Strontium titanate is seeing increasing interest in fields ranging from thin-film growth to water-splitting catalysis and electronic devices. Although the surface structure and chemistry are of vital importance to many of these applications, theories about the driving forces vary widely 1,2 . We report here a solution to the 3 × 1 SrTiO 3 (110) surface structure obtained through transmission electron diffraction and direct methods, and confirmed through density functional theory calculations and scanning tunnelling microscopy images and simulations, consisting of rings of six or eight cornersharing TiO 4 tetrahedra. Further, by changing the number of tetrahedra per ring, a homologous series of n × 1 (n ≥ 2) surface reconstructions is formed. Calculations show that the lower members of the series (n ≤ 6) are thermodynamically stable and the structures agree with scanning tunnelling microscopy images. Although the surface energy of a crystal is usually thought to determine the structure and stoichiometry, we demonstrate that the opposite can occur. The n × 1 reconstructions are sufficiently close in energy for the stoichiometry in the near-surface region to determine which reconstruction is formed. Our results indicate that the rules of inorganic coordination chemistry apply to oxide surfaces, with concepts such as homologous series and intergrowths as valid at the surface as they are in the bulk.The structure of SrTiO 3 is a cubic close-packed lattice of strontium and oxygen with strontium at the corners and oxygen at the face centres, and titanium at the body centres occupying those octahedral holes that are surrounded only by oxygen. Along the (110) direction SrTiO 3 is polar, composed of alternating layers of SrTiO 4+ and O 2 4− , that is, alternating layers with uncompensated nominal valence charges of 4+/4−. In a fully ionic model, this leads to an unbalanced macroscopic dipole and infinite surface energy. Therefore, we expect a (110) surface to have a nominal excess surface valence of either 2+ or 2− per surface unit cell, as otherwise energetically unfavourable holes in the valence band or electrons in the conduction band would be formed. There has been extensive discussion of the mechanisms of this 'charge compensation' for polar oxide surfaces in the literature (see for instance refs 3-5 and references therein). Various theories, such as a reduction of Coulomb forces 2 or a minimization of 'dangling bonds' 1 , have been described as the driving force behind surface structure formation. An alternative model for oxide surfaces, first proposed for the SrTiO 3 (001) 2 × 1 surface 6 , is that the rules of inorganic coordination chemistry dominate, although, as the (001) surface is not polar, we might question the generality of this model.

Background Transfusion-associated circulatory overload (TACO) is a leading cause of transfusion-related fatalities, but its incidence and associated patient and transfusion characteristics are poorly understood. To inform surgical transfusion practice and to begin mitigating perioperative TACO, the authors aimed to define its epidemiology. Methods In this retrospective cohort study, the medical records of adult patients undergoing noncardiac surgery with general anesthesia during 2004 or 2011 and receiving intraoperative transfusions were screened using an electronic algorithm for identification of TACO. Those patients who were screened as high probability for TACO underwent rigorous manual review. Univariate and multivariate analyses evaluated associations between patient and transfusion characteristics with TACO rates in a before-and-after study design. Results A total of 2,162 and 1,908 patients met study criteria for 2004 and 2011, respectively. The incidence of TACO was 5.5% (119 of 2,162) in 2004 versus 3.0% (57 of 1,908) in 2011 (P < 0.001), with comparable rates for men (4.8% [98 of 2,023]) and women (3.8% [78 of 2,047]) (P = 0.09). Overall, vascular (12.1% [60 of 497]), transplant (8.8% [17 of 193]), and thoracic surgeries (7.2% [10 of 138]) carried the highest TACO rates. Obstetric and gynecologic patients had the lowest rate (1.4% [4 of 295]). The incidence of TACO increased with volume transfused, advancing age, and total intraoperative fluid balance (all P < 0.001). Conclusions The incidence of perioperative TACO is similar to previous estimates in nonsurgical populations. There was a reduction in TACO rate between 2004 and 2011, with incidence patterns remaining comparable in subgroup analyses. Future efforts exploring risk factors for TACO may guide preventive or therapeutic interventions, helping to further mitigate this transfusion complication.

Background Transfusion-related acute lung injury (TRALI) is the leading cause of transfusion-related death in the United States; however, it remains poorly characterized in surgical populations. To better inform perioperative transfusion practice, and to help mitigate perioperative TRALI, the authors aimed to better define its epidemiology before and after TRALI mitigation strategies were introduced. Methods This retrospective cohort study examined outcomes of adult patients undergoing noncardiac surgery with general anesthesia who received intraoperative transfusions during 2004 (n = 1,817) and 2011 (n = 1,562). The demographics and clinical characteristics of transfusion recipients, blood transfusion descriptors, and combined TRALI/possible TRALI incidence rates were evaluated. Univariate analyses were used to compare associations between patient characteristics, transfusion details, and TRALI mitigation strategies with TRALI/possible TRALI incidence rates in a before-and-after study design. Results The incidence of TRALI/possible TRALI was 1.3% (23 of 1,613) in 2004 versus 1.4% (22 of 1,562) in 2011 (P = 0.72), with comparable overall rates in males versus females (1.4% [23 of 1,613] vs. 1.2% [22 of 1,766]) (P = 0.65). Overall, thoracic (3.0% [4 of 133]), vascular (2.7% [10 of 375]), and transplant surgeries (2.2% [4 of 178]) carried the highest rates of TRALI/possible TRALI. Obstetric and gynecologic surgical patients had no TRALI episodes. TRALI/possible TRALI incidence increased with larger volumes of blood product transfused (P < 0.001). Conclusions Perioperative TRALI/possible TRALI is more common than previously reported and its risk increases with greater volumes of blood component therapies. No significant reduction in the combined incidence of TRALI/possible TRALI occurred between 2004 and 2011, despite the introduction of TRALI mitigation strategies. Future efforts to identify specific risk factors for TRALI/possible TRALI in surgical populations may reduce the burden of this life-threatening complication.

Background Transfusion-associated circulatory overload remains underappreciated in the perioperative environment. The authors aimed to characterize risk factors for perioperative transfusion-associated circulatory overload and better understand its impact on patient-important outcomes. Methods In this case–control study, 163 adults undergoing noncardiac surgery who developed perioperative transfusion-associated circulatory overload were matched with 726 transfused controls who did not develop respiratory complications. Univariate and multivariable logistic regression analyses were used to evaluate potential risk factors for transfusion-associated circulatory overload. The need for postoperative mechanical ventilation, lengths of intensive care unit and hospital stay, and mortality were compared. Results For this cohort, the mean age was 71 yr and 56% were men. Multivariable analysis revealed the following independent predictors of transfusion-associated circulatory overload: emergency surgery, chronic kidney disease, left ventricular dysfunction, previous β-adrenergic receptor antagonist use, isolated fresh frozen plasma transfusion (vs. isolated erythrocyte transfusion), mixed product transfusion (vs. isolated erythrocyte transfusion), and increasing intraoperative fluid administration. Patients who developed transfusion-associated circulatory overload were more likely to require postoperative mechanical ventilation (73 vs. 33%; P &lt; 0.001) and experienced prolonged intensive care unit (11.1 vs. 6.5 days; P &lt; 0.001) and hospital lengths of stay (19.9 vs. 9.6 days; P &lt; 0.001). Survival was significantly reduced (P &lt; 0.001) in transfusion recipients who developed transfusion-associated circulatory overload (1-yr survival 72 vs. 84%). Conclusions Perioperative transfusion-associated circulatory overload was associated with a protracted hospital course and increased mortality. Efforts to minimize the incidence of transfusion-associated circulatory overload should focus on the judicious use of intraoperative blood transfusions and nonsanguineous fluid therapies, particularly in patients with chronic kidney disease, left ventricular dysfunction, chronic β-blocker therapy, and those requiring emergency surgery.

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In our study, care by additional attending anesthesiologists and in-room providers was independently associated with an increased odds of postoperative complications. These findings challenge the assumption that anesthesia transitions are care neutral and not contributory to surgical outcomes.

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We report an experimental refinement of the local charge density at the Si (111) 7x7 surface utilizing a combination of x-ray and high energy electron diffraction. By perturbing about a bond-centered pseudoatom model, we find experimentally that the adatoms are in an anti-bonding state with the atoms directly below. We are also able to experimentally refine a charge transfer of 0.26±0.04 e -from each adatom site to the underlying layers. These results are compared with a full-potential all-electron density functional DFT calculation.