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Beyond the macroscopic perspective, this study microscopically investigates Si 1-x Ge x (001)-2×1 samples that were grown on the epi Ge(001) and epi Si(001) substrates via molecular-beam epitaxy, using the high-resolution synchrotron radiation photoelectron spectroscopy (SRPES) as a probe. The low-energy electron diffraction equipped in the SRPES chamber showed 2×1 double-domain reconstruction. Analyses of the Ge 3d core-level spectra acquired using different photon energies and emission angles consistently reveal the ordered spots to be in a Ge-Ge tilted configuration, which is similar to that in epi Ge(001)-2×1. It was further found that the subsurface layer was actually dominated by Ge, which supported the buckled configuration. The Si atoms were first found in the third surface layer. These Si atoms were further divided into two parts, one underneath the Ge-Ge dimer and one between the dimer row. The distinct energy positions of the Si 2p core-level spectrum were caused by stresses, not by charge alternations.

To realize the quantum anomalous Hall effect (QAHE) at elevated temperatures, the approach of magnetic proximity effect (MPE) was adopted to break the time-reversal symmetry in the topological insulator (Bi 0.3 Sb 0.7 ) 2 Te 3 (BST) based heterostructures with a ferrimagnetic insulator europium iron garnet (EuIG) of perpendicular magnetic anisotropy. Here we demonstrate large anomalous Hall resistance ( R AHE ) exceeding 8 Ω ( ρ AHE of 3.2 μΩ·cm) at 300 K and sustaining to 400 K in 35 BST/EuIG samples, surpassing the past record of 0.28 Ω ( ρ AHE of 0.14 μΩ·cm) at 300 K. The large R AHE is attributed to an atomically abrupt, Fe-rich interface between BST and EuIG. Importantly, the gate dependence of the AHE loops shows no sign change with varying chemical potential. This observation is supported by our first-principles calculations via applying a gradient Zeeman field plus a contact potential on BST. Our calculations further demonstrate that the AHE in this heterostructure is attributed to the intrinsic Berry curvature. Furthermore, for gate-biased 4 nm BST on EuIG, a pronounced topological Hall effect-like (THE-like) feature coexisting with AHE is observed at the negative top-gate voltage up to 15 K. Interface tuning with theoretical calculations has realized topologically distinct phenomena in tailored magnetic TI-based heterostructures.

Introduction: The COVID-19 pandemic has brought unprecedented numbers of patients with acute respiratory distress to medical centers. Hospital systems require rapid adaptation to respond to the increased demand for airway management while ensuring high quality patient care and provider safety. There is limited literature detailing successful system-level approaches to adapt to the surge of COVID-19 patients requiring airway management., Methods: A deliberate system-level approach was used to expand a preexisting airway response service. Through a needs analysis (taking into account both existing resources and anticipated demands), we established priorities and solutions for the airway management challenges encountered during the pandemic., Results: During our COVID-19 surge (March 10, 2020, through May 26, 2020), there were 619 airway consults, and the COVID airway response team (CART) performed 341 intubations. Despite a 4-fold increase in intubations during the surge, there was no increase in cardiac arrests or surgical airways and no documented COVID-19 infections among the CART., Conclusions: Our system-level approach successfully met the sudden escalation in demand in airway management incurred by the COVID-19 surge. The approach that addressed staffing needs prioritized provider protection and enhanced quality and safety monitoring may be adaptable to other institutions., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2021 National Association for Healthcare Quality.)

The role of an atomic-layer thick periodic Y-O array in inducing the epitaxial growth of single-crystal hexagonal YAlO 3 perovskite (H-YAP) films was studied using high-angle annular dark-field and annular bright-field scanning transmission electron microscopy in conjunction with a spherical aberration-corrected probe and in situ reflection high-energy electron diffraction. We observed the Y-O array at the interface of amorphous atomic layer deposition (ALD) sub-nano-laminated (snl) Al 2 O 3 /Y 2 O 3 multilayers and GaAs(111)A, with the first film deposition being three cycles of ALD-Y 2 O 3 . This thin array was a seed layer for growing the H-YAP from the ALD snl multilayers with 900 °C rapid thermal annealing (RTA). The annealed film only contained H-YAP with an excellent crystallinity and an atomically sharp interface with the substrate. The initial Y-O array became the bottom layer of H-YAP, bonding with Ga, the top layer of GaAs. Using a similar ALD snl multilayer, but with the first film deposition of three ALD-Al 2 O 3 cycles, there was no observation of a periodic atomic array at the interface. RTA of the sample to 900 °C resulted in a non-uniform film, mixing amorphous regions and island-like H-YAP domains. The results indicate that the epitaxial H-YAP was induced from the atomic-layer thick periodic Y-O array, rather than from GaAs(111)A.

Background: Limited data exist regarding ventilation in patients with class III obesity [body mass index (BMI) > 40 kg/m 2 ] and acute respiratory distress syndrome (ARDS). The aim of the present study was to determine whether an individualized titration of mechanical ventilation according to cardiopulmonary physiology reduces the mortality in patients with class III obesity and ARDS., Methods: In this retrospective study, we enrolled adults admitted to the ICU from 2012 to 2017 who had class III obesity and ARDS and received mechanical ventilation for > 48 h. Enrolled patients were divided in two cohorts: one cohort (2012-2014) had ventilator settings determined by the ARDSnet table for lower positive end-expiratory pressure/higher inspiratory fraction of oxygen (standard protocol-based cohort); the other cohort (2015-2017) had ventilator settings determined by an individualized protocol established by a lung rescue team (lung rescue team cohort). The lung rescue team used lung recruitment maneuvers, esophageal manometry, and hemodynamic monitoring., Results: The standard protocol-based cohort included 70 patients (BMI = 49 ± 9 kg/m 2 ), and the lung rescue team cohort included 50 patients (BMI = 54 ± 13 kg/m 2 ). Patients in the standard protocol-based cohort compared to lung rescue team cohort had almost double the risk of dying at 28 days [31% versus 16%, P = 0.012; hazard ratio (HR) 0.32; 95% confidence interval (CI95%) 0.13-0.78] and 3 months (41% versus 22%, P = 0.006; HR 0.35; CI95% 0.16-0.74), and this effect persisted at 6 months and 1 year (incidence of death unchanged 41% versus 22%, P = 0.006; HR 0.35; CI95% 0.16-0.74)., Conclusion: Individualized titration of mechanical ventilation by a lung rescue team was associated with decreased mortality compared to use of an ARDSnet table.

In this paper, we investigate the embryonic stage of oxidation of an epi Ge(001)-2 × 1 by atomic oxygen and molecular O₂ via synchrotron radiation photoemission. The topmost buckled surface with the up- and down-dimer atoms, and the first subsurface layer behaves distinctly from the bulk by exhibiting surface core-level shifts in the Ge 3d core-level spectrum. The O₂ molecules become dissociated upon reaching the epi Ge(001)-2 × 1 surface. One of the O atoms removes the up-dimer atom and the other bonds with the underneath Ge atom in the subsurface layer. Atomic oxygen preferentially adsorbed on the epi Ge(001)-2 ×1 in between the up-dimer atoms and the underneath subsurface atoms, without affecting the down-dimer atoms. The electronic environment of the O-affiliated Ge up-dimer atoms becomes similar to that of the down-dimer atoms. They both exhibit an enrichment in charge, where the subsurface of the Ge layer is maintained in a charge-deficient state. The dipole moment that was originally generated in the buckled reconstruction no longer exists, thereby resulting in a decrease in the ionization potential. The down-dimer Ge atoms and the back-bonded subsurface atoms remain inert to atomic O and molecular O₂, which might account for the low reliability in the Ge-related metal-oxide-semiconductor (MOS) devices., Competing Interests: The authors declare no conflict of interest.

Thulium iron garnet (TmIG) films with perpendicular magnetic anisotropy (PMA) were grown on gadolinium gallium garnet (GGG) (111) substrates by off-axis sputtering. High-resolution synchrotron radiation X-ray diffraction studies and spherical aberration-corrected scanning transmission electron microscope (Cs-corrected STEM) images showed the excellent crystallinity of the films and their sharp interface with GGG. Damping constant of TmIG thin film was determined to be 0.0133 by frequency-dependent ferromagnetic resonance (FMR) measurements. The saturation magnetization (M s ) and the coercive field (H c ) were obtained systematically as a function of the longitudinal distance (L) between the sputtering target and the substrate. A 170% enhancement of PMA field (H ⊥ ) was achieved by tuning the film composition to increase the tensile strain. Moreover, current-induced magnetization switching on a Pt/TmIG structure was demonstrated with an ultra-low critical current density (j c ) of 2.5 × 10 6  A/cm 2 , an order of magnitude smaller than the previously reported value. We were able to tune M s , H c and H ⊥ to obtain an ultra-low j c of switching the magnetization, showing the great potential of sputtered TmIG films for spintronics.

Y 2 O 3 was in situ deposited on a freshly grown molecular beam epitaxy GaAs(001)-4 × 6 surface by atomic layer deposition (ALD). In situ synchrotron radiation photoemission was used to study the mechanism of the tris(ethylcyclopentadienyl)yttrium [Y(CpEt) 3 ] and H 2 O process. The exponential attenuation of Ga 3d photoelectrons confirmed the laminar growth of ALD-Y 2 O 3 . In the embryo stage of the first ALD half-cycle with only Y(CpEt) 3 , the precursors reside on the faulted As atoms and undergo a charge transfer to the bonded As atoms. The subsequent ALD half-cycle of H 2 O molecules removes the bonded As atoms, and the oxygen atoms bond with the underneath Ga atoms. The product of a line of Ga-O-Y bonds stabilizes the Y 2 O 3 films on the GaAs substrate. The resulting coordinatively unsaturated Y-O pairs of Y 2 O 3 open the next ALD series. The absence of Ga 2 O 3 , As 2 O 3 , and As 2 O 5 states may play an important role in the attainment of low interfacial trap densities ( D it ) of <10 12 cm -2 eV -1 in our established reports., Competing Interests: The authors declare no competing financial interest.

Harnessing the spin-momentum locking of topological surface states in conjunction with magnetic materials is the first step to realize novel topological insulator-based devices. Here, we report strong interfacial coupling in Bi 2 Se 3 /yttrium iron garnet (YIG) bilayers manifested as large interfacial in-plane magnetic anisotropy (IMA) and enhancement of damping probed by ferromagnetic resonance. The interfacial IMA and damping enhancement reaches a maximum when the Bi 2 Se 3 film approaches its two-dimensional limit, indicating that topological surface states play an important role in the magnetization dynamics of YIG. Temperature-dependent ferromagnetic resonance of Bi 2 Se 3 /YIG reveals signatures of the magnetic proximity effect of T C as high as 180 K, an emerging low-temperature perpendicular magnetic anisotropy competing the high-temperature IMA, and an increasing exchange effective field of YIG steadily increasing toward low temperature. Our study sheds light on the effects of topological insulators on magnetization dynamics, essential for the development of topological insulator-based spintronic devices.

Background: This study aimed to investigate whether reversal of rocuronium-induced neuromuscular blockade with sugammadex reduced the incidence of residual blockade and facilitated operating room discharge readiness., Methods: Adult patients undergoing abdominal surgery received rocuronium, followed by randomized allocation to sugammadex (2 or 4 mg kg(-1)) or usual care (neostigmine/glycopyrrolate, dosing per usual care practice) for reversal of neuromuscular blockade. Timing of reversal agent administration was based on the providers' clinical judgement. Primary endpoint was the presence of residual neuromuscular blockade at PACU admission, defined as a train-of-four (TOF) ratio <0.9, using TOF-Watch® SX. Key secondary endpoint was time between reversal agent administration and operating room discharge-readiness; analysed with analysis of covariance., Results: Of 154 patients randomized, 150 had a TOF value measured at PACU entry. Zero out of 74 sugammadex patients and 33 out of 76 (43.4%) usual care patients had TOF-Watch SX-assessed residual neuromuscular blockade at PACU admission (odds ratio 0.0, 95% CI [0-0.06], P<0.0001). Of these 33 usual care patients, 2 also had clinical evidence of partial paralysis. Time between reversal agent administration and operating room discharge-readiness was shorter for sugammadex vs usual care (14.7 vs. 18.6 min respectively; P=0.02)., Conclusions: After abdominal surgery, sugammadex reversal eliminated residual neuromuscular blockade in the PACU, and shortened the time from start of study medication administration to the time the patient was ready for discharge from the operating room., Clinical Trial Registration: Clinicaltrials.gov:NCT01479764., (© The Author 2015. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)

The proportion of patients defined as obese continues to grow in many westernized nations, particularly the United States (USA). This trend has shifted the perioperative management of obese patients into the realm of routine care. As obese patients present for all types of procedures, it is crucial for anesthesiologists, surgeons, internists, and perioperative health care providers alike to have a firm understanding of their altered multi-organ physiology in order to safely prepare the obese patient for an operation. A careful preoperative evaluation may also serve to identify risk factors for postoperative adverse events. Subsequently, preoperative measures may be implemented to mitigate these complications. In this manuscript we address the major considerations for the preoperative evaluation of the severely obese patient.

The electronic structure of single-crystal (In)GaAs deposited with tri-methylaluminum (TMA) and water via atomic layer deposition (ALD) is presented with high-resolution synchrotron radiation core-level photoemission and capacitance-voltage (CV) characteristics. The interaction of the precursor atoms with (In)GaAs is confined at the topmost surface layer. The Ga-vacant site on the GaAs(111)A-2 × 2 surface is filled with Al, thereby effectively passivating the As dangling bonds. The As-As dimers on the GaAs(001)-2 × 4 surface are entirely passivated by one cycle of TMA and water. The presumed layerwise deposition fails to happen in GaAs(001)-4 × 6. In In0.20Ga0.80As(001)-2 × 4, the edge row As atoms are partially bonded with the Al, and one released methyl then bonds with the In. It is suggested that the unpassivated surface and subsurface atoms cause large frequency dispersions in CV characteristics under the gate bias. We also found that the (In)GaAs surface is immune to water in ALD. However, the momentary exposure of it to air (less than one minute) introduces significant signals of native oxides. This indicates the necessity of in situ works of high κ/(In)GaAs-related experiments in order to know the precise interfacial atomic bonding and thus know the electronic characteristics. The electric CV measurements of the ALD-Al2O3 on these (In)GaAs surfaces are correlated with their electronic properties.

High-resolution synchrotron radiation photoemission was employed to study the effects of atomic-layer-deposited trimethylaluminum (TMA) and water on Ga-rich GaAs(001)-4 × 6 and As-rich GaAs(001)-2 × 4 surfaces. No high charge states were found in either As 3d or Ga 3d core-level spectra before and after the deposition of the precursors. TMA adsorption does not disrupt the GaAs surface structure. For the (4 × 6) surface, the TMA precursor existed in both chemisorbed and physisorbed forms. In the former, TMA has lost a methyl group and is bonded to the As of the As-Ga dimer. Upon water purge, the dimethylaluminum-As group was etched off, allowing the now exposed Ga to bond with oxygen. Water also changed the physisorbed TMA into the As-O-Al(CH3)2 configuration. This configuration was also found in 1 cycle of TMA and water exposure of the (2 × 4) surface, but with a greater strength, accounting for the high interface defect density in the mid-gap region.

High quality nanometer-thick Gd₂O₃ and Y₂O₃ (rare-earth oxide, R₂O₃) films have been epitaxially grown on GaN (0001) substrate by molecular beam epitaxy (MBE). The R₂O₃ epi-layers exhibit remarkable thermal stability at 1100 °C, uniformity, and highly structural perfection. Structural investigation was carried out by in situ reflection high energy electron diffraction (RHEED) and ex-situ X-ray diffraction (XRD) with synchrotron radiation. In the initial stage of epitaxial growth, the R₂O₃ layers have a hexagonal phase with the epitaxial relationship of R₂O₃ (0001)(H)<1120>(H)//GaN(0001)(H)<1120>(H). With the increase in R₂O₃ film thickness, the structure of the R₂O₃ films changes from single domain hexagonal phase to monoclinic phase with six different rotational domains, following the R₂O₃ (201)(M)[020](M)//GaN(0001)(H)<1120>(H) orientational relationship. The structural details and fingerprints of hexagonal and monoclinic phase Gd₂O₃ films have also been examined by using electron energy loss spectroscopy (EELS). Approximate 3-4 nm is the critical thickness for the structural phase transition depending on the composing rare earth element.

Two different types of lasing modes, vertical Fabry-Perot cavity and random lasing, were observed in ZnO epi-films of different thicknesses grown on Si (111) substrates. Under optical excitation at room temperature by a frequency tripled Nd:YVO₄ laser with wavelength of 355 nm, the lasing thresholds are low due to high crystalline quality of the ZnO epitaxial films, which act as microresonators. For the thick ZnO layer (1,200 nm), its lasing action is originated from the random scattering due to the high density of crack networks developed in the thick ZnO film. However, the low crack density of the thin film (555 nm) fails to provide feedback loops essential for random scattering. Nevertheless, even the lower threshold lasing is achieved by the Fabry-Perot cavity formed by two interfaces of the thin ZnO film. The associated lasing modes of the thin ZnO film can be characterized as the transverse Gaussian modes attributed to the smooth curved surfaces.

Most studies of spin caloritronic effects to date, including spin-Seebeck effect, utilize thin films on substrates. We use patterned ferromagnetic thin film to demonstrate the profound effect of a substrate on the spin-dependent thermal transport. With different sample patterns and on varying the direction of temperature gradient, both longitudinal and transverse thermal voltages exhibit asymmetric instead of symmetric spin dependence. This unexpected behavior is due to an out-of-plane temperature gradient imposed by the thermal conduction through the substrate and the mixture of anomalous Nernst effects. Only with substrate-free samples have we determined the intrinsic spin-dependent thermal transport with characteristics and field sensitivity similar to those of the anisotropic magnetoresistance effect.

Background: Obstructive sleep apnea (OSA) is an independent risk factor to develop perioperative complications during weight loss surgery, but the mechanisms are unclear. It is possible, that patients with OSA have a higher incidence of desaturation during induction of anesthesia., Methods: We enrolled 100 morbidly obese (body mass index: 53+/-10) adult patients undergoing open bariatric surgery in a prospective study. At least 1 h before induction of anesthesia, peripheral oxygen saturation (SpO(2)) was measured by an oximetry finger probe in the sitting and supine positions, and Mallampati score was taken. Oxygen saturation was recorded also during induction of anesthesia, and nadir values were analyzed, and the STOP-BANG questionnaire was applied., Results: Thirty-six patients presented with clinical suspicion of OSA. Body weight predicted oxygen saturation in the supine and sitting position, prior to induction of anesthesia. Nadir oxygen saturation during induction of anesthesia was considerably higher in patients with clinical suspicion of OSA, a significant finding that persisted as a trend after correction for age, gender and BMI. The Mallampati score was an independent predictor of OSA, even in morbidly obese patients scheduled for weight loss surgery., Conclusions: Morbidly obese patients presenting for weight loss surgery have a significant risk to desaturate during induction of anesthesia. A history of OSA does not independently increase the risk of desaturation during induction of anesthesia, if the appropriate precautions are being taken.

Hexagonal-phase single-crystal Gd2 O3 is deposited on GaN in a molecular beam epitaxy system. The dielectric constant is about twice that of its cubic counterpart when deposited on InGaAs or Si. The capacitive effective thickness of 0.5 nm in hexagonal Gd2 O3 is perhaps the lowest on GaN-metal-oxide-semiconductor devices. The heterostructure is thermo dynamically stable at high temperatures and exhibits low interfacial densities of states after high-temperature annealing., (Copyright © 2009 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.)

It has been long appreciated that anesthetic drugs induce stereotyped changes in electroencephalogram (EEG), but the relationships between the EEG and underlying brain function remain poorly understood. Functional imaging methods including positron emission tomography (PET) and functional magnetic resonance imaging (fMRI), have become important tools for studying how anesthetic drugs act in the human brain to induce the state of general anesthesia. To date, no investigation has combined functional MRI with EEG to study general anesthesia. We report here a paradigm for conducting combined fMRI and EEG studies of human subjects under general anesthesia. We discuss the several technical and safety problems that must be solved to undertake this type of multimodal functional imaging and show combined recordings from a human subject. Combined fMRI and EEG exploits simultaneously the high spatial resolution of fMRI and the high temporal resolution of EEG. In addition, combined fMRI and EEG offers a direct way to relate established EEG patterns induced by general anesthesia to changes in neural activity in specific brain regions as measured by changes in fMRI blood oxygen level dependent (BOLD) signals.

Background: Tracheostomy tube malposition is a barrier to weaning from mechanical ventilation. We determined the incidence of tracheostomy tube malposition, identified the associated risk factors, and examined the effect of malposition on clinical outcomes., Methods: We performed a retrospective study on 403 consecutive patients with a tracheostomy who had been admitted to an acute care unit specializing in weaning from mechanical ventilation between July 1, 2002, and December 31, 2005. Bronchoscopy reports were reviewed for evidence of tracheostomy tube malposition (ie, > 50% occlusion of lumen by tissue). The main outcome parameters were the incidence of tracheostomy tube malposition; demographic, clinical, and tracheostomy-related factors associated with malposition; clinical response to correct the malposition; the duration of mechanical ventilation; the length of hospital stay; and mortality., Results: Malpositioned tracheostomy tubes were identified in 40 of 403 patients (10%). The subspecialty of the surgical service physicians who performed the tracheostomy was most strongly associated with malposition. Thoracic and general surgeons were equally likely to have their patients associated with a malpositioned tracheostomy tube, while other subspecialty surgeons were more likely (odds ratio, 6.42; 95% confidence interval, 1.82 to 22.68; p = 0.004). Malpositioned tracheostomy tubes were changed in 80% of cases. Malposition was associated with prolonged mechanical ventilation posttracheostomy (median duration, 25 vs 15 d; p = 0.009), but not with increased hospital length of stay or mortality., Conclusion: Tracheostomy tube malposition appears to be a common and important complication in patients who are being weaned from mechanical ventilation. Surgical expertise may be an important factor that impacts this complication.

Patients with Morquio syndrome can develop respiratory failure secondary to reduced chest wall compliance and airway collapse from irregularly shaped vocal cords and trachea. We report the case of a patient with Morquio syndrome whose clinical course was complicated by tracheomalacia. An obese 29-year-old female with Morquio syndrome presented with severe wheezing and tachycardia. One month prior to admission, she underwent elective spinal stabilization surgery, which resulted in fixed head flexion. The surgery was complicated by paraplegia and the need for mechanical ventilation via tracheostomy. Initial bronchoscopy revealed severe tracheomalacia, and the tracheostomy tube was changed to one with an adjustable flange. On 3 occasions over the next 20 days she had labored breathing with dramatically decreased V(T). Each time, bronchoscopy revealed almost complete occlusion of the distal end of the tracheostomy tube. Ventilation became much easier when the tracheostomy tube was advanced past the obstruction. After one month, she became febrile, severely hypoxemic, and her family decided to withdraw care. In patients with Morquio syndrome, close attention must be given to the patient's abnormal airways and malformed chest cage. Mechanical ventilation may be difficult because of upper-airway obstruction or low compliance imposed by the restrictive chest wall. Complete tracheal collapse can occur in these patients, especially with fixed head flexion.

Flail chest occurs when a series of adjacent ribs are fractured in at least 2 places, anteriorly and posteriorly. This section of the chest wall becomes unstable and it moves inwards during spontaneous inspiration. The physiological impact of a flail chest depends on multiple factors, including the size of the flail segment, the intrathoracic pressure generated during spontaneous ventilation, and the associated damage to the lung and chest wall. Treatment varies with the severity of the physiologic impairment attributable to the flail segment itself. Immediate surgical fixation may decrease morbidity, but conservative treatment with positive pressure ventilation is preferred when multiple injuries to the intrathoracic organs are present.

Unlabelled: Inhaled nitric oxide (NO) is a selective pulmonary vasodilator used to treat intraoperative pulmonary hypertension and hypoxemia. In contrast to NO delivered by critical care ventilators, NO delivered by anesthesia machines can be complicated by rebreathing. We evaluated two methods of administering NO intraoperatively: via the nitrous oxide (N(2)O) flowmeter and via the INOvent (Datex-Ohmeda, Madison, WI). We hypothesized that both systems would deliver NO accurately when the fresh gas flow (FGF) rate was higher than the minute ventilation (VE). Each system was set to deliver NO to a lung model. Rebreathing of NO was obtained by decreasing FGF and by simulating partial NO uptake by the lung. At FGF > or = VE (6 L/min), both systems delivered an inspired NO concentration ([NO]) within approximately 10% of the [NO] set. At FGF < VE and complete NO uptake, the N(2)O flowmeter delivered a lower [NO] (70 and 40% of the [NO] set at 4 and 2 L/min, respectively) and the INOvent delivered a higher [NO] (10 and 23% higher than the [NO] set at 4 and 2 L/min, respectively). Decreasing the NO uptake increased the inspired [NO] similarly with both systems. At 4 L/min FGF, [NO] increased by 10%-20% with 60% uptake and by 18%-23% with 30% uptake. At 2 L/min, [NO] increased by 30%-33% with 60% uptake and by 60%-69% with 30% uptake. We conclude that intraoperative NO inhalation is accurate when administered either by the N(2)O flowmeter of an anesthesia machine or by the INOvent when FGF > or = VE., Implications: Inhaled nitric oxide (NO) is a selective pulmonary vasodilator. In a lung model, we demonstrated that NO can be delivered accurately by a N(2)O flowmeter or by a commercial device. We provide guidelines for intraoperative NO delivery.

Epitaxial growth of single-crystal gadolinium oxide dielectric thin films on gallium arsenide is reported. The gadolinium oxide film has a cubic structure isomorphic to manganese oxide and is (110)-oriented in single domain on the (100) gallium arsenide surface. The gadolinium oxide film has a dielectric constant of approximately 10, with low leakage current densities of about 10(-9) to 10(-10) amperes per square centimeter at zero bias. Typical breakdown field is 4 megavolts per centimeter for an oxide film 185 angstroms thick and 10 megavolts per centimeter for an oxide 45 angstroms thick. Both accumulation and inversion layers were observed in the gadolinium oxide-gallium arsenide metal oxide semiconductor diodes, using capacitance-voltage measurements. The ability to grow thin single-crystal oxide films on gallium arsenide with a low interfacial density of states has great potential impact on the electronic industry of compound semiconductors.