Up to 14% of individuals with a trial of labour after caesarean birth (TOLAC) require an operative vaginal birth (OVB). We evaluated the association between forceps vs vacuum birth and severe maternal morbidity (SMM) among individuals with a TOLAC. This is a population-based cohort study of individuals with one prior caesarean birth who delivered a singleton, cephalic, term infant via OVB following a TOLAC in Canada (excluding Québec), using administrative health data (2010-2021). Procedure codes were used to identify forceps and vacuum births. Modified Poisson regression with propensity score overlap weighting was used to estimate adjusted relative risks (ARR), accounting for clinical factors. SMM included diagnoses and procedures associated with high case fatality, extended length of hospital stay and long-term disability from the birth admission to 42 days postpartum. Among 72,140 individuals with a TOLAC, 10,030 (13.9%) had an attempted operative vaginal birth (vacuum: 70.5%, forceps: 29.5%). SMM rates were higher with forceps vs vacuum (23.6 versus 14.1 per 1,000). In adjusted models, forceps use was associated with increased risk of SMM (ARR 1.58, 95% confidence interval [CI] 1.14-2.18). The two leading causes of SMM included severe hemorrhage (15.2‰ forceps vs 9.2‰ vacuum; ARR 1.55, 95%CI 1.03-2.34) and surgical complications (6.8‰ forceps vs 2.1‰ vacuum; ARR 3.55, 95%CI 1.75-7.20). Among individuals with a TOLAC, forceps birth is associated with higher risk of severe hemorrhage or surgical complications versus vacuum. Patient counseling and clinical decision-making should incorporate maternal safety by instrument attempts in tandem with attaining vaginal birth.
Ultrasound-guided Vacuum-Assisted Breast Biopsy has been widely utilized as a key modality for breast nodule resection. Nevertheless, its application remains relatively contraindicated in patients who have undergone breast prosthesis placement. This study aimed to evaluate the feasibility and safety of ultrasound‑guided vacuum‑assisted breast biopsy (US‑VABB) for the resection of breast nodules ≤ 1.5 cm with BI-RADS 3-4a in patients with retroglandular breast implants. A single-center retrospective observational study was conducted on patients with breast nodules who underwent US-VABB in the Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University from January 2020 to October 2024. A total of 18 patients (18 nodules) who had previously undergone breast implant placement with implants located behind the glandular tissue were included. The complete nodule resection rate, implant-related complications, postoperative pathological results, and short-term follow-up data were analyzed. Primary outcomes included complete resection rate and implant-related complications, while secondary outcomes included pathological findings and short-term follow-up results. The maximum diameter of the nodules in the 18 patients ranged from 0.5 to 1.5 cm (mean: 1.1 ± 0.4 cm), and all nodules were completely resected in a single operation, with no evidence of residual lesions on imaging. No serious complications such as breast implant rupture or leakage occurred during or after the operation. The implant rupture rate was 0% (0/18), and minor complications occurred in 16.7% of patients. Postoperative pathology revealed fibroadenoma (n=11), breast adenosis (n=3), intraductal papilloma (n=2), atypical ductal hyperplasia (n=1), and ductal carcinoma in situ (DCIS, n=1). The patient with DCIS underwent additional resection, with no residual tumor detected. These findings demonstrate that US-VABB is a safe and feasible minimally invasive approach for patients with retroglandular breast implants presenting with breast nodules ≤1.5 cm and BI-RADS 3-4a, with high resection success and low complication rates.
Digital tomosynthesis-guided vacuum-assisted breast biopsy is a standard minimally invasive technique for diagnosing focal breast lesions, with vascular complications such as pseudoaneurysm formation being exceedingly rare. We report the case of a 64-year-old postmenopausal woman who developed a 2.6-cm intramammary pseudoaneurysm in the right breast following digital tomosynthesis-guided vacuum-assisted breast biopsy for high-grade ductal carcinoma in situ adjacent to an invasive carcinoma with choriocarcinomatous differentiation, successfully treated with ultrasound-guided percutaneous thrombin injection, without complications. This case emphasizes the importance of early recognition of post-biopsy pseudoaneurysms to avoid potential hemorrhagic complications. Furthermore, this case demonstrates that ultrasound-guided breast thrombin injection is a safe and effective minimally invasive treatment option and highlights the importance of individualized therapeutic approaches to optimize outcomes.
Percutaneous vacuum-assisted mechanical thrombectomy using venovenous bypass is a potential alternative to open surgery for the removal of intracardiac and intravascular/caval thrombi. We sought to evaluate the unique role and efficacy of this procedure in the treatment of high-risk patients deemed poor candidates for surgical thrombectomy. Between May 2015 and October 2023, 40 patients underwent vacuum-assisted thrombectomy for intracardiac or caval thrombi using venovenous bypass at our medical center. Patient and case characteristics, procedural details, and postprocedural outcomes were collected retrospectively. All procedures involved a multidisciplinary approach by cardiac surgeons, interventional radiologists, and cardiac anesthesiologists. Cardiac electrophysiologists also participated in the procedures when patients needed concomitant cardiovascular implantable electronic device system extractions. Mean age of patients was 50 ± 16 years. Indications included indwelling catheter thrombus (n = 10; 25%), cardiovascular implantable electronic device infection (n = 12, 30%), tricuspid endocarditis (n = 8, 20%), and bland and tumor thrombus (n = 11, 28%, n = 7, 18%, respectively). Successful removal rate (>70% of thrombus removed) was 85% (n = 34). Interventional adjuncts included cardiovascular implantable electronic device lead extraction (n = 10, 25%) and snaring from contralateral access site (n = 7, 18%). In-hospital and 30-day mortality were 5% (n = 2) and 8% (n = 3), respectively. Complications included postoperative red blood cell transfusion (n = 5, 13%), pulmonary embolism (n = 2, 5%), and recurrent thrombosis (n = 2, 5%). Median total follow-up time was 16 ± 3 months, with either complete resolution or decreased burden of residual thrombus. Vacuum-assisted thrombectomy is a rapid, effective, and safe technique when treating critically ill patients with acute intracardiac and caval thrombi and vegetation. It can be a highly valuable adjunct when treating poor candidates for open cardiovascular surgery.
Autologous fat transfer (AFT) is an emerging option for total breast reconstruction. To improve graft survival, perioperative external vacuum expansion (EVE) is used to optimise recipient-site environment. However, the efficacy of EVE and its treatment burden on women needs consideration. This interim analysis of a multicentre randomised controlled trial (RCT) evaluates the effect of EVE on volumetric outcomes and safety. Women undergoing total breast reconstruction with AFT were randomised 2:1 to perioperative EVE or no EVE. All participants underwent three AFT sessions followed by magnetic resonance imaging (MRI)-based volumetric assessment at six months. Primary outcomes were percentage augmentation and graft retention. Secondary outcomes included (serious) adverse events (SAEs). Quality-of-life (QoL) outcomes were not analysed in this interim analysis, as reconstruction was ongoing. Fifty-three participants were included (EVE, N = 32; control, N = 21). Mean augmentation was 190.7% with EVE versus 176.4% without (adjusted difference 14.6%; 95% CI -80.0 to 109.1; p = 0.757). Graft retention was 39.3% and 34.9%, respectively (difference 4.5%; 95% CI -6.4 to 15.4; p = 0.405). Both outcomes showed no statistically significant between-group differences. The EVE group experienced more AEs (22 AEs and 5 SAEs) compared with the control group (three AEs and two SAEs), which were predominantly skin-related complications. Perioperative EVE use did not yield significant improvements in augmentation or graft retention; however, it was associated with higher treatment burden and more (S)AEs. Final analyses of our ongoing RCT, incorporating patient-reported QoL outcomes are still awaited. Based on this interim analysis, the clinical benefit of EVE in reconstructive settings remains uncertain and warrants additional research.
Postoperative systemic inflammatory response syndrome (SIRS) remains a key complication after mini-percutaneous nephrolithotomy (mini-PCNL) and is often related to elevated intrarenal pressure and bacterial translocation. Vacuum-assisted mini-PCNL (VmPCNL) has been developed to mitigate this risk through active pressure control. To evaluate the association between VmPCNL and postoperative SIRS and to identify the independent predictors of SIRS in a real-world cohort. A retrospective cohort study was conducted of patients undergoing mini-PCNL at a tertiary referral center between January 2021 and May 2025. Patients were stratified into standard mini-PCNL (SmPCNL) and VmPCNL groups. The primary endpoint was SIRS within 48 hours post-surgery. Secondary outcomes included operative time, stone-free rate (SFR), and length of hospital stay (LOS). Multivariable logistic regression was used to identify independent predictors of SIRS. A total of 136 patients were included in the study (SmPCNL, n = 78; VmPCNL, n = 58). The incidence of postoperative SIRS was significantly lower in the VmPCNL group (8.6% vs 21.8%, p = 0.036). VmPCNL was also associated with shorter operative time (median 90 minutes vs 115 minutes, p = 0.038) and reduced LOS (p = 0.012). Stone-free rates were comparable between the groups, indicating no compromise in procedural efficacy. In the multivariable analysis, VmPCNL was independently associated with a lower risk of SIRS (adjusted OR [aOR] 0.44, 95% CI 0.19-0.98, p = 0.041), while a positive preoperative urine culture was an independent risk factor (aOR 2.60, 95% CI 1.01-6.60, p = 0.045). In this real-world cohort, VmPCNL was associated with a lower SIRS incidence and improved perioperative efficiency without compromising stone-free outcomes. The mechanism may involve improved intraoperative outflow dynamics through active suction, although direct measurement of intrarenal pressure is needed to confirm this hypothesis.
Vacuum-deposited lead halide perovskite thin films enable solvent-free fabrication, eliminating residual processing solvents that might compromise the long-term stability. Here, we investigate the stability of thermally evaporated mixed-cation compositions FA0.8Cs0.2PbI3 and FA0.8MA0.2PbI3 (FA+ = formamidinium and MA+ = methylammonium) under thermal and light stress. Although from a thermodynamic perspective the phase stability hierarchy is typically described as MA+ < FA+ < Cs+, with Cs-based perovskites expected to be the most stable, both compositions exhibit thermal robustness, retaining their structural, optical, and morphological properties after continuous heating at 85 °C for over 500 h. Under continuous illumination, however, distinct degradation pathways emerge: FA0.8Cs0.2PbI3 shows the largest morphological and optical changes. This is attributed to chemical inhomogeneities caused by CsI-rich segregations during crystallization, which make point defects effective triggers for photodegradation. Film homogeneity improves by partially replacing iodide with bromide. Based on these results, we selected FA0.8MA0.2PbI3 and FA0.8Cs0.2Pb-(I0.8Br0.2)3 for device fabrication and evaluated their operational stability. The resulting perovskite solar cells maintain their performance after four months of outdoor operation and withstand 900 h under continuous sun-equivalent indoor illumination at room temperature. These results demonstrate how a high-quality crystallization process can reveal the potential of MA-containing perovskite formulations for long-lived perovskite photovoltaics.
Indoor dust is an important exposure pathway for potentially toxic elements (PTEs) in industrial hotspots such as the Meža Valley (Slovenia), impacted by centuries of Pb-Zn mining/smelting and ongoing metallurgical activities. This study is the first to examine household dust from homes of children participating in biomonitoring, providing a unique opportunity to directly assess the relationship between indoor contamination and biomonitoring outcomes. Household vacuum dust from 27 homes (Upper Meža Valley, n = 13; Lower Meža Valley, n = 14) was analysed for 12 metal(loid)s. Statistical analyses identified three dominant source-related groups: (1) Pb-Zn-Cd (legacy mining/smelting), (2) Cu-Sn (Pb recycling), and (3) Cr-Ni-Mo (steel production), indicating a mixed anthropogenic fingerprint across the valley. Health risk assessment of PTEs indicates that ingestion is the primary exposure pathway, with children facing 7-12 times higher non-carcinogenic risks than adults. Children's blood lead levels (BLLs) were generally low (75th percentile = 31 µg L⁻¹), although 6 of 27 exceeded the CDC blood lead reference value of 35 µg L⁻¹. Lead concentrations in household dust significantly predicted BLL variability (adjusted R² ≈ 0.23), highlighting indoor dust as a relevant contributor to internal lead exposure. Cumulative cancer risks remained within acceptable regulatory limits under both worst-case (100% Cr(VI), 9.03 × 10⁻⁵) and more realistic (5% Cr(VI), 1.97 × 10⁻⁵) scenarios. Persistent indoor contamination following the 2023 flooding events, despite ongoing remediation efforts, underscores the need for area-wide mitigation strategies and continued environmental and health monitoring to limit PTE transfer into indoor environments.
Background Vacuum-assisted closure (VAC) therapy is a well-established method that uses negative pressure to promote wound healing and enhance skin graft adherence. While globally accepted, outcomes following its use in anatomically challenging wound sites within the Bangladeshi population remain underexplored. This study aimed to assess graft take and postoperative complications following VAC-assisted skin grafting in anatomically challenging wound sites. Methods A prospective observational study was conducted at the National Institute of Burn and Plastic Surgery, Dhaka, from September 2020 to August 2021, involving 50 patients undergoing split-thickness skin grafting over difficult anatomical regions. VAC therapy was applied postoperatively at -90 to -125 mmHg for five days. Graft take was assessed on the 5th and 14th postoperative days and categorized as good (<10% loss), satisfactory (10%-25% loss), or poor (>25% loss). Postoperative complications were recorded. Statistical analyses included the chi-square test, Fisher's exact test, and Pearson's correlation, with p<0.05 considered significant. Results Complete (100%) graft take was achieved in 31 (62%) patients, while 41 (82%) demonstrated good overall graft outcomes. Complete graft take was more frequently observed in well-vascularized wound beds than in less vascularized wound beds (25/32 vs. 6/18, p=0.005). No significant correlation was observed between wound size and graft loss (r=0.0418, p=0.773). Younger patients (2-19 years) showed significantly better graft outcomes, whereas poor outcomes were confined to patients aged ≥40 years (p<0.001). Postoperative complications were minimal and transient. Conclusion VAC-assisted dressing was associated with favorable graft take and few short-term postoperative complications in anatomically challenging wound sites. However, due to the observational design, small sample size, absence of formal power analysis, and lack of a standard dressing control group, these findings should be interpreted cautiously and cannot establish relative efficacy compared with conventional dressing methods.
A vacuum ultraviolet-assisted electrospray ionization (VUV-ESI) hybrid ionization source was developed by orthogonally coupling 124 nm photons to the electrospray plume to enhance the ionization of moderately polar and nonpolar analytes. Using five representative volatile aroma compounds as model analytes, the VUV-ESI system produced signal enhancements of up to 46-fold relative to conventional electrospray ionization. Mechanistic analyses indicate that this enhanced ionization efficiency arises from a synergistic combination of VUV-induced solvent processes and analyte-dependent photoactivation. Specifically, VUV irradiation promotes the formation of protonated solvent clusters that sustain efficient proton-transfer reactions. Concurrently, near-resonant excitation transiently increases the proton affinity of target analytes to favor proton capture, while molecules with relatively low ionization potentials undergo direct single-photon ionization followed by rapid solvent-mediated hydrogen abstraction. Density functional theory (DFT) and time-dependent DFT (TD-DFT) calculations support this analyte-dependent modulation, revealing excitation-induced increases in apparent proton affinity, exemplified by a 19.04 kcal/mol enhancement for azulene. Under optimized conditions, VUV-ESI demonstrated robust quantitative performance with coefficients of determination (R2) ≥ 0.99 and limits of detection down to 12.5 nmol/L. The method also exhibited reliable spike recoveries in complex Baijiu and essential oil matrices. These results establish the VUV-ESI hybrid source as a highly effective analytical platform for overcoming inherent ionization biases and expanding the accessible analyte coverage in mass spectrometry.
Environmental monitoring of viral pathogens will be a critical tool to prevent morbidity and mortality in future pandemics and yearly disease cycles. One approach in early stages of utilization is monitoring viruses from building dust. To date, these efforts have primarily used PCR-based methods to target individual viruses. Additional methods that can identify multiple viruses simultaneously, and in a semi-quantitative manner, would increase the efficiency and utility of these efforts. The goal of this project was to evaluate a whole-genome, hybrid-capture based high-throughput sequencing approach for measuring pathogens in building dust. We utilized the Illumina Viral Surveillance Panel v2 to enrich for targeted amplification of viral nucleic acid followed by sequencing in 27 samples from school, university, and professional settings. We identified 54 viruses that included pathogens such as SARS-CoV-2, influenza, adenovirus, norovirus, cytomegalovirus, Epstein-Barr virus, and more. Three of the viruses that are known to be associated with childhood infection were significantly more prevalent in child-associated settings than in buildings primarily occupied by adults (fdr p<0.05). A total of 85% of all collected samples contained at least one rhinovirus. Abundances of SARS-CoV-2 and influenza A viruses were estimated with traditional qPCR methods, and were correlated with relative abundances estimated from the sequencing data (R=0.76 and 0.42, p=0.000005 and 0.03, respectively). The methods utilized here measure nucleic acid and does not indicate viability. Overall, our results demonstrate a novel environmental surveillance technique for simultaneous and semi-quantitative measurement of multiple viral pathogens using building dust that can help us better understand viral spread, inform public health policy, and promote health.
Chemical proteomics approaches often yield low peptide recovery because they aim to enrich low-abundance proteins. Poor sample handling further reduces recovery through peptide adsorption to plastic surfaces and losses due to vacuum evaporation. We systematically mapped these losses across buffers, volumes, plastics and pH, then developed an Evotip-compatible handling protocol that minimizes adsorption and removes the need for vacuum evaporation. Losses to plastic adsorption and vacuum evaporation were most apparent at low inputs (< 200 ng) and with larger volumes (> 20 µL) but were also dependent on acidification as well as the buffer and plastic used. The optimized workflow: direct acidification of peptides, frozen storage if needed, and direct loading onto Evotips, resulted in up to ∼90-fold gains versus workflows incorporating vacuum concentration steps, a common practice in proteomics sample preparation, when peptide input was limited to 10 ng. This optimized sample handling method enables high-throughput chemical proteomics by reducing manual handling steps and enables the characterization of low abundance proteins previously lost during sample preparation.
Aspiration thrombectomy is a widely adopted acute ischemic stroke treatment with low complication rates. Traditional aspiration catheter delivery relies on microcatheters and microwires. Their removal before active aspiration has been observed to incidentally promote clot engagement; however, the mechanical basis and clinical relevance of this interaction remain poorly understood. Recently developed internal delivery catheters (DCs), such as Tenzing (Route 92 Medical), closely match the aspiration catheter lumen and appear to accentuate this effect, enabling quantification of the underlying mechanism. A physiologic benchtop cerebrovascular model was used to measure vacuum pressures during DC withdrawal and assess their effect on clot interaction. Test configurations included 3 aspiration catheter sizes (0.054″, 0.070″, 0.088″) tested with and without a Tenzing DC using synthetic thrombi. Vacuum pressure data were synchronized with fluoroscopic imaging and correlated with clot engagement and ingestion outcomes. Institutional Review Board approval and patient consent were not required for this in vitro study. Tenzing DC withdrawal produced a brief but substantial negative pressure spike (0.45-1.81 seconds), reaching 52% to 97% of maximum syringe vacuum (-560 mm Hg). This transient vacuum coincided with clot motion before active aspiration. Overall rates of successful clot capture were similar with and without DC use; however, DC-assisted trials showed a higher incidence of corked and fully ingested clots (P < .05), whereas aspiration catheter-only trials more frequently resulted in full clot aspiration. Withdrawal of a closely size-matched DC generates a previously unquantified transient vacuum that initiates preaspiration clot engagement. This study identifies synthetic aperture aspiration as a mechanism creating a localized low-pressure field that may promote early clot mobilization and wall detachment before active suction. While DC withdrawal likely contributes to clot engagement, the primary value of a DC remains safe navigation and device delivery.
In this work, we present a simple protocol for processing and analyzing multi-peak scanning tunneling microscope light emission (STM-LE) spectra obtained using an all-optical setup integrated into a standard low temperature, ultrahigh vacuum, scanning tunneling microscope system. The method involves measuring the polarization dependence of the STM-LE spectra and evaluating the localized surface plasmon confinement length to determine the presence and orientation of dipole emitter/s. We apply this technique to the STM-LE from Au-tip/Au(111) surface and Au-tip/Ag(111) surface systems. The observed spectra contain multiple peaks that cannot be described by a single confinement length, indicating the presence of multiple dipole emissions arising from electrical excitation within the tip-surface junction. The polarization of the STM-LE from distinct dipoles reveals that these dipoles have different orientations. Our work demonstrates that a simple and all-optical addition to a standard ultrahigh vacuum STM system can be used to obtain more in-depth information from the STM-LE spectra.
Counterions and the solvent environment are critical factors determining the electrical properties of DNA. Previous studies have reported the effects of Na+ ion concentration variations and solvent environments on the electrical conductivity of B-DNA. However, the mechanism by which they exert their influence on the drug-DNA complex remains unclear. This model integrates density functional theory and the nonequilibrium Green's function formalism to explore the impact of Na+ ions on the electrical properties of three drug-DNA complexes in both aqueous and vacuum environments. By minimizing the energy, Na+ ions are added to the drug-DNA complexes to render them electrically neutral. Subsequently, the electrical properties of the three DNA molecules are calculated under neutral conditions and after randomly removing one Na+ ion in different solvent environments to investigate the effects of the solvent environment and Na+ ions. The results show that the presence of Na+ hinders charge transport at the HOMO level both in aqueous solvent and vacuum. The removal of one Na+ ion from each of the three complexes leads to an increase in molecular conductivity and charge transfer efficiency, among which the Noga-DNA complex is particularly significantly affected by Na+ ions in the aqueous environment.
Serratia sp. are opportunistic Gram-negative bacteria capable of forming robust biofilms and expressing a wide range of quorum sensing (QS)-regulated virulence factors, including motility, protease secretion, and prodigiosin production. The rise of multidrug-resistant strains has emphasized the urgent need for alternative therapeutic strategies targeting bacterial virulence rather than viability. In this context, nonsteroidal anti-inflammatory drugs (NSAIDs) such as ketoprofen have emerged as potential quorum-quenching agents. This study explores the antivirulence activity of ketoprofen against Serratia sp. through a combination of in-vitro phenotypic assays and an advanced in-silico framework. In-vitro assays demonstrated that sub-inhibitory concentrations of ketoprofen significantly impair key virulence traits. Ketoprofen exhibited up to 90.68% inhibition of initial bacterial adhesion and disrupted mature biofilms, reducing biomass by up to 79.1%. Furthermore, motility assays revealed profound inhibition of both swimming and swarming behaviors, alongside a 100% suppression of protease activity and a 60.4% reduction in prodigiosin production, without exerting direct bactericidal effects. To elucidate the molecular basis of this competitive antagonism, an integrative computational approach was deployed. Deep learning-driven molecular docking (GNINA) revealed that ketoprofen targets the LuxR-type QS receptor SmaR with exceptional and reproducible affinity (mean Vina affinity of -9.51 kcal/mol), vastly outperforming natural acyl-homoserine lactone (AHL) autoinducers. Kinetic stability was validated through 5 ns vacuum molecular dynamics (MD), followed by 100 ns explicit solvent MD simulations in independent replicates. The trajectories confirmed remarkable positional retention of the ligand (Ligand RMSD ~ 0.08-0.16 nm) within the binding pocket. Rigorous MM/PBSA free energy calculations on the equilibrated trajectories yielded highly favorable binding free energies (ΔG ranging from - 19.90 to -30.11 kcal/mol), driven by massive enthalpic contributions (ΔH up to -34.20 kcal/mol) and a persistent network engaging 10 to 14 key interacting residues. Overall, these findings demonstrate that ketoprofen acts as a highly stable "molecular plug", effectively outcompeting endogenous AHL signals to lock the SmaR receptor in an inactive state. This highlights ketoprofen's immense potential as a repurposed antivirulence agent for combating biofilm-associated and multidrug-resistant Serratia infections.
Biomacromolecular therapeutics face critical size-dependent transdermal delivery limitations that restrict their clinical effectiveness. To overcome this constraint, a conformation-altering strategy using controlled mechanical stress is reported to achieve substantial structural compaction of polydeoxyribonucleotide (PDRN) without chemical intervention. By applying mild vacuum conditions that force PDRN molecules to pass through a silica particle media, a 1.8-fold size reduction of the radius of gyration was achieved, from 52.92 nm to 29.36 nm. The characterization of these molecules through SAXS and gel electrophoresis confirms the spatial conformational alteration without damage to the molecule structure or biofunctionality. Clinical trials validated the therapeutic superiority of conformationally modified PDRN, supported by enhanced cellular uptake, superior procollagen synthesis, accelerated wound healing kinetics, and upregulated extracellular matrix remodeling while preserving native adenosine A2A receptor-mediated signaling pathways. This conformational control methodology transcends traditional structure-function paradigms, establishing a platform for enhancing biomacromolecule bioavailability in dermatological therapeutics and regenerative medicine, allowing deepened tissue penetration without compromising biological activity.
Silicon, known for its high Li+ storage capacity, low redox potential, abundant reserves, and low cost, is regarded as a promising anode material for all-solid-state lithium-ion batteries (ASSLBs). Nevertheless, its practical application is hindered by severe volume expansion and sluggish reaction kinetics. Herein, Si@Mg3N2 composites are synthesized via a vacuum evaporation method, wherein ultrasmall Mg3N2 nanoparticles with an average size of 9 nm are uniformly coated onto the surface of commercial silicon microsheets. During the initial lithiation process, these Mg3N2 nanoparticles undergo an in situ phase transformation, forming a Li-Mg-Si alloy, Li-Mg alloy, and Li3N irreversibly. The resulting Li-rich substances with the mixed ionic/electronic conductive function effectively mitigate the substantial volume expansion associated with the Li-Si alloying reaction (reducing it from 210% to 38.6%), thereby enhancing electrode kinetics and mechanical stability. As a result, the Si@Mg3N2 composite anode delivers a reversible capacity of 2619 mAh g-1 at 0.1 A g-1 and maintains a discharge capacity of 1460 mAh g-1 even at a high rate of 5 A g-1 in half-cell configurations. Furthermore, ASSLBs incorporating the Si@Mg3N2 anode exhibit excellent rate capability (50.8 mAh g-1 at 40 C) and robust cycling stability (61.6% capacity retention after 1000 cycles).
Obese pregnant women (body mass index ≥ 30 kg/m2) often receive epidural analgesia (EA) during their deliveries. However, there is scarce evidence on the effect of EA on maternal and perinatal outcomes in these women. The goal of this study is to evaluate outcomes in obese women receiving EA during their planned vaginal deliveries. Patient records of obese women undergoing a planned vaginal delivery from January 2018 until December 2023 in a tertiary care center were screened. Women were stratified into two groups depending on whether or not they received EA during their deliveries. EA was provided after shared decision making between provider and mother. Baseline characteristics and perinatal outcomes were collected for both groups. Primary outcomes were conversion to cesarean section (CS) and reduced Apgar scores (<7 at 5 min). Secondary outcomes were mode of delivery, type of anesthesia, estimated blood loss, episiotomies, perineal ruptures, hospital length of stay, fetal umbilical artery pH and base excess. Using inverse probability of treatment weights, primary outcomes per group were adjusted for baseline characteristics in a logistic regression model. 259 women received EA, 144 did not. Women with EA had lower gravidity and parity, more often induction of labor and delivered children with higher birthweights. In total 88 (22%) women in both groups required secondary CS. General anesthesia was avoided for all 64 women with EA. In the non-EA group, general anesthesia was used for seven out of 24 women. After adjustment, conversion to CS (OR 0.984, CI 0.542-1.786, P = 0.957) and reduced Apgar scores (OR 1.138, CI 0.375-3.458, P = 0.820) were not significantly different. Secondary outcomes (unadjusted) showed several differences. EA was associated with more vacuum deliveries (16% vs 2%, P < 0.001), more episiotomies (18% vs 7%, P = 0.003), higher mean blood loss (523 ml vs 351 ml, P < 0.001), and longer mean length of hospital admittance (4.3 days vs 3.5, P < 0.001). Women with a BMI ≥ 30 kg/m2 receiving EA for planned vaginal delivery showed similar conversion to CS and similar Apgar scores, when compared to obese women without EA. Secondary maternal outcomes were less beneficial for the group receiving EA, but fetal outcomes were not. When conversion to surgical delivery was required, general anesthesia was avoided in 100% of women with EA, while 29% of women without EA required general anesthesia, although fetal outcomes were not worse in this group. In conclusion, early epidural placement for intended vaginal delivery in obese women is safe for mother and child and may prevent the need for general anesthesia for conversion to CS.
Rare-earth-doped transparent ceramics, as novel luminescent materials, show broad application prospects in the field of advanced photonics. In this study, a series of Gd2Hf2O7:Yb3+,Er3+ transparent ceramics were prepared by controlling Yb3+ concentration via vacuum sintering. These ceramics exhibit a dense microstructure that effectively suppresses light scattering and nonradiative relaxation, enabling simultaneous visible light, near-infrared emission, and upconversion luminescence within a single ceramic system. The dual-mode emissions are attributed to the strong near-infrared absorption of Yb3+ ions, as well as the efficient Yb3+ → Er3+ energy transfer under 980 nm excitation and the presence of Er3+ → Yb3+ energy transfer under ultraviolet light. Furthermore, these ceramics exhibit superior environmental resilience and hydrophobic properties. Accelerated hydrothermal aging tests reveal negligible phase decomposition, minimal decay in near-infrared and upconversion luminescence, and significantly enhanced performance compared to commercial aluminate phosphors. This property stems from the inherent chemical stability and dense structure of the ceramics. Gd2Hf2O7-based dense transparent ceramics, characterized by dual-mode luminescence, high transmittance, and exceptional durability, hold promise in addressing the stability limitations and integration challenges in harsh environments and high-power optoelectronic devices.