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This study aimed to investigate the effects of esketamine (Esk) combined with dexmedetomidine (Dex) on postoperative delirium (POD) and quality of recovery (QoR) in elderly patients undergoing thoracoscopic radical lung cancer surgery.
Methods
In this prospective, randomized, and controlled study, 172 elderly patients undergoing thoracoscopic radical lung cancer surgery were divided into two groups: the Esk + Dex group (n = 86) and the Dex group a (n = 86). The primary outcome was the incidence of POD within 7 days after surgery and the overall Quality of Recovery−15 (QoR − 15) scores within 3 days after surgery. Secondary outcomes included postoperative adverse reactions, extubation time, PACU stay, and hospitalization time. Serum levels of IL-6, IL-10, S100β protein, NSE, CD3+, CD4+, and CD8+ were detected from T0 to T5.
Results
Compared with the Dex group, the incidence of POD in the Esk + Dex group was significantly lower at 7 days after surgery (14.6% vs 30.9%; P = 0.013). The QoR − 15 score was significantly increased 3 days after surgery (P < 0.01). Levels of IL-6 and CD8+ were significantly decreased, and IL − 10 levels were significantly increased at T1-T2 (P < 0.05). At T1-T4, NSE levels were significantly decreased, while CD3+ and CD4+/CD8+ values were significantly increased (P < 0.01). At T1-T5, serum S100β protein concentration decreased significantly, and CD4+ value increased significantly (P < 0.01). The incidence of nausea/vomiting and hyperalgesia decreased significantly 48 hours after surgery (P < 0.01). The duration of extubation, PACU stay, and postoperative hospitalization were significantly shortened.
Conclusions
Esketamine combined with dexmedetomidine can significantly reduce the POD incidence and improve the QoR in patients undergoing thoracoscopic radical lung cancer surgery, which may be related to the improvement of cellular immune function.
In this paper, a capsule endoscopy system with a sensing function is proposed for medical devices. A single-arm spiral antenna is designed for data transmission and is combined with the voltage controlled oscillator to achieve sensing capabilities. The designed antenna operates at a 900 MHz industrial scientific medical band. By establishing a three-layer cylindrical model of the stomach, it was concluded that the antenna in the stomach has a high peak gain of −1.1 dBi. Additionally, the antenna achieved a −10 dB impedance bandwidth of 5%. The capsule endoscopy was experimentally measured in both actual stomach and simulated environments. The maximum working distance of the capsule endoscope was measured to be 6.8 m. Additionally, the proposed capsule endoscope was tested for its sensing function using solutions with different dielectric constants. Finally, it was confirmed through link analysis that it has good communication capabilities. The results and analysis confirm that the proposed capsule endoscope can be used for examining gastric diseases.
Based on 30 high-resolution U-Th dating controls, we reconstruct stalagmite δ18O records from 45 to 15 thousand years ago (ka B.P., before AD 1950) from the Shizhu Cave, which is located in southwestern China under the influence of both the Indian Summer Monsoon (ISM) and the East Asian Summer Monsoon (EASM). By integrating with the other stalagmite δ18O records in Asia during the middle to late last glacial, our results reveal two main moisture trajectories: one from the Indian Ocean, through the Shizhu Cave towards central China, and the other from the Pacific Ocean to central and northern China. The systematic decrease of the average values of stalagmite δ18O records from oceans to inland China reveals a spatial pattern of water vapour fractionation and moisture trajectory during the middle to late last glacial. In contrast, the variation amplitude, which is defined as the departures apart from the background δ18O records during Heinrich stadials 1 to 4 (HS1–HS4), show an increasing trend from the coastal oceans to mid-latitude inland China, presenting a ‘coastal-inland’ pattern, which can be interpreted by the enhanced East Asian Winter Monsoon (EAWM) and the weakened EASM. More specifically, the enriched stalagmite δ18O records in the EASM region during HS1 to HS4 are caused by the decreased summer rainfall amount or/and the increased proportion of summer moisture resources from the Pacific Ocean. These new observations deepen our understanding of the complicated stalagmite δ18O records in the EASM region.
The perturbation electron density and stopping power caused by the movement of charged particles above two-dimensional quantum electron gases (2DQEG) have been studied in numerous works using the quantum hydrodynamic (QHD) theory. In this paper, the QHD is modified by introducing the two-dimensional electron exchange-correlation potential at high density Vxc2DH and the pump wave modulations. Based on the modified QHD, the perturbation electron density and stopping power are calculated for pump waves with various parameters. The results show that the stopping power values are more accurate after considering Vxc2DH. Under the modulation of pump waves with the wavelength from 0.1nm to 0.1cm, the perturbation electron density of 2DQEG and the stopping power of charged particles show periodic changes. Under the modulation of pump waves with λ = 1.76 × 10−4 cm and , the average stopping power with respect to the time phase θ becomes negative, which means that the charged particles will gain energy and can be accelerated. This is a new phenomenon in the fields of 2DQEG and of great significance in surface physics and surface modification in nanoelectronic devices with beam matter interactions.
In two-dimensional (2D) electron systems, the viscous flow is dominant when electron-electron collisions occur more frequently than the impurity or phonon scattering. In this work, a quantum hydrodynamic model, considering viscosity, is proposed to investigate the interaction of a charged particle moving above the two-dimensional viscous electron gas. The stopping power, perturbed electron gas density, and the spatial distribution of the velocity vector field have been theoretically analyzed and numerically calculated. The calculation results show that viscosity affects the spatial distribution and amplitude of the velocity field. The stopping power, which is an essential quantity for describing the interactions of ions with the 2D electron gas, is calculated, indicating that the incident particle will suffer less energy loss due to the weakening of the dynamic electron polarization and induced electric field in 2D electron gas with the viscosity. The values of the stopping power may be more accurate after considering the effect of viscosity. Our results may open up new possibilities to control the interaction of ions with 2D electron gas in the surface of metal or semiconductor heterostructure by variation of the viscosity.
Adsorption of uranyl (UO22+) ions to mineral surfaces is a potentially effective method for removing this hazardous metal from water, but other toxic trace metal ions (Xn+: Rb+, Sr2+, Cr3+, Mn2+, Ni2+, Zn2+, Cd2+) in uraniferous wastewaters compete with UO22+ for adsorption sites and thus may diminish the capacity of adsorbents to sequester UO22+. A better understanding of competitive adsorption among these metal ions and the development of better adsorbents are, therefore, of critical importance. The purpose of the present study was to synthesize and characterize magnetic adsorbents, consisting of MFe2O4 (M = Mn, Fe, Zn, Co, or Ni) nanoparticles synthesized on montmorillonite (Mnt) edge sites, and to investigate their use as adsorbents for UO22+, including competitive adsorption with trace metal ions. Selective adsorption was studied using Langmuir, Freundlich, and Dubinin-Radushkevich isotherms, and the results showed that Xn+ ions were adsorbed primarily on MFe2O4-montmorillonite surfaces, and the UO22+ ions were adsorbed on the interfaces between montmorillonite edge surfaces and MFe2O4 nanoparticles. Using the Freundlich model, the interface adsorption capacity of UO22+ reached 25.1 mg·g–1 in mixed solution. Further, the UO22+ and Cr3+ ions had a redox reaction on the interfaces with synergistic adsorption. Herein, the adsorption capacity of Cr3+ was 60.2 mg·g–1 using the Freundlich isotherm. The results demonstrated that the MFe2O4-montmorillonite with highly selective adsorption of UO22+ ions is applicable to UO22+ treatment in the presence of toxic trace metal ions.
As frontline workers, pharmacists often face significant work stress, especially in psychiatric settings. A multicenter cross-sectional design was conducted in 41 psychiatric hospitals. The Depression, Anxiety and Stress Scale–21 (DASS-21) was used to measure the mental health of 636 pharmacists. We also collected demographic data and work-related variables. The prevalence of depression, anxiety and stress was 20.60%, 22.96% and 8.96%, respectively. Multivariate logistic regression showed that several common factors were associated with depression, anxiety and stress, including professional identity (odds ratio [OR] = 0.132, 0.381 and 0.352) and verbal violence (OR = 2.068, 2.615 and 2.490). Those who were satisfied with their job were less likely to develop depression (OR = 0.234) or anxiety (OR = 0.328). We found specific factors associated with mental health. Older age (OR = 1.038) and perceived negative impact (OR = 2.398) of COVID-19 on medical work were associated with anxiety, and those with frontline experience with COVID-19 patients (OR = 2.306) were more likely to experience stress. More than one-fifth of pharmacists in psychiatric hospitals experienced symptoms of depression or anxiety during the pandemic, highlighting the need for policy change to improve workplace conditions and psychological well-being for this professional group.
Painting therapy uses nonverbal tools to meet the psychological needs of painters, with emotional, visual, and motivational characteristics. Integrating painting therapy into the teaching of folk art creation enriches students’ emotional experience, effectively alleviates their tense psychology, increases their confidence in innovation, and promotes their healthy psychological development.
Subjects and Methods
The study selected 90 patients with depression who were in the recovery stage and were treated at our psychological clinic from January 2022 to December 2022. Randomly divided into two groups: the experimental group and the control group. The control group received medication and routine care, while the experimental group received folk art creation and painting therapy on top of the control group. The treatment period for both groups is three months. After treatment, patients will be followed up to assess their depressive symptoms.
Results
The study used the Hamilton Depression Scale (HAMD) and Social Deficiency Screening Scale (SDSS) as evaluation criteria. Use SPSS23.0 software for data statistics. The results showed a significant score difference between the two groups after treatment (P<0.05). The experimental group continued to show a significant decrease (P<0.05) after six months and one year of follow-up, while the control group showed no significant decrease (P>0.05).
Conclusions
Relying solely on medication treatment and rest is difficult for patients with depression to recover, while painting therapy can effectively alleviate their depressive symptoms and improve their daily life.
Acknowledgement
The program of Sichuan Key Research Base of Social Sciences and Cultural Industry Development Research Center, Key Research Base of Humanities and Social Sciences, Education Office of Sichuan Province (No. WHCY2023B14); Program of Key Research Base of Humanities and Social Sciences, Education Office of Sichuan Province and China Salt Culture Research Center, Sichuan Key Research Base of Philosophy and Social Sciences (No. YWHY23-07); Teaching reform of Sichuan University of Science& Engineering (No. JG-2354).
As the southernmost part of the central segment of the Central Asian Orogenic Belt, the northern Alxa area is characterized by abundant Permian magmatism and records key information on the geological evolution of the Palaeo-Asian Ocean. This study reports new zircon U–Pb and Lu–Hf isotopic and whole-rock geochemical data of the early Permian (285–286 Ma) Huisentala gabbro and Huodonghaer diorites from the Zhusileng–Hangwula Belt in the northern Alxa area. The gabbro is characterized by high Al, Ca, Mg# and light rare-earth elements, and low K, P and high field strength elements (e.g., Ti, Nb and Ta). Furthermore, the gabbro shows heterogeneous zircon ϵHf(t) value (−2.5 to +2.6). The Huodonghaer diorites show high MgO (3.46–6.32 wt%), Mg# (49–58), Sr (408–617 ppm) and Ba (223–419 ppm), and low FeOT/MgO (1.27–1.83) and TiO2 (0.48–0.90 wt%), with geochemical features similar to the high-Mg andesite/diorite. They show radiogenic zircon ϵHf(t) values of +1.2 to +4.9 and high Th/Nb ratios. These features suggest that the Huisentala gabbro and the Huodonghaer diorites were derived from the partial melting of mantle peridotite that was metasomatized by subduction-related fluids and by subducted sediment-derived melts, respectively.
Finite state Markov processes and their aggregated Markov processes have been extensively studied, especially in ion channel modeling and reliability modeling. In reliability field, the asymptotic behaviors of repairable systems modeled by both processes have been paid much attention to. For a Markov process, it is well-known that limiting measures such as availability and transition probability do not depend on the initial state of the process. However, for an aggregated Markov process, it is difficult to directly know whether this conclusion holds true or not from the limiting measure formulas expressed by the Laplace transforms. In this paper, four limiting measures expressed by Laplace transforms are proved to be independent of the initial state through Tauber’s theorem. The proof is presented under the assumption that the rank of transition rate matrix is one less than the dimension of state space for the Markov process, which includes the case that all states communicate with each other. Some numerical examples and discussions based on these are presented to illustrate the results directly and to show future related research topics. Finally, the conclusion of the paper is given.
We present the third data release from the Parkes Pulsar Timing Array (PPTA) project. The release contains observations of 32 pulsars obtained using the 64-m Parkes ‘Murriyang’ radio telescope. The data span is up to 18 yr with a typical cadence of 3 weeks. This data release is formed by combining an updated version of our second data release with $\sim$3 yr of more recent data primarily obtained using an ultra-wide-bandwidth receiver system that operates between 704 and 4032 MHz. We provide calibrated pulse profiles, flux density dynamic spectra, pulse times of arrival, and initial pulsar timing models. We describe methods for processing such wide-bandwidth observations and compare this data release with our previous release.
We numerically investigated the global linear instability and bifurcations in electro-thermo-convection (ETC) of a dielectric liquid confined in a two-dimensional (2-D) concentric annulus subjected to a strong unipolar injection. Seven kinds of solutions exist in this ETC system due to the complex bifurcations, i.e. saddle-node, subcritical and supercritical Hopf bifurcations. These bifurcation routes constitute at most four solution branches. Global linear instability analysis and energy analysis were conducted to explain the instability mechanism and transition of different solutions and to predict the local instability regions. The linearized lattice Boltzmann method (LLBM) for global linear instability analysis, first proposed by Pérez et al. (Theor. Comput. Fluid Dyn., vol. 31, 2017, pp. 643–664) to analyse incompressible flows, was extended here to solve the whole set of coupled linear equations, including the linear Navier–Stokes equations, the linear energy equation, Poisson's equation and the linear charge conservation equation. A multiscale analysis was also performed to recover the macroscopic linearized Navier–Stokes equations from the four different discrete lattice Boltzmann equations (LBEs). The LLBM was validated by calculating the linear critical value of 2-D natural convection; it has an error of 1.39% compared with the spectral method. Instability with global travelling wave behaviour is a unique behaviour in the annulus configuration electrothermohydrodynamic system, which may be caused by the baroclinity. Finally, the chaotic behaviour was quantitatively analysed through calculation of the fractal dimension and Lyapunov exponent.
Preterm birth is a global health problem and associated with increased risk of long-term developmental impairments, but findings on the adverse outcomes of prematurity have been inconsistent.
Methods
Data were obtained from the baseline session of the ongoing longitudinal Adolescent Brain and Cognitive Development (ABCD) Study. We identified 1706 preterm children and 1865 matched individuals as Control group and compared brain structure (MRI data), cognitive function and mental health symptoms.
Results
Results showed that preterm children had higher psychopathological risk and lower cognitive function scores compared to controls. Structural MRI analysis indicated that preterm children had higher cortical thickness in the medial orbitofrontal cortex, parahippocampal gyrus, temporal and occipital gyrus; smaller volumes in the temporal and parietal gyrus, cerebellum, insula and thalamus; and smaller fiber tract volumes in the fornix and parahippocampal-cingulum bundle. Partial correlation analyses showed that gestational age and birth weight were associated with ADHD symptoms, picvocab, flanker, reading, fluid cognition composite, crystallized cognition composite and total cognition composite scores, and measures of brain structure in regions involved with emotional regulation, attention and cognition.
Conclusions
These findings suggest a complex interplay between psychopathological risk and cognitive deficits in preterm children that is associated with changes in regional brain volumes, cortical thickness, and structural connectivity among cortical and limbic brain regions critical for cognition and emotional well-being.
The relationships between childhood weight self-misperception and obesity-related factors particularly health markers have not been extensively discussed. This study aims to examine the associations between weight self-misperception and obesity-related knowledge, attitudes, lifestyles and cardio-metabolic markers among Chinese paediatric population.
Design:
Cross-sectional study.
Setting:
Data sourced from a national survey in Chinese seven provinces in 2013.
Participants:
Children and adolescents aged 5–19 years.
Results:
Of the total 14 079 participants, there were 14·5 % and 2·2 % participants over-estimated and under-perceived their weight, respectively. Multi-variable logistic regression was applied to calculate OR and 95 % CI (95 % Cl) of obesity-related behaviours and cardio-metabolic markers by actual and perceived weight status. Individuals who perceived themselves as overweight/obese were more likely to have prolonged screen time, insufficient dairy intake and over sugar-sweetened beverages consumption (all P < 0·05), regardless of their weight. Furthermore, actual overweight/obese individuals had higher odds of abnormal cardio-metabolic markers, but a smaller magnitude of association was found among weight under-estimators. Among non-overweight/obese individuals, weight over-estimation was positively associated with abdominal obesity (OR: 10·49, 95 % CI: 7·45, 14·76), elevated blood pressure (OR: 1·30, 95 % CI: 1·12, 1·51) and dyslipidemia (OR: 1·43, 95 % CI: 1·29, 1·58).
Conclusions:
Weight over-perception was more prevalent than under-estimation, particularly in girls. Weight over-estimators tended to master better knowledge but behave more unhealthily; both weight over-perception and actual overweight/obesity status were associated with poorer cardio-metabolic markers. Future obesity intervention programmes should additionally pay attention to the population with inaccurate estimation of weight who were easily overlooked.
A single-shot measurement of electron emittance was experimentally accomplished using a focused transfer line with a dipole. The betatron phase of electrons based on laser wakefield acceleration (LWFA) is energy dependent owing to the coupling of the longitudinal acceleration field and the transverse focusing (defocusing) field in the bubble. The phase space presents slice information after phase compensation relative to the center energy. Fitting the transverse size of the electron beam at different energy slices in the energy spectrum measured 0.27 mm mrad in the experiment. The diagnosis of slice emittance facilitates local electron quality manipulation, which is important for the development of LWFA-based free electron lasers. The quasi-3D particle-in-cell simulations matched the experimental results and analysis well.
Circulating n-3 PUFA, which integrate endogenous and exogenous n-3 PUFA, can be better used to investigate the relationship between n-3 PUFA and disease. However, studies examining the associations between circulating n-3 PUFA and colorectal cancer (CRC) risk were limited, and the results remained inconclusive. This case–control study aimed to examine the association between serum n-3 PUFA and CRC risk in Chinese population. A total of 680 CRC cases and 680 sex- and age-matched (5-year interval) controls were included. Fatty acids were assayed by GC. OR and 95 % CI were calculated using multivariable logistic regression after adjustment for potential confounders. Higher level of serum α-linolenic acid (ALA), docosapentaenoic acid (DPA), DHA, long-chain n-3 PUFA and total n-3 PUFA were associated with lower odds of CRC. The adjusted OR and 95 % CI were 0·34 (0·24, 0·49, Pfor trend < 0·001) for ALA, 0·57 (0·40, 0·80, Pfor trend < 0·001) for DPA, 0·48 (0·34, 0·68, Pfor trend < 0·001) for DHA, 0·39 (0·27, 0·56, Pfor trend < 0·001) for long-chain n-3 PUFA and 0·31 (0·22, 0·45, Pfor trend < 0·001) for total n-3 PUFA comparing the highest with the lowest quartile. However, there was no statistically significant association between EPA and odds of CRC. Analysis stratified by sex showed that ALA, DHA, long-chain n-3 PUFA and total n-3 PUFA were inversely associated with odds of CRC in both sexes. This study indicated that serum ALA, DPA, DHA, long-chain n-3 PUFA and total n-3 PUFA were inversely associated with odds of having CRC in Chinese population.
This study aimed to determine the ideal pacing site in children by comparing the postoperative ventricular synchrony in children with left bundle branch area pacing and those with right ventricular septal pacing.
Methods:
This retrospective study included children with complete atrioventricular block who underwent permanent pacemaker implantation from March 2019 to August 2021. Patients were grouped according to their ventricular pacing site, the left bundle branch area pacing group and the right ventricular septal pacing group. Two-dimensional speckle tracking echocardiography was used to evaluate the ventricular synchrony.
Results:
Forty-eight children (median age, 2.7 years; interquartile range, 1.7–4.6 years) were included. The paced QRS duration in the left bundle branch area pacing group was significantly narrower than that in the right ventricular septal pacing group (100.2 ± 9.3 versus 115.4 ± 15.1 ms, p = 0.001). The median follow-up duration was 1.5 years (interquartile range, 1–2 years). At the last follow-up, the average capture threshold of the ventricular electrode in the left bundle branch area pacing group was lower than that in the right ventricular septal pacing group (0.79 ± 0.18 versus 1.20 ± 0.56 V, p = 0.008). The left ventricular intraventricular synchrony parameters in the left bundle branch area pacing group were better than those in the right ventricular septal pacing group (e.g. standard deviation of the time to peak longitudinal strain, 37.4 ± 4.3 versus 46.6 ± 8.2 ms, p = 0.000). The average interventricular mechanical delay time in the left bundle branch area pacing group was significantly shorter than that in the right ventricular septal pacing group (36.4 ± 14.2 versus 52.5 ± 22.7 ms, p = 0.016).
Conclusion:
Compared with right ventricular septal pacing, left bundle branch area pacing in children produces a narrower QRS duration and better pacing and ventricular synchrony parameters postoperatively.
Pie charts are often used to communicate risk, such as the risk of driving. In the foreground-background salience effect (FBSE), foreground (probability of bad event) has greater salience than background (no bad event) in such a chart. Experiment 1 confirmed that the displays format of pie charts showed a typical FBSE. Experiment 2 showed that the FBSE resulted from a difference in cognitive efforts in processing the messages and that a foreground-emphasizing display was easier to process. Experiment 3 manipulated subjects’ information processing mindset and explored the interaction between displays format and information processing mindset. In the default mindset, careless subjects displayed a typical FBSE, while those who were instructed to be careful reported similar risk-avoidant behavior preference reading both charts. Suggestions for improving risk communication are discussed.
The evolution of granulation is an important mechanism of the light variations of red supergiants (RSGs). Based on pure and complete samples of RSGs in the Magellanic Clouds, the mechanisms and characteristics of the granulation of RSGs are investigated based on time-series data. As predicted by the basic physical process of granulation and previous works, there are tight relations between granulation and stellar parameters of RSGs (i.e., the scaling relations). The scaling relations of RSGs provide a new method to infer stellar parameters by using the characteristic timescale and amplitude of granulations. Some faint sources deviate from the scaling relations, which may be due to the difference in the properties of the granulation of the RSGs before and after the blue loop or contamination by Mira variables. However, both of these possibilities suggest that the scaling relations of granulation is different among different types of stars.