Background
This is the fourth updated Enhanced Recovery After Surgery (ERAS
®
) Society guideline presenting a consensus for optimal perioperative care in colorectal surgery and providing graded ...recommendations for each ERAS item within the ERAS
®
protocol.
Methods
A wide database search on English literature publications was performed. Studies on each item within the protocol were selected with particular attention paid to meta-analyses, randomised controlled trials and large prospective cohorts and examined, reviewed and graded according to Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system.
Results
All recommendations on ERAS
®
protocol items are based on best available evidence; good-quality trials; meta-analyses of good-quality trials; or large cohort studies. The level of evidence for the use of each item is presented accordingly.
Conclusions
The evidence base and recommendation for items within the multimodal perioperative care pathway are presented by the ERAS
®
Society in this comprehensive consensus review.
We examined the number of tropical cyclones and cyclone days as well as tropical cyclone intensity over the past 35 years, in an environment of increasing sea surface temperature. A large increase ...was seen in the number and proportion of hurricanes reaching categories 4 and 5. The largest increase occurred in the North Pacific, Indian, and Southwest Pacific Oceans, and the smallest percentage increase occurred in the North Atlantic Ocean. These increases have taken place while the number of cyclones and cyclone days has decreased in all basins except the North Atlantic during the past decade.
Many members of the genus Flavivirus are the agents of important diseases of humans, livestock, and wildlife. Currently, no complete genome sequence is available for the three African viruses, ...Bagaza, Zika, and Kedougou viruses, each representing a distinct virus subgroup according to the latest virus classification. In this study, we obtained a complete genome sequence of each of those three viruses and characterized the open reading frames (ORFs) with respect to gene sizes, cleavage sites, potential glycosylation sites, distribution of cysteine residues, and unique motifs. The sequences of the three viruses were then scanned across the entire length of the ORF against available sequences of other African flaviviruses and selected reference viruses for genetic relatedness. The data collectively indicated that Kedougou virus was close to dengue viruses but nonetheless distinct, while Bagaza virus shared genetic relatedness with West Nile virus in several genomic regions. In the non-coding regions, it was found that a particular organizational pattern of conserved sequences in the 3' terminal region generally correlated with the current virus grouping.
Despite optimal pharmacotherapy and cognitive-behavioral treatments, a proportion of patients with obsessive-compulsive disorder (OCD) remain refractory to treatment. Neurosurgical ablative or ...nondestructive stimulation procedures to treat these refractory patients have been investigated. However, despite the potential benefits of these surgical procedures, patients show significant surgery-related complications. This preliminary study investigated the use of bilateral thermal capsulotomy for patients with treatment-refractory OCD using magnetic resonance-guided focused ultrasound (MRgFUS) as a novel, minimally invasive, non-cranium-opening surgical technique. Between February and May 2013, four patients with medically refractory OCD were treated with MRgFUS to ablate the anterior limb of the internal capsule. Patients underwent comprehensive neuropsychological evaluations and imaging at baseline, 1 week, 1 month and 6 months following treatment. Outcomes were measured with the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), the Hamilton Rating Scale for Depression (HAM-D) and the Hamilton Rating Scale for Anxiety (HAM-A), and treatment-related adverse events were evaluated. The results showed gradual improvements in Y-BOCS scores (a mean improvement of 33%) over the 6-month follow-up period, and all patients showed almost immediate and sustained improvements in depression (a mean reduction of 61.1%) and anxiety (a mean reduction of 69.4%). No patients demonstrated any side effects (physical or neuropsychological) in relation to the procedure. In addition, there were no significant differences found in the comprehensive neuropsychological test scores between the baseline and 6-month time points. This study demonstrates that bilateral thermal capsulotomy with MRgFUS can be used without inducing side effects to treat patients with medically refractory OCD. If larger trials validate the safety, effectiveness and long-term durability of this new approach, this procedure could considerably change the clinical management of treatment-refractory OCD.
A number of “top-down” lithographic and “bottom-up” self-assembly methods have been developed to fabricate three-dimensional (3D) nanostructures to support the recent advances in nanotechnology. But ...they are limited by a number of factors such as fabrication cost, pattern resolution, and/or flexibility of geometry. Here we present a 3D nanolithography process that utilizes self-assembled nanospheres to create a periodic array of focal spots, which are then replicated across multiple depth in a transparent medium according to the Talbot effect. The Talbot field then exposes a pattern onto the underlying photoresist, recording the 3D intensity distribution. We have demonstrated designable complex 3D periodic structures with 80 nm minimum feature size, roughly one-fourth of the operating wavelength. This approach combines 2D colloidal self-assembly and 3D phase lithography, is robust, cost-effective, and widely applicable to nanoscale research and manufacturing.
We use the Nernst effect to delineate the boundary of the pseudogap phase in the temperature-doping phase diagram of hole-doped cuprate superconductors. New data for the Nernst coefficient ν(T) of ...YBa2Cu3Oy (YBCO), La1.8−xEu0.2SrxCuO4 (Eu-LSCO), and La1.6−xNd0.4SrxCuO4 (Nd-LSCO) are presented and compared with previously published data on YBCO, Eu-LSCO, Nd-LSCO, and La2−xSrxCuO4 (LSCO). The temperature Tν at which ν/T deviates from its high-temperature linear behavior is found to coincide with the temperature at which the resistivity ρ(T) deviates from its linear-T dependence, which we take as the definition of the pseudogap temperature T★-in agreement with the temperature at which the antinodal spectral gap detected in angle-resolved photoemission spectroscopy (ARPES) opens. We track T★ as a function of doping and find that it decreases linearly vs p in all four materials, having the same value in the three LSCO-based cuprates, irrespective of their different crystal structures. At low p,T★ is higher than the onset temperature of the various orders observed in underdoped cuprates, suggesting that these orders are secondary instabilities of the pseudogap phase. A linear extrapolation of T★(p) to p=0 yields T★(p→0)≃TN(0), the Néel temperature for the onset of antiferromagnetic order at p=0, suggesting that there is a link between pseudogap and antiferromagnetism. With increasing p,T★(p) extrapolates linearly to zero at p≃pc2, the critical doping below which superconductivity emerges at high doping, suggesting that the conditions which favor pseudogap formation also favor pairing. We also use the Nernst effect to investigate how far superconducting fluctuations extend above the critical temperature Tc, as a function of doping, and find that a narrow fluctuation regime tracks Tc, and not T★. This confirms that the pseudogap phase is not a form of precursor superconductivity, and fluctuations in the phase of the superconducting order parameter are not what causes Tc to fall on the underdoped side of the Tc dome.
Nanotechnology has unprecedentedly revolutionized human societies over the past decades and will continue to advance our broad societal goals in the coming decades. The research, development, and ...particularly the application of engineered nanomaterials have shifted the focus from “less efficient” single-component nanomaterials toward “superior-performance”, next-generation multifunctional nanohybrids. Carbon nanomaterials (e.g., carbon nanotubes, graphene family nanomaterials, carbon dots, and graphitic carbon nitride) and metal/metal oxide nanoparticles (e.g., Ag, Au, CdS, Cu2O, MoS2, TiO2, and ZnO) combinations are the most commonly pursued nanohybrids (carbon–metal nanohybrids; CMNHs), which exhibit appealing properties and promising multifunctionalities for addressing multiple complex challenges faced by humanity at the critical energy–water–environment (EWE) nexus. In this frontier review, we first highlight the altered and newly emerging properties (e.g., electronic and optical attributes, particle size, shape, morphology, crystallinity, dimensionality, carbon/metal ratio, and hybridization mode) of CMNHs that are distinct from those of their parent component materials. We then illustrate how these important newly emerging properties and functions of CMNHs direct their performances at the EWE nexus including energy harvesting (e.g., H2O splitting and CO2 conversion), water treatment (e.g., contaminant removal and membrane technology), and environmental sensing and in situ nanoremediation. This review concludes with identifications of critical knowledge gaps and future research directions for maximizing the benefits of next-generation multifunctional CMNHs at the EWE nexus and beyond.
We report the experimental generation of highly energetic carbon ions up to 48 MeV per nucleon by shooting double-layer targets composed of well-controlled slightly underdense plasma and ultrathin ...foils with ultraintense femtosecond laser pulses. Particle-in-cell simulations reveal that carbon ions are ejected from the ultrathin foils due to radiation pressure and then accelerated in an enhanced sheath field established by the superponderomotive electron flow. Such a cascaded acceleration is especially suited for heavy ion acceleration with femtosecond laser pulses. The breakthrough of heavy ion energy up to many tens of MeV/u at a high repetition rate would be able to trigger significant advances in nuclear physics, high energy density physics, and medical physics.
Backward-angle meson electroproduction above the resonance region, which was previously ignored, is anticipated to offer unique access to the three quark plus sea component of the nucleon wave ...function. In this Letter, we present the first complete separation of the four electromagnetic structure functions above the resonance region in exclusive ω electroproduction off the proton, ep→e′pω, at central Q2 values of 1.60, 2.45 GeV2, at W=2.21 GeV. The results of our pioneering −u≈−umin study demonstrate the existence of a unanticipated backward-angle cross section peak and the feasibility of full L/T/LT/TT separations in this never explored kinematic territory. At Q2=2.45 GeV2, the observed dominance of σT over σL, is qualitatively consistent with the collinear QCD description in the near-backward regime, in which the scattering amplitude factorizes into a hard subprocess amplitude and baryon to meson transition distribution amplitudes: universal nonperturbative objects only accessible through backward-angle kinematics.
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