Anesthetic Management of a Patient With Spinocerebellar Ataxia Type 1.

Spinocerebellar ataxia type 1 (SCA1) is one of the autosomal dominant spinocerebellar degeneration (SCD) diseases characterized by progressive cerebellar ataxia, muscle atrophy, and peripheral neuropathy. We report the management of a 43-year-old man with SCA1 who underwent general anesthesia for open reduction and internal fixation of a mandibular fracture. Although anesthesia-induced vocal cord paralysis has been reported in patients with SCD, nasotracheal intubation was performed uneventfully with video laryngoscope. After taking into consideration the increased risk of postoperative respiratory depression in patients with SCD, rocuronium dosing was titrated carefully, and fentanyl was not used during surgery. Preparation for an anticipated difficult airway and avoiding significant respiratory depression are crucial when providing general anesthesia for patients with SCA1.

Effectiveness of Indirect and Direct Laryngoscopes in Pediatric Patients: A Systematic Review and Network Meta-Analysis.

This research aimed to produce a coherent ranking of the effectiveness of intubation devices in pediatric patients using network meta-analysis (NMA). We searched the electric databases for prospective randomized studies that compared different tracheal intubation devices in pediatric patients. The primary outcome was intubation failure at the first attempt. Secondary outcomes were glottic visualization and intubation time. The statistical analysis performed used DerSimonian and Laird random-effects models. Frequentist network meta-analysis was conducted, and network plots and network league tables were produced. Subgroup analysis was performed after excluding rigid-fiberscope-type indirect laryngoscopes. Thirty-four trials comparing 13 devices were included. Most laryngoscopes had the same intubation failure rate as the Macintosh reference device. Only the Truview PCD™ had a significantly higher intubation failure rate than the Macintosh (odds ratio 4.78, 95% confidence interval 1.11-20.6) The highest-ranking laryngoscope was the Airtaq™ (P score, 0.90), and the AirwayScope™, McGrath™, and Truview EVO2™ ranked higher than the Macintosh. The Bullard™ had the lowest ranking (P score, 0.08). All laryngoscopes had the same level of glottic visualization as the Macintosh and only the C-MAC™ had a significantly shorter intubation time. Intubation time was significantly longer when using the GlideScope™, Storz DCI™, Truview PCD™, or Bullard™ compared with the Macintosh. P score and ranking of devices in the subgroup analyses were similar to those in the main analysis. We applied NMA to create a consistent ranking of the effectiveness of intubation devices in pediatric patients. The findings of NMA suggest that there is presently no laryngoscope superior to the Macintosh laryngoscope in terms of tracheal intubation failure rate and glottic visualization in pediatric patients.

Photoactivation of Strong Photoluminescence in Superacid-Treated Monolayer Molybdenum Disulfide.

To advance the development of atomically thin optoelectronics using two-dimensional (2D) materials, engineering strong luminescence with a physicochemical basis is crucial. Semiconducting monolayer transition-metal dichalcogenides (TMDCs) are candidates for this, but their quantum yield (QY) is known to be poor. Recently, a molecular superacid treatment of bis(trifluoromethane)sulfonimide (TFSI) generated unambiguously bright monolayer TMDCs and a high QY. However, this method is highly dependent on the processing conditions and therefore has not been generalized. Here, we shed light on environmental factors to activate the photoluminescence (PL) intensity of the TFSI-treated monolayer MoS2, with a factor of more than 2 orders of magnitude greater than the original by photoactivation. The method is useful for both mechanically exfoliated and chemically deposited samples. The existence of photoirradiation larger than the band gap demonstrates enhancement of the PL of MoS2; on the other hand, activation by thermal annealing, as demonstrated in the previous report, is less effective for enhancing the PL intensity. The photoactivated monolayer MoS2 shows a long lifetime of ∼1.35 ns, more than a 30-fold improvement over the original as exfoliated. The consistent realization of the bright monolayer MoS2 reveals that air exposure is an essential factor in the process. TFSI treatment in a N2 environment was not effective for achieving a strong PL, even after the photoactivation. These findings can serve as a basis for engineering the bright atomically thin materials for 2D optoelectronics.

Surface Degradation Mechanism on CH3NH3PbBr3 Hybrid Perovskite Single Crystal by a Grazing E-Beam Irradiation.

To start a step such as some realization of minimized and integrated devices, it requires simply understanding the surface status of hybrid perovskite on the e-beam irradiation because many commercial semiconductor devices are performed with a surface patterning process using e-beam or etching gas. The surface status of CH3NH3PbBr3 (MAPbBr3) single crystal was studied after a grazing e-beam irradiation in an ultra-high vacuum. The prepared hybrid perovskite single crystal was irradiated by the 3 degree-grazing e-beam with energy of 15 kV for 10 min using a reflection high-electron energy diffraction technique. The e-beam irradiation on the MAPbBr3 hybrid perovskite single crystal induced the deformation from MAPbBr3 into MABr, Br2, and Pb on the surface. The gas phases of MABr and Br2 are depleted from the surface and the Pb element has remained on the surface. As a result of the e-beam irradiation, it formed a polycrystalline-like phase and Pb metal particles on the surface, respectively.

Visualization of in-plane dispersion of hole subbands by photoelectron spectroscopy.

The in-plane dispersion of the hole subband (HSB) in a Si quantum well is obtained for the first time by applying angle-resolved photoemission spectroscopy and surface science techniques. The entire shape of the HSB over a wide ranged wave vector, including admixing of heavy and light hole subbands around the crossing point and the camelback structure inducing negative effective mass, is visualized directly. Energy separations between the subbands are quantitatively explained.