Recovery Area Research Articles

Association of Inpatient Postpartum Quality of Recovery With Postpartum Depression: A Prospective Observational Study

(J Clin Anesth. 2023;91:111263 I, https://doi.org/10.1016/j.jclinane.2023.111263 I) Nearly 7% to 9% of postpartum women have postpartum depression (PPD), which is a significant mood disorder. PPD can adversely influence postpartum recovery areas such as maternal-infant bonding, sleep, pain, cognitive function, and overall functionality. Suicide is a leading cause of death up to 1 year postpartum, highlighting the importance of identifying women at risk for PPD to facilitate early interventions and reduce depressive symptoms. The American College of Obstetricians and Gynecologists (ACOG) recommends routine screening, generally conducted at 6 weeks postpartum in the United States and Israel. However, about one-third of women do not attend the 6-week postpartum visit, presenting a challenge in timely identification and intervention.

BN SO11 - Optimising Day Case Laparoscopic Cholecystectomy: A GIRFT-Based Audit and Efficiency Analysis

Abstract Background Laparoscopic cholecystectomy (LC) is the gold standard for managing symptomatic gallstone disease and is commonly performed as a day surgery procedure due to its safety and efficiency. Despite its established benefits, recent analyses at our local hospital revealed a decline in the day case rate for elective LC, falling below the national median as highlighted by the Get It Right First Time (GIRFT) data. Method We analysed patient data for elective LC performed between 1st October 2023 and 29th February 2024. The data included patient demographics, length of stay, and reasons for unplanned admissions. Procedures from the hot and emergency lists were excluded from the analysis. To enhance the day case rate, a business case was developed to extend recovery staffing levels and coverage hours in the DSU from 6pm to 9pm. Additionally, we requested the coding team to distinguish elective cases from hot list cases for more accurate future analyses. The impact of these changes will be evaluated in a subsequent audit cycle. Results During the observed period, 86 elective LC cases were performed, with a day case rate of 64% (55/86), exceeding the national median of 60%. The discrepancy with the GIRFT analysis was due to the inclusion of hot list cases in their data. The primary reasons for unplanned admissions included monitoring observations (46%), late afternoon extubations (29%), and intra-operative concerns (18%). The median length of stay for unsuccessful day cases was 1 day. Cost analysis estimated the unplanned admission costs at over £12,000 for LC alone during the observed period, based on the NHS National Tariff 2024/25. Conclusion This audit demonstrated that our day case rate for elective LC surpasses the national median. By identifying key factors leading to unplanned admissions, we implemented targeted interventions, such as extending recovery area hours. These measures aim to further improve the day case rate, enhance patient care, and achieve significant cost savings.

Perioperative intravenous lidocaine infusion for postsurgical pain management in bariatric surgery patients

IntroductionObesity is one of the biggest modern health issues worldwide. Owing to the failure of both behavioral and pharmacological measures, the surgical approach has been established as the main conduct to follow, with bariatric surgery being one of the most effective and safe procedures. One of the bases for the optimal analgesic strategy is the use of adjuvants during the perioperative period. One of the main drugs in use is lidocaine.AimTo evaluate postoperative pain after perioperative lidocaine infusion in patients undergoing bariatric surgery and describe the presence of nausea and vomiting during the first 24 h.MethodsThis was a retrospective study of patients who underwent laparoscopic bariatric surgery at ABC Medical Center. Two study arms were established: a group of patients who received lidocaine infusion and a control group. The presence of pain, nausea, or vomiting was evaluated upon admission to the recovery area and 1 h and 24 h after the intervention. The normal distribution of the data was first verified via the Shapiro–Wilk test. The data are presented as medians for quantitative variables and as frequencies for qualitative variables.ResultsA total of 50 surgeries were performed, with a significant correlation between lidocaine infusion and lower pain values at 1 h (p = 0.04). Similarly, there was a marked trend in the presence of nausea in control group 4 (18.6%) vs. 15 (53.5%).ConclusionsOur data suggest that the use of intraoperative lidocaine infusion is limited in postoperative pain management; nonetheless, it significantly improves the incidence of postoperative nausea.

A typology of potential hydraulic barriers to adult salmon migration in a bedrock river

Adult Pacific salmon (Oncorhynchus spp.) in the Fraser River, British Columbia, can die trying to retrace and ascend the river network to their natal spawning grounds due to hydraulic barriers, where encounter velocities exceed swim speeds of adult salmon. We evaluated river hydraulics, river morphology, and swimming ability to better understand these potential hydraulic barriers. A 375 km centerline velocity survey of the Fraser Canyon identified 22 high velocity locations where the distribution of velocity within the reach could produce a hydraulic barrier. We identified and studied three flow types associated with these 22 high velocity locations: 1) plunging flows, 2) rapids, and 3) overfalls, using drone footage at various discharges to examine flow structure and compare surface velocities with swimming modes. Complex flow within the major hydraulic features highlight the spatial locations requiring anaerobic swimming and areas of potential recovery that change with discharge. This approach can be used to improve the understanding of fish migration limits in a natural river system and aid in future mitigation.

Adapting a Telehealth Physical Activity and Diet Intervention to a Co-Designed Website for Self-Management After Stroke: Tutorial.

People who experience a stroke are at a higher risk of recurrent stroke when compared with people who have not had a stroke. Addressing modifiable risk factors like physical inactivity and poor diet has been shown to improve blood pressure, a leading contributor to stroke. However, survivors of stroke often experience challenges with accessing risk reduction services including long wait lists, difficulty with transportation, fatigue, impaired function, and diminished exercise capacity. Providing health interventions via a website can extend the reach when compared with programs that are only offered face to face or via real-time telehealth. Given global challenges of accessing secondary prevention programs, it is important to consider alternative ways that this information can be made available to survivors of stroke worldwide. Using the "design thinking" framework and drawing on principles of the integrated knowledge translation approach, we adapted 2 co-designed telehealth programs called i-REBOUND - Let's get moving (physical activity intervention) and i-REBOUND - Eat for health (diet Intervention) to create the i-REBOUND after stroke website. The aim of this paper is to describe the systematic process undertaken to adapt resources from the telehealth delivered i-REBOUND - Let's get moving and i-REBOUND - Eat for health programs to a website prototype with a focus on navigation requirements and accessibility for survivors of stroke. We engaged a variety of key stakeholders with diverse skills and expertise in areas of stroke recovery, research, and digital health. We established a governance structure, formed a consumer advisory group, appointed a diverse project team, and agreed on scope of the project. Our process of adaptation had the following 3 phases: (1) understand, (2) explore, (3) materialize. Our approach considered the survivor of stroke at the center of all decisions, which helped establish guiding principles related to our prototype design. Careful and iterative engagement with survivors of stroke together with the application of design thinking principles allowed us to establish the functional requirements for our website prototype. Through user testing, we were able to confirm the technical requirements needed to build an accessible and easy-to-navigate website catering to the unique needs of survivors of stroke. We describe the process of adapting existing content and co-creating new digital content in partnership with, and featuring, people who have lived experience of stroke. In this paper, we provide a road map for the steps taken to adapt resources from 2 telehealth-delivered programs to a website format that meets specific navigation and accessibility needs of survivors of stroke.

Three-dimensional stagnation point motion of bioconvection nanofluid via moving stretching sheet with convective and anisotropic slip condition

The current article deals with the SM of a NFs on a 3D moving surface containing bioconvection, microorganisms, and convective conditions over anisotropic slip. This work reports describes the characteristics of bioconvection aspects of nanofluid containing microorganisms with anisotropic slip condition. The study may be important from the application point of view in microfluidic devices, antibiotics, enhanced oil recovery and many other areas. Applying the similarity variables, the basic gov. Eqs are translated to ordinary ones, and such Eqs are calculate by R-K-F fourth order programming with shooting scheme by MATLAB software. The physical parameters on the moving surface are explained in detail via graphs. We found that the temperature increases with a higher revolution and larger numerical numbers (convection parameter), while the HTR declined for various values of the SFP. The HTR enhances with surface convection, and therefore, the convection condition is helpful in reducing the viscous drag on the moving SS.

Comparison between Anterior Approach and Posterior Approach of Suprascapular Nerve Block for Postoperative Analgesia in Shoulder Arthroscopy

Abstract Background Severe intraoperative and postoperative pain associated with arthroscopic shoulder surgery has high incidence reaching up to 45%, it is often significant enough to interfere with initial recovery and rehabilitation. This pain is difficult to manage without large-dose opioids. Aim of the Work compare between anterior approach and posterior approach of suprascapular nerve block for postoperative analgesia in shoulder arthroscopy. Patients and Methods The study was conducted in Ain Shams University Eldemerdash Hospitals after approval from the ethics committee of anesthesia, intensive care and pain management department and written patients‟ consent. It included a total of 72 adult patients aged 18-60 years, Scheduled for shoulder arthroscopic surgeries. Patients were randomly divided into two equal groups, 36 each, according to the inclusion and exclusion criteria. Results no statistically significant differences in pain scores at 6, 12, and 24 hours postoperatively between the anterior SSNB and posterior SSNB groups. Postoperative First analgesia request time/hour early in posterior approach comparing to anterior approach (6.03±0.74, 5.64±0.68).opioid requirements were statistically different between the two groups, with a benefit in favour of the anterior route in the recovery area and during the first 24 postoperative hours. Conclusion the main finding is the anterior approach of SSNB provided superior analgesia compared with posterior approach of SSNB in postoperative opioid consumption.

Opportunities and Threats for the Strategic Development of Ukraine's Economy until 2030

The process of strategic development of Ukraine's economy is largely complicated by the presence of a hot vase of military operations on the territory of the state. Nevertheless, for the post-war recovery, it is necessary to develop key areas of economic development today. Given the current level of GDP, which has decreased by 4% compared to the pre-war period, and the outflow of capital investments, which amounted to almost 50%. Given the relevance of the research topic, its purpose can be defined as a generalisation of approaches to the development of directions for the strategic development of Ukraine's economy with specification of opportunities and threats until 2030. The study used a systematic review of the scientific literature with a focus on publications from the last five years to ensure that the analysis of Ukraine's economic development strategy is up-to-date and relevant. The research methods included the construction of a strategic map to outline key areas of economic recovery, complemented by a SWOT analysis to assess opportunities, threats, strengths, and weaknesses. Based on the results of the literature search, 40 scientific papers were selected from the Web of Science and Scopus databases that are directly related to the research topic. It is proved that during the period of post-war recovery and the creation and further implementation of the economic growth strategy, emphasis should be placed on ensuring the following areas of development of the Ukrainian economy: creating a favourable and maximally transparent investment climate to attract investors; countering demographic changes and creating conditions for the return of the population that left Ukraine at the beginning of the war; diversifying economic processes and the economic potential of the State; ensuring the restoration of the energy sector In addition, in the process of developing the topic, a strategic map for the implementation of strategic directions for ensuring Ukraine's economic development until 2030 was created. The SWOT analysis has identified both opportunities and threats in implementing the action plan, with the main condition being the end of active hostilities in the country.

Assessment of Knowledge, Attitude and Practice of Nurses’ Towards Physical Restraints for Critical Ill Patients in Orotta National Referral Hospital

<i>Background</i>: Physical restraint can be defined as any act that avoids a person's liberated body change to a position of preference and, or regular evaluation to their body by the application of any technique, attached or adjacent to a person’s body that they cannot manage or remove easily. Inappropriate use of physical restraints may cause patients grave damage. Different studies informed that patients faced to physical restraints pass on due to pneumonia, constipation, and incontinence, as well as circulatory and respiratory problems. Critical care nurses should make correct decisions regarding use of physical restraints if they are to guarantee patient safety by the accountable nurse. <i>Aim</i>: the intention of this study was to assess nurses’ knowledge, attitude and practice; towards physical restraints use. <i>Method</i>: study design was a descriptive cross Sectional that used to assess knowledge, attitude and practice of nurses towards physical restraints in Orotta national referral hospital with self-administered questionnaire. Lastly data was analyzed using SPSS version 26. <i>Results</i>: the study was conducted among 100 nurses. 60% of the respondents were females and the median age of the study participants was 28 (IQR=6) years, with a minimum age of 21 and maximum age of 50yrs. Most of the study participants 31% had age of 25 or less years. Majority of them were diploma level and did not take any physical restraint related training 55% and 84% respectively. Except in recovery (12%) and adult ICU (27%) areas, the number of nurses in medical, surgical and adult was similar (each 20%). More than ninety percent (94%) of the study participants were not aware of the presence of guidelines regarding physical restraint in their work area. <i>Conclusion</i>: In this current study we concluded that, there was no correlation between knowledge and attitude and also between attitude and practice. But there was correlation between knowledge and practice. Those who have good knowledge can practice well. <i>Nursing implication</i>: By evaluating the current nurses’ knowledge, attitude and practice, this study will contribute recommendation on the frequent training of nurses on physical restraints and possible avoidance of it or safe practice.

Safety Assessment of Sedation Services in Radiology at Shaukat Khanum Memorial Cancer Hospital and Research Center, Peshawar.

The purpose of this retrospective observational study was to evaluate the safety of newly started sedation services in the department of Radiology Shaukat Khanum Memorial Cancer Hospital and Research Center Peshawar, Pakistan. Medical record of the patients who underwent sedation for different types of imaging studies at Shaukat Khanum Memorial Cancer Hospital, Peshawar center were retrospectively reviewed to evaluate the safety outcome of sedation. Process variables included preoperative assessment, obtaining informed consent acquisition, confirmation of nulla per os (NPO) status, monitoring during the procedure, post-anesthetic care unit (PACU) handover, and discharge instructions. The monitored complications included instances of cardiac arrest, respiratory arrest, hypoxia, apnea and vomiting. No major adverse events, such as respiratory or cardiovascular arrest, were observed among the patients in our study. A limited number of cases experienced minor events, specifically hypoxia and apnea, all of which were effectively addressed through simple maneuvers. However, one patient with previously undiagnosed obstructive sleep apnea encountered upper airway obstruction, necessitating the discontinuation of the procedure. Subsequently, all patients were safely discharged to their homes from the recovery area. Sedation in Radiology department can be safely performed by adhering to a structured approach aligned with hospital policies and procedures.

The Effect of Preoperative Oral Glucose Administration on Blood Glucose Levels in Diabetes Mellitus Patients in General Anesthesia Surgery

Background The administration of general anesthesia during surgery can trigger the body’s stress response causing changes in regular metabolic patterns that result in hyperglycemia and ketosis. The goal of this study is to investigate how preoperative oral glucose and non-glucose administration affect patients with diabetes mellitus with blood glucose levels during surgery under general anesthesia. Methods This is a single-blind, randomized controlled trial (RCT) being carried out by the Central Surgical Installation and postoperative recovery area at Haji Adam Malik General Hospital Medan. The study sample consists of 38 patients with diabetes mellitus who underwent electively scheduled laparotomies under general anesthesia and met inclusion/exclusion criteria. For treatment group participants, mineral water containing 50 grams of glucose was administered with 400 cc. Research hypotheses were assessed using the t-test, and significant findings had p-values equal to or less than 0.05 within a confidence interval of 95%. Results The study sample had a mean age of 50.1 ± 12.73 and showed a significant effect between glucose levels before (178.47) and after (163.78) administration of maltodextrin, with a P value (0.001). No side effects were observed during or after the post-operative evaluation process conducted in this study's participants. Conclusions Patients with diabetes mellitus experience a preoperative oral glucose-induced impact on blood glucose levels.

A new metric for conducting 5‐year reviews to evaluate recovery progress under the Endangered Species Act

AbstractThe Endangered Species Act (ESA) provides legal protection to imperiled populations and their associated habitats. As a part of this process, listed species must undergo a general status review (also called 5‐Year Review) to assess the progress toward recovery every 5 years. However, almost all 5‐year reviews result in a status of “no change,” prompting scientists to question if the review process is robust enough to detect changes in recovery. The U.S. Fish and Wildlife Service (USFWS) was therefore interested in developing a standardized metric for monitoring more nuanced recovery progress as part of the status review. In collaboration with the USFWS, over 75 biologists from five different organizations developed and tested a set of novel metrics to summarize recovery progress of listed species by considering current and future conditions, threats, and conservation measures. We found that, although the majority of species had reviews with a recommendation of no change, scorers were able to use the metrics to interpret more nuanced changes in the 3Rs (resiliency, redundancy, and representation), threats, and conservation measures than in the status review. Our results suggest that these metrics could illuminate more nuanced areas of recovery and decline in species' conditions, but consistency among scorers and status reports should be a focus of future development. Our approach offers a rigorous set of metrics to systematically track the recovery progress of all ESA species.

Behavioral, Functional Imaging, and Neurophysiological Outcomes of Transcranial Direct Current Stimulation and Speech-Language Therapy in an Individual with Aphasia.

Speech-language therapy (SLT) is the most effective technique to improve language performance in persons with aphasia. However, residual language impairments remain even after intensive SLT. Recent studies suggest that combining transcranial direct current stimulation (tDCS) with SLT may improve language performance in persons with aphasia. However, our understanding of how tDCS and SLT impact brain and behavioral relation in aphasia is poorly understood. We investigated the impact of tDCS and SLT on a behavioral measure of scripted conversation and on functional connectivity assessed with multiple methods, both resting-state functional magnetic resonance imaging (rs-fMRI) and resting-state electroencephalography (rs-EEG). An individual with aphasia received 15 sessions of 20-min cathodal tDCS to the right angular gyrus concurrent with 40 min of SLT. Performance during scripted conversation was measured three times at baseline, twice immediately post-treatment, and at 4- and 8-weeks post-treatment. rs-fMRI was measured pre-and post-3-weeks of treatment. rs-EEG was measured on treatment days 1, 5, 10, and 15. Results show that both communication performance and left hemisphere functional connectivity may improve after concurrent tDCS and SLT. Results are in line with aphasia models of language recovery that posit a beneficial role of left hemisphere perilesional areas in language recovery.

Cloud-based application for spatial and statistical analysis about environmental fragility and land cover

The MapBiomas project developed a free and open-source platform to monitor Brazilian land use land cover (LULC) changes since 1985. To increase its analytic power, we developed the Environmental Fragility Mapping System (EFMS), using Google Earth Engine (GEE). Environmental fragility (EF) analysis has its origins in ecodynamics, and it is composed of potential environmental fragility (PEF) and emergent environmental fragility (EEF). The advantage of EF analysis over LULC analysis is its flexibility in evaluating multiple scenarios for different aspects of environmental challenges. EFMS calculates three environmental fragility indexes: potential fragility index (PFI), land cover fragility index (LCFI), and emergent fragility index (EFI). Combined with LULC change analysis from the MapBiomas, EFMS can provide spatial analysis and generate maps and data for environmental management. In this article we describe the EFMS method, provide the code and present a case study to generate fragility scenarios for selecting priority areas for environmental recovery.

Efficacy of EMLA for Office-based Andrology Procedures Under Local Anesthesia: A Randomized Control Trial

ObjectiveTo evaluate the effectiveness of Eutectic Mixture of Local Anesthetic (EMLA), a topical anesthetic cream, in office-based invasive andrological procedures such as hydrocelectomy, spermatocelectomy, and others, aimed at minimizing pain perception and enhancing the overall patient experience. MethodsA double-blinded randomized controlled trial was conducted for patients undergoing scrotal andrology surgeries under LA. Power calculation was performed with an estimated sample size of 72. Participants were randomly assigned in a 1:1 ratio to topical EMLA + LA vs LA alone. In the post-operative recovery area, patient will be asked to complete a VAS questionnaire rating pain with LA administration and pain with procedure. Analysis comparing VAS pain scores of both groups was performed using the independent sample t-test method. Results72 patients were included in our analysis, with 36 in the control and 36 in the intervention arm. For patient pain with administration of LA, the control arm reported an average VAS pain score of 4.31, compared to 3.72 in the intervention arm (p=0.319). For patient pain with procedure, patients in the control arm reported a median VAS pain score of 3.47 compared to 3.03 (p=0.432) in the intervention arm. Overall, 86% (62/72) of patients reported that they would either be “very likely” (4/5) or “highly likely” (5/5) to undergo future procedures under local anesthetic. ConclusionsWhile performing scrotal surgeries under LA appears to be well tolerated and a feasible option, the application of EMLA cream does not appear to significantly alter patient-reported outcomes.

Self-organizing recruitment of compensatory areas maximizes residual motor performance post-stroke.

Whereas the orderly recruitment of compensatory motor cortical areas after stroke depends on the size of the motor cortex lesion affecting arm and hand movements, the mechanisms underlying this reorganization are unknown. Here, we hypothesized that the recruitment of compensatory areas results from the motor system's goal to optimize performance given the anatomical constraints before and after the lesion. This optimization is achieved through two complementary plastic processes: a homeostatic regulation process, which maximizes information transfer in sensory-motor networks, and a reinforcement learning process, which minimizes movement error and effort. To test this hypothesis, we developed a neuro-musculoskeletal model that controls a 7-muscle planar arm via a cortical network that includes a primary motor cortex and a premotor cortex that directly project to spinal motor neurons, and a contra-lesional primary motor cortex that projects to spinal motor neurons via the reticular formation. Synapses in the cortical areas are updated via reinforcement learning and the activity of spinal motor neurons is adjusted through homeostatic regulation. The model replicated neural, muscular, and behavioral outcomes in both non-lesioned and lesioned brains. With increasing lesion sizes, the model demonstrated systematic recruitment of the remaining primary motor cortex, premotor cortex, and contra-lesional cortex. The premotor cortex acted as a reserve area for fine motor control recovery, while the contra-lesional cortex helped avoid paralysis at the cost of poor joint control. Plasticity in spinal motor neurons enabled force generation after large cortical lesions despite weak corticospinal inputs. Compensatory activity in the premotor and contra-lesional motor cortex was more prominent in the early recovery period, gradually decreasing as the network minimized effort. Thus, the orderly recruitment of compensatory areas following strokes of varying sizes results from biologically plausible local plastic processes that maximize performance, whether the brain is intact or lesioned.

РЕЙТИНГ ТА ГРАДІЄНТ ЕФЕКТИВНОСТІ ФУНКЦІОНУВАННЯ ТЕРИТОРІАЛЬНИХ ГРОМАД

The revitalization and functioning of territorial communities in wartime requires special attention from scientists and specialists due to the postponement of the necessary methodological support and complete statistical data, which leads to the search for new approaches and methods. The aim of the article is to determine the rating and gradient of efficiency of functioning of territorial communities of Luhansk and Donetsk regions in the conditions of war. Methods used in the study: comparative analysis, gradient, detailing and generalization, rating and grouping, etc. The hypothesis of the study was the assumption that it is expedient to assess the functioning of territorial communities by means of their rating and calculation of the efficiency gradient. Presentation of the main material: Given the diversity of living conditions of the territorial communities of Luhansk and Donetsk regions, effective management of their daily functioning, development or recovery requires taking into account the characteristics of each community, which were consolidated into three blocks: territorial and security; operational and priority-oriented block of features. The article builds a rating efficiency of the functioning of territorial communities in the dynamics for 2022-2023. for territorial communities of Luhansk Oblast and Donetsk Oblast with structuring according to the spatial and security type. Based on the data obtained, an efficiency gradient for the temporarily occupied territorial communities, a gradient of the efficiency of the functioning of recovery territories and depopulated communities of Luhansk and Donetsk regions for 2022-2023 were built. The originality and practical significance of the study lies in the comprehensive application of ratings and the gradient of efficiency of the functioning of territorial communities of Luhansk and Donetsk regions for 2022-2023, that is, during the war. Conclusions. Quantification of the results of the overall rating calculated in dynamics made it possible to identify certain highly efficient, effective, ineffective or inefficient communities, forming a gradient of efficiency. In turn, its additional analysis, taking into account the type of territory (recovery areas, depopulated communities and temporarily occupied territories), became the basis for determining the main triggers for changes in socio-economic efficiency. Further research - the identified trigger points (community indicators) will allow to form an array of substantiated recommendations or proposals to improve the socio-economic efficiency of the functioning of communities in Luhansk and Donetsk regions in wartime and post-war times for each type of territory, which will be the object of further research.

Efficacy of Aloe Vera Gel vs. 1% Silver Sulfadiazine in First- and Second-Degree Burn Wound Healing: A Systematic Review and Meta-Analysis

Abstract Taking into account the availability of numerous clinical trials on the effects of Aloe vera gel on the prevention and healing of skin wounds, as well as its popularity among people and widespread use in the cosmetic industry, the current study compares the healing efficacy of Aloe vera gel vs. 1% silver sulfadiazine (SSD) in burn patients. We searched PubMed, Medline, Embase, and ClinicalKey database from January 1, 1990, to January 1, 2023 period. Our study included a patient who were having first- and second-degree burns. The intervention group received Aloe vera gel, while the control group received 1% SSD. The outcome variables assessed were tissue healing. Randomized controlled trials (RCTs) and non-RCTs were included to ensure a comprehensive evaluation of the intervention effects. Studies had to be available in English and published in full text to be eligible for inclusion. Initially, the search strategy’s flow diagram, which reported, screened, excluded, and eventually included studies, was created using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis 2020 principles. Using the population, intervention, control, and outcome format (PubMed-65, Embase-52, and ClinicalKey-131), 248 studies were included, while 220 studies were eliminated. As a result, 18 full-text RCTs were evaluated, and 7 studies that satisfied all of the meta-analysis’s eligibility requirements were eventually qualified. In comparison to the control group, the mean healing (in days) for first- and second-degree burn wounds was significantly lower in the total pooled result from the four RCTs. The mean difference was −2.73 [95% confidence interval (CI) −3.85 to −1.62; P ≤ 0.0001*]. When comparing the area of recovery in percentage for first- and second-degree burn wounds to the control group, the total pooled result from the four RCTs revealed a significant decrease, with odds ratio of 0.20 (95% CI 0.08–0.53; P ≤ 0.001*). Thus, the results of this meta-analysis demonstrate that Aloe vera gel is far more beneficial for first- and second-degree burn wound healing and patient recovery than 1% SSD.

Multi-factor coupling optimization of heat recovery effectiveness in a transcritical CO2 heat pump

In the background of energy shortage and climate change, transcritical CO2 heat pump(HTP) technology has attracted lots of attention because of its energy-saving and environmentally friendly advantages. In this research, an experimentally verified simulation model of transcritical CO2 HTP is established to investigate multi-factor coupling optimization of heat recovery effectiveness(ηIHX). First, the coupling optimization mechanism of ηIHX and discharge pressure(pdis) is analyzed. Moreover, this research explores the influence of ηIHX on heating capacity, power consumption, discharge temperature(tdis), and internal heat exchanger(IHX) cost, and further proposes a comprehensive heat recovery index to optimize the above factors. Based on this index the optimal heat recovery effectiveness(ηIHX,opt) for each operating condition is obtained. Also, a failure boundary for the coupling optimization of the ηIHX is also indicated. In addition, the optimal discharge pressure(pdis,opt) prediction correlation for different ηIHXs is proposed, which can be used for heat recovery effectiveness collaborative optimization control. Finally, a general method for evaluating IHX is provided. Taking Xi'an as an example, the optimal heat recovery area(AIHX,opt) of this HTP system is 0.42m2, with which the optimized HTP system operates safely at extreme operating conditions, resulting in an annual lucre of 1,211 CNY.

Response of macrobenthic communities to a Spartina alterniflora management project on tidal flats in Hangzhou Bay, China

Spartina alterniflora is one of the most invasive plants on Chinese tidal flats. To explore the responses of macrobenthic communities to the removal of S. alterniflora and the restoration of tidal flats, a survey of macrobenthic and sediment environmental factors was carried out in June 2022 in the mudflat recovery area (MRA) of tidal flats on the south bank of Hangzhou Bay, China. A proximate natural mudflat area (NMA), S. alterniflora area (SAA) and Scirpus mariqueter area (SMA) were selected for comparison with the MRA. A total of 48 macrobenthic species were identified, with 13, 28, 22 and 21species in the MRA, NMA, SAA and SMA, respectively. Cluster, multidimensional scaling (MDS) and SIMPER analysis suggested that the similarity between macrobenthic communities in the MRA and the NMA was high, whereas the similarity between macrobenthic communities in the MRA and SAA and the MRA and SMA was very low. The similarity between macrobenthic communities in the SAA and the SMA was high. ANOSIM analysis suggested that the differences between regions were greater than those within regions (R = 0.881). The sediment factors in the MRA were substantially different from those in the other three habitats, while the sediment factors in the SMA and the SAA were the most similar. Macrobenthos were mainly affected by the mean diameter of the sediment particles. After 1 year of natural recovery in the MRA, the macrobenthos approached the pre-project levels, but to ensure the effectiveness of the treatment project and prevent the recurrence of S. alterniflora, continuous monitoring should be carried out.