Managing Interfacial Defects and Charge-Carriers Dynamics by a Cesium-Doped SnO2 for Air Stable Perovskite Solar Cells.

A high-quality nanostructured tin oxide (SnO2) has garnered massive attention as an electron transport layer (ETL) for efficient perovskite solar cells (PSCs). SnO2 is considered the most effective alternative to titanium oxide (TiO2) as ETL because of its low-temperature processing and promising optical and electrical characteristics. However, some essential modifications are still required to further improve the intrinsic characteristics of SnO2, such as mismatch band alignments, charge extraction, transportation, conductivity, and interfacial recombination losses. Herein, an inorganic-based cesium (Cs) dopant is used to modify the SnO2 ETL and to investigate the impact of Cs-dopant in curing interfacial defects, charge-carrier dynamics, and improving the optoelectronic characteristics of PSCs. The incorporation of Cs contents efficiently improves the perovskite film quality by enhancing the transparency, crystallinity, grain size, and light absorption and reduces the defect states and trap densities, resulting in an improved power conversion efficiency (PCE) of ≈22.1% with Cs:SnO2 ETL, in-contrast to pristine SnO2-based PSCs (20.23%). Moreover, the Cs-modified SnO2-based PSCs exhibit remarkable environmental stability in a relatively higher relative humidity environment (>65%) and without encapsulation. Therefore, this work suggests that Cs-doped SnO2 is a highly favorable electron extraction material for preparing highly efficient and air-stable planar PSCs.

Individualized estimation of arterial carbon dioxide partial pressure using machine learning in children receiving mechanical ventilation.

BACKGROUND: Measuring arterial partial pressure of carbon dioxide (PaCO2) is crucial for proper mechanical ventilation, but the current sampling method is invasive. End-tidal carbon dioxide (EtCO2) has been used as a surrogate, which can be measured non-invasively, but its limited accuracy is due to ventilation-perfusion mismatch. This study aimed to develop a non-invasive PaCO2 estimation model using machine learning. METHODS: This retrospective observational study included pediatric patients (< 18 years) admitted to the pediatric intensive care unit of a tertiary children's hospital and received mechanical ventilation between January 2021 and June 2022. Clinical information, including mechanical ventilation parameters and laboratory test results, was used for machine learning. Linear regression, multilayer perceptron, and extreme gradient boosting were implemented. The dataset was divided into 7:3 ratios for training and testing. Model performance was assessed using the R2 value. RESULTS: We analyzed total 2,427 measurements from 32 patients. The median (interquartile range) age was 16 (12-19.5) months, and 74.1% were female. The PaCO2 and EtCO2 were 63 (50-83) mmHg and 43 (35-54) mmHg, respectively. A significant discrepancy of 19 (12-31) mmHg existed between EtCO2 and the measured PaCO2. The R2 coefficient of determination for the developed models was 0.799 for the linear regression model, 0.851 for the multilayer perceptron model, and 0.877 for the extreme gradient boosting model. The correlations with PaCO2 were higher in all three models compared to EtCO2. CONCLUSIONS: We developed machine learning models to non-invasively estimate PaCO2 in pediatric patients receiving mechanical ventilation, demonstrating acceptable performance. Further research is needed to improve reliability and external validation.

Addressing desaturation in a tracheal stenosis patient using the transnasal humidified rapid-insufflation ventilatory exchange technique during tracheostomy: A case report.

RATIONALE: Transnasal humidified rapid-insufflation ventilatory exchange (THRIVE) is used in tracheostomy but not in cases of airway obstruction. This case report explores the use of THRIVE for managing airway obstruction during tracheostomy in patients with subglottic and tracheal stenosis, thereby addressing the current knowledge gap and exploring its potential for airway management. PATIENT CONCERNS: A 63-year-old female with subglottic and tracheal stenoses underwent tracheostomy. Multiple attempts to establish a patent airway were unsuccessful, and oxygen saturation dropped to 56%. DIAGNOSIS: Endotracheal tube was directed toward the tracheal wall, causing airway obstruction. INTERVENTIONS: THRIVE was administered to the patient. Subsequently, the tube position was adjusted to enhance ventilation. OUTCOMES: The patient's oxygen saturation increased to 99%. The postoperative complications, including subcutaneous emphysema, pneumothorax, pneumomediastinum and pneumopericardium, resolved. The patient was discharged on postoperative day 9. LESSONS: THRIVE could be considered a temporary measure to enhance oxygenation before initiating a definitive treatment strategy.

Remimazolam Induction in a Patient with Super-Super Obesity and Obstructive Sleep Apnea: A Case Report.

Background: With the rising prevalence of obesity, anesthesiologists are expected to increasingly encounter patients with obesity, which poses challenges for anesthetic management. The use of remimazolam, an intravenous anesthetic agent approved in 2020, may be beneficial in these patients. However, its use in patients with super-super obesity remains underexplored. Case Description: A 55-year-old woman with a body mass index (BMI) of 60.6 kg/m2 and moderate obstructive sleep apnea (OSA) underwent laparoscopic sleeve gastrectomy under general anesthesia. The transnasal humidified rapid-insufflation ventilatory exchange (THRIVE) technique was used along with the administration of remimazolam at a rate of 6 mg/kg/h based on the total body weight. The patient was sedated within 125 s without any signs of hemodynamic instability, and the surgery was completed successfully. Conclusions: This case study demonstrates the potential effectiveness of remimazolam infusion for inducing general anesthesia in patients with super-super obesity. The infusion rate, derived from the total body weight, yielded an outcome comparable with that observed in individuals without obesity. Further studies with larger cohorts are required to confirm these findings.

Hemophagocytic Lymphohistiocytosis as Initial Presentation of Malignancy in Pediatric Patients: Rare but Not to Be Ignored.

It is complicated to establish a consensus on the management and diagnosis of malignancy-triggered hemophagocytic lymphohistiocytosis (M-HLH) in children, as an initial presentation of malignancy is complicated. In this paper, we analyze the clinical characteristics and outcomes of eight pediatric patients in which M-HLH was the initial presentation of malignancy. All patients had hematologic malignancies: three subcutaneous panniculitis-like T-cell lymphomas, two acute lymphoblastic leukemias, two anaplastic large cell lymphomas, and a systemic EBV + T-cell lymphoma of childhood. The incidence rate of M-HLH among leukemia and malignant lymphoma patients in our institution was 1.9%. From the initial diagnosis of HLH, the median time taken to be diagnosed as a malignancy was about 1.3 months. The majority of patients received HLH-targeted immunosuppression and/or etoposide at first. The patients' clinical response to treatment for HLH and malignancies were varied. Five out of the eight patients died, one of whom died due to HLH-related cerebral edema after the initiation of chemotherapy. The median overall survival was 1.6 years. In order to improve the survival rate, the early detection of M-HLH, rapid screening for malignancy, and complete control of M-HLH with HLH-directed therapy followed by a thorough response monitoring are required.

Oxaliplatin-loaded chemically cross-linked hydrogels for prevention of postoperative abdominal adhesion and colorectal cancer therapy.

Colorectal cancer (CRC) is the third most commonly diagnosed cancer among both men and women worldwide. New therapeutic strategies involving cytoreductive surgery and intra-peritoneal chemotherapy could lead to a definitive cure in some cases. However, postoperative intra-abdominal adhesion can cause further complications. In this study, hyaluronic acid (HA)- and carboxymethyl cellulose sodium (CMCNa)-based novel cross-linked hydrogels (HC hydrogels) were synthesized and fully characterized. We demonstrated that varied compositions of HA and CMCNa altered the microstructure, rheology, and degradation behavior of hydrogels. Pre-constructed hydrogels were further loaded with oxaliplatin to prevent intra-abdominal adhesion following chemotherapy. Sustained release of oxaliplatin was observed from hydrogels compared that from solutions, which release drugs through diffusion, following the Higuchi and Korsmeyer-Peppas models. Moreover, low adhesion scores in an in vivo SD rat model demonstrated inhibition of intra-peritoneal adhesion in response to HC hydrogels. Therefore, HC hydrogels offer a novel formulation strategy for providing an intra-abdominal anti-adhesion barrier after cytoreductive surgery and intra-peritoneal chemotherapy for CRC treatment.

Growth of Silver Nanowires from Controlled Silver Chloride Seeds and Their Application for Fluorescence Enhancement Based on Localized Surface Plasmon Resonance.

A "Polyol" method has granted low-cost and facile process-controllability for silver-nanowire (Ag-NW) synthesis. Although homogenous and heterogeneous nucleation and growth during Ag-NW synthesis are possible using polyol methods, heterogeneous nucleation and growth of Ag NW guarantees highly selective growth of nanostructures using silver chloride (AgCl) seeds, which provides a stable source of chloride ions (Cl-) and thermodynamic reversibility. In this paper, a microdroplet has been adopted to synthesize uniform AgCl seeds with different diameter that are used for seed-mediated Ag-NW synthesis. The concentration of two precursors (AgNO3 and NaCl) in the droplets is modulated to produce different sizes of AgCl seeds, which determines the diameter and length of Ag NWs. The process of the seed-mediated growth of Ag NWs has been monitored by observing the peak shift in the time-resolved UV-vis extinction spectrum. Furthermore, the distinct plasmonic property of Ag NWs for transverse and longitudinal localized-surface-plasmon-resonance (LSPR)-mediated fluorescence enhancement is utilized. The high aspect ratio and sharp tips work as simple antennas that induce the enhanced fluorescence emission intensity of a fluorophore, which can be applied in the fields of biological tissue imaging and therapy.