Quality Of Recovery Research Articles

Patient-reported outcomes, postoperative pain and pain relief after day case surgery (POPPY): methodology for a prospective, multicentre observational study.

In the UK, approximately 70% of surgical procedures are undertaken as day-cases. Little information exists about recovery from day-case surgery, yet international data highlights patients are at risk of developing significant longer-term health problems including chronic post-surgical pain and persistent postoperative opioid use. The Patient-reported Outcomes, Postoperative Pain and pain relief after daY case surgery (POPPY) study was a national prospective multicentre observational study, measuring short- and longer-term patient-reported outcomes, postoperative pain and pain relief after day-case surgery. This was a collaborative project led by resident anaesthetists under the Research and Audit Federation of Trainees umbrella. Adult day-case surgical patients were recruited on the day of surgery. Baseline data including patient characteristics; procedure details; pre-operative analgesic use; pre-existing pain; and quality of life scores were recorded. Patients were followed up through automated short message service messages. Short-term (postoperative days 1, 3 and 7) outcomes included: quality of recovery; pain severity; impact of pain on function; and analgesic use. Longer-term outcomes (postoperative day 97) included: quality of life; analgesic use; incidence of chronic post-surgical pain; and incidence persistent postoperative opioid use. Additional outcomes were completed by those patients with chronic post-surgical pain and persistent postoperative opioid use, with 30 patients recruited to a qualitative semi-structured interview study exploring postoperative expectations, recovery, postoperative pain and opioid use. An embedded pilot study at four sites recruited 129 patients. Responses to the automated short message service were gained from 129 patients (100%) at day 1; 116 (89.9%) at day 3; 108 (83.7%) at day 7; and 77 (59.7%) at day 97 postoperatively. The pilot enabled refinement of the methods and processes before the national roll out. This paper outlines the methods for the POPPY study, the largest UK multicentre prospective observational study considering short- and longer-term outcomes following day-case surgery.

Visual detection of drilling robot position for rockburst prevention in mining processing by a new image dehazing method

AbstractThe positioning of drill pipe based on visual detection is a crucial aspect in achieving unmanned operation of drilling robot for rockburst prevention. However, the images directly collected from mechanized mining face are always polluted. In order to eliminate the interference of dust and haze in the image, an image dehazing method based on improved CycleGAN model is proposed in this paper. Firstly, a pipe image dehazing dataset for the rockburst prevention drilling robot is collected and established. Moreover, a generator architecture with a multi-scale U-shaped network structure is designed to improve the quality and accuracy of image recovery. A new reconstruction block is designed and an SK fusion layer is introduced to improve the feature extraction capability of the model, and a MU-CycleGAN network structure is constructed. Finally, an experimental platform for drill pipe image dehazing of the drilling robot for rockburst prevention is set up in the intelligent mining equipment laboratory. Experimental results showed that the PSNR and SSIM of the image dehazing model achieved 27.04 and 0.946, and the success rate of drill pipe grabbing has increased by 13.75%. Experimental results reveal that the proposed framework achieves superior image enhancement performance than the comparison algorithms.

A Randomized Controlled Trial of Adding Deep Parasternal Intercostal Plane Block to Interpectoral-Pectoserratus Plane Block in Breast Cancer Surgery.

The interpectoral-pectoserratus plane block is expected to anesthetize the lateral breast, but it is unclear whether the deep parasternal intercostal plane block may enhance recovery by providing analgesia to the medial breast. Patients undergoing breast cancer surgery were randomly assigned to receive either the interpectoral-pectoserratus block (single block) or interpectoral-pectoserratus combined with deep parasternal intercostal block (combined block). The primary outcome was the quality of recovery-15 questionnaire score assessed at 24 hours postoperatively. Secondary measures included dermatomal block assessment, pain severity, opioid consumption, opioid-related adverse events, hospital length of stay, and chronic postsurgical pain at 3 months after surgery. One hundred and sixteen patients were recruited, 58 in the single block group and 58 in the combined block group. There was no important difference in the 24-hour quality of recovery scores with mean (standard deviation [SD]) 123.6 (6.3) in the single block group and 123.2 (7.1) in the combined block group (mean difference, 0.4; 95% confidence interval [CI], -2.0 to 2.9; P =.731). There was greater dermatomal block on medial breast in the combined block group. There were no differences in other secondary outcomes. Addition of deep parasternal intercostal plane block was not superior to interpectoral-pectoserratus plane block alone for the quality of recovery in patients undergoing breast cancer surgery.

Effect of clustered nursing on liver function indexes, nutrition, and emotional status of patients with severe liver failure.

Liver failure is a metabolic disorder caused by a variety of mixed factors. For such diseases, adopting cluster care can effectively improve the relevant symptoms of patients. To explore the nursing effect of nutritional nursing combined with clustered nursing for patients with severe liver failure. A total of 129 patients with severe liver failure were selected as retrospective study subjects. Nine cases were due to an end event, such as death. The other patients were divided into control group and observation group according to different nursing methods. Among them, the control group adopted nutrition nursing, and the observation group implemented cluster nursing on this basis. The differences of liver function, anxiety and depression score, gastrointestinal recovery, nutritional status, and sleep quality were compared between the 2 groups before and after nursing. After nursing, the total bilirubin, albumin, and aspartate aminotransferase of the observation group were significantly higher than those of the control group (P < .05). The nursing staff used Self-Rating Anxiety Scale and Self-Rating Depression Scale of the observation group, which were slightly lower than those of the control group. The difference was statistically significant after testing (P < .05). After nursing, the observation group's upper arm circumference, brachial tri-scalp fold thickness, and hemoglobin were better than those of the control group. Statistics showed that the difference was statistically significant (P < .05). The depth of sleep, time to fall asleep, number of awakenings, time to fall asleep after awakening, overall sleep quality, and intensive care unit environmental noise intensity in the Richards-Campbell Sleep Questionnaire sleep scale after nursing in the 2 groups were significantly higher than those before nursing, and the scores of the observation group were significantly lower than those in the observation group. In the control group, this difference was statistically significant (P < .05). Nutritional nursing combined with clustered nursing can effectively promote the recovery of gastrointestinal function in patients with severe liver failure.

The effect of erector spinae plane block on postoperative pain and quality of recovery in patients undergoing percutaneous nephrolithotomy

Percutaneous nephrolithotomy (PNL) is the preferred surgical procedure for treating renal stones larger than 2 cm. Patients may experience significant pain in the postoperative period due to factors such as the catheter entry site and tension in the renal capsule. Erector Spinae Plane (ESP) block provides perioperative muscle relaxation and reduces analgesic use. In this study, we investigated the effect of ESP block on postoperative pain scale and quality of recovery in patients undergoing PNL. The study was conducted with a total of 96 patients, with 45 patients receiving the ESP block and 51 patients not receiving the ESP block. Following the surgery, the visual pain scale (VAS) was completed at 0, 2, 6, 12, and 24 h, and the Quality of Recovery-15 (QoR-15) scale along with the willingness scale were completed at the 24-hour mark. The normal distribution of data was evaluated with the Kolmogorov-Smirnov test, histogram, and skewness-kurtosis coefficients. For comparing paired groups, the Student’s T-test was used for normally distributed variables, while the Mann-Whitney U test was used for parameters that did not have a normal distribution. The comparison of postoperative pain, as measured by VAS scores between the groups, revealed statistically significantly lower scores in the ESP block group at 0, 2, 6, 12, and 24 h (p < 0.001, p < 0.001, p < 0.001, p = 0.008, p = 0.010, respectively). Our study results indicated that patients who received the ESP block experienced reduced pain levels and had higher QoR-15 scores compared to those who did not receive the ESP block.

Use of opioids and opioid alternatives during general anesthesia: a pan-Canadian survey among anesthesiologists.

While there is limited patient-centred evidence (i.e., evidence that is important for patients and end-users) to inform the use of pharmacologic opioid minimization strategies (i.e., the use of opioid alternatives) for adult surgical patients requiring general anesthesia, such strategies are increasingly being adopted into practice. Our objectives were to describe anesthesiologists' beliefs regarding intraoperative opioid minimizing strategies use and utility, and to explore important clinical decision-making factors. We conducted a pan-Canadian web-based survey of anesthesiologists that was distributed using a modified Dillman technique. Our multidisciplinary team, including a patientpartners panel, participated in the process of domains and items generation, items reduction, formatting, and composition. Our sampling frames were members of the Canadian Anesthesiologists' Society and members of the Association des Anesthésiologistes du Québec. We used the newsletters of each organization to distribute our survey, which was available in English and French and housed on the LimeSurvey (LimeSurvey GmbH, Hamburg, Germany) platform. From our eligible sampling frame, 18% completed the survey (356 respondents out of 2,008 eligible participants). Most of the respondents believed that using opioid minimization strategies during general anesthesia could improve postoperative clinical outcomes, including pain control (84% agree or strongly agree, n = 344/409). Reported use of pharmacologic opioid minimization strategies was variable; however, most respondents believed that nonsteroidal anti-inflammatory drugs, acetaminophen, N-methyl-D-aspartate receptor antagonists (ketamine), α2-adrenoceptor agonists (dexmedetomidine), corticosteroids, and intravenous lidocaine improve prostoperative clinical outcomes. The primary factors guiding decision-making regarding the use of opioid minimization strategies were postoperative acute pain intensity, the impact of acute pain on functioning, patient well-being (i.e., quality of recovery) and patient satisfaction with care. A lack of evidence was the most important barrier limiting the use of opioid minimization strategies. In our survey of Canadian anesthesiologists, several opioid minimization strategies were believed to be effective complements to general anesthesia, although there was substantial variation in their reported use. Future randomized controlled trials and systematic reviews evaluating the effectiveness of opioid minimization strategies should prioritize patient-centred outcome measures assessment such as the quality of recovery or the impact ofacute pain on functioning.

Synthetic double inversion recovery imaging for rectal cancer T staging evaluation: imaging quality and added value to T2-weighted imaging

ObjectiveTo assess the image quality of synthetic double inversion recovery (SyDIR) imaging and enhance the value of T2-weighted imaging (T2WI) in evaluating T stage for rectal cancer patients.MethodsA total of 112 pathologically confirmed rectal cancer patients were retrospectively selected after undergoing MRI, including synthetic MRI. The image quality of T2WI and SyDIR imaging was compared based on signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), overall picture quality, presence of motion artifacts, lesion edge sharpness, and conspicuity. The concordance between MRI and pathological staging results, using T2WI alone and the combination of T2WI and SyDIR for junior and senior radiologists, was assessed using the Kappa test. The area under the receiver operating characteristic curve (AUC) was used to assess the diagnostic efficacy of extramural infiltration in rectal cancer patients.ResultsNo significant differences in imaging quality were observed between conventional T2WI and SyDIR (p = 0.07–0.53). The combination of T2WI and SyDIR notably improved the staging concordance between MRI and pathology for both junior (kappa value from 0.547 to 0.780) and senior radiologists (kappa value from 0.738 to 0.834). In addition, the integration of T2WI and SyDIR increased the AUC for diagnosing extramural infiltration for both junior (from 0.842 to 0.918) and senior radiologists (from 0.917 to 0.938).ConclusionThe combination of T2WI and SyDIR increased the consistency of T staging between MRI and pathology, as well as the diagnostic performance of extramural infiltration, which would benefit treatment selection.Critical relevance statementSyDIR sequence provides additional diagnostic value for T2WI in the T staging of rectal cancer, improving the agreement of T staging between MRI and pathology, as well as the diagnostic performance of extramural infiltration.Key PointsSynthetic double inversion recovery (SyDIR) and T2WI have comparable image quality.SyDIR provides rectal cancer anatomical features for extramural infiltration detections.The combination of T2WI and SyDIR improves the accuracy of T staging in rectal cancer.Graphical

Optimizing lung cancer surgery in the elderly: sublobar resection versus lobectomy for early-stage non-small cell lung cancer patients aged 80 and above

The optimal surgical approach for elderly patients with early-stage non-small cell lung cancer (NSCLC) remains a topic of debate. A retrospective analysis was conducted on patients who underwent pulmonary resection for early-stage NSCLC at our single institution between January 2018 and December 2022. Propensity score matching was used to balance baseline characteristics between the sublobar resection and lobectomy groups. Perioperative outcomes, pulmonary function recovery, postoperative quality of life, and survival were compared between the two groups. A total of 151 patients were included, with 42 undergoing sublobar resection and 109 undergoing lobectomy. After propensity score matching, baseline characteristics were well-balanced between the two groups. Sublobar resection was associated with shorter operative time (125.83 ± 33.56 min vs. 161.14 ± 61.54 min, p = 0.048), less intraoperative blood loss [65 (30, 75) ml vs. 120 (70, 170) ml, p < 0.001], shorter drainage duration [3 (2, 5) days vs. 5 (3, 6) days, p < 0.001], shorter hospital stay [6 (4, 8) days vs. 10 (7, 13) days, p < 0.001], and fewer postoperative complications (11.9% vs. 47.6%, p < 0.001), compared to lobectomy. Moreover, sublobar resection led to better pulmonary function recovery and higher postoperative quality of life scores, with no significant difference in overall and disease-free survival between the groups. Sublobar resection in patients aged 80 and above with early-stage NSCLC offered comparable oncological outcomes to lobectomy while preserving more lung function and providing better postoperative recovery and long-term quality of life. These findings have important implications for treatment decision-making in elderly NSCLC patients.

Comparison of intrathecal fentanyl as an adjunct in spinal anaesthesia to ultrasound-guided quadratus lumborum block as an effective postoperative analgesia for Caesarean section surgery.

Postoperative pain in patients, if dealt with inadequately, has been a significant cause of morbidity. The present study compared the postoperative analgesic efficacy of intrathecal fentanyl and ultrasound-guided quadratus lumborum block following Caesarean surgery. A prospective randomised controlled study was planned for parturients who underwent Caesarean surgery under spinal anaesthesia. Patients received bupivacaine (10mg) and 25µg of intrathecal fentanyl in the spinal anaesthesia (group intrathecal fentanyl, n = 30) or 20mL of 0.375% ropivacaine bilateral quadratus lumborum block (group quadratus lumborum; n = 30) after surgery. The visual analogue scale score, quality of recovery-15 score and incidence of ill effects were recorded. The postoperative haemodynamic parameters were comparable between the two groups. The visual analogue scale score at different time intervals decreased after the quadratus lumborum block (p < 0.05). The mean global quality of recovery score was better in the quadratus lumborum group (p < 0.001). In the quadratus lumborum group, the mean time to first ambulation was lower than that in the intrathecal fentanyl group (p < 0.05). The requirement for first-rescue analgesia was earlier in the intrathecal fentanyl group (4.67 ± 0.72) than in the quadratus lumborum group (4.92 ± 0.88). Intrathecal fentanyl and quadratus lumborum block had effective postoperative analgesic effects on Caesarean surgery patients. However, the quadratus lumborum block group exhibited better analgesia and early ambulation than the intrathecal fentanyl group, with an improved quality of recovery.

Composition and Injection Rate Co-Optimization Method of Supercritical Multicomponent Thermal Fluid Used for Offshore Heavy Oil Thermal Recovery

Supercritical multicomponent thermal fluid injection is a new technology with great potential for offshore heavy oil thermal recovery. In the process of thermal fluid generation, the reaction conditions including temperature, pressure, and the organic mass concentration in the reaction material will significantly affect its composition and injection rate and will further affect the thermal recovery and development quality of heavy oil. However, there is a lack of relevant research on the variation rules and control methods of the composition and injection rate of supercritical multicomponent thermal fluids, resulting in a lack of technical mechanisms for effective optimization. To fill this gap, a reaction molecular dynamics simulation method was used to simulate thermal fluid generation under different temperatures, pressures, and organic mass concentrations. The changes in thermal fluid composition and yield with reaction conditions were studied, and a control model of thermal fluid composition and yield was established. The proportional relationship between the thermal fluid generation scale of an offshore heavy oil platform and the simulated thermal fluid generation scale is analyzed, and a collaborative optimization method of thermal fluid composition and injection rate in field applications is proposed. The results show the following: (1) The higher the mass concentration of organic matter, the higher the content of supercritical carbon dioxide and supercritical nitrogen in thermal fluids, and the lower the content of supercritical water. (2) The higher the temperature and pressure, the higher the thermal fluid yield, and the higher the organic mass concentration, the lower the thermal fluid yield. (3) The component fitting model conforms to the power function relationship, and the coefficient of determination R2 is greater than 0.9; the yield fitting model conforms to the modified inverse linear logarithmic function relationship, the determination coefficient R2 is greater than 0.8, and the fitting degree is high. (4) The ratio between the actual injection rate of thermal fluids in the mine field and the molecular simulated thermal fluid yield is the ratio of organic matter mass in the platform thermal fluid generator and organic matter mass in the simulated box. (5) Based on the composition and yield control model, combined with the simulation of the ratio relationship between yield and injection rate in the field, a collaborative optimization method of thermal fluid composition and injection rate was established. The research results can provide an effective technical method for predicting, controlling, and optimizing the composition and injection rate of supercritical multicomponent thermal fluids.

Microenvironmental pH modulating oxygen self-boosting microalgal prodrug carboxymethyl chitosan/hyaluronic acid/puerarin hydrogel for accelerating wound healing in diabetic rats

Chronic diabetic wounds are characterized by a range of detrimental features, including hypoxia, elevated levels of reactive oxygen species, impaired angiogenesis, chronic inflammation, and an increased susceptibility to bacterial infections. We have developed an innovative multifunctional hydrogel system based on carboxymethyl chitosan, which incorporates embedded microalgae PCC7942 along with hyaluronic acid and puerarin, termed PCC7942@carboxymethyl chitosan/hyaluronic acid/puerarin hydrogel. It demonstrated outstanding capabilities in exudate absorption, mechanical flexibility, hemostatic action, and antibacterial efficacy. Furthermore, it effectively modulated the pH of wound microenvironment through the hydrolysis of amide bonds, thereby establishing a favorable low-pH microenvironment. Microalgae in hydrogel covered in the wound exhibited stable and continuous oxygen production within 24 h, with more efficiency in dissolved oxygen penetration through skin. Furthermore, prodrugs such as hyaluronic acid and puerarin from hydrogel displayed the controlled release behavior and facilitated the fast and enhanced accumulation of drugs at wound site, thereby accelerating the process of wound healing via enhanced angiogenesis and anti-inflammation effects. In summary, the healing-promoting effect of PCC7942@carboxymethyl chitosan/hyaluronic acid/puerarin hydrogel in type 1 diabetic rats can be attributed to the synergistic effects of microalgae, hyaluronic acid, and puerarin, which collectively accelerated wound healing rate and improved the quality of wound recovery.

Research on the Application of "Internet Plus" Rehabilitation Nursing in Children with Cerebral Palsy

Abstract: Currently, cerebral palsy has emerged as a severe disease deserving significant attention. Amidst the thriving development of internet technology, the "Internet+" platform has brought new support to the medical field. This study aims to explore the application effects of "Internet+"-based rehabilitation nursing for children with cerebral palsy. A total of 60 children with cerebral palsy were randomly divided into a control group and an experimental group. The control group received conventional rehabilitation nursing, while the experimental group underwent "Internet+"-based rehabilitation nursing intervention. Comparisons were made between the two groups in terms of overall disease recovery, fine motor function, gross motor function, activities of daily living (ADL), nursing satisfaction, and quality of life. The results showed that the experimental group surpassed the control group in motor function, ADL, disease recovery efficiency, nursing satisfaction, and quality of life assessments, with statistically significant differences (P&lt;0.05). The application of "Internet+"-based rehabilitation nursing for children with cerebral palsy can lead to more desirable overall nursing outcomes.

Postoperative quality of recovery comparison between ciprofol and propofol in total intravenous anesthesia for elderly patients undergoing laparoscopic major abdominal surgery: A randomized, controlled, double-blind, non-inferiority trial

Study objectivesWe conducted a non-inferiority study to assess the postoperative quality of recovery (QoR) in elderly patients receiving ciprofol or propofol total intravenous anesthersia(TIVA)after elective laparoscopic major abdominal surgery, with QoR-15 scores as the main measure. DesignA prospective, double-blind, randomized non-inferiority trial was conducted in the theater, post-anesthesia care unit (PACU), and the ward. Participants144 elderly patients (age ≥ 65 years) were randomly assigned to either the ciprofol group or the propofol group. InterventionsThe ciprofol group received continuous infusion of ciprofol with remifentanil, and the propofol group received infusion of propofol with remifentanil. Outcome measuresThe primary outcome was the QoR-15 on the first postoperative day (POD1), assessed in both intention-to-treat and per-protocol populations, with the mean difference between groups compared to a non-inferiority threshold of −8. Additional assessments included QoR-15 scores on POD2, 3, and 5 for both analysis sets. Other evaluated perioperative value factors included hemodynamic parameters and injection discomfort in the intention-to-treat analysis. A linear mixed model was utilized to examine the impact of group-time interactions on hemodynamic data and QoR-15. Main resultsThe QoR-15 scores on POD1 in the ciprofol group were non-inferior to those in the propofol group both in intention-to-treat set (mean [95 %CI], 95.9[93.7–98.2] vs. 95.6 [93.3–97.8]; mean difference [95 % CI], 0.4 [−2.8–3.5]; P<0.001 for noninferiority) and per-protocol set (mean [95 %CI], 96.7 [94.4–99.0] vs. 95.7 [93.4–98.0]; mean difference [95 % CI], 1.0 [−2.2–4.3]; P<0.001 for noninferiority). Comparable outcomes were noted on postoperative days 2, 3, and 5 following the procedure in both analysis sets. Additionally: compared with propofol group, the occurrence of injection pain was lower (2.8 % vs. 27.8 %, P < 0.001); the hypotension was less frequent (33.3 % vs. 54.2 %, P = 0.012); the bradycardia was more common (38.9 % vs. 23.6 %, P = 0.048). ConclusionsCiprofol is not inferior to propofol in QoR. Ciprofol can be suitably administered to elderly patients undergoing elective laparoscopic major abdominal surgery.

The application effect of preventive nursing intervention in patients with traumatic flail chest: A retrospective study.

This retrospective study explores the intervention effect of preventive nursing on participants with traumatic flail chest caused by multiple rib fractures. In this study, 92 patients with multiple rib fractures from a certain hospital from July 2020 to June 2022 were chosen as the research subjects. They were divided into research group and a control group according to different nursing methods. The control group received routine care. The research group received preventive care on the basis of the control group. Then, questionnaire survey was collected to evaluate the quality of life, pain degree, psychological state, complications, and lung function recovery of patients before and after nursing. In the quality of life score, before nursing, the scores of the research group and the control group were between 52 and 69, and the difference among the participants in the experiment did not possess statistical significance (P > .05). After nursing, the scores of the research group were markedly superior to the control group, and all scores possessed statistical significance (P < .05). In the pain score, the pain scores of the research group and the control group before preventive nursing were 7.87 ± 0.86 and 7.68 ± 0.75, respectively, and the difference among the participants in the experiment did not possess statistical significance (P > .05). After 6 months of nursing, the pain scores of the participants in the experiment were 2.84 ± 0.69 and 3.04 ± 0.72, respectively. The difference among the participants in the experiment possessed statistical significance (P < .05). In the Hamilton Anxiety Scale, the psychological state scores of the experimental group and the control group before intervention nursing were 52.87 ± 4.97 and 51.74 ± 4.56, respectively, and the scores after intervention nursing were 22.68 ± 4.69 and 36.87 ± 5.21, respectively. The difference among the participants in the experiment possessed statistical significance (P < .05). Preventive nursing interventions can improve long-term quality of life, significantly alleviate postoperative pain, decrease the incidence of postoperative complications, as well as enhance nursing satisfaction in patients with traumatic flail chest.

Benchmarking Stroke Outcome Prediction through Comprehensive Data Analysis - NeuralCup 2023.

Stroke is a significant cause of mortality and long-term disability worldwide, with variable recovery trajectories posing substantial challenges in anticipating post-event care and rehabilitation planning. The NeuralCup 2023 consortium was established to address these challenges by comparing the predictability of stroke outcome models through a collaborative, data-driven approach. This study presents the consortium's findings, which involved 15 participating teams worldwide. Using a comprehensive dataset, which included clinical and imaging data, we conducted an open competition to identify and compare predictors of motor, cognitive, and neuropsychological (emotional) outcomes one-year post-stroke. Analyses incorporated both traditional and novel methods, including machine learning algorithms. These efforts culminated in the search for 'optimal recipes' for predicting each domain through an exhaustive exploration of the features of all the approaches. Key predictors included lesion characteristics, T1-weighted MRI sequences, and demographic factors. Notably, integrating FLAIR imaging and white matter tract analysis emerged as crucial to improving the accuracy of cognitive and motor outcome predictions, respectively. These findings advocate for a tailored, multifaceted approach to stroke outcome prediction, underscoring the potential of collaborative data science in addressing complex neurological prognostication challenges. This study also sets a new benchmark methodology in stroke research, offering a foundational step toward personalized care strategies that could significantly impact recovery planning and quality of life for stroke survivors.

Effect of preoperative oral carbohydrate on the postoperative recovery quality of patients undergoing daytime oral surgery: a randomized controlled trial

BackgroundPreoperative oral carbohydrate intake can improve the postoperative recovery of fasting patients in many kinds of surgeries; however, the effect of carbohydrates on patients undergoing daytime oral surgery is still unclear. This study was designed to evaluate the effect of preoperative oral carbohydrate intake on the quality of recovery of patients undergoing daytime oral surgery using the quality of recovery-15 (QoR-15) questionnaire.MethodsNinety-two patients scheduled for daytime oral surgery were randomly allocated to the midnight fasting group (F group, n = 45) or the carbohydrate-Outfast loading group (O group, n = 47). Participants in the F group fasted from midnight the day before surgery. Patients in the O group also fasted but received the Outfast drink (4 ml/kg) 2–3 h before the induction of anesthesia. QoR-15 questionnaire, patient well-being, and satisfaction were assessed before anesthesia induction and 24 h after surgery. Perioperative blood glucose, postoperative exhaust time, and adverse events were also recorded.ResultsThe QoR-15 scores were significantly higher in the O group than in the F group preoperatively and postoperatively. Seven parameters representing patient well-being evaluated on a numeric rating scale (NRS, 0–10) were lower in the O group than in the F group postoperatively, except for the hunger and sleep quality scores. Patient satisfaction scores on a 5-point scale were higher in the O group than in the F group preoperatively and postoperatively. Meanwhile, the postoperative exhaust time was significantly shorter in the O group compared to the F group, while there were no significant differences in blood glucose concentrations between two groups.ConclusionsPreoperative oral carbohydrate intake could improve postoperative recovery quality, well-being, and satisfaction of patients undergoing daytime oral surgery 24 h after surgery, and may serve as a treatment option for patients undergoing daytime oral surgery.Trial registrationThis trial was registered in the Chinese Clinical Trial Registry (ChiCTR2100053753) on 28/11/2021.

From antidepressants and psychotherapy to oxytocin, vagus nerve stimulation, ketamine and psychedelics: how established and novel treatments can improve social functioning in major depression.

Social cognitive deficits and social behavior impairments are common in major depressive disorder (MDD) and affect the quality of life and recovery of patients. This review summarizes the impact of standard and novel treatments on social functioning in MDD and highlights the potential of combining different approaches to enhance their effectiveness. Standard treatments, such as antidepressants, psychotherapies, and brain stimulation, have shown mixed results in improving social functioning, with some limitations and side effects. Newer treatments, such as intranasal oxytocin, mindfulness-based cognitive therapy, and psychedelic-assisted psychotherapy, have demonstrated positive effects on social cognition and behavior by modulating self-referential processing, empathy, and emotion regulation and through enhancement of neuroplasticity. Animal models have provided insights into the neurobiological mechanisms underlying these treatments, such as the role of neuroplasticity. Future research should explore the synergistic effects of combining different treatments and investigate the long-term outcomes and individual differences in response to these promising interventions.

Effect of transcutaneous electrical acupoint stimulation on postoperative recovery quality in patients undergoing endoscopic sinus surgery: a randomized controlled trial

To observe the effects of transcutaneous electrical acupoint stimulation (TEAS) on postoperative recovery and pain in patients undergoing elective endoscopic sinus surgery. One hundred and six patients scheduled for elective endoscopic sinus surgery were randomly divided into an observation group and a control group, with 53 patients in each group. Patients in both groups received TEAS or sham TEAS, respectively, from 30 min before intravenous anesthesia induction until the end of surgery. Acupoints selected were bilateral Neiguan (PC 6) and Zusanli (ST 36). The quality of requirements-15 (QoR-15) scores were assessed on the day before surgery (T0) and on postoperative days 1 (T1), 2 (T2) and 3 (T3). Pain visual analogue scale (VAS) scores were recorded at T1, T2 and T3. Athens insomnia scale (AIS) scores were measured at T0, T1, T2 and T3 in the two groups. The incidence of postoperative nausea-vomiting and dizziness-headache, usage of analgesics, number of patient-controlled analgesia (PCA) pump presses, and extubating time were also recorded in the two groups. At T1, T2 and T3, the observation group had higher QoR-15 scores (P<0.01, P<0.001) and lower AIS scores (P<0.001) than the control group. At T1 and T2, the observation group had lower pain VAS scores than the control group (P<0.001). The incidence of postoperative nausea-vomiting and dizziness-headache was 24.5% (13/53) and 37.7% (20/53) in the observation group, which were lower than 56.6% (30/53) and 66.0% (35/53) in the control group (P<0.01). There were no statistically significant differences in the use of rescue analgesics or the number of PCA pump presses between the two groups (P>0.05). The extubating time was shorter in the observation group compared with that in the control group (P<0.001). TEAS could improve postoperative recovery quality, alleviate postoperative pain, improve sleep quality, and reduce the incidence of postoperative nausea and vomiting in patients undergoing elective endoscopic sinus surgery.

Second-Generation Supraglottic Airway Devices Versus Endotracheal Intubation in Adults Undergoing Abdominopelvic Surgery: A Systematic Review and Meta-Analysis

BACKGROUND: Second-generation supraglottic airway (SGA) devices are widely used, but thought to have inferior safety performance to endotracheal tubes (ETTs), but might be equally efficacious while improving patient-centered outcomes. We compared second-generation SGAs with ETTs for perioperative safety, efficacy, and quality of recovery in adults undergoing abdominopelvic surgery under general anesthesia. Our primary objective was to assess safety in the form of major airway complications. Secondary objectives were other safety, efficacy, and quality of recovery outcomes. METHODS: We searched 4 databases for randomized controlled trials of adult patients having abdominopelvic surgery comparing second-generation SGAs and ETTs. After 2-person screening and data extraction, pairwise meta-analysis was conducted and the grading of recommendations, assessment, development, and evaluation (GRADE) approach was applied to assess the certainty of evidence. RESULTS: A total of 51 studies, randomizing 5110 patients, were included. Second-generation SGAs significantly reduced the risk of major perioperative airway complications (risk ratio [RR], 0.41; 95% confidence interval [CI], 0.23–0.71; P = .007; low certainty), with no clear clinically relevant difference in regurgitation or pulmonary aspiration (low certainty). SGAs significantly increased the risk of inadequate ventilation (RR, 3.36; 95% CI, 1.43–7.89; P = .011; very low certainty); however, postoperative sore throat (RR, 0.52; 95% CI, 0.38–0.70; P &lt; .001; moderate certainty), hoarseness (RR, 0.32; 95% CI, 0.231–0.48; P &lt; .001; low certainty), coughing at the emergence of anesthesia (RR, 0.17; 95% CI, 0.08–0.36; P &lt; .001; low certainty), and postoperative nausea and vomiting (RR, 0.64; 95% CI, 0.42–0.98; P = .042; very low certainty) were all less frequent with SGAs. No other clinically relevant differences were observed for other remaining outcomes. CONCLUSIONS: Second-generation SGAs reduce the risk of major airway complications compared with ETTs in adults undergoing abdominopelvic procedures under general anesthesia, with no reported clinically relevant differences in the risk of regurgitation or pulmonary aspiration. Additionally, they improve the quality of postoperative recovery with lower risk of sore throat, hoarseness, and postoperative nausea and vomiting. These data provide an opportunity for clinicians to reassess the implications of conservative airway management, and potentially expand the role of second-generation SGAs in routine clinical practice.

Research of the impact of noise reduction methods on the quality of audio signal recovery

The subject of the study is the analysis of various filtering algorithms for the quality of the resulting audio files. The importance of audio line filtering has grown significantly in recent years due to its key role in a variety of applications such as speech reduction and artificial intelligence. Taking into account the growing demand for solving problems related to speech recognition, the processing of audio series becomes important for determining the accuracy and efficiency of the obtained solution.The purpose of the work is to study the impact of noise suppression methods on the quality of restoration of an audio signal, which was alternately noisy with one of five types of noise - white, pink, brown, impulse, Gaussian with different power. To achieve the goal, the following tasks were solved: an analysis of the types of noise was carried out and analysis of noise reduction and filtering methods. A generalized model of noise reduction and filtering was developed, and an experiment was planned depending on the type and power of noise. Simulation of the experiment was performed by comparing the parameters of the signal-to-noise ratio before and after the experiment and the peak signal-to-noise ratio in the processed file. The following methods are used: spectral subtraction, filtering based on frequency filters and wavelet transformation.The following results were obtained: depending on the selected noises and algorithms, it was possible to achieve the lowest value of the peak signal-to-noise ratio of 21.52db, and the signal-to-noise ratio increased, which allowed further work with these audio files. The practical significance of this work is the increase in the number of available audio files for further work.Conclusions: the analysis of the obtained results showed that filtering based on frequency filters only worsened the output signal, that is, not only noise, but also useful information is filtered. In all runs, the SNR deteriorates to - 18dB. which is worse than no filtering. Algorithms of spectral subtraction and wavelet transformation improved SNR parameters and output audio files noisy with the most powerful noises in the range of 20dB, which can be considered acceptable for further processing. The results highlight the importance of using denoising and filtering for complex audio processing tasks, particularly neural network training tasks.