The ORCID identification number(s) for the author(s) of this article can be found under https://doi.org/10.1002/smll.201905842. Rechargeable Zn/MnO 2 batteries using mild aqueous electrolytes are attracting extensive attention due to their low cost, high safety, and environmental friendliness. However, the charge-storage mechanism involved remains a topic of controversy so far. Also, the practical energy density and cycling stability are still major issues for their applications. Herein, a free-standing α-MnO 2 cathode for aqueous zinc-ion batteries (ZIBs) is directly constructed with ultralong nanowires, leading to a rather high energy density of 384 mWh g −1 for the entire electrode. Greatly, the H + /Zn 2+ coinsertion mechanism of α-MnO 2 cathode for aqueous ZIBs is confirmed by a combined analysis of in situ X-ray diffractometry, ex situ transmission electron microscopy, and electrochemical methods. More interestingly, the Zn 2+ -insertion is found to be less reversible than H + -insertion in view of the dramatic capacity fading occurring in the Zn 2+ -insertion step, which is further evidenced by the discovery of an irreversible ZnMn 2 O 4 layer at the surface of α-MnO 2 . Hence, the H + -insertion process actually plays a crucial role in maintaining the cycling performance of the aqueous Zn/α-MnO 2 battery. This work is believed to provide an insight into the charge-storage mechanism of α-MnO 2 in aqueous systems and paves the way for designing aqueous ZIBs with high energy density and long-term cycling ability. www.advancedsciencenews.com

The practical application of Li-rich Mn-based oxide cathode is predominately retarded by the capacity decline and voltage fading, associated with the structure distortion and anionic redox reactions. Here, a linkagefunctionalized modification approach to tackle these challenges via a synchronous lithium oxidation strategy is reported. The doping of Ce in the bulk phase activates the pseudo-bonding effect, effectively stabilizing the lattice oxygen evolution and suppressing the structure distortion. Interestingly, it also induces the formation of spinel phase Li 4 Mn 5 O 12 in the subsurface, which in turn constructs the phase boundaries, thereby arousing the interior self-built-in electric field to prevent the outward migration of bulk oxygen anions and boost the charge transfer. Moreover, the formed coating layer Li 2 CeO 3 with oxygen vacancies accelerates Li + diffusion and mitigates electrolyte cauterization. The corresponding cathode exhibits superior longcycle stability after 300 cycles with only a 0.013% capacity drop and 1.76 mV voltage decay per cycle. This work sheds new light on the development of Li-rich Mn-based oxide cathodes toward high energy density applications.

Single-injection subcostal TAP block was more effective than IV opioid analgesia, while continuous thoracic epidural analgesia was more effective than the single-injection subcostal TAP block.

The aim of this meta-analysis is to examine the effects of dexmedetomidine on serum inflammatory markers when administered perioperatively. We searched multiple electronic databases for relevant research papers, and carried out meta-analyses of weighted mean differences and interpreted in the light of statistical heterogeneity (I2). Fifteen RCTs recruiting 641 patients were included. Dexmedetomidine treatment significantly decreased interleukin-6 (IL-6), IL-8 and tumor necrosis factor-alpha (TNF-α) levels with mean differences [95% CI] in the changes from baseline between dexmedetomidine treated and controls of −25.14 [−35.29, −15.00]; P < 0.00001 (for IL-6), −5.69 [−10.77, −0.60]; P < 0.04 (for IL-8), and −20.30 [−30.93, −9.67]; P < 0.0002 (for TNF-α) immediately after surgery; and −41.55 [−57.41, −25.70]; P < 0.00001 (IL-6), −6.46 [−10.83, −2.08]; P < 0.005 (IL-8), and −14.67 [−22.61, −6.73]; P < 0.0003 (TNF-α) on postoperative day 1 (random effects). IL-10 levels were found to increase significantly a day after surgery (8.33 [3.31, 13.36]; P = 0.001). Subgroup analyses did not reveal significant differences. In conclusion, perioperative adjunctive use of dexmedetomidine substantially decreases serum IL-6, IL-8 and TNF-α levels.

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Background Fiberoptic bronchoscopy is a complex procedure with the need for sufficient patient anesthesia/sedation while maintaining safety. This trial aimed to evaluate the efficacy, safety, and pharmacokinetics of HSK3486 during fiberoptic bronchoscopy. Methods This multicenter, double-blind, randomized, non-inferiority, parallel-group phase 3 trial was conducted in patients who underwent fiberoptic bronchoscopy. Patients randomly received HSK3486 0.4 mg/kg (N = 134) or propofol 2.0 mg/kg (N = 133). The primary efficacy endpoint was the successful rate of fiberoptic bronchoscopy, and secondary efficacy endpoints included successful induction of anesthesia/sedation, duration, time to being fully alert, and time to patient discharge. Safety assessments and drug concentrations were also measured. Results A total of 267 patients completed fiberoptic bronchoscopy, with a success rate of 100% and a 95% confidence interval of − 2.8 to 2.8% for the difference between the groups, which met the predesigned criteria of > − 8%, confirming the noninferiority of anesthesia/sedation produced by HSK3486 compared to propofol. Among the secondary efficacy endpoints, only time to full alertness (median 8.50 vs. 6.00 min, P = 0.012) and time to discharge (median 13.00 vs. 9.87 min, P = 0.002) were slightly longer in the HSK3486 group. The incidence of adverse events was significant lower in the HSK3486 group (52.6 vs. 76.5%, P < 0.001) mainly because of less pain on injection (4.4 vs. 39.4%, P < 0.001) compared to the propofol group. HSK3486 had a similar terminal elimination half-life as propofol. Conclusions HSK3486 exhibited non-inferiority anesthesia/sedation compared to propofol in patients undergoing fiberoptic bronchoscopy, and had a good safety profile with a lower incidence of pain on injection. Trial Registration Clinicaltrials.gov, NCT04111159, registered on