Chiral-Induced Surface-Enhanced Raman Optical Activity on a Single-Particle Substrate.

Surface-enhanced Raman optical activity (SEROA) is a promising method for analyzing chiral molecules' molecular chirality and structural changes. However, conventional SEROA measurements face challenges related to substrate stability, signal uniformity, and interference from electronic circular dichroism (ECD). Therefore, in this study, we present a uniform and stable substrate for SEROA measurements by utilizing Au nanoparticles on the Au nanofilm structure to confine hotspots to the film-particle junctions and minimize ECD interference. This method also uses the induction of chirality from chiral molecules to achiral molecules to overcome the limitation of chiral molecules in SEROA measurements, specifically their lower signal efficiency. Successful chirality transfer is demonstrated through distinguishable SEROA signals when the l/d-alanine mixture is present. Enantiomeric discrimination of different l/d-alanine ratios was achieved with linear responses in the circular intensity difference (CID). Altogether, the proposed chiral-induced SEROA on the AuNP_on_AuNF substrate shows promising potential for detecting and characterizing structural changes in biomolecules, thus making it a valuable tool for various research applications.

Perioperative dobutamine infusion in an African lion (Panthera leo).

Laparoscopic ovariectomy under general anesthesia was planned in a 10-year-old, 146 kg, apparently healthy female African lion (Panthera leo). The lion was immobilized via intramuscular darts containing midazolam (0.033 mg/kg), medetomidine (50 µg/kg) and ketamine (2.5 mg/kg), and intubated using an endotracheal tube (16 mm internal diameter). The anesthesia was maintained using sevoflurane (0.9-2.1% end-tidal concentration), in combination with remifentanil (0.1 µg/kg/min) and ketamine (11 µg/kg/min) at a constant rate infusion (CRI), with Hartmann's solution (5 mL/kg/hr). Surgery was conducted with stable vital signs, but hypotension (mean arterial blood pressure 55 mmHg) developed, requiring dobutamine treatment. The hypotension was effectively controlled by adjusting dobutamine from 5 µg/kg/min to 0.2 to 0.3 µg/kg/min. This case suggests possibilities that dosages in this range can be clinically useful for peri-anesthetic hypotension in lions.

Repeated bolus injections of bupivacaine for continuous bilateral transversus thoracis plane block undergoing median sternotomy in a dog: A case report.

An 8-year-old, 6.5 kg, neutered female Shih-Tzu dog was presented for surgical resection of a mediastinal mass. A median sternotomy and left cranial lung lobectomy were performed. Intraoperatively, with the patient under general anaesthesia, a bilateral transversus thoracis plane (TTP) block was performed by injecting 0.5% bupivacaine (0.2 ml/kg) per side using real-time ultrasound guidance. After surgery, indwelling catheters for repeated bolus injections of bupivacaine in TTP were placed as follows: the fifth sternebra was palpated in dorsal recumbency, and the transducer was placed in the longitudinal plane lateral to the sternal border. A 16 gauge over-the-needle catheter was inserted caudo-cranially using an in-plane technique and located in the TTP. An intermittent bolus of bupivacaine (0.1 ml/kg) per side was injected via the indwelling catheter every 8 h for 3 days, with a constant rate infusion of an intravenous fentanyl (1 µg/kg/h) and ketamine (0.12 mg/kg/h) combination. Post-operative pain was evaluated using the Glasgow composite measure pain scale and the score was 4-5/24 on the day of surgery and gradually decreased over time. Additional rescue analgesia was not required. Repeated boluses of bupivacaine for a continuous bilateral TTP block may be a useful adjuvant for perioperative pain management strategies, including median sternotomy, in dogs.

Evaluation of a novel, low-cost, 3D printed video laryngoscope with borescope in anesthetized Beagle dogs.

OBJECTIVE: To develop and evaluate a low-cost three-dimensional (3D)-printed video laryngoscope (VLVET) for use with a commercial borescope. STUDY DESIGN: Instrument development and pilot study. ANIMALS: A total of six adult male Beagle dogs. METHODS: The VLVET consisted of a laryngoscope handle and a Miller-type blade, and a detachable camera holder that attached to various locations along the blade. The laryngoscope and camera holder were 3D-printed using black polylactic acid filament. Dogs were premedicated with intravenous (IV) medetomidine (15 µg kg-1) and anesthesia induced with IV alfaxalone (1.5 mg kg-1). The VLVET, combined with a borescope, was used for laryngeal visualization and intubation. Performance was evaluated by comparing direct and video-assisted views in sternal recumbency. The borescope camera was sequentially positioned at 2, 4, 6, 8 and 10 cm from the blade tip (distanceLARYNX-CAM), which was placed on the epiglottis during intubation or laryngoscopy. At the 10 cm distanceLARYNX-CAM, laryngeal visualization was sequentially scored at inter-incisor gaps of 10, 8, 6, 4 and 2 cm. Laryngeal visualization scores (0-3 range, with 0 = obstructed and 3 = unobstructed views) were statistically analyzed using the Friedman's test. RESULTS: Under direct visualization, the 2 cm distanceLARYNX-CAM had a significantly lower score compared with all other distanceLARYNX-CAM (all p = 0.014) because the view was obstructed by the camera holder and borescope camera. With both direct and camera-assisted views, visualization scores were higher at inter-incisor gaps ≥ 4 cm compared with 2 cm (all p < 0.05). CONCLUSIONS AND CLINICAL RELEVANCE: During laryngoscopy and intubation, the VLVET and borescope facilitated both direct and video laryngoscopy at distanceLARYNX-CAM in Beagle dogs when inter-incisor gaps were ≥ 4 cm.

Perianesthetic metabolic acidosis is associated with 2% dorzolamide eye drops in dogs that underwent ophthalmic surgery: a retrospective study (2019-2022).

OBJECTIVE: To evaluate whether the administration of 2% dorzolamide ophthalmic solution in dogs undergoing ophthalmic surgery is associated with perianesthetic metabolic acidosis. ANIMALS: 60 dogs, with or without dorzolamide administration, underwent arterial blood gas analysis immediately after anesthesia for ophthalmic surgery between 2019 and 2022; a total of 60 surgeries were evaluated. METHODS: This was a retrospective cross-sectional study. Logistic regression analysis was performed to investigate the association between the administration of 2% dorzolamide ophthalmic solution in dogs and the development of metabolic acidosis. Additionally, the influence of various potential risk factors, including age, body weight, sex, use of topical or systemic NSAIDs, and preoperative medications on the occurrence of metabolic acidosis, was evaluated. RESULTS: A significant association was found between the use of 2% dorzolamide ophthalmic solution and perianesthetic metabolic acidosis (OR, 6.79; 95% CI, 2.00 to 23.02; P = .002). Furthermore, topical dorzolamide administration was significantly associated with both perianesthetic hypokalemia (OR, 3.52; 95% CI, 1.11 to 11.20; P = .033) and perianesthetic hyperchloremia (OR, 9.25; 95% CI, 1.71 to 50.01; P = .010). CLINICAL RELEVANCE: The use of 2% dorzolamide ophthalmic solution is associated with perianesthetic metabolic acidosis, hypokalemia, and hyperchloremia in dogs. It is prudent to be aware of these risks, especially before anesthesia.

Switchable Chemical-Bond Reorganization for the Stable Charge Trapping in Amorphous Silicon Nitride.

Despite the widespread use of charge-trap flash (CTF) memory, the atomistic mechanism behind the exceptionally stable charge storage at the localized trap sites is still controversial. Herein, by combining first-principles calculations and orbital interaction analysis, a charge-dependent switchable chemical-bond reorganization is elucidated as the underpinning chemistry in the working mechanism of CTF. Especially, positively charged fourfold-coordinated nitrogen (dubbed N+ center), unappreciated until now, is the decisive component of the entire process; once an electron occupies this site, the N+ center disappears by breaking one N─Si bond, simultaneously forming a new Si─Si bond with a nearby Si atom which, in turn, creates fivefold coordinated Si. As a result, the electron is stored in a multi-center orbital belonging to multiple atoms including the newly formed Si─Si bond. It is also observed that hole trapping accompanies the creation of an N+ center by forming a new N─Si bond, which represents the reverse process. To further support and validate this model by means of core-level calculations, it is also shown that an N+ center's 1s core level is 1.0-2.5 eV deeper in energy than those of the threefold coordinated N atoms, in harmony with experimental X-ray photoelectron spectroscopy data.

Atomistic insights into adhesion characteristics of tungsten on titanium nitride using steered molecular dynamics with machine learning interatomic potential.

As transistor integration accelerates and miniaturization progresses, improving the interfacial adhesion characteristics of complex metal interconnect has become a major issue in ensuring semiconductor device reliability. Therefore, it is becoming increasingly important to interpret the adhesive properties of metal interconnects at the atomic level, predict their adhesive strength and failure mode, and develop computational methods that can be universally applied regardless of interface properties. In this study, we propose a method for theoretically understanding adhesion characteristics through steering molecular dynamics simulations based on machine learning interatomic potentials. We utilized this method to investigate the adhesion characteristics of tungsten deposited on titanium nitride barrier metal (W/TiN) as a representative metal interconnect structure in devices. Pulling tests that pull two materials apart and sliding tests that pull them against each other in a shear direction were implemented to investigate the failure mode and adhesive strength depending on TiN facet orientation. We found that the W/TiN interface showed an adhesive failure where they separate from each other when tested with pulling force on Ti-rich (111) or (001) facets while cohesive failures occurred where W itself was destroyed on N-rich (111) facet. The adhesion strength was defined as the maximum force causing failure during the pulling test for consistent interpretation and the strengths of tungsten were predicted to be strongest when deposited onto N-rich (111) facet while weakest on Ti-rich (111) facet.

Novel Mechanism-Based Descriptors for Extreme Ultraviolet-Induced Photoacid Generation: Key Factors Affecting Extreme Ultraviolet Sensitivity.

Predicting photolithography performance in silico for a given materials combination is essential for developing better patterning processes. However, it is still an extremely daunting task because of the entangled chemistry with multiple reactions among many material components. Herein, we investigated the EUV-induced photochemical reaction mechanism of a model photoacid generator (PAG), triphenylsulfonium cation, using atomiC-Scale materials modeling to elucidate that the acid generation yield strongly depends on two main factors: the lowest unoccupied molecular orbital (LUMO) of PAG cation associated with the electron-trap efficiency 'before C-S bond dissociation' and the overall oxidation energy change of rearranged PAG associated with the proton-generation efficiency 'after C-S bond dissociation'. Furthermore, by considering stepwise reactions accordingly, we developed a two-parameter-based prediction model predicting the exposure dose of the resist, which outperformed the traditional LUMO-based prediction model. Our model suggests that one should not focus only on the LUMO energies but also on the energy change during the rearrangement process of the activated triphenylsulfonium (TPS) species. We also believe that the model is well suited for computational materials screening and/or inverse design of novel PAG materials with high lithographic performances.

Layered hydrated-titanium-oxide-laden reduced graphene oxide composite as a high-performance negative electrode for selective extraction of Li via membrane capacitive deionization.

In this work, we initially prepared layered lithium titanate (Li2TiO3) using a solid-state reaction. Then Li+ of Li2TiO3 were acid-eluded with Hydrochloric acid to obtain hydrated titanium oxide (H2TiO3). Different weight percentages (50%, 60%, 70%, 80%, and 90%) of the as-prepared H2TiO3 were deposited on a conductive reduced graphene oxide (rGO) matrix to obtain a series of rGO/ H2TiO3 composites. Of the prepared composites, rGO/H2TiO3-60% showed excellent current density, high specific capacitance, and rapid ion diffusion. An asymmetric MCDI (membrane capacitive deionization) cell fabricated with activated carbon as the anode and rGO/H2TiO3-60% as the cathode displayed outstanding Li+ electrosorption capacity (13.67 mg g-1) with a mean removal rate of 0.40 mg g-1 min-1 in a 10 mM LiCl aqueous solution at 1.8 V. More importantly, the rGO/H2TiO3-60% composite electrode exhibited exceptional Li+ selectivity, superior cyclic stability up to 100,000 s, and a Li+ sorption capacity retention of 96.32% after 50 adsorption/desorption cycles. The excellent Li+ extraction obtained by MCDI using the rGO/H2TiO3-60% negative electrode was putatively attributed to: (i) ion exchange between Li+ and H+ of H2TiO3; (ii) the presence of narrow lattice spaces in H2TiO3 suitable for selective Li+ capture; (iii) capture of Li+ by isolated and hydrogen-bonded hydroxyl groups of H2TiO3; and (iv) enhanced interfacial contact and transfer of large numbers of Li+ ions from the electrolyte to H2TiO3 achieved by compositing H2TiO3 with a highly conductive rGO matrix.

Evaluation of an automatic approach device to the epidural space of Beagle dogs.

OBJECTIVE: To compare the epidural anesthesia device (EPIA), which facilitates an automatic approach to location of the epidural space, with the performance of clinicians using tactile sensation and differences in pressure when inserting an epidural needle into the epidural space of a dog. STUDY DESIGN: Prospective, crossover experiment. ANIMALS: A total of 14 Beagle dogs weighing 7.5 ± 2.4 kg (mean ± standard deviation). METHODS: Each dog was anesthetized three times at 2 week intervals for three anesthesiologists (two experienced, one novice) to perform 14 epidural injections (seven manual and EPIA device each). The sequence of methods was assigned randomly for each anesthesiologist. The dogs were anesthetized with medetomidine (10 µg kg-1), alfaxalone (2 mg kg-1) and isoflurane and positioned in sternal recumbency with the pelvic limbs extended cranially. Epidural puncture in the manual method was determined by pop sensation, hanging drop technique and reduced injection pressure, whereas using the device a sudden decrease in reaction force on the device was detected. A C-arm identified needle placement in the epidural space, and after administration of iohexol (0.3 mL), the needle length in the epidural space was defined as the mean value measured by three radiologists. Normality was tested using the Kolmogorov-Smirnov test, and significant differences between the two methods were analyzed using an independent sample t test. RESULTS: In both methods, the success rates of epidural insertion were the same at 95.2%. The length of the needle in the epidural space using the device and manual methods was 1.59 ± 0.50 and 1.68 ± 0.88 mm, respectively, with no significant difference (p = 0.718). CONCLUSIONS AND CLINICAL RELEVANCE: EPIA device was comparable to human tactile sense for an epidural needle insertion in Beagle dogs. Further research should be conducted for application of the device in clinical environments.

Agreement Between Tongue-Based Oscillometric and Invasive Blood Pressure in Anesthetized Dogs of Various Weights.

This study aimed to evaluate the agreement between oscillometric blood pressure (OBP) measured from the tongue and invasive blood pressure (IBP) measured from the dorsal pedal artery in anesthetized dogs of various body weights. Forty-five client-owned dogs undergoing general anesthesia for surgery or imaging scan were included; weights ranged from 2.5 to 42.6 kg. Agreement between paired IBP and OBP during normotension was verified with reference standards used in small animals and humans. The data were stratified by body weight (≤5 kg versus >5 kg). In the >5 kg group (n = 29), the bias ± standard deviation for mean (2.1 ± 7.9 mm Hg) and diastolic pressure (-2.7 ± 7.9 mm Hg) exhibited reliability that met human standards (<5 ± 8 mm Hg). However, in the ≤5 kg group (n = 16), the bias ± standard deviation met only veterinary standards (≤10 ± 15 mm Hg) for mean (3.1 ± 10.2 mm Hg) and diastolic pressure (-2.5 ± 12.6 mm Hg). Agreement for systolic pressure did not meet either standard for both groups. This study demonstrates that tongue-based OBP is a close estimate of mean/diastolic blood pressure in anesthetized dogs (>5 kg) during normotension by small-animal and human criteria.

Transillumination facilitates coccygeal arterial cannulation in anaesthetised small-breed dogs.

BACKGROUND: Arterial access in small-breed dogs is challenging, but arterial visualisation may facilitate the procedure, as evidenced in human medicine. This prospective, randomised study investigated the result of using transillumination to guide coccygeal artery cannulation in small-breed dogs. METHODS: Coccygeal artery cannulation was attempted in dogs anaesthetised with butorphanol, midazolam, propofol and sevoflurane. In 70 dogs (standard technique group [STECHNIQUE group]), arterial cannulation was performed using pulse palpation. In 71 dogs (transilluminating-standard technique group [TSTECHNIQUE group]), a transilluminating device was utilised. The device was placed on the dorsal tail, and the cannula was advanced towards the dark line visible against the bright background. If the artery was not well visualised due to pigmentation, pulse palpation was used. The success rate of arterial cannulation was compared between the groups using the chi-squared test. RESULTS: Arterial cannulation was significantly more successful (p < 0.001) in the TSTECHNIQUE group (63/71 [88.7%]) than in the STECHNIQUE group (43/70 [61.4%]). LIMITATIONS: The number of punctures attempted and the time to cannulation were not assessed, and the procedure was only performed by veterinarians experienced in arterial cannulation. CONCLUSIONS: The transillumination allows for a more accurate approach to the coccygeal artery, improving the success of arterial cannulation when combined with pulse palpation.

Percentages of Hepatocellular Carcinoma in LI-RADS Categories with CT and MRI: A Systematic Review and Meta-Analysis.

Background The Liver Imaging Reporting and Data System (LI-RADS) CT and MRI algorithm applies equally to CT, MRI with extracellular contrast agents (ECA-MRI), and MRI with gadoxetate (Gx-MRI). Purpose To estimate pooled percentages of hepatocellular carcinoma (HCC) and overall malignancy for each LI-RADS category with CT and MRI. Materials and Methods MEDLINE and EMBASE databases were searched for research articles (January 2014-April 2021) reporting the percentages of observations in each LI-RADS category with use of versions 2014, 2017, or 2018. Study design, population characteristics, imaging modality, reference standard, and numbers of HCC and non-HCC malignancies in each category were recorded. A random-effects model evaluated the pooled percentage of HCC and overall malignancy for each category. Results There were 49 studies with 9620 patients and a total 11 562 observations, comprising 7921 HCCs, 1132 non-HCC malignancies, and 2509 benign entities. No HCC or non-HCC malignancies were reported with any modality in the LR-1 category. The pooled percentages of HCC for CT, ECA-MRI, and Gx-MRI, respectively, were 10%, 6%, and 1% for LR-2 (P = .16); 48%, 31%, and 38% for LR-3 (P = .42); 76%, 64%, and 77% for LR-4 (P = .62); 96%, 95%, and 96% for LR-5 (P = .76); 88%, 76%, and 78% for LR-5V or LR-TIV (tumor in vein) (P = .42); and 20%, 30%, and 35% for LR-M (P = .32). Most LR-M (93%-100%) and LR-5V or LR-TIV (99%-100%) observations were malignant, regardless of modality. Conclusion There was no difference in percentages of hepatocellular carcinoma and overall malignancy between CT, MRI with extracellular contrast agents, and MRI with gadoxetate for any Liver Imaging Reporting and Data System categories. © RSNA, 2023 Supplemental material is available for this article See also the editorial by Ronot in this issue.

On the atomistic origin of the polymorphism and the dielectric physical properties of beryllium oxide.

Polymorphic beryllium oxide has been theoretically investigated from first principles as regards orbital occupancies, chemical bonding, polarization, as well as dielectric properties. By means of Crystal-Orbital Bond Index (COBI) analysis, the important role of the 2p orbitals on beryllium has been elucidated, in particular in terms of the correlation between polarization and beryllium-atom displacement, including the impact of the latter on the covalency of the BeO bond. In addition, several structural possibilities for a Bex Mg1-x O solid solution have been investigated for a Be content between 6% and 22%; for those, dynamically stable structures have been found, displaying large polarization values, more covalent BeO bonds, and a tendency for tetrahedral Be coordination. The dynamically unstable structures, however, resemble rock-salt BeO in their local structural properties around the Be atom. High dielectric constants and band gaps indicating insulating behavior have been found for those.

Diagnostic Performance of LI-RADS v2018 versus KLCA-NCC 2018 Criteria for Hepatocellular Carcinoma Using Magnetic Resonance Imaging with Hepatobiliary Agent: A Systematic Review and Meta-Analysis of Comparative Studies.

Background/Aims: To compare the performance of the Liver Imaging Reporting and Data System (LI-RADS) v2018 and Korean Liver Cancer Association-National Cancer Center (KLCA-NCC) 2018 criteria for diagnosing hepatocellular carcinoma (HCC) using magnetic resonance imaging (MRI) with hepatobiliary agent (HBA). Methods: We searched the MEDLINE and EMBASE for studies from January 1, 2018, to October 20, 2021, that compared the diagnostic performance of two imaging criteria on HBA-MRI. A bivariate random-effects model was fitted to calculate the per-observation sensitivity and specificity, and the estimates of paired data were compared. Subgroup analysis was performed based on the observation size. Meta-regression analysis was also performed for study heterogeneity. Results: Of the six studies included, the pooled sensitivity of the definite HCC category of the KLCA-NCC criteria (82%; 95% confidence interval [CI], 74% to 90%; I2=84%) was higher than that of LR-5 of LI-RADS v2018 (65%; 95% CI, 52% to 77%; I2=96%) for diagnosing HCC (p<0.001), while the specificity was lower for KLCA-NCC criteria (87%; 95% CI, 84% to 91%; I2=0%) than LI-RADS v2018 (93%; 95% CI, 91% to 96%; I2=0%) (p=0.017). For observations sized ≥20 mm, the sensitivity was higher for KLCA-NCC 2018 than for LI-RADS v2018 (84% vs 74%, p=0.012), with no significant difference in specificity (81% vs 85%, p=0.451). The reference standard was a significant factor contributing to the heterogeneity of sensitivities. Conclusions: The definite HCC category of KLCA-NCC 2018 provided a higher sensitivity and lower specificity than the LR-5 of LI-RADS v2018 for diagnosing HCC using MRI with HBA.

Effects of radiofrequency catheter ablation for premature ventricular complexes originating from the right ventricular outflow tract on right ventricular function.

INTRODUCTION: This study aimed to elucidate the relationship between premature ventricular complexes (PVCs) and right ventricular (RV) dysfunction, and the effects of radiofrequency catheter ablation (RFCA) on RV function. METHODS: A total of 110 patients (age, 50.8 ± 14.4 years; 30 men) without structural heart disease who had undergone RFCA for RV outflow tract (RVOT) PVCs were retrospectively included. RV function was assessed using fractional area change (FAC) and global longitudinal strain (GLS) before and after RFCA. Clinical data were compared between the RV dysfunction (n = 63) and preserved RV function (n = 47) groups. The relationship between PVC burden and RV function was analyzed. Change in RV function before and after RFCA was compared between patients with successful and failed RFCA. RESULTS: PVC burden was significantly higher in the RV dysfunction group than in the preserved RV function group (p < .001). FAC and GLS were significantly worse in proportion to PVC burden (p < .001 and p < .001, respectively). The risk factor associated with RV dysfunction was PVC burden [odds ratio (95% confidence interval), 1.092 (1.052-1.134); p < .001]. Improvement in FAC (13.0 ± 8.7% and -2.5 ± 5.6%, respectively; p < .001) and GLS (-6.8 ± 5.7% and 2.1 ± 4.2%, respectively; p < .001) was significant in the patients with successful RFCA, compared to the patients in whom RFCA failed. CONCLUSIONS: Frequent RVOT PVCs are associated with RV dysfunction. RV dysfunction is reversible by successful RFCA.

Effect of temperature-responsive hydrogel on femoral and sciatic nerve blocks using bupivacaine in Beagle dogs.

OBJECTIVES: To compare the duration of regional anesthesia of the pelvic limb using bupivacaine with and without a temperature-responsive hydrogel (TRH) in dogs. METHODS: Under anesthesia using medetomidine (10 µg·kg-1 ), alfaxalone (2 mg·kg-1 ), and isoflurane, seven healthy male Beagles received four injections of 0.5% bupivacaine (1 mg·kg-1 with 5 µg·ml-1 epinephrine) to block the femoral and sciatic nerves bilaterally via ultrasound with nerve stimulation guidance. Bupivacaine was used on one pelvic limb (Bup treatment), and bupivacaine with TRH was used on the contralateral limb (Bup-TRH treatment). The nerve block was considered successful upon the absence of responses to pinching the digital pads and mid-tibial skin of both pelvic limbs with mosquito forceps; the pinch, proprioception, and locomotion tests were performed before (baseline) and at each hour after the nerve block until sensory and motor functions returned to baseline. The effect of TRH on nerve blocks was analyzed using a linear mixed model. RESULTS: The duration of the sensory nerve block at the digital pads and mid-tibial skin was longer with Bup-TRH (8.0 ± 1.6 h and 10.9 ± 1.6 h, respectively) than with Bup treatment (3.7 ± 2.0 h and 8.0 ± 1.6 h, respectively). Motor block times of proprioception and locomotion were longer with Bup-TRH (9.3 ± 1.6 and 12.7 ± 1.5 h, respectively) than with Bup treatment (4.6 ± 1.9 and 9.6 ± 1.5 h, respectively). No complications were observed. CLINICAL SIGNIFICANCE: TRH extended the duration of regional anesthesia of the pelvic limb using bupivacaine.

Risk factors for lower extremity lymphedema after surgery in cervical and endometrial cancer.

OBJECTIVE: Lower extremity lymphedema (LEL) is a well-known adverse effect related to cervical and endometrial cancer (CEC); however, very few studies have elucidated the clinicopathologic risk factors related to LEL. We investigated the incidence and risk factors in patients who received primary surgery and/or adjuvant radiotherapy (RT) or chemotherapy for CEC. METHODS: We retrospectively reviewed 2,565 patients who underwent primary surgery following CEC diagnosis between January 2007 and December 2020. LEL diagnosis was based on objective and subjective assessments by experts. We identified important predictors of LEL to construct a nomogram predicting individual risks of LEL. For internal validation of the nomogram, the original data were separated using the split-sample method in a 7:3 ratio of training data and test data. RESULTS: Overall, 858 patients (33.5%) received RT, 586 received external beam RT (EBRT), and 630 received intracavitary RT. During follow-up period, LEL developed in 331 patients, with an overall cumulative 5-year incidence of 13.3%. In multivariate analysis, age at primary treatment, use of docetaxel-based chemotherapy, type of hysterectomy, type of surgical pelvic lymph node (LN) assessment, number of dissected pelvic and para-aortic LNs, and EBRT field were the independent predictors of LEL. We subsequently developed the nomogram showing excellent predictive power for LEL. CONCLUSION: LEL is associated with various treatment modalities, and their interactions may increase the possibility of occurrences. De-escalation strategies for treatment modalities should be considered to reduce LEL in patients with CEC.

In vivo surface-enhanced Raman scattering nanosensor for the real-time monitoring of multiple stress signalling molecules in plants.

When under stress, plants release molecules to activate their defense system. Detecting these stress-related molecules offers the possibility to address stress conditions and prevent the development of diseases. However, detecting endogenous signalling molecules in living plants remains challenging due to low concentrations of these analytes and interference with other compounds; additionally, many methods currently used are invasive and labour-intensive. Here we show a non-destructive surface-enhanced Raman scattering (SERS)-based nanoprobe for the real-time detection of multiple stress-related endogenous molecules in living plants. The nanoprobe, which is placed in the intercellular space, is optically active in the near-infrared region (785 nm) to avoid interferences from plant autofluorescence. It consists of a Si nanosphere surrounded by a corrugated Ag shell modified by a water-soluble cationic polymer poly(diallyldimethylammonium chloride), which can interact with multiple plant signalling molecules. We measure a SERS enhancement factor of 2.9 × 107 and a signal-to-noise ratio of up to 64 with an acquisition time of ~100 ms. To show quantitative multiplex detection, we adopted a binding model to interpret the SERS intensities of two different analytes bound to the SERS hot spot of the nanoprobe. Under either abiotic or biotic stress, our optical nanosensors can successfully monitor salicylic acid, extracellular adenosine triphosphate, cruciferous phytoalexin and glutathione in Nasturtium officinale, Triticum aestivum L. and Hordeum vulgare L.-all stress-related molecules indicating the possible onset of a plant disease. We believe that plasmonic nanosensor platforms can enable the early diagnosis of stress, contributing to a timely disease management of plants.