Increasing frailty is associated with higher prevalence and reduced recognition of delirium in older hospitalised inpatients: results of a multi-centre study

Purpose: Delirium is a neuropsychiatric disorder delineated by an acute change in cognition, attention, and consciousness. It is common, particularly in older adults, but poorly recognised. Frailty is the accumulation of deficits conferring an increased risk of adverse outcomes. We set out to determine how severity of frailty, as measured using the CFS, affected delirium rates, and recognition in hospitalised older people in the United Kingdom. Methods: Adults over 65 years were included in an observational multi-centre audit across UK hospitals, two prospective rounds, and one retrospective note review. Clinical Frailty Scale (CFS), delirium status, and 30-day outcomes were recorded. Results: The overall prevalence of delirium was 16.3% (483). Patients with delirium were more frail than patients without delirium (median CFS 6 vs 4). The risk of delirium was greater with increasing frailty [OR 2.9 (1.8–4.6) in CFS 4 vs 1–3; OR 12.4 (6.2–24.5) in CFS 8 vs 1–3]. Higher CFS was associated with reduced recognition of delirium (OR of 0.7 (0.3–1.9) in CFS 4 compared to 0.2 (0.1–0.7) in CFS 8). These risks were both independent of age and dementia. Conclusion: We have demonstrated an incremental increase in risk of delirium with increasing frailty. This has important clinical implications, suggesting that frailty may provide a more nuanced measure of vulnerability to delirium and poor outcomes. However, the most frail patients are least likely to have their delirium diagnosed and there is a significant lack of research into the underlying pathophysiology of both of these common geriatric syndromes

Effectiveness of clonidine as a preanesthetic drug on intra operative blood loss in oral and maxillofacial surgery: A systematic review

Controlled hypotension during a surgical procedure is a way to decrease blood pressure and subsequently to improve the field of operation. Clonidine is an antihypertensive drug which acts through facilitation of Alph-2 post-synaptic receptors and in addition to its antihypertensive, anti-anxiety and analgesic effects, its beneficial effects in reducing the bleeding during. Correction of maxillomandibular discrepancies may necessitate performing osteotomy on both the jaws in several cases. Bimaxillary orthognathic surgery and rhinoplasty are procedures associated with significant blood making proper hemostasis essential for a surgical field that is free of excessive blood, reduced postoperative swelling, and appropriate surgical results. The aim of this systematic review is to assess the effectiveness of Clonidine as a pre-anesthetic drug on intraoperative blood loss in maxillofacial surgery. The Databases of PubMed, Cochrane and Google scholar were searched for the related topics along with a complimentary manual search of all oral surgery journals till January 2021. Articles were selected based on the inclusion criteria, which included all RCTs. From this study it is concluded that clonidine premedication is effective in reducing intraoperative blood loss as well as providing hemodynamic stability in patients undergoing different maxillofacial surgeries

Substantially enhanced photoelectrochemical performance of TiO2 nanorods/CdS nanocrystals heterojunction photoanode decorated with MoS2 nanosheets

Two-dimensional (2D) MoS2 nanosheets (NSs) modified 1D TiO2 nanorods/0D CdS nanocrystals (NCs) heterojunction has been fabricated by all solution process as a potential anode for photoelectrochemical (PEC) water splitting applications. This heterojunction photoanode shows high photocurrent density of 3.25 mA/cm2 at 0.9 V vs. RHE (0 V vs. Ag/AgCl) compared to the pristine TiO2/CdS photoanode. The influence of MoS2 NSs on PEC performance of TiO2/CdS/MoS2 heterojunction has been systematically investigated. We demonstrate that MoS2 NSs transfer holes from CdS and facilitate further charge separation in TiO2/CdS. Time resolved photoluminescence measurement reveals increase in photoluminescence lifetime due to the presence of MoS2 NSs in TiO2/CdS/MoS2 resulting in enhanced PEC activity. This work suggests that 1D TiO2/0D CdS/2D MoS2 heterojunction prototype is an interesting system where MoS2 NSs can be utilized to improve charge separation in photoanodes. This study would pave the way towards designing new heterojunction functional materials for efficient PEC applications

Nanostructured Na 2 Ti 9 O 19 for Hybrid Sodium-Ion Capacitors with Excellent Rate Capability

Herein, we report a new Na-insertion electrode material, Na2Ti9O19, as a potential candidate for Na-ion hybrid capacitors. We study the structural properties of nanostructured Na2Ti9O19, synthesized by a hydrothermal technique, upon electrochemical cycling vs Na. Average and local structures of Na2Ti9O19 are elucidated from neutron Rietveld refinement and pair distribution function (PDF), respectively, to investigate the initial discharge and charge events. Rietveld refinement reveals electrochemical cycling of Na2Ti9O19 is driven by single-phase solid solution reaction during (de)sodiation without any major structural deterioration, keeping the average structure intact. Unit cell volume and lattice evolution on discharge process is inherently related to TiO6 distortion and Na ion perturbations, while the PDF reveals the deviation in the local structure after sodiation. Raman spectroscopy and X-ray photoelectron spectroscopy studies further corroborate the average and local structural behavior derived from neutron diffraction measurements. Also, Na2Ti9O19 shows excellent Na-ion kinetics with a capacitve nature of 86% at 1.0 mV s–1, indicating that the material is a good anode candidate for a sodium-ion hybrid capacitor. A full cell hybrid Na-ion capacitor is fabricated by using Na2Ti9O19 as anode and activated porous carbon as cathode, which exhibits excellent electrochemical properties, with a maximum energy density of 54 Wh kg–1 and a maximum power density of 5 kW kg–1. Both structural insights and electrochemical investigation suggest that Na2Ti9O19 is a promising negative electrode for sodium-ion batteries and hybrid capacitors

Photoluminescence tuning of Na_1−xK_xNdW₂O₈ (0.0 ≤ x ≤ 0.7) nanoparticles: synthesis, crystal structure and Raman study

A series of Na_1−xK_xNdW₂O₈ (0.0 ≤ x ≤ 0.7) nanoparticles have been synthesized by an efficient glycothermal technique for the first time. SEM measurements confirmed the particle size ranges from 30–200 nm with ellipsoidal shaped morphology. Combined X-ray and neutron diffraction and Raman spectroscopy techniques were utilized in order to investigate the influence of K⁺ ion substitution in NaNdW₂O₈. K⁺ ion substitution in the crystal lattice introduced a change in the Nd–O bond length and the Nd–O–W bond angle of NaNdW₂O₈. The photoluminescence intensity increased up to the threshold composition x = 0.4. K⁺ ion substitution resulted in blue shifted emission of NaNdW₂O₈. Size mismatch, the Nd–O–W angle and local disorder contributed to the observed difference in luminescence properties. Also, the chromaticity diagram for this blue emitting phosphor showed the possibility of tuning the emission by incorporation of K

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Influence of C3N4 Precursors on Photoelectrochemical Behavior of TiO2/C3N4 Photoanode for Solar Water Oxidation

Photoelectrochemical water splitting is considered as a long-term solution for the ever-increasing energy demands. Various strategies have been employed to improve the traditional TiO2 photoanode. In this study, TiO2 nanorods were decorated by graphitic carbon nitride (C3N4) derived from different precursors such as thiourea, melamine, and a mixture of thiourea and melamine. Photoelectrochemical activity of TiO2/C3N4 photoanode can be modified by tuning the number of precursors used to synthesize C3N4. C3N4 derived from the mixture of melamine and thiourea in TiO2/C3N4 photoanode showed photocurrent density as high as 2.74 mA/cm2 at 1.23 V vs. RHE. C3N4 synthesized by thiourea showed particle-like morphology, while melamine and melamine with thiourea derived C3N4 yielded two dimensional (2D) nanosheets. Nanosheet-like C3N4 showed higher photoelectrochemical performance than that of particle-like nanostructures as specific surface area, and the redox ability of nanosheets are believed to be superior to particle-like nanostructures. TiO2/C3N4 displayed excellent photostability up to 20 h under continuous illumination. Thiourea plays an important role in enhancing the photoelectrochemical performance of TiO2/C3N4. This study emphasizes the fact that the improved photoelectrochemical performance can be achieved by varying the precursors of C3N4 in TiO2/C3N4 heterojunction. This is the first report to show the influence of C3N4 precursors on photoelectrochemical performance in TiO2/C3N4 systems. This would pave the way to explore different precursors influence on C3N4 with respect to the photoelectrochemical response of TiO2/C3N4 heterojunction photoanode

Triple Planar Heterojunction of SnO2/WO3/BiVO4 with Enhanced Photoelectrochemical Performance under Front Illumination

The performance of a BiVO4 photoanode is limited by poor charge transport, especially under front side illumination. Heterojunction of different metal oxides with staggered band configuration is a promising route, as it facilitates charge separation/transport and thereby improves photoactivity. We report a ternary planar heterojunction photoanode with enhanced photoactivity under front side illumination. SnO2/WO3/BiVO4 films were fabricated through electron beam deposition and subsequent wet chemical method. Remarkably high external quantum efficiency of ~80% during back side and ~90% upon front side illumination at a wavelength of 400 nm has been witnessed for SnO2/WO3/BiVO4 at 1.23 V vs. reversible hydrogen electrode (RHE). The intimate contact between the heterojunction films enabled efficient charge separation at the interface and promoted electron transport. This work provides a new paradigm for designing triple heterojunction to improve photoactivity, particularly under front illumination, which would be beneficial for the development of tandem devices

Nanostructured Na₂Ti₉O₁₉ for Hybrid Sodium-Ion Capacitors with Excellent Rate Capability

Herein, we report a new Na-insertion electrode material, Na₂Ti₉O₁₉, as a potential candidate for Na-ion hybrid capacitors. We study the structural properties of nanostructured Na₂Ti₉O₁₉, synthesized by a hydrothermal technique, upon electrochemical cycling vs Na. Average and local structures of Na₂Ti₉O₁₉ are elucidated from neutron Rietveld refinement and pair distribution function (PDF), respectively, to investigate the initial discharge and charge events. Rietveld refinement reveals electrochemical cycling of Na₂Ti₉O₁₉ is driven by single-phase solid solution reaction during (de)­sodiation without any major structural deterioration, keeping the average structure intact. Unit cell volume and lattice evolution on discharge process is inherently related to TiO₆ distortion and Na ion perturbations, while the PDF reveals the deviation in the local structure after sodiation. Raman spectroscopy and X-ray photoelectron spectroscopy studies further corroborate the average and local structural behavior derived from neutron diffraction measurements. Also, Na₂Ti₉O₁₉ shows excellent Na-ion kinetics with a capacitve nature of 86% at 1.0 mV s^–1, indicating that the material is a good anode candidate for a sodium-ion hybrid capacitor. A full cell hybrid Na-ion capacitor is fabricated by using Na₂Ti₉O₁₉ as anode and activated porous carbon as cathode, which exhibits excellent electrochemical properties, with a maximum energy density of 54 Wh kg^–1 and a maximum power density of 5 kW kg^–1. Both structural insights and electrochemical investigation suggest that Na₂Ti₉O₁₉ is a promising negative electrode for sodium-ion batteries and hybrid capacitors

Polymorphism in photoluminescent KNdW₂O₈: synthesis, neutron diffraction and Raman study

Polymorphs of KNdW2O8 (α-KNdW2O8 and β-KNdW2O8) phosphors were synthesized by an efficient solution combustion technique for the first time. The crystal structure of the polymorphs analyzed from Rietveld refinement of neutron diffraction data confirms that α-KNdW2O8 crystallizes in the tetragonal system (space groupI4̅), and β-KNdW2O8 crystallizes in the monoclinic system (space group C2/m). The local structure of both polymorphs was elucidated using combined neutron Pair Distribution Function (PDF) and Raman scattering techniques. Photoluminescence measurements of the polymorphs showed broadened emission line width and increased intensity for β-KNdW2O8 in the visible region compared to α-KNdW2O8. This phenomenon is attributed to the increased distortion in the coordination environment of the luminescing Nd3+ ion. Combined PDF, Rietveld and Raman measurements reveal distortions of the WO6 octahedra and NdO8 polyhedra in β-KNdW2O8. This crystal structure–photoluminescence study suggests that this class of tungstates can be exploited for visible light emitting devices by tuning the crystal symmetr