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Poly(3,4-ethylenedioxythiophene):poly(styrenesulfonate) (PEDOT: PSS) is widely used as a hole-transport layer (HTL) in perovskite solar cells (PSCs) with inverted (p-i-n) structures. However, problems associated with the corrosivity of PEDOT:PSS prevent the commercialization of such PSCs. To solve this problem, we fabricated inverted PSCs using [2-(9H-carbazol-9-yl)ethyl]phosphonic acid (2PACz) as HTL. We used a mixture of N-methyl-2-pyrrolidone and N, N-dimethylformamide in the perovskite precursor, which reduced the amount of the antisolvent chlorobenzene. We investigated the physical effects of the amount of antisolvent used. In addition, we suggest a method to improve the performance of inverted PSCs using 2PACz as the HTL, thereby achieving higher performance. [ABSTRACT FROM AUTHOR]

Background: Pheochromocytoma often carries a risk for perioperative hemodynamic instability (HDI). The aim of this study is to evaluate the risk factors of intraoperative HDI during minimally invasive posterior retroperitoneal adrenalectomy (PRA) for pheochromocytoma. Materials and methods: This retrospective study analyzed the prospectively collected data of 172 patients who underwent laparoscopic PRA or robotic PRA for pheochromocytoma between January 2014 and December 2020 at a single tertiary center. The patients were divided into two groups according to the intraoperative hypertensive event of systolic blood pressure (> 160 mmHg). The clinical manifestations and perioperative hemodynamic conditions were analysed. Results: In the multivariate logistic regression analysis, the tumor size (> 3.4 cm) [OR 3.14, 95% confidence intervals (CI) (1.48–6.64), p = 0.003], type of preoperative alpha-blocker (selective type) [OR 3.9, 95% CI (1.52–10.02), p = 0.005], preoperative use of beta-blockers [OR 3.94, 95% CI (1.07–14.49), p = 0.039] and type of anesthesia [total intravenous anesthesia (TIVA) vs. balanced anesthesia (BA)] [OR 2.57, 95% CI (1.23–5.38), p = 0.012] were determined as independent risk factors of intraoperative hypertensive events during minimally invasive adrenalectomy. Conclusions: The type of anesthesia was independently associated with intraoperative HDI along with larger tumor size, type of preoperative alpha-blocker and the use of preoperative beta-blockers. TIVA increased the risk of intraoperative hypertensive events compared with BA. Thus, the consideration of the type of anesthesia prior to adrenal surgery for pheochromocytoma along with the use of preoperative non-selective alpha-blockers may be beneficial in minimizing the risk of intraoperative HDI. [ABSTRACT FROM AUTHOR]

Although epidural patient-controlled analgesia (PCA) to control postoperative pain after total knee arthroplasty (TKA), the relationship of epidural PCA with postoperative bleeding remains controversial. Therefore, we aimed to evaluate the effect of epidural and intravenous PCA on postoperative bleeding in patients undergoing unilateral TKA. Total of 2467 patients who underwent TKA were divided to intravenous PCA (n = 2339) or epidural PCA (n = 128) group. After 1:1 propensity score-matching, 212 patients were analyzed to assess the associations between the perioperative blood loss and epidural PCA between the groups. Mean postoperative blood loss was significantly greater in epidural PCA than in intravenous PCA (900.9 ± 369.1 mL vs. 737.8 ± 410.1 mL; P = 0.007). The incidence of red blood cell (RBC) administration (> 3 units) was significantly higher in epidural PCA than in intravenous PCA (30.2% vs. 16.0%; OR 2.5; 95% CI 1.201–5.205; P = 0.014). Epidural PCA may be strongly related to postoperative bleeding and the incidence of RBC transfusion of more than 3 units after unilateral TKA, as compared to intravenous PCA. Therefore, the use of epidural PCA may be carefully considered for postoperative pain management in TKA. [ABSTRACT FROM AUTHOR]

In children with mandibular hypoplasia, airway management is challenging. However, detailed cephalometric assessment data for this population are sparse. The aim of this study was to find risk factors for predicting difficult airways in children with mandibular hypoplasia, and compare upper airway anatomical differences using three-dimensional computed tomography (3D CT) between children with mandibular hypoplasia and demographically matched healthy controls. There were significant discrepancies in relative tongue position (P < 0.01) and anterior distance of the hyoid bone (P < 0.01) between patients with mandibular hypoplasia and healthy controls. All mandibular measures were significantly different between the two groups, except for the height of the ramus of the mandible. After adjusting for age and sex, the anterior distance of hyoid bone and inferior pogonial angle were significantly associated with a difficult airway (P = 0.01 and P = 0.02). Quantitative analysis of upper airway structures revealed significant discrepancies, including relative tongue position, hyoid distance, and mandible measures between patients with mandibular hypoplasia and healthy controls. The anterior distance of the hyoid bone and inferior pogonial angle may be risk factors for a difficult airway in patients with mandibular hypoplasia. [ABSTRACT FROM AUTHOR]

Individuals with myotonic dystrophy type 1 (DM1) reportedly have a higher risk of postoperative complications than those without DM1; however, factors related to perioperative complications in DM1 patients remain unclear. We aimed to identify the risk factors that may be associated with postoperative complications in DM1 patients. We reviewed medical records of 256 patients with DM1 from 1998 to 2018, among whom 42 (16.4%) had previously undergone 51 surgeries under general and regional anaesthesia. Among the 42 patients, 11 (21.5%) had 13 postoperative complications including respiratory complications, sustained hypotension, wound infection and dehiscence, artery thrombosis and occlusion, and delayed recovery from anaesthesia. There were significant inter-group differences between the non-complicated and complicated groups considering the following parameters: high-grade (≥ 3) muscular impairment rating scale (MIRS), extubation time, postoperative opioid use, and hospital length of stay. Furthermore, univariate analysis revealed that an MIRS score ≥ 3 (odds ratio [OR] 9.346, confidence interval [CI] 1.761–49.595, p = 0.009) and postoperative opioid use (OR 8.000, CI 1.772–36.127, p = 0.007) were the only statistically significant factors. Therefore, clinicians should be cautious in administering opioids, particularly in patients with a high-grade MIRS score during the perioperative period. [ABSTRACT FROM AUTHOR]

Difficult tracheal intubation is the third most common respiratory-related adverse co-morbid episode and can lead to death or brain damage. Since difficult tracheal intubation is less frequent, trainees have fewer opportunities to perform difficult tracheal intubation; this leads to the need to practice with a hyper-realistic intubation simulator. However, conventional simulators are expensive, relatively stiffer than the human airway, and have a lack of diversity in terms of disease variations and anatomic reproducibility. Therefore, we proposed the development of a patient-specific and hyper-realistic difficult tracheal intubation simulator using three-dimensional printing technology and silicone moulding and to test the feasibility of patient-specific and hyper-realistic difficult intubation simulation using 3D phantom for the trainee. This difficult tracheal intubation phantom can provide a realistic simulation experience of managing various difficult tracheal intubation cases to trainees, which could minimise unexpected tissue damage before anaesthesia. To achieve a more realistic simulation, a patient-specific phantom was fabricated to mimic human tissue with realistic mouth opening and accurate difficult airway shape. This has great potential for the medical education and training field. [ABSTRACT FROM AUTHOR]

The visceral analgesic efficacy of erector spinae plane block (ESPB) is still a matter of debate. This study attempted to investigate the visceral analgesic efficacy of ESPB in clinical setting. After randomized, we performed ultrasound-guided bilateral rectus sheath block (RSB), which was aimed to prevent postoperative somatic pain on all patients who underwent laparoscopic cholecystectomy (LC). Ultrasound-guided bilateral ESPB at T7 level was performed only to the intervention group to provide the visceral analgesic block. The intraoperative requirement for remifentanil (P = 0.021) and the cumulative fentanyl consumption at postoperative 24-hours was significantly lower in the ESPB group (206.5 ± 82.8 μg vs.283.7 ± 102.4 μg, respectively; P = 0.004) compared to non-ESPB group. The ESPB group consistently showed lower accumulated analgesic consumption compared with those in the non-ESPB group at all observed time-points (all P < 0.05) after 2 hours and the degree of the accumulated analgesic consumption reduction was greater (P = 0.04) during the 24-hour postoperative period. Pain severity was lower in the ESPB group at 6-hours postoperatively. The significantly reduced opioid consumption in ESPB group may imply that while preliminary and in need of confirmation, ESPB has potential visceral analgesic effect. Therefore, performing ESPB solely may be feasible in inducing both somatic and visceral analgesia. [ABSTRACT FROM AUTHOR]

Elderly patients undergoing urological surgery in the lithotomy position may be vulnerable to perioperative hypoxemia. Positive end-expiratory pressure (PEEP) can improve arterial oxygenation. Although laryngeal mask airway (LMA) is widely utilized in urological surgery, it is not known how PEEP affects arterial oxygenation in these patients. We, therefore, evaluated the effect of PEEP on arterial oxygen partial pressure (PaO2) in elderly patients using LMA during urological surgery in the lithotomy position. Patients randomly received zero end-expiratory pressure (group Z, n = 34) or PEEP of 7 cmH2O (group P, n = 33). Ventilatory, respiratory, and haemodynamic variables were measured at 5 min (T0), 30 min (T1), and 60 min (T2) after LMA Supreme™ (sLMA) insertion. The primary outcome was the difference of PaO2 at T2 between the two groups. Atelectasis score, the incidence of a significant leak, and complications associated with sLMA insertion were also evaluated. PaO2 at T2 was significantly higher in group P than in group Z (20.0 ± 4.9 vs. 14.7 ± 3.7 kPa, P < 0.001). Atelectasis score at T2 was lower in group P than in group Z (5.3 ± 1.7 vs. 8.4 ± 2.3, P < 0.001). However, the incidence of a significant leak and complications associated with LMA insertion did not significantly differ between the two groups. PEEP can improve arterial oxygenation and reduce atelectasis in elderly patients using sLMA during urological surgery in the lithotomy position, suggesting that PEEP may be useful for elderly patients with an increased risk of perioperative hypoxemia when using sLMA. [ABSTRACT FROM AUTHOR]

An efficient in vitro plant regeneration method through somatic embryogenesis has been established in Haworthia retusa. Somatic embryos were induced from leaf explants on Murashige and Skoog (MS) medium supplemented with different concentrations of 2,4-dichlorophenoxyacetic acid (2,4-D), indole-3-acetic acid (IAA), indole-3-butyric acid (IBA), and α-naphthaleneacetic acid (NAA) either alone or in combination with 4 μM thidiazuron (TDZ). Of the four auxins studied, IBA was found to be the most promising in terms of somatic embryo induction, followed in decreasing frequency by 2,4-D, IAA, and NAA. The highest somatic embryo induction (60.7%), with a mean of 20.7 embryos per leaf explant, was observed on MS medium amended with 20 μM IBA. The inclusion of 4 μM TDZ to the auxin-containing medium significantly (p < 0.0001) increased the somatic embryo induction frequency as well as the number of somatic embryos. The best combination for somatic embryogenesis was IBA + TDZ. The highest incidence of somatic embryo induction (100%), with a mean of 55.8 somatic embryos, was obtained on a culture medium containing 16 μM IBA + 4 μM TDZ. Somatic embryos germinated best on MS medium supplemented with 2 μM gibberellic acid. Morphological variations were observed among the regenerated plantlets. Well-developed plantlets obtained from germination media were acclimatized in the greenhouse. [ABSTRACT FROM AUTHOR]

Nanotechnology has impacted every aspect of human life and the environment. The raising concern against influenza outbreaks is an ongoing issue. With the current drugs and natural remedies, some amount of resolution has been reached. Yet, nothing conclusive has been achieved. With every resource tapped, it is now time to combine strategies. This review highlights the low enthusiasm in this area, where not much has been probed into employing nanomaterials into influenza research. The achievements made through the intervention of nanotechnology into anti influenza research, has been surveyed in this review. Except for a few, not much progress was evidenced. Although significant progress has been achieved with nano inputs, yet nothing much has been done in this direction. This review emphasizes the need to combine strategies and find new remedies against influenza virus using nano platforms. New directions and future perspectives for accessing the nano inputs for combating the influenza issues have been discussed. [ABSTRACT FROM AUTHOR]

An efficient protocol for asymbiotic seed germination and multiple shoot production of Thrixspermum japonicum has been established. Seeds were cultured on MSB (Murashige and Skoog, (MS) macro- and micro-nutrients, 0.1% (w/v) activated charcoal (AC), and 3.0% (w/v) sucrose) medium fortified with different concentrations of coconut water (CW), indole-3-acetic acid (IAA), or α-naphthaleneacetic acid (NAA), and gibberellic acid (GA3) to promote seed germination. The highest seed germination percentage (88.1%) was observed on MSB medium fortified with 0.2% (v/v) CW, 0.2 mg L−1 NAA and 0.5 mg L−1 GA3. Optimized shoot induction (94.3%) and maximum shoot numbers (8.3) were obtained on protocorm cultured on MS medium amended with 0.1% (w/v) AC, 3.0% (w/v) banana pulp, 2.0% (w/v) potato homogenate, 0.3 mg L−1 KN, 0.2 mg L−1 NAA, and 0.5 mg L−1 GA3. Rooting of the shoots was best achieved on MS medium supplemented with 0.1% (w/v) AC, 3.0% (w/v) banana pulp and 2.0% (w/v) potato homogenate, and 0.8 mg L−1 indole-3-butyric acid. Plantlets were acclimatized in the greenhouse with 88.1% survival rates. The protocol proposed in this study could be useful for conservation of S. japonicus, an important and rare epiphytic orchid. [ABSTRACT FROM AUTHOR]

Nematodes are considered as major plant parasites damaging most of the crops, and neem plant exhibits potential nematicidal and insecticidal properties. This study aimed to check nemato-toxic potential of neem (Azadirachta indica) plant using in vitro and in-planta trials against Meloidogyne incognita. The findings suggested that the neem extracts were lethal to second-stage juvenile (J2) and egg hatching with simultaneous enhancement in treated tomato plant growth. The egg numbers of M. incognita found less sensitive to the aqueous and alcoholic extracts than those of J2 as per LC50 values. Complete mortality of J2s was recorded at 40, 60, and 80% of neem standard extract (SE) dilutions and for undiluted SE of neem. The undiluted SE extract showed 100% inhibition of egg production. The highest reductions in the number of galls/root system, J2 population, and egg production were observed with 80, 85, and 82% SE as compared control (untreated distilled water). The maximum 250% growth increment was observed in the length of tomato roots supplemented with neem extracts. Resistance-related enzyme [phenylalanine ammonia lyase (PAL), polyphenol oxidase (PPO), and peroxidase (POX)] activities in tomato plant have been increased significantly by supplementation with neem extracts. It appears that the aerial parts of neem (A. indica) extracts showed significant and sustainable eco-friendly nemato-toxic potential towards M. incognita growth inhibition and eradication using alcoholic extracts compared to aqueous. From this study, it was concluded that the neem aerial parts were useful for the control of M. incognita and could be a possible replacement for synthetic nematicides in crop protection with utilization in enhancement of specific enzyme activity in tomato plants. [ABSTRACT FROM AUTHOR]

There is a growing interest in developing embedded systems that consume low energy in such application areas as mobile communications or wireless sensor networks. To especially provide the complex and diverse functions of embedded software with limited energy consumption, many studies of low-energy software are being performed. The existing studies to analyze energy consumption of embedded software have mainly focused on source code. However, some studies recently explored model-based energy consumption analysis to fulfill the requirement of energy consumption in the early phase of software development process. This paper proposes a model-based energy consumption analysis framework to develop an energy-efficient design model of embedded software. The proposed framework can analyze energy consumption without building an additional analysis model in software development and provide the chance to fulfill the energy consumption requirements in the early phase of the software development process, which can reduce the feedback efforts. [ABSTRACT FROM AUTHOR]

Cruciferous hairy roots are often used for improving drought adaptability, peroxidase production, and in vitro subculturing of Plasmodiophora brassicae. For metabolic engineering, Agrobacterium tumefaciens-mediated systems have previously been developed for hairy root production in other plant species. Here, we used the rolABC gene binary construct in A. tumefaciens strain GV3101 to establish cultures of Chinese cabbage hairy roots. On both solid and liquid media, the rolABC hairy root lines exhibited a wild-type hairy root syndrome in terms of their growth and morphology. This demonstrates that those three genes are sufficient to induce high-quality hairy roots in Chinese cabbage. Such a system could be useful for the stable production of secondary metabolites in that species. [ABSTRACT FROM AUTHOR]

Embryogenic calli were induced from the seeds of creeping bentgrass ( Agrostis palustris Huds.) cv. Regent and colonial bentgrass ( Agrostis Tenuis Sibth. Fl. Oxen.) cv. Tiger. The embryogenic calli were precultured on fresh medium for 4–7 days and then co-cultivated with Agrobacterium tumefaciens, LBA4404. which contains plasmid vector-pSBGM harboring bar coding region, synthetic green fluorescent protein (sGFP) coding region and matrix attachment region (MAR). After 3 days of co-cultivation, the calli were washed thoroughly and transferred to MS medium containing 2 mg/L of 2, 4-D, 12–15 mg/L phosphinothricin (PPT) and 250 mg/L of cefotaxime. After 2–3 months of selection, the actively growing calli of ‘Regent’ and ‘Tiger’ were transferred to MS medium with 12–15 mg/L PPT and 250 mg/L cefotazime for regeneration. The putative transformants were maintained on MS medium with 3 mg/L PPT for long period but control died within 1 month. After establishing in greenhouse, the transformants also showed strong resistance to 0.4% of herbicide Basta but control plants died within 2 weeks. Under confocal microscope, both young leaves and roots showed significant GFP expression. PCR analysis revealed the presence of a DNA fragment of GFP gene at the expected size (380 bp) in the transformants and its absence in a randomly selected control plant. [ABSTRACT FROM AUTHOR]