Among adults undergoing noncardiac surgery, MINS is common and associated with substantial mortality.

BACKGROUND The incidence, severity, and duration of postoperative oxygen desaturation in the general surgical population are poorly characterized. We therefore used continuous pulse oximetry to quantify arterial oxygen saturation (SpO2) in a cross-section of patients having noncardiac surgery. METHODS Oxygen saturation, blinded to clinicians, was recorded at 1-minute intervals in patients >45 years old for up to 48 hours after noncardiac surgery in 1250 patients from Cleveland Clinic Main Campus and 250 patients from the Juravinski Hospital. We determined (1) the cumulative minutes of raw minute-by-minute values below various hypoxemic thresholds; and (2) the contiguous duration of kernel-smoothed (sliding window) values below various hypoxemic thresholds. Finally, we compared our blinded continuous values with saturations recorded during routine nursing care. RESULTS Eight hundred thirty-three patients had sufficient data for analyses. Twenty-one percent had ≥10 min/h with raw SpO2 values <90% averaged over the entire recording duration; 8% averaged ≥20 min/h <90%; and 8% averaged ≥5 min/h <85%. Prolonged hypoxemic episodes were common, with 37% of patients having at least 1 (smoothed) SpO2 <90% for an hour or more; 11% experienced at least 1 episode lasting ≥6 hours; and 3% had saturations <80% for at least 30 minutes. Clinical hypoxemia, according to nursing records, measured only in Cleveland Clinic patients (n = 594), occurred in 5% of the monitored patients. The nurses missed 90% of smoothed hypoxemic episodes in which saturation was <90% for at least one hour. CONCLUSIONS Hypoxemia was common and prolonged in hospitalized patients recovering from noncardiac surgery. The SpO2 values recorded in medical records seriously underestimated the severity of postoperative hypoxemia.

Abstract:We have developed a method for performing light-sheet microscopy with a single high numerical aperture lens by integrating reflective side walls into a microfluidic chip. These 45°side walls generate light-sheet illumination by reflecting a vertical light-sheet into the focal plane of the objective. Light-sheet illumination of cells loaded in the channels increases image quality in diffraction limited imaging via reduction of out-of-focus background light. Single molecule super-resolution is also improved by the decreased background resulting in better localization precision and decreased photo-bleaching, leading to more accepted localizations overall and higher quality images. Moreover, 2D and 3D single molecule superresolution data can be acquired faster by taking advantage of the increased illumination intensities as compared to wide field, in the focused light-sheet. 94, 4957-4970 (2008).

An electroformed, three-dimensional stylus Paul trap was designed to confine a single atomic ion for use as a sensor to probe the electric-field noise of proximate surfaces. The trap was microfabricated with the UV-LIGA technique to reduce the distance of the ion from the surface of interest. We detail the fabrication process used to produce a 150 μm tall stylus trap with feature sizes of 40 μm. We confined single, laser-cooled, (25)Mg(+) ions with lifetimes greater than 2 h above the stylus trap in an ultra-high-vacuum environment. After cooling a motional mode of the ion at 4 MHz close to its ground state ( = 0.34 ± 0.07), the heating rate of the trap was measured with Raman sideband spectroscopy to be 387 ± 15 quanta/s at an ion height of 62 μm above the stylus electrodes.