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The “Fast track” protocol is an early extubation strategy to reduce ventilator-associated complications and induce early recovery after open-heart surgery. This study compared clinical outcomes between operating room extubation and ICU extubation after open-heart surgery in patients with CHD.
We retrospectively reviewed 215 patients who underwent open-heart surgery for CHDs under the scheduled “Fast track” protocol between September 2016 and April 2022. The clinical endpoints were post-operative complications, including bleeding, respiratory and neurological complications, and hospital/ICU stays.
The patients were divided into operating room extubation (group O, n = 124) and ICU extubation (group I, n=91) groups. The most frequently performed procedures were patch closures of the atrial septal (107/215, 49.8%) and ventricular septal (89/215, 41.4%) defects. There were no significant differences in major post-operative complications or ICU and hospital stay duration between the two groups; however, patients in group I showed longer mechanical ventilatory support (0.0 min vs. 59.0 min (interquartile range: 17.0–169.0), p < 0.001). Patients in Group O showed higher initial lactate levels (3.2 ± 1.7 mg/dL versus 2.5 ± 2.0 mg/dL, p = 0.007) and more frequently used additional sedatives and opioid analgesics (33.1% versus 19.8%, p = 0.031).
Extubation in the operating room was not beneficial for patients during post-operative ICU or hospital stay. Early extubation in the ICU resulted in more stable hemodynamics in the immediate post-operative period and required less use of sedatives and analgesics.
This study investigated the effect of the flavonoid-based compound isorhamnetin (ISO) on maturation and developmental competence in oxidative stress-exposed porcine oocytes in vitro. Treatment with 2 μM ISO (2 ISO) increases the developmental rate of oxidative stress-exposed porcine oocytes during in vitro maturation (IVM). The glutathione level and mRNA expression of antioxidant-related genes (NFE2L2 and SOD2) were increased in the 2 ISO-treated group, whereas the reactive oxygen species level was decreased. Treatment with 2 ISO increased mRNA expression of a cumulus cell expansion-related gene (SHAS2) and improved chromosomal alignment. mRNA expression of maternal genes (CCNB1, MOS, BMP15 and GDF9) and mitogen activated protein kinase (MAPK) activity were increased in the 2 ISO-treated group. The total cell number per blastocyst and percentage of apoptotic cells were increased and decreased in the 2 ISO-treated group, respectively. Treatment with 2 ISO increased mRNA expression of development-related genes (SOX2, NANOG, and POU5F1) and anti-apoptotic genes (BCL2L1 and BIRC5) and decreased that of pro-apoptotic genes (CASP3 and FAS). These results demonstrate that 2 ISO improves the quality of porcine oocytes by protecting them against oxidative stress during IVM and enhances subsequent embryo development in vitro. Therefore, we propose that ISO is a useful supplement for IVM of porcine oocytes.
Our previous studies have already revealed that β-cryptoxanthin (BCX), hesperetin (HES), and icariin (ICA) antioxidants are effective for in vitro maturation (IVM) of porcine oocytes. In this study, we investigated which of BCX, HES, or ICA was more effective for IVM of porcine oocytes. The antioxidant properties were assessed with aged porcine oocytes and embryos by comparing 2,2-diphenyl-1-(2,4,6-trinitrophenyl)hydrazyl (DPPH), reducing power, and H2O2 scavenging activity assays. The chemical assay results demonstrated that BCX had a greater DPPH scavenging activity and reducing power than HES and ICA, compared with controls. However, the H2O2 scavenging activity of the antioxidants was similar when tested at the optimal concentrations of 1 μM BCX (BCX-1), 100 μM HES (HES-100), and 5 μM ICA (ICA-5). The biological assay results showed that BCX-1 treatment was more effective in inducing a significant reduction in reactive oxygen species (ROS), improving glutathione levels, and increasing the expression of antioxidant genes. In addition, BCX-1 inhibited apoptosis by increasing the expression of anti-apoptotic genes and decreasing pro-apoptotic genes in porcine parthenogenetic blastocysts. BCX-1 also significantly increased the blastocyst formation rate compared with the ageing control group, HES-100 and ICA-5. This study demonstrates that damage from ROS produced during oocyte ageing can be prevented by supplementing antioxidants into the IVM medium, and BCX may be a potential candidate to improve assisted reproductive technologies.
Although neurocognitive dysfunction and physical performance are known to be impaired in patients with schizophrenia, evidence regarding the relationship between these two domains remains insufficient. Thus, we aimed to investigate the relationship between various physical performance domains and cognitive domains in individuals with schizophrenia, while considering other disorder-related clinical symptoms.
Sixty patients with schizophrenia participated in the study. Cardiorespiratory fitness and functional mobility were evaluated using the step test and supine-to-standing (STS) test, respectively. Executive function and working memory were assessed using the Stroop task and Sternberg working memory (SWM) task, respectively. Clinical symptoms were evaluated using the Brief Psychiatric Rating Scale, Beck Depression Inventory, and State-Trait Anxiety Inventory. Multivariate analyses were performed to adjust for relevant covariates and identify predictive factors associated with neurocognition.
Multiple regression analysis revealed that the step test index was most strongly associated with reaction time in the Stroop task (β = 0.434, p = 0.001) and SWM task (β = 0.331, p = 0.026), while STS test time was most strongly associated with accuracy on the Stoop task (β=−0.418, p = 0.001) and SWM task (β=−0.383, p = 0.007). Total cholesterol levels were positively associated with Stroop task accuracy (β=−0.307, p = 0.018) after controlling for other clinical correlates. However, clinical symptoms were not associated with any variables in Stroop or SWM task.
The present findings demonstrate the relationship between physical performance and neurocognition in patients with schizophrenia. Considering that these factors are modifiable, exercise intervention may help to improve cognitive symptoms in patients with schizophrenia, thereby leading to improvements in function and prognosis.
The in vitro corrosion mechanism of the biodegradable cast Mg–10% Ca binary alloy in Hanks' solution was evaluated through transmission electron microscopy observations. The corrosion behavior depends strongly on the microstructural peculiarity of Mg2Ca phase surrounding the island-like primary Mg phase and the fast corrosion induced by the interdiffusion of O and Ca via the Mg2Ca phase of lamellar structure. At the corrosion front, we found that a nanosized crack-like pathway was formed along the interface between the Mg2Ca phase and the primary Mg phase. Through the crack-like pathway, O and Ca are atomically exchanged each other and then the corroded Mg2Ca phase was transformed to Mg oxides. The in vitro corrosion by the exchange of Ca and O at the nanosized pathway led to the rapid bulk corrosion in the Mg–Ca alloys.
We present a rapid and sensitive surface acoustic wave (SAW) immunosensor that utilizes gold staining as a signal enhancement method. A sandwich immunoassay was performed on sensing area of the SAW sensor, which could specifically capture and detect cardiac markers (cardiac troponin I (cTnI), creatine kinase (CK)-MB, and myoglobin). The analytes in human serum were captured on gold nanoparticles (AuNPs) that were conjugated in advance with detection antibodies. Introduction of these complexes to the capture antibody-immobilized sensor surface resulted in a classic AuNP-based sandwich immunoassay format that has been used for signal amplification. In order to achieve further signal enhancement, a gold staining method was performed, which demonstrated that it is possible to obtain gold staining-mediated signal augmentation on a mass-sensitive device. The sensor response due to gold staining varied as a function of cardiac marker concentration.
We present a versatile and facile route for highly sensitive detection of
analytes through coupling the enlargement of gold nanoparticles (Au NPs)
with fluorescence decrease. The fluorescence intensity of dye molecules
(e.g., fluorescein or rhodamine B) significantly decreased with the
increasing concentration of reducing agents, such as hydrogen peroxide and
hydroquinone. The sensitivity for the detection of reducing agents was much
higher than other detection methods based on the absorbance measurement of
enlarged gold nanoparticles or quantum dot-enzyme hybridization. We could
successfully detect acetylthiocholine with the detection limit of several nM
orders, using an enzymatic reaction by acetylcholinesterase, a key route for
the detection of toxic organophosphate compounds. The fluorescence
decreasing approach described in this work requires only a simple addition
of fluorescence dye to the reaction solution without any chemical
modification. The strategy of fluorescence decrease coupled with
nanoparticle growth will be applied on the fluorescent substrate to develop
detection templates for highly sensitive optical biosensor.
We investigated the pressure dependence of the inductive coupled plasma (ICP) oxidation on the electrical characteristics of the thin oxide films. Activation energies and electron temperatures with different pressures were estimated. To demonstrate the pressure effect on the plasma oxide quality, simple N type metal-oxide-semiconductor (NMOS) transistors were fabricated and investigated in a few electrical properties. At higher pressure than 200mTorr, plasma oxide has a slightly higher on-current and a lower interfacial trap density. The on-current gain seems to be related to the field mobility increase and the lower defective interface to the electron temperature during oxidation.
A novel route to organic-inorganic composites was described based on biomineralization of poly(ethylene glycol) (PEG)-based hydrogels. The 3-dimensional hydrogels were synthesized by radical crosslinking polymerization of poly(ethylene glycol fumarate) (PEGF) in the presence of ethylene glycol methacrylate phosphate (EGMP) as an apatite-nuclating monomer, acrylamide (AAm) as a composition-modulating comonomer, and potassium persulfate (PPS) as a radical initiator. We used the urea-mediated solution precipitation technique for biomineralization of hydrogels. The apatite grown on the surface and interior of the hydrogel was similar to biological apatites in the composition and crystalline structure. Powder x-ray diffraction (XRD) showed that the calcium phosphate crystalline platelets on hydrogels are preferentially aligned along the crystallographic c-axis direction. Inductively-coupled plasma mass spectroscopy (ICP-MS) analysis showed that the Ca/P molar ratio of apatites grown on the hydrogel template was found to be 1.60, which is identical to that of natural bones. In vitro cell experiments showed that the cell adhesion/proliferation on the mineralized hydrogel was more pronounced than on the pure polymer hydrogel.
We synthesized bulk amorphous alloy systems of Cu43Zr43Al7X7 (X = Be, Ag; numbers indicate at.%), with the objective of simultaneously enhancing the glass-forming ability (GFA) and the plasticity. The alloys not only exhibit high plasticity (∼7%, ∼8%), but also possess enhanced GFA (alloys with 12 and 8 mm diameter). The possible mechanisms underlying this enhanced GFA and plasticity exhibited by these alloys are discussed based on the atomic-packing state and atomistic-scale compositional separation associated with the mixing enthalpy difference. A strategy for designing bulk amorphous alloys with simultaneous improvement in the GFA and the plasticity is proposed from the viewpoint of atomic-packing state and atomistic-scale phase separation.
W-rich particle-reinforced Ti-based bulk metallic glass (BMG) matrix composites with a compressive strength approaching 3 GPa and a fracture strain of approximately 12% were developed. In contrast to most existing BMG matrix composites, in which the improved ductility was obtained only at the expense of the strength, the composites developed in this study exhibited a significant enhancement in their strength, as well as an improvement in the plasticity. This improvement in the plasticity was attributed to the blocking and circumscription of the shear band propagation, leading to the formation of a large number of shear bands. Using a classical elasticity theory of inclusions, the improvement of the strength was interpreted as resulting from the generation of tensile residual stresses in the matrix due to the difference in the coefficient of thermal expansion between the W-rich particles and the BMG matrix.
The sliding friction and wear performance of Al–Ni–Co–Si quasicrystalline coatings deposited by the high-velocity oxy-fuel technique were investigated under dry sliding conditions. This study indicated that changes in the imposed sliding test conditions modified the friction and wear behavior of quasicrystalline coatings. Qualitative analysis of the contact interface and wear debris were performed with the aim of understanding the role of the third body on the friction and wear processes. The dependence of the coefficient of friction on the sliding velocity and counterpart material was explained by the stick-slip behavior. It was also shown that test conditions favorable for the formation of thick intermediate layers and the densification of the coating subsurface led to low wear rates. Large cylindrical particles, formed by agglomeration of small wear debris, were suggested as a beneficial factor for the reduction of the coefficient of friction.
A new self-aligned poly-Si TFT has been fabricated by employing a photoresist backside exposure technique. A pre-patterned aluminum (Al) layer on a-Si film not only induces the lateral grain growth (∼1.6 μm) in excimer laser crystallization but also implements the selfalignment of the gate region with the lateral grain region. Photoresist backside exposure through poly-Si film has been successfully performed because crystallized poly-Si has a fairly high UV transmittance. A self-aligned poly-Si TFT with a single grain boundary within the 2 μm channel was successfully fabricated and high on/off current ratio (∼107) was obtained.
The electrical and mechanical properties in indium-tin-oxide films deposited on polymer substrate were examined. The materials of substrates are polyethersulfone(PES), polycarbonate(PC), polyethylene terephthalate(PET) which have gas barrier layer and anti-glare coating for plastic-based devices. The experiments were performed by rf-magnetron sputtering using a special instrument and buffer layers. Therefore, we obtained a very flat polymer substrate deposited ITO film and investigated the effects of buffer layers, in addition to the instrument. Moreover, the influences of an oxygen partial pressure and post-deposition annealing in ITO films deposited on polymer substrates were clarified. X-ray diffraction observation, measurement of electrical property, and optical microscope observation were performed for the investigation of micro-structure and electro-mechanical properties. They indicated that as-deposited ITO thin films are amorphous and become quasi-crystalline after adjustment of oxygen partial pressure and thermal annealing above 180 °C. As the results, we obtained 20-25 Ω/ of ITO films with a good transmittance (above 80%) under 0.2 % oxygen contents and vacuum annealing. Furthermore, using organic buffer layer, we obtained ITO films which have rather high electrical resistance (40-45 Ω/ ) but have improved optical (more than 85%) and mechanical characteristics compared to the counterparts.
In this study, the quality of thin film diode (TFD) as a switching device for active-matrix liquid-crystal-displays (AM-LCDs) was enhanced by low temperature annealing conditions with high reliability and good electrical properties. Device was composed with Ta as bottom electrode, anodic Ta2O5 as insulator layer and top electrode. Two types of material such as Ti and Cr were evaluated as a top electrode of the TFD device to optimize the symmetry of current-voltage characteristic curve, respectively. The annealing was done at low temperature conditions below 350°C. The low temperature annealing improved the TFD device with nearly perfect symmetry under high electric field.
In this paper, we show that the absolute value of the signature of the 2-parallel version of a link is less than or equal to the nullity of it and show that the signature, nullity, and Minkowski units of the 2-parallel version of a certain class of links are always equal to 0, 2, and 1 respectively.
We have proposed and fabricated a new poly-Si TFT that employs selectively doped regions between the source and drain in order to reduce leakage current without the sacrifice of the on current. In the proposed poly-Si TFTs, the selectively doped regions where doping concentration is identical to that of source/drain, reduce the effective channel length during the on state. Under the off state, the selectively doped regions may reduce the lateral electric field induced in the depletion region near drain so that the leakage current reduces considerably. The experimental data of the proposed TFT shows that it has the high on-current, low leakage current and low threshold voltage when compared with conventional TFT. The fabrication steps for the proposed TFT are reduced because ion-implantation for source/drain and selectively doped regions is performed simultaneously prior to an excimer laser irradiation. It should be noted that, in the proposed TFT, only one excimer laser annealing is required while two excimer laser annealing steps are required in conventional TFT.
We propose new poly-Si TFT's with selectively doped region in the center of channel in order to reduce large leakage current. In proposed TFT's, the selectively doped region redistributes total induced electric field in the channel. For VGS<0, VDS> 0 in the n-channel proposed TFT's, most of the high electric field applies in the depletion regions which exist the drain/undoped region and undoped region/selectively doped region which faces to the source. Comparing with conventional TFT's, the electric field induced near the drain junction reduces to about 1/2, therefore, electron-hole pairs generated in drain junction are considerably reduced. Furthermore, the ON-current of proposed TFT's is the same or slightly lower than that of conventional ones. Consequently, the experimental data show the considerable improvement of the ON/OFF current ratio.
A novel method to control the recrystallization depth of amorphous silicon (a-Si) film during the excimer laser annealing (ELA) is proposed in order to preserve a-Si that is useful for fabrication of poly-Si TFT with a-Si offset in the channel. A XeCl excimer laser beam is irradiated on a triple film structure of a-Si thin native silicon oxide (~20Å)/thick a-Si layer. Only the upper a-Si film is recrystallized by the laser beam irradiation, whereas the lower thick a-Si film remains amorphous because the thin native silicon oxide layer stops the grain growth of the poly-crystalline silicon (poly-Si). So that the thin oxide film sharply divides the upper poly-Si from the lower a-Si.
Excimer laser annealing method employing artificial nucleation seed is proposed to increase the grain size of polycrystalline silicon(poly-Si). We utilize Si component incorporated in aluminum(Al)-sputtering source for the nucleation seed. Si clusters which are to be used as nucleation seed are successfully formed on the substrate by deposition and etch-back of Si-incorporated Al layer. Irradiation of excimer laser on amorphous silicon(a-Si) film deposited on the substrate prepared by our method results in enlargement of poly-Si grains, compared with conventional laser recrystallization. Poly-Si thin film transistor also shows much improved electrical perfbrmance which directly reflects the quality of poly-Si film recrystallized by our method.