Synthesis of graphene and graphene nanostructures by ion implantation and pulsed laser annealing

In this paper, we report a systematic study that shows how the numerous processing parameters associated with ion implantation (II) and pulsed laser annealing (PLA) can be manipulated to control the quantity and quality of graphene (G), few-layer graphene (FLG), and other carbon nanostructures selectively synthesized in crystalline SiC (c-SiC). Controlled implantations of Si− plus C− and Au + ions in c-SiC showed that both the thickness of the amorphous layer formed by ion damage and the doping effect of the implanted Au enhance the formation of G and FLG during PLA. The relative contributions of the amorphous and doping effects were studied separately, and thermal simulation calculations were used to estimate surface temperatures and to help understand the phase changes occurring during PLA. In addition to the amorphous layer thickness and catalytic doping effects, other enhancement effects were found to depend on other ion species, the annealing environment, PLA fluence and number of pulses, and even laser frequency. Optimum II and PLA conditions are identified and possible mechanisms for selective synthesis of G, FLG, and carbon nanostructures are discussed

Oil disturbance reduces infaunal family richness but does not affect phylogenetic diversity

Infaunal organisms are susceptible to disturbances such as hypoxia and sediment contamination; changes in infaunal community structure are therefore often used as indicators of anthropogenic disturbance. Susceptibility to disturbance varies across taxa, either due to physiological factors or to behaviors or functional roles that increase exposure. Both sources of variability are likely to be heritable and shared among related taxa. Thus, we would expect oil disturbance to disproportionately affect related taxa and therefore decrease phylogenetic diversity (PD). We test this hypothesis for a shallow water marine infaunal community using a simulation approach that iteratively removes clades with shared vulnerability to oil exposure. Infauna were sampled at two sites in the Chandeleur Islands, LA, that reflect different exposures to crude oil after the Deepwater Horizon event. Seagrass and adjacent bare sediment habitats were sampled in 2015, 5 years after initial oil exposure, and again in 2016 after an acute re-oiling event. We found that strong correlation between PD and family richness masked any detectable PD patterns with oil exposure. For our full community tree, sensitivity analysis indicated that the removal of larger clades did not disproportionately reduce PD, against our prediction. For this pair of sites, PD did not provide a better metric for assessing the impacts of oil exposure than family richness alone. It is possible, however, that finer-scale taxonomic resolution of infaunal communities may better decouple PD from taxonomic richness. More work is needed to fully evaluate the impacts of disturbance on PD

La Grange Comprehensive Plan 2018 - 2038

In the Fall of 2017, the City of La Grange and Texas Target Communities partnered to create a task force to represent the community. The task force was integral to the planning process, contributing the thoughts, desires, and opinions of community members—as well as their enthusiasm about La Grange’s future. This fifteen-month planning process ended in August 2018. The result of this collaboration is the La Grange Comprehensive Plan, which is the official policy guide for the community’s growth over the next twenty years.La Grange Comprehensive Plan 2018 - 2038 provides a guide for the future growth of the City. This document was developed by Texas Target Communities in partnership with the City of La Grange.Texas Target Communitie

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Mortality analysis of COVID-19 infection in chronic kidney disease, haemodialysis and renal transplant patients compared with patients without kidney disease: a nationwide analysis from Turkey

Background. Chronic kidney disease (CKD) and immunosuppression, such as in renal transplantation (RT), stand as one of the established potential risk factors for severe coronavirus disease 2019 (COVID-19). Case morbidity and mortality rates for any type of infection have always been much higher in CKD, haemodialysis (HD) and RT patients than in the general population. A large study comparing COVID-19 outcome in moderate to advanced CKD (Stages 3-5), HD and RT patients with a control group of patients is still lacking. Methods. We conducted a multicentre, retrospective, observational study, involving hospitalized adult patients with COVID-19 from 47 centres in Turkey. Patients with CKD Stages 3-5, chronic HD and RT were compared with patients who had COVID-19 but no kidney disease. Demographics, comorbidities, medications, laboratory tests, COVID-19 treatments and outcome [in-hospital mortality and combined in-hospital outcome mortality or admission to the intensive care unit (ICU)] were compared. Results. A total of 1210 patients were included [median age, 61 (quartile 1-quartile 3 48-71) years, female 551 (45.5%)] composed of four groups: Control (n = 450), HD (n = 390), RT (n = 81) and CKD (n = 289). The ICU admission rate was 266/ 1210 (22.0%). A total of 172/1210 (14.2%) patients died. The ICU admission and in-hospital mortality rates in the CKD group [114/289 (39.4%); 95% confidence interval (CI) 33.9-45.2; and 82/289 (28.4%); 95% CI 23.9-34.5)] were significantly higher than the other groups: HD = 99/390 (25.4%; 95% CI 21.3-29.9; P<0.001) and 63/390 (16.2%; 95% CI 13.0-20.4; P<0.001); RT = 17/81 (21.0%; 95% CI 13.2-30.8; P = 0.002) and 9/81 (11.1%; 95% CI 5.7-19.5; P = 0.001); and control = 36/450 (8.0%; 95% CI 5.8-10.8; P<0.001) and 18/450 (4%; 95% CI 2.5-6.2; P<0.001). Adjusted mortality and adjusted combined outcomes in CKD group and HD groups were significantly higher than the control group [hazard ratio (HR) (95% CI) CKD: 2.88 (1.52- 5.44); P = 0.001; 2.44 (1.35-4.40); P = 0.003; HD: 2.32 (1.21- 4.46); P = 0.011; 2.25 (1.23-4.12); P = 0.008), respectively], but these were not significantly different in the RT from in the control group [HR (95% CI) 1.89 (0.76-4.72); P = 0.169; 1.87 (0.81-4.28); P = 0.138, respectively]. Conclusions. Hospitalized COVID-19 patients with CKDs, including Stages 3-5 CKD, HD and RT, have significantly higher mortality than patients without kidney disease. Stages 3-5 CKD patients have an in-hospital mortality rate as much as HD patients, which may be in part because of similar age and comorbidity burden. We were unable to assess if RT patients were or were not at increased risk for in-hospital mortality because of the relatively small sample size of the RT patients in this study