Recovery Time Research Articles

Virtual Follow-Up after Cataract Surgery: A Systematic Review.

To examine the association between virtual postoperative follow-up care and patient outcomes after cataract surgery. Cataract surgery is a safe and commonly performed surgery. Follow-up visits are used to monitor for complications. It is uncertain whether virtual follow-up provides a safe alternative to in-person review. Medline, Embase and CINAHL were searched from inception to October 2023 for relevant articles containing original data. Studies that: 1) included patients that were seen in a virtual follow-up (i.e., telephone or video call) for postoperative appointments after cataract surgery, and 2) reported patient outcomes were included. Risk of bias was assessed using the Newcastle-Ottawa and ROB2 assessment tools. Descriptive statistics were used to summarize findings. The review was registered in PROSPERO (registration number, CRD42023477207) and PRISMA guidelines were followed. The search yielded 1710 records with seven studies included in this review. The seven studies reported on 2113 cataract surgeries in 1994 patients. The studies ranged between 2004 and 2020. Most of the studies (5/7) included only patients with uncomplicated cataract surgery. Virtual follow-ups were all conducted by telephone. The follow-up calls were made at varying timepoints including postoperative day 1 (n= 3), day 7 (n=2) and day 14 (n=1). Two observational studies directly compared patients who had a telephone follow-up to a control group who had an in-person follow-up. There were no significant differences in complication rates (p=0.22) or visual acuity (p=0.28) between these follow-up groups. None of the studies reported serious adverse outcomes from replacing in-person follow-up with telephone follow-up. One study used virtual follow-up in conjunction with in-person visits for elderly patients and found that additional telephone follow-up was associated with decreased surgical recovery time and decreased patient anxiety. Three studies reported on patient perceptions about telephone follow-up. A common theme was that patients preferred telephone reviews and found them to be more convenient than in-person follow-up. For patients with uncomplicated cataract surgery, virtual follow-ups seem to be a safe alternative to in-person visits and were preferred by patients. These conclusions are preliminary given the limited literature base, and further study is needed.

Strain and External Electric Field Engineering of S-Terminated MXene on Selective and Sensitive Detection of N-Containing Compound Gases: A Computational Study.

Gas sensors are used for monitoring hazardous gases and vapors. With the emergence of S-terminated MXene synthesis, herein, we explore the sensing ability of Ti3C2S2 toward N-containing gases, including NH3, NO, NO2, trimethylamine (TMA), and nicotine (NT), using first-principles calculations and a statistical thermodynamic model. We find that Ti3C2S2 exhibits high selectivity to TMA, NO, and NT with moderate adsorption energies of -0.610, -0.490, and -0.476 eV, respectively, minimizing environmental noise from ambient gases. The electronic structure of Ti3C2S2 subtly alters upon adsorption of TMA, NO, and NT, facilitating detectable signals in the sensing device. However, the adsorption of NO2 and NH3 is less pronounced due to weak physisorption (<0.3 eV). Employing engineering strategies including biaxial strain and an external electric field greatly enhances the selectivity and sensitivity of NO2 (NH3) detection by boosting adsorption strength up to -0.351 eV with ε = 5% (-0.370 eV with |E⃗| = 0.6 V/ Å). In addition, the moderate adsorption energies of the gases result in a suitable recovery time in the range of milliseconds, leading to high reusability of the sensing device. The estimated adsorption densities suggest potential coverage of these N-containing molecules even at low concentrations and room temperature. Computational analysis of the sensing capability of Ti3C2S2 using the nonequilibrium Green's function method indicates that it is a promising gas-sensing material. In addition, mechanical modifications, electric field adjustments, and gate voltage alterations could be used to obtain effective sensing materials for N-containing gas detection.

SiO2-capped ZnO quantum dot based highly sensitive optical fiber humidity sensor with potential applications in human breath monitoring and voice print recognition

This article describes the development and characterization of an optical fiber humidity sensor employing intensity modulation via the evanescent wave (EW) absorption technique. For the development of the sensor, SiO2-capped ZnO quantum dot (QDs) thin film is synthesized over the decladded portion of plastic cladding silica (PCS) fiber via the sol-gel method. A thorough experimental investigation was conducted by varying the thickness of the sensing film to optimize the sensor’s response. The sensing probe with optimized film thickness of 891 nm demonstrates a linear response over 30.5%–92.5%RH with an enhanced sensitivity of 46.2 mV/%RH (0.0138RH−1). Very fast response and recovery times of 2 s and 2.5 s are observed during humidification and dehumidification for the optimized sensing probe. The maximum resolution recorded during the short stability test is ±0.12%RH. Additionally, the proposed sensor demonstrates a very high degree of repeatability, reversibility, and stability. The proposed sensor has also been tested for human breath monitoring and voice print recognition. The result shows the sensor is able to detect minute humidity fluctuations in exhaled air during breathing and speaking.

Preoperative Imaging-Guided Surgical Planning in Complex Pelvic Fractures - Innovations in Traumatology and Radiology for Enhanced Clinical Outcomes: A Systematic Review

This systematic review will explore role of preoperative imaging-guided surgical planning for the management of complex pelvic fractures. Pelvic fractures occurs in high-energy trauma and cause challenges for intricate anatomy and have a high association with vascular, visceral injuries. Traditional imaging methods frequently fail to capture injury complexity while increasing surgical risks. Recent advancements of imaging technology CT, MRI, 3D reconstructions along with and AI-based predictive models offer enhanced precision in diagnosing and planning surgical interventions with detailed insights into fracture patterns, bone density, and soft tissue damage which enable accurate surgical planning to reduce intraoperative complications and shorten recovery times. We aim to systematically investigate effectiveness of modern imaging techniques with potencies in clinical outcomes, with an emphasis on improved surgical accuracy and patient safety. Analyzing range of studies, we have established evidence-based recommendations for integrating advanced imaging technologies into routine trauma care showing critical role these innovations play in improving both short-term recovery and long-term clinical outcomes for patients having complex pelvic fractures.

Propofol-alone sedative efficacy in observational biliopancreatic endoscopic ultrasound.

Appropriate sedative and analgesic selection is essential to reduce patient discomfort and body movement to safely conduct endoscopic ultrasonography (EUS). However, few cases have examined sedation with propofol in EUS, and few studies the need for combined analgesia. In this study, we retrospectively evaluated the usefulness and safety of propofol without analgesics for sedation in biliopancreatic observational EUS. This single-center retrospective study included 516 observational biliopancreatic EUS procedures using propofol alone performed between April 2021 and March 2023. The primary and secondary endpoints were the observational biliopancreatic EUS results obtained with propofol alone and adverse event occurrence, respectively. The median examination time and total propofol dose were 22 (range: 10-67) min and 186.5 (range: 50-501) mg, respectively. The median starting Richmond Agitation-Sedation Scale and Visual Analog Scale scores were -5 (range: -5-1) and 0 (range: 0-10), respectively. The median recovery time was 22 (range: 5-80) min. Adverse events occurred in 60 (11.6%) patients. Trainee-performed examination (odds ratio [OR] 3.52, 95% confidence interval [CI]: 1.63-7.60, p = 0.0014) and examination length (>22 min; OR 1.67, 95% CI: 0.95-2.92, p = 0.07) were risk factors for adverse events.High body mass index (OR 1.87, 95% CI: 1.10-3.16, p = 0.02) and extended examination time (OR 4.23, 95% CI: 2.08-8. 57, p < 0.001) were risk factors for delayed recovery. During observational biliopancreatic EUS, propofol is useful as a single sedative and offers high patient satisfaction and relative safety.

Comparison of Butorphanol-Azaperone-Medetomidine and Nalbuphine-Medetomidine-Azaperone in Free-Ranging Elk (Cervus canadensis) in Pennsylvania, USA.

Chemical immobilization is commonly used to capture and handle free-ranging elk (Cervus canadensis). Butorphanol-azaperone-medetomidine (BAM) and nalbuphine-medetomidine-azaperone (NalMed-A) are compounded drug combinations that are lower-scheduled in the US than drugs historically used for elk immobilizations. We compared BAM and NalMed-A for immobilization of free-ranging elk using free-darting and Clover trapping. From January 2020 to April 2022, 196 female elk were immobilized in Pennsylvania, USA. We report vital rates, induction and recovery times, and the need for supplemental drugs. We built mixed-effects logistic regression models to describe differences between drug choice based on induction and recovery times, capture method, and individual variation. Several models were competing, including our null model, which suggests that BAM and NalMed-A are comparable based on the parameters we evaluated. Supplemental drug administration was more frequently needed in NalMed-A immobilizations (21.2%) than in BAM immobilizations (9.0%). Overall, we found minor differences between BAM and NalMed-A, both of which appear to be effective for immobilizing elk in both free-darting and Clover trapping scenarios when performing moderately invasive, minimally painful procedures on free-ranging elk.

The effectiveness of the synbiotic Maxilac&lt;sup&gt;®&lt;/sup&gt; for the new coronavirus infection after antibacterial therapy

The new coronavirus infection (COVID-19) that emerged in 2019 is a infection caused by the SARS-CoV-2 virus. Although SARS-CoV-2 predominantly affects the respiratory system, numerous studies suggest significant gastrointestinal involvement in COVID-19, particularly in children. Aim. To evaluate the effect of the synbiotic Maxilac® in children with COVID-19 after antibacterial therapy (ABT). Materials and methods. A clinical post-approval open-label observational prospective single-center study with minimal intervention was conducted. The microbiome of children with COVID-19 was studied. Twelve children with COVID-19 complicated by a bacterial infection (pneumonia, sinusitis, otitis) were included, receiving ABT and then taking the synbiotic Maxilac® for 4 weeks. Patient data were collected: symptoms, medical history, clinical status, study of intestinal microbiota (IM) by 16S sequencing, stool test for zonulin, and review of drug therapy. The material was sampled in patients with COVID-19 at 3 time points: at the time of acute COVID-19 disease, at the time of recovery from COVID-19, and 4 weeks after starting the synbiotic therapy. Results. The administration of the synbiotic Maxilac® to patients who received ABT for bacterial complications of COVID-19 relieves clinical gastroenterological symptoms, prevents the development of dysbiosis, and normalizes intestinal permeability. The results indicated significant changes in IM after ABT in complicated COVID-19 and the normalizing effect of synbiotic Maxilac® on IM during administration for 30 days. The synbiotic Maxilac® in the group of children with COVID-19 who received ABT had no side effects and was safe. Conclusion. Children with COVID-19, complicated by a bacterial infection, treated with ABT are recommended to receive the synbiotic Maxilac® for at least 30 days after recovery.

Magneto-Dielectric Synergy and Multiscale Hierarchical Structure Design Enable Flexible Multipurpose Microwave Absorption and Infrared Stealth Compatibility

HighlightsA multiscale hierarchical structure design, integrating wrinkled MXene radar-infrared shielding layer and flexible Fe3O4@C/PDMS microwave absorption layerThe assembled stealth devices realize a near-perfect stealth capability in both X-band (8-12 GHz) and long-wave infrared (8-14 µm) wavelength ranges.The optimal device demonstrates exceptional curved surface conformability, self-cleaning capability (contact angle ≈ 129°), and abrasion resistance (recovery time ≈ 5 s).

Protective Effect of Allergen Immunotherapy in Patients With Allergic Rhinitis and Asthma Against COVID-19 Infection: Observational, Nationwide, and Multicenter Study.

Allergic diseases are associated with an increased susceptibility to respiratory tract infections. Although allergen immunotherapy (AIT) alters the course of allergies, there is limited evidence from clinical practice demonstrating its ability to enhance the host defense against pathogens. The aim of this study was to investigate the protective effect of AIT against viral infection in patients with allergic rhinitis (AR) and allergic asthma (AS) based on clinical evidence. A multicenter, questionnaire-based survey was conducted during a tremendous surge in COVID-19 cases between February 10, 2023, and March 15, 2023, in 81 centers across China recruiting healthy volunteers and patients with AR and AS to investigate the clinical outcomes of COVID-19 infection. Of 10,151 participants recruited in the survey, 3654 patients and 2192 healthy volunteers who tested positive for COVID-19 were included in this analysis after screening. Overall, no significant differences in COVID-19 outcomes were observed between patients and healthy volunteers. An additional 451 patients were excluded due to their use of biologics as the sole add-on treatment, leaving 3203 patients in the further analysis. Of them, 1752 were undergoing routine medication treatment (RMT; the RMT group), whereas 1057 and 394 were receiving AIT and a combination of AIT and omalizumab (OMA) as adjunct therapies to RMT, respectively (AIT+RMT and AIT+OMA+RMT groups). The AIT group showed milder COVID-19 symptoms, shorter recovery periods, and a lower likelihood of hospitalization or emergency department visits than the RMT group (all P<.05). After adjusting for confounding factors, including demographic characteristics and COVID-19 vaccination, AIT remained a significant protective factor associated with shorter recovery time (adjusted odds ratio [OR] 0.62, 95% CI 0.52-0.75; adjusted P<.001) and a lower incidence of hospitalization or emergency department visits (adjusted OR 0.73, 95% CI 0.54-0.98; adjusted P=.03). Furthermore, the AIT+OMA+RMT group showed greater protection with a shorter recovery time (adjusted OR 0.51, 95% CI 0.34-0.74; adjusted P<.001) than the AIT+RMT group. Our multicenter observational study provides valuable clinical evidence supporting the protective effect of AIT against COVID-19 infection in patients with AR and AS.

Thinning-induced decrease in fine root biomass, but not other fine root traits in global forests

In forest ecosystems, changes in the expression of tree absorptive root traits following management interventions are expected to influence post-thinning forest structure and function. Fine root traits are expected to be especially responsive to forest thinning—one of the most common forest management interventions and the focus of our research here—influencing tree-level responses to environmental change, and thereby contributing to post-thinning stand-level dynamics and ecosystem processes. However, there remains limited understanding surrounding whether or not forest thinning influences the expression of root morphological, chemical, and physiological traits associated with belowground resource acquisition. We conducted a global meta-analysis to evaluate the response of 13 fine root traits to forest thinning. Our study included analysis of 769 paired observations of root traits values pre- and post-thinning, derived from 89 peer-reviewed publications. Our meta-analysis found that forest thinning leads to a decrease in fine root biomass by 11.7% on average, while other root traits including fine root length, root C and N concentrations, root lifespan, and root respiration rates, are largely unresponsive to thinning treatments. Thinning tended to reduce fine root biomass at early stand recovery stages, with increases in fine root biomass being detected at later seral stages, especially in heavy thinning experiments. The effect of thinning on fine root biomass was most pronounced in deeper soil horizons. The influence of thinning on fine root trait expression was not affected by ecosystem or stand type, with the exception of biomass which decreased in temperate and coniferous forests. Our results demonstrate variations of fine root traits to forest management, as well as the importance of stand recovery time and thinning intensity in regulating fine root trait expression in retention trees. These patterns may have strong implications for governing soil carbon stocks in managed forests associated with decreased root inputs into deeper soils. Overall, our findings can enhance our comprehension of how forest management affects fine root trait expression, and relationship between managed forests and belowground ecosystem structure and function.

Fabrication of Au-decorated V2O5 based sensor for ultra trace level detection of ammonia in an environment resembling human exhaled breath

Ammonia stands out as a significant breath biomarker for kidney-related diseases. Here we present the fabrication of a gold (Au) decorated V2O5 based sensor designed for detecting ammonia at parts per billion (ppb) level. The V2O5 particles were synthesized by thermal decomposition of ammonium metavanadate (NH4VO3) instead of using tedious and expansive synthesis routes. The product of the thermal decomposition of NH4VO3 was characterized utilizing various analytical techniques. Then this product (V2O5) was used for gas sensing study as original and when decorated with gold. The V2O5 based sensor, decorated with gold (Au) for a duration of 10 s, exhibits favorable characteristics including a linear response range spanning 50–5000 ppb, heightened sensitivity, stability, and remarkable resistance to humidity within the range of 50–90 % relative humidity (RH). Remarkably, the sensor demonstrates insensitivity towards higher concentrations of possible interfering liquid vapors. The sensor exhibits response and recovery times of 36 s and 300 s, respectively, in the presence of 1000 ppb ammonia and has the potential for accurately detecting and quantifying ammonia in an environment resembling human exhaled breath. The sensing device based on this material will be a valuable tool for clinical applications.

Radiative heat transfer to enhance the performance of liquid metal-based phase change heat sink under natural convection condition

Liquid metal phase change materials have the advantages of high thermal conductivity and high volumetric latent heat, which are expected to address the growing challenges of thermal management of advanced electronics. In previous studies, the effect of radiative heat transfer from fins of a phase change heat sink on thermal management performance has rarely been considered. In this study, radiative coating materials with high emissivity were prepared and coated on the fins of the liquid metal phase change heat sink. The effect of radiative heat transfer on the performance of liquid metal phase change heat sink was investigated. The experimental results of continuous heating under natural convection conditions show that the introduction of the radiative coating with an emissivity of 0.9298 can extend the time for the surface temperature of the heat source to reach 100 °C by 9.4%, while shortening the recovery time of the phase change heat sink by 14.9%. The results of high-power cyclic heating indicate that the high emissivity coating can reduce the peak temperature by 16.6 °C in the tenth working cycle. A simplified numerical model was subsequently developed and validated to determine the specific effects of phase change and radiative heat transfer on the overall thermal control performance. The radiation-enhanced liquid metal phase change heat sink proposed in this study is simple and maintenance-free. It is expected to address the thermal management issues of electronic devices that cannot use active cooling or operate in thin-air environments.

Exploring the nexus between post-traumatic stress disorder and patriarchy: a gender-based variation

Respected Editor, Post-traumatic stress disorder (PTSD) is a psychological disorder resulting from witnessing or experiencing trauma, aggravated by repeated exposure to stress and anxiety. We aim to highlight the underrepresentation of PTSD in a third-world country, its gender-specific variations, and its disproportionate prevalence in women in a male-dominated society. According to recent studies, gender-based differences in PTSD are reported as 2:1, favouring women. Statistics reveal that men face more traumatic incidents, ranging from violence, bloodshed, and natural disasters.1. Yet women are more susceptible to PTSD because men, encountering such occurrences regularly, perceive it as a norm and find it easier to cope with it than their female counterparts, who happen to have a more significant post-trauma recovery time, which may be a result of fluctuating gonadal hormone levels in young females, as hypothesized by recent studies.2 Furthermore, Pimlott-Kubiak’s theory of trauma and PTSD (2003) suggests that patriarchy exacerbates mental health disorders in women as a vast majority of victims of abuse happen to have their spouses as assailants, categorizing as intimate partner violence.3 Being considered a taboo, women who have experienced assault are silenced due to stigmatization. They become a target of victim shaming and are discouraged from discussing the matter. With no therapy, self-blame ensues, along with a wide spectrum of symptoms of PTSD, like borderline personality disorder, flashbacks, eating disorders, disassociation, and depression, forcing the ‘labelled’ women to sever all positive connections and distance themselves from their loved ones due to fear of being judged.4 Complex Chronic PTSD may result from witnessing or experiencing assault since childhood in an abusive household from an aggressive male, which can trigger mental health issues when dealing with life's challenges as adults.5 Failing to find any discussion on this topic in medical research databases including PubMed and PakMediNet, solidifies our point that lack of awareness and research about the adverse effects of patriarchy on the mental health of women living in a developing country leads to a society where negligence prevails, fueling a vicious cycle of psychological disorders, passed on from generation to generation. Being a disorder that haunts victims for life, PTSD should be tackled with awareness, therapies, and emotional support to ensure a healthy life for all women. More research should be conducted to highlight this issue so that people can talk about such concerns more comfortably and the harm caused by PTSD in Pakistani society can be minimized.

Unexplained high and persistent methyl bromide emissions in China

Methyl bromide (CH3Br) is an important ozone-depleting substance whose use is regulated under the Montreal Protocol. Quantifying emissions on the national scale is required to assess compliance with the Montreal Protocol and thereby ensure the timely recovery of the ozone layer. However, the spatial-temporal patterns of China’s national CH3Br emissions remain unclear. Here we estimate the national emissions of CH3Br in China during 2011−2020 using atmospheric observations at 10 sites across China combined with an inversion technique (top-down) and compare those with an updated inventory of identified emission sources (bottom-up). Measured CH3Br mole fractions are enhanced well above the background mole fractions, especially at sites in eastern China. Top-down emission estimates exceed bottom-up estimates by 5.5 ± 1.4 gigagrams per year, with the largest fraction (60%) of observationally derived CH3Br emissions arising from underestimated or unidentified emissions sources. This study shows the potential impacts of the unaccounted emissions on stratospheric ozone depletion, with implications for the Montreal Protocol.

Factors that Influence Recovery From Concussion in Young Children and Preadolescents

Objective: To examine differences in the presentation and management of concussion in younger children (aged 4–8 years) versus preadolescents (9–12 years) and identify factors that influence recovery time. Design: Retrospective analysis of prospectively collected data. Setting: Pediatric sports medicine and orthopedics clinic. Patients: Three hundred seventy-five patients aged 4 to 12 years diagnosed with concussion between 2020 and 2022. Independent Variables: Age, gender, race/ethnicity, mechanism of injury (sport vs nonsport related), neurodevelopmental or psychiatric diagnosis, concussion history, Post-Concussion Symptom Scale (PCSS) score, and Vestibular Ocular Motor Screening (VOMS) overall change scores. Main Outcome Measures: Days since injury (DSI) to initial visit, total number of visits, recovery time (days). Results: Groups significantly differed in DSI (P = 0.01) and overall VOMS change score (P = 0.03). No differences were observed between groups on total number of visits or recovery time. Patients with fewer DSI [odds ratio (OR) = 1.15], less change in overall VOMS score (OR = 1.02), lower PCSS scores (OR = 1.02), and who were injured in sport were less likely to experience a protracted recovery. Conclusions: Younger children with concussion may be appropriately treated with a similar approach to preadolescent patients despite greater DSI and differences in VOMS change scores, without sacrificing overall recovery time. Consistent with research in older cohorts, protracted recovery was seen in nonsport patients, and patients seen sooner at a specialty concussion clinic were less likely to experience a protracted recovery, endorsed lower PCSS scores, and had lower overall VOMS change scores. Further research is needed to solidify a child-specific paradigm to concussion management.

Clinical Efficacy of Transconjunctival Lower Eyelid Blepharoplasty for Treating Lower Eye Bags

Objective: To analyze the clinical effect of transconjunctival lower eyelid blepharoplasty for the treatment of lower eye bags. Methods: Retrospective analysis was done on 50 cases of patients with lower eye bags admitted to the hospital from August 2022 to August 2023. The control group received transcutaneous lower eyelid blepharoplasty, while the observation group received transconjunctival lower eyelid blepharoplasty. The efficacy, surgical indexes, and the difference in complications of the two groups were compared. Results: The efficacy of the observation group was higher than that of the control group (P &lt; 0.05); the surgical time and postoperative skin recovery time of the observation group were shorter than that of the control group (P &lt; 0.05); the rate of postoperative complications after blepharoplasty in the observation group was lower than that in the control group (P &lt; 0.05). Conclusion: Transconjunctival lower eyelid blepharoplasty for the treatment of lower eye bags is safe and effective, which is favorable to the recovery of patients’ skin appearance.

Safety and feasibility of pure laparoscopic living donor right hepatectomy.

Pure laparoscopic living-donor right hepatectomy (PLDRH) has emerged as a significant advancement in liver transplantation, offering reduced donor morbidity and improved recovery times. However, PLDRH is still performed in only a limited number of centers. This retrospective study reports on the outcomes of 215 living donors who underwent PLDRH at Asan Medical Center in Seoul, Korea between November 2014 and December 2021. We reviewed donor and recipient demographics and anatomical characteristics of the donor grafts. Donor complications were classified and evaluated based on the Clavien-Dindo classification. The incidence of early donor complications within 30days of surgery was 0.9% (n = 3), with minor complications in 0.3% (n = 1) patients and major complications in 0.6% (n = 2). No biliary complications were observed and no late complications had been reported by 30days after surgery. The mean length of postoperative hospital stay was 7.2days. PLDRH was a safe and feasible surgical technique characterized by a low complication rate and short hospital stays. PLDRH has the potential to become the standard procedure for the retrieval of right liver grafts from living donors.

Clinical implications of midazolam in preoperative anxiety and sedation: a review

Preoperative anxiety, a common reaction to the unfamiliar setting of medical procedures, affects 60-80% of patients and can lead to significant psychological and physiological stress. This stress can exacerbate hemodynamic instability during surgery, complicate anesthetic management, and contribute to adverse postoperative outcomes such as increased pain perception, longer recovery times, and extended hospital stays. Midazolam, a short-acting benzodiazepine, is frequently used to address these issues due to its rapid onset and effective anxiolytic and sedative properties. By acting on GABA-A receptors, midazolam provides relief from preoperative anxiety and facilitates smoother anesthesia induction. However, its use is not without risks, including potential respiratory depression, paradoxical reactions, and oversedation, which may be particularly concerning in vulnerable populations. These concerns have prompted exploration of non-pharmacological approaches, such as cognitive-behavioral therapy and mindfulness-based interventions, which can reduce anxiety without the side effects associated with pharmacological agents. This review aims to critically evaluate the clinical implications of midazolam use for preoperative anxiety and sedation, highlighting its efficacy, safety profile, and the growing interest in alternative non-pharmacological strategies.

Adaptive sensor attack detection and defense framework for autonomous vehicles based on density

The security of autonomous vehicles heavily depends on localization systems that integrate multiple sensors, which are vulnerable to sensor attacks and increase the risk of accidents. Given the diversity of sensor attacks and the dynamic changing of driving scenarios of autonomous vehicles, an adaptive and effective attack detection and defense framework faces a considerable challenge. This paper proposes a novel real-time adaptive attack detection and defense framework based on density, which can detect and identify attacked sensors and effectively recover data. We first develop a reinforcement learning multi-armed Bandit-based Density-Based Spatial Clustering of Applications with Noise (BDBSCAN) algorithm that selects hyperparameters adaptively. The Adaptive Extended Kalman Filter (AEKF) combines with the vehicle dynamic model on the localization system and extracts data features used for the BDBSCAN algorithm to monitor potential sensor attacks. If attack detection indicates possible system compromise, AEKF is further employed on localization sensors with anomalies identified through the BDBSCAN algorithm of the attacked sensors. To ensure precision and reliability, the data recovery incorporates a redundancy mechanism to apply a decision tree to select the optimal state estimation between AEKF and Extended Kalman Filter (EKF) to replace corrupted sensor data. To evaluate the effectiveness and adaptability of the proposed framework, we conducted 15,000 experiments using the real-world KITTI and V2V4Real datasets across various driving and sensor attack scenarios. The results demonstrate that our proposed framework achieves 100% accuracy and 0% false alarm rate in various driving scenarios for attack detection within 0.15 s, with a recovery time of 0.08 s.

Efficacy of combined surgical approaches in the management of sinonasal and orbital pathologies: innovations in minimally invasive techniques and their impact on postoperative outcomes

Sinonasal and orbital pathologies present unique challenges due to their anatomical complexity requiring advanced surgical approaches for optimal management. This systematic study demonstrates the effectiveness of combined surgical interventions based on advancements in minimally invasive approaches. An electronic literature search was performed on articles reporting patient outcomes after combined surgical management in sinonasal and orbital pathologies through the PubMed, Scopus, and Cochrane databases. Under the inclusion criteria, randomized controlled trials, literature reviews, cohort studies, and case reports published in the last decade on reputable journals were taken under consideration. Complications and functional outcomes were improved as compared to the conventional surgery techniques when looked into the previous evidences. Heterogeneities of the study designs and duration of follow-up did not permit a meta-analysis. The endoscopic orbital decompression, and other such sinonasal surgeries were now performed with less intraoperative blood loss, shorter hospital stays, and quicker recovery times. After all research, it can be concluded that combined surgical techniques do improve outcomes, but more high-quality, standardized work needs to be done to establish long-term efficacy. Our research findings support this trend of minimalization of invasive techniques to treat pathologies within the sinonasal and orbital spaces and stress their overall capacity to enhance postoperative results. Future research should focus on standardizing protocols and longer follow up periods to evaluate recurrence and long-term complications better.