also by the specific organization of the electrolyte side at the SLG surface originating from the strong interactions existing between the EMIm+ cations and SLG surface. EQCM measurements also show that the carbon structure, with the presence of sp2 carbons, affects the charge storage mechanism by favoring counter-ion adsorption on SLG electrode versus ion exchange mechanism in amorphous porous carbons.

Stronger Interlayer Interactions Contribute to Faster Hot Carrier Cooling of Bilayer Graphene under Pressure.

We perform femtosecond pump-probe spectroscopy to in situ investigate the ultrafast photocarrier dynamics in bilayer graphene and observe an acceleration of energy relaxation under pressure. In combination with in situ Raman spectroscopy and ab initio molecular dynamics simulations, we reveal that interlayer shear and breathing modes have significant contributions to the faster hot-carrier relaxations by coupling with the in-plane vibration modes under pressure. Our work suggests that further understanding the effect of interlayer interaction on the behaviors of electrons and phonons would be critical to tailor the photocarrier dynamic properties of bilayer graphene.

Population pharmacokinetic modeling and clinical application of vancomycin in Chinese patients hospitalized in intensive care units.

Management of vancomycin administration for intensive care units (ICU) patients remains a challenge. The aim of this study was to describe a population pharmacokinetic model of vancomycin for optimizing the dose regimen for ICU patients. We prospectively enrolled 466 vancomycin-treated patients hospitalized in the ICU, collected trough or approach peak blood samples of vancomycin and recorded corresponding clinical information from July 2015 to December 2017 at Tai Zhou Hospital of Zhejiang Province. The pharmacokinetics of vancomycin was analyzed by nonlinear mixed effects modeling with Kinetica software. Internal and external validation was evaluated by the maximum likelihood method. Then, the individual dosing regimens of the 92 patients hospitalized in the ICU whose steady state trough concentrations exceeded the target range (10-20 µg/ml) were adjusted by the Bayes feedback method. The final population pharmacokinetic model show that clearance rate (CL) of vancomycin will be raised under the conditions of dopamine combined treatment, severe burn status (Burn-S) and increased total body weight (TBW), but reduced under the conditions of increased serum creatinine (Cr) and continuous renal replacement therapy status; Meanwhile, the apparent distribution volume (V) of vancomycin will be enhanced under the terms of increased TBW, however decreased under the terms of increased age and Cr. The population pharmacokinetic parameters (CL and V) according to the final model were 3.16 (95%CI 2.83, 3.40) L/h and 60.71 (95%CI 53.15, 67.46). The mean absolute prediction error for external validation by the final model was 12.61% (95CI 8.77%, 16.45%). Finally, the prediction accuracy of 90.21% of the patients' detected trough concentrations that were distributed in the target range of 10-20 µg/ml after dosing adjustment was found to be adequate. There is significant heterogeneity in the CL and V of vancomycin in ICU patients. The constructed model is sufficiently precise for the Bayesian dose prediction of vancomycin concentrations for the population of ICU Chinese patients.

High Capacity and Energy Density of Zn-Ni-Co-P Nanowire Arrays as an Advanced Electrode for Aqueous Asymmetric Supercapacitor.

Developing multicomponent transition-metal phosphides has become an efficient way to improve the capacitive performance of single-component transition-metal phosphides. However, reports on quaternary phosphides for supercapacitor applications are still scarce. Here, we report high capacity and energy density of Zn-Ni-Co-P quaternary phosphide nanowire arrays on nickel foam (ZNCP-NF) composed of highly conductive metal-rich phosphides as an advanced binder-free electrode in aqueous asymmetric supercapacitors. In a three-electrode system using the new electrode, a high specific capacity of 1111 C g-1 was obtained at a current density of 10 A g-1. Analysis of this aqueous asymmetric supercapacitor with ZNCP-NF as the positive electrode and commercial activated carbon as the negative electrode reveals a high energy density (37.59 Wh kg-1 at a power density of 856.52 W kg-1) and an outstanding cycling performance (capacity retention of 92.68% after 10 000 cycles at 2 A g-1). Our results open a path for a new design of advanced electrode material for supercapacitors.

Graphene foil as a current collector for NCM material-based cathodes.

When used as a current collector, aluminum foil (AF) is vulnerable to local anodic corrosion during the charge/discharge process, which can lead to the deterioration of lithium-ion batteries (LIBs). Herein, a graphene foil (GF) with high electrical conductivity (∼5800 S cm-1) and low mass density (1.80 g cm-3) was prepared by reduction of graphene oxide foil with ultra-high temperature (2800 °C) annealing, and it exhibited significantly anodic corrosion resistance when serving as a current collector. Moreover, a LiNi0.5Co0.2Mn0.3O2 (NCM523) cathode using GF as a current collector (NCM523/GF) demonstrated a gravimetric capacity of 137.3 mAh g-1 at 0.5 C based on the mass of the whole electrode consisting of the active material, carbon black, binder, and the current collector, which is 44.5% higher than that of the NCM523/AF electrode. Furthermore, the NCM523/GF electrode retains higher capacity at relatively faster rates, from 0.1 C to 5.0 C. Therefore, GF, a lightweight corrosion-resistant current collector, is expected to replace the current commercial metal current collectors in LIBs and to achieve high energy-density batteries.

Designing ionic channels in novel carbons for electrochemical energy storage.

Tremendous efforts have been dedicated to developing high-performance energy storage devices based on the micro- or nano-manipulation of novel carbon electrodes, as certain nanocarbons are perceived to have advantages such as high specific surface areas, superior electric conductivities, excellent mechanical properties and so on. In typical electrochemical electrodes, ions are intercalated/deintercalated into/from the bulk (for batteries) or adsorbed/desorbed on/from the surface (for electrochemical capacitors). Fast ionic transport, significantly determined by ionic channels in active electrodes or supporting materials, is a prerequisite for the efficient energy storage with carbons. In this report, we summarize recent design strategies for ionic channels in novel carbons and give comments on the promising features based on those carbons towards tailorable ionic channels.

Charge Storage Mechanisms of Single-Layer Graphene in Ionic Liquid.

Graphene-based carbon materials are promising candidates for electrical double-layer (EDL) capacitors, and there is considerable interest in understanding the structure and properties of the graphene/electrolyte interface. Here, electrochemical impedance spectroscopy (EIS) and electrochemical quartz crystal microbalance (EQCM) are used to characterize the ion fluxes and adsorption on single-layer graphene in neat ionic liquid (EMI-TFSI) electrolyte. It is found that a positively charged ion-species desorption and ion reorganization dominate the double-layer charging during positive and negative polarizations, respectively, leading to the increase in EDL capacitance with applied potential.