Total Rate Research Articles

Laparoscopic repair of duodenal atresia: systematic review and meta-analysis after consistent implementation of the technique in the past decade.

Laparoscopic repair of duodenal atresia (LRDA) remains a technically challenging procedure and its benefits ambiguous. To assess the safety and efficacy of LRDA, we performed a systematic review of techniques and material for LRDA and a meta-analysis comparing outcomes with open repair (OR). Comprehensive search of EMBASSE, PubMed and Cochrane was performed from 2000 to 2023. Studies comparing LRDA with OR were identified and outcomes extracted included operative time, time to enteral feeds, length of hospitalisation, anastomotic leaks and stricture and total complications. χ2 was used to assess associations between complications and conversions rates of different LRDA approaches (laparoscopic technique, suturing technique). Comprehensive meta-analysis was used for Meta-analysis. Twelve studies were identified and 1731 patients were enrolled in the study (398 [LRDA] and 1325 [OR]). Total rate of complications and conversion for LRDA was 15.58% and 18.84%, respectively. Complication rates were not significantly affected by operative technique and suturing technique. Conversion rates were not significantly affected operative technique; using a combination of interrupted and running suturing was significantly higher than using running or interrupted (χ2 = 7.45, p < 0.05). Anastomotic leaks, strictures and total complications were equivocal between LRDA and OR (OR 1.672, 95% CI 0.796-3.514; OR 2.010, 95% CI 0.758-5.333; OR 1.172, 95% CI 0.195-7.03). Operative time was significantly greater for LRDA (SDM 1.035, 95% CI 0.574-1.495, p < 0.001). Time to initial and full enteral feeds and length of hospitalisation were shorter in the LRDA group (SDM -0.493, 95% CI -2.166 to 1.752, p = 0.466; SDM -0.207, 95% CI -1.807 to 0.822, p = 0.019; SDM -0.111, 95% CI -1.101 to 0.880, p = 0.466, respectively). LRDA showed equivalent complication rates compared to OR with an additional benefit of quicker establishment of feeds. There was no significant difference in complication and conversion rates between laparoscopic techniques. Despite a longer operative time, LRDA provides a safe minimal access approach for neonates after this consistent implementation of the technique in the past decade.

Energy and Exergy Analysis of an Ejector Expansion Transcritical Carbon Dioxide Air Conditioning System

A carbon dioxide based transcritical air conditioning system integrated with an ejector is thermodynamically modeled and the system is simulated for different ambient conditions. Throughout the analysis, the isentropic efficiency of motive nozzle, suction nozzle and diffuser is assumed as 85% while the mixing takes place at constant pressure. A step-by-step iterative procedure is adopted to obtain the pressure lift and entrainment ratio. The present thermodynamic model is validated with the experimental results available in the open literature. Results were then compared to a conventional transcritical carbon dioxide system working between the same operating conditions. Results show a significant improvement of about 21% and more in system performance compared to a conventional system working under the same operating conditions. To justify the application of an ejector as an expansion work recovery device and to identify the component level exergy destruction rate, a comprehensive exergy analysis is implemented and the results show 20% reduction in total exergy destruction rate of the system, with an ejector.

Enhancing fire safety, electromagnetic interference shielding, and photothermal conversion performances of wearable polyamide fabrics through eco-friendly coatings

The demand for smart textiles in wearable technology has significantly increased in the last decade. However, the inherent flammability of most textiles poses a big challenge, especially when exposed to elevated surface temperatures induced by electrical or optical stimuli, increasing the risk of fire. The process of synthesizing flame retardants involves the use of organic solvents, which is not in line with the requirements of sustainable development. This research focuses on establishing an eco-friendly and stable coating for polyamide 6 (PA6) fabric through a solvent-free synthesis and innovative alternating deposition method. It has been demonstrated that the treated PA6 fabric exhibits rapid self-extinguishing properties, eliminating melt dripping and achieving a remarkable limiting oxygen index of 25.5%. Furthermore, the peak heat release rate and total heat release rate of the treated PA6 fabric decrease by 32.9% and 22.7%, respectively, compared to that of the control PA6. Under simulated sunlight exposure at an intensity of 150 mW·cm−2, the treated PA6 fabric rapidly reaches a surface temperature of 78.6 °C within 300 s. Additionally, the treated PA6 fabric demonstrates an electromagnetic interference (EMI) shielding efficiency of 24.0 dB in the X-band, highlighting the efficacy of the innovative coating. This result is attributed to the conductive network formed by the alternating deposition of MXene and polyphosphamide. This work not only improves the fire safety in wearable textiles but also presents a promising and green strategy for developing multifunctional wearable textiles with enhanced safety features.

Assessing the Impacts of Climate Change-induced Variations in Air Temperature and Precipitation on Plant Physiological and Soil Microbial Processes with DNDC Model

Abstract The DNDC (DeNitrification-DeComposition) model (version 9.5) was applied to predict the differences in transpiration and photosynthesis rates of perennial grasses (red clover and timothy), and autotrophic respiration of a sandy Spodosol. The input parameters for two growing seasons (from 1st of May to 31st of August in 2010 and 2015) contrasting in meteorological conditions were used in the modeling experiment. In 2010, the mean air temperature of the period was 14.1 ±3.3 °C and the total precipitation – 0.1796 m, while in 2015 the mean air temperature was 16.8 ±5.5 °C and the total precipitation – 0.538 m. These meteorological parameters were unfavorable for plants in 2010 and favorable in 2015. The results have shown that the DNDC model adequately predicted the weather-induced differences in total and mean transpiration rates of perennial grasses: 0.12204 m. and 0.00099 ±0.00040 m.day−1, respectively, under favorable meteorological conditions of 2015 and 0.05969 m. and 0.00049 ±0.00035 m.day−1, respectively, under unfavorable meteorological conditions of 2010. Dynamics of daily transpiration rates of plants was significantly (r = 0.34 p &lt;0.001) correlated with soil water content only under unfavorable meteorological conditions. Mean values of simulated photosynthesis rates were equal to 84.4 ±27.9 kg.C.ha−1.day−1 in 2015 and 52.3 ±23.4 kg.C.ha-1.day−1 in 2010. There were significant differences (p &lt;0.001) in the mean values of photosynthesis rates between the two weather scenarios. The results of one-way analysis of variance (ANOVA) have shown that the rates of autotrophic respiration were significantly (p &lt;0.001) higher under favorable (8.14 ±2.25 kg.C.ha−1.day−1) than under unfavorable (5.17 ±2.19 kg.C.ha−1.day−1) meteorological conditions.

Performance evaluation of the Fe–Cl and Mg–Cl cycle for hydrogen production of the minor actinide fuelled PACER fusion blanket

Thermochemical processes used to produce clean hydrogen (H2) on a large scale by utilizing renewable energy and nuclear power sources are considered one of the most environmentally friendly strategies. In this study, the neutronic performance and hydrogen production potential of the PACER fusion blanket have been investigated during the operation period. Firstly, neutronic calculations have been performed to produce an electrical energy of 1000 MW from fusion explosions of 8.36 TJ to be repeated every 40 min with Monte Carlo Calculation Method (MCNP). Minor actinide flouride (MA) fuel out of the nuclear waste of LWRs with volume fractions of 2% have been mixed homogenously in the Flibe coolant. Tritium breeding ratio (TBR) at startup is calculated as 1.27. TBR and energy multiplication factor (M) decrease gradually. TBR >1.05 can be kept over 7 years for a self-sustained reactor. The M due to higher fissionable fuel content in the molten salt computes as 3.3 at initial. The burn up exceeds ∼800 GWd/tM at the end of operation period. Secondly, the potential of hydrogen production for four step iron chloride (Fe–Cl) and three step magnesium chloride (Mg–Cl) thermochemical cycles of the hydrogen unit PACER fusion blanket. The ratio of thermal power (1 − ψ), total thermal power (Phpf) and rate of mass flow of hydrogen (m˙H2) depends on M for Fe–Cl, Mg–Cl (option I) and Mg–Cl (option II) thermochemical cycle have been presented. The ratio of thermal power (1 − ψ) for Fe–Cl, Mg–Cl (option I) and Mg–Cl (option II) have been obtained as 0.6494, 0.131 and 0.095 whereas, total thermal power (Phpf) have been computed as 5298.8, 3608.43 and 3488.925 MW, respectively, at start up. The produced of hydrogen amount for Fe–Cl, Mg–Cl (option I) and Mg–Cl (option II) have been calculated as ∼ 534.65; ∼1236.82 and ∼806.03 kg/year, respectively, at startup.

Complications and visual outcomes following surgical resection of pediatric optic pathway/hypothalamic gliomas: a systematic review and meta-analysis.

Pediatric optic pathway/hypothalamic gliomas (OPHG) pose challenges in treatment due to their location and proximity to vital structures. Surgical resection plays a key role in the management of OPHG especially when the tumor exhibits mass effect and causes symptoms. However, data regarding outcomes and complications of surgical resection for OPHG remains heterogenous. The authors performed a systematic review on pediatric OPHG in four databases: PubMed, EMBASE, Cochrane Library, and Google Scholar. We included studies that reported on the visual outcomes and complications of OPHG resection. A meta-analysis was performed and reported per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A total of 26 retrospective studies were included. Seven hundred ninety-seven pediatric patients with OPHG undergoing surgical resection were examined. A diagnosis of NF1 was confirmed in 9.7%. Gross total resection was achieved in 36.7%. Intraorbital optic pathway gliomas showed a significantly higher gross total resection rate compared to those located in the chiasmatic/hypothalamic region (75.8% vs. 9.6%). Postoperatively, visual acuity improved in 24.6%, remained unchanged in 68.2%, and worsened in 18.2%. Complications included hydrocephalus (35.4%), anterior pituitary dysfunction (19.6%), and transient diabetes insipidus (29%). Tumor progression post-resection occurred in 12.8%, through a mean follow-up of 53.5months. Surgical resection remains an essential strategy for treating symptomatic and large pediatric OPHG and can result in favorable vision outcomes in most patients. Careful patient selection is critical. Patients should be monitored for hydrocephalus development postoperatively and followed up to assess for tumor progression and adjuvant treatment necessity.

Comparative outcomes of obese and non-obese patients with lumbar disc herniation receiving full endoscopic transforaminal discectomy: a systematic review and meta-analysis

ObjectiveThis study aimed to assess the impact of full endoscopic transforaminal discectomy (FETD) on clinical outcomes and complications in both obese and non-obese patients presenting with lumbar disc herniation (LDH).MethodsA systematic search of relevant literature was conducted across various primary databases until November 18, 2023. Operative time and hospitalization were evaluated. Clinical outcomes included preoperative and postoperative assessments of the Oswestry Disability Index (ODI) and visual analogue scale (VAS) scores, conducted to delineate improvements at 3 months postoperatively and during the final follow-up, respectively. Complications were also documented.ResultsFour retrospective studies meeting inclusion criteria provided a collective cohort of 258 patients. Obese patients undergoing FETD experienced significantly longer operative times compared to non-obese counterparts (P = 0.0003). Conversely, no statistically significant differences (P > 0.05) were observed in hospitalization duration, improvement of VAS for back and leg pain scores at 3 months postoperatively and final follow-up, improvement of ODI at 3 months postoperatively and final follow-up. Furthermore, the overall rate of postoperative complications was higher in the obese group (P = 0.02). The obese group demonstrated a total incidence of complications of 17.17%, notably higher than the lower rate of 9.43% observed in the non-obese group.ConclusionThe utilization of FETD for managing LDH in individuals with obesity is associated with prolonged operative times and a higher total complication rate compared to their non-obese counterparts. Nevertheless, it remains a safe and effective surgical intervention for treating herniated lumbar discs in the context of obesity.

Effects of a Vertical Cloud Condensation Nuclei Concentration Explosion in an Idealized Hailstorm Simulation

AbstractDetermination of the key vertical level for cloud condensation nuclei concentration (CCNC) explosions has been a long‐term issue in CCN‐cloud interaction studies. An idealized hailstorm is simulated with 37 sensitivity runs, including an initial CCNC grouping vertically from the ground to the cloud top, increasing from 100 to 3,000 mg−1. The results reveal a key zone from 750 to 800 hPa near the median boundary layer, where an explosion of CCNC plays a dominant role in the nonmonotonic response of the hail precipitation rate. The explosion of CCNC in this zone could initially result in the condensation of more water vapor into the clouds, which could be transported to a greater vertical extent to significantly affect the riming collection efficiency. However, the dominant zone for the total precipitation rate is wider at heights of 700–800 hPa due to the lower sensitivity of the riming collection efficiency.

Postoperative complications after surgery for lumbar spinal stenosis, assessment using two different data sources

PurposeLumbar spinal stenosis (LSS) is a prevalent disorder, and surgery for LSS is a common procedure. Postoperative complications occur after any surgery and impose costs for society and costs and additional morbidity for patients. Since complications are relatively rare, medical registries of large populations may provide valuable knowledge. However, recording of complications in registries can be incomplete.To better estimate the true prevalence of complications after LSS surgery, we reviewed two different sources of data and recorded complications for a sample of Norwegian LSS patients.Methods474 patients treated surgically for LSS during 2015 and 2016 at four hospitals reported to a national spine registry (NORspine).Postoperative complications were recorded by patients in NORspine, and we cross-referenced complications documented in NORspine with the patients´ electronic patient records (EPR) to re-test the complication rates. We performed descriptive statistics of complication rates using the two different data sources above, and analyzed the association between postoperative complications and clinical outcome with logistic regression.ResultsThe mean (95%CI) patient age was 66.3 (65.3–67.2) years, and 254 (53.6%) were females. All patients were treated with decompression, and 51 (10.7%) received an additional fusion during the index surgery. Combining the two data sources, we found a total rate for postoperative complications of 22.4%, the NORspine registry reported a complication rate of 15.6%, and the EPR review resulted in a complication rate of 16.0%. However, the types of complications were inconsistent across the two data sources. According to NORspine, the frequency of reoperation within 90 days was 0.9% and according to EPR 3.4%. The rates of wound infection were for NORspine 3.1% and EPR review 2.1%.There was no association between postoperative complication and patient reported outcome.ConclusionPostoperative complications occurred in 22% of LSS patients. The frequency of different postoperative complications differed between the two data sources.

Long-Term Care Healthcare-Associated Infections in 2023: An Analysis of 23,970 Reports

Background The Pennsylvania Patient Safety Reporting System (PA-PSRS) is the largest database of patient safety event reports in the United States. In addition to over 4.7 million acute care reports, the PA-PSRS database contains more than 420,000 long-term care (LTC) healthcare-associated infection (HAI) reports. Methods LTC HAI data from PA-PSRS were extracted on March 1, 2024. Infection counts were calculated based on report submission date and rates were calculated based on infection confirmation date. Reports submitted by LTC facilities and specific care areas were included for infection rates each month if resident and device days were also entered in PA-PSRS for the facility and care area. Results A total of 23,970 infection reports were submitted by Pennsylvania’s LTC facilities in 2023, representing an 18.6% increase from 2022. The overall infection rate increased by 11.4%, from 0.88 in 2022 to 0.98 in 2023, and all six regions of the state had an increase in infection rate. The Northeast region had the highest rate, with 1.28 reports per 1,000 resident days, and the Southeast region had the lowest rate, at 0.72. The overall rate increase was driven by rates of urinary tract infection (UTI) and skin and soft tissue infection (SSTI), which increased by 20.1% and 17.4%, respectively. Within the UTI infection type, symptomatic urinary tract infection (SUTI) rates increased by 21.1% and catheter-associated urinary tract infection (CAUTI) rates increased by 11.8%. Conclusion There was an increase in the total number and rate of infections reported to PA-PSRS in 2023.

Rising incidence of severe maxillofacial space infections in Germany

ObjectivesSevere maxillofacial space infection (MSI) as an end stage of dentoalveolar diseases or complication of sialadenitis is a potentially life-threatening disease accompanied by complications including airway obstruction, jugular vein thrombosis, descending mediastinitis, sepsis and acute respiratory distress syndrome. The aim of this study was to analyze the incidence and time trends of severe MSI and potentially influencing factors in the German healthcare system over time.Materials and methodsNationwide data regarding the national diagnosis-related-group (DRG) inpatient billing system was received from the German Federal Statistical Office. A retrospective analysis of incidence and time trends of MSI-associated procedures classified with the Operation and Procedure Classification System (OPS), were statistically evaluated using Poisson regression analysis between 2005 and 2022 and were associated with different epidemiological factors.ResultsThe total standardized incidence rate of MSI-associated procedures in the observational period 2005—2022 was 9.8 (♀8.2; ♂11.4) per 100,000 person years. For all age groups a significant increase of 46.1% in severe MSI – related surgical interventions was registered within the observational period. The largest increase (120.5%) was found in elderly patients over 80 years. There were significant differences of the incidences of MSI-associated surgeries between the different federal states in Germany.ConclusionsSevere MSI are a growing challenge in German health care especially among elderly patients over 80 years.Clinical relevanceSevere MSI is a promising target for prevention. There should be more focus in primary dental and medical care especially in groups depending on social support.

High throughput microfluidics-based synthesis of PEGylated liposomes for precise size control and efficient drug encapsulation

The low scalability and reproducibility of existing synthesis methods have hindered the translation of liposome nanoparticles as carriers for targeted drug delivery from conventional laboratory techniques to mass production. To this end, in this study, we present a high-throughput microfluidics-based approach for the synthesis of PEGylated liposomes with a primary focus on achieving precise size control and efficient encapsulation of hydrophobic drug molecules. In this platform, liposomes were self-assembled through a controllable mixing of lipids (EYPC, cholesterol, and DSPE-PEG 2000) dissolved in ethanol and an aqueous solution. The key parameters, including the chip design, total flow rate, flow rate ratio, lipid concentrations, as well as variations in buffer (HEPES and NaCl) and solvent composition (commercial and reagent-grade ethanol) were explored in detail. Through comprehensive parametric studies, we gained valuable insights into the influence of these variables on the size distribution of liposomes and succeeded in producing highly reproducible liposomes ranging from approximately 60 nm (corresponding to small unilamellar vesicles) to 150 nm (representing large unilamellar vesicles), all while maintaining a polydispersity index (PDI) of less than 0.2. To assess the encapsulation efficiency of hydrophobic drug molecules, Nile red (NR) was employed as a surrogate. We meticulously examined the impact of NR concentration on the drug encapsulation process, resulting in up to 74% drug encapsulation efficiency within the PEGylated liposomes. This research offers crucial advances in liposome synthesis and drug delivery, providing a high-throughput, controllable method for PEGylated liposomes with potential in pharmaceutical and biomedical fields.

15-year survivorship of a unique dual-modular femoral stem in primary hip arthroplasty

BackgroundHip offset, version, and length are interdependent femoral variables which determine stability and leg length. Balancing these competing variables remains a core challenge in hip arthroplasty. The potential benefits of modular femoral stems have been overshadowed by higher rates of failure. The objective of this study was to assess the survivorship of a unique dual-modular femoral stem at an average 15-year follow-up period.MethodsThe records of all patients with osteoarthritis who underwent primary total hip arthroplasty with this device between 2004–2009 were reviewed. There were no exclusions for BMI or other factors. We examined the data with Kaplan–Meier survival analysis. The primary endpoint for survival was mechanical failure of the modular neck-body junction.ResultsThe survivorship of this device in 172 subjects was 100% with none experiencing mechanical failure of the modular junction at an average of 15 years. 60 patients died of causes unrelated to their THA and 9 patients were lost to follow-up. There were three early (≤ 12 months) dislocations (1.7%), and seven total dislocations (4.1%). 16 patients underwent reoperations during the follow-up period, none for any complication of the modular junction. Radiographic results showed well-fixed femoral stems in all cases. There were no leg length discrepancies of greater than 10 mm, and 85% were within 5 mm.ConclusionThere were no mechanical failures of the modular junction in any of the subjects over the average 15-year period, demonstrating that this dual-modular design is not associated with increased failure rates. We achieved a 1.7% early dislocation rate and a 4.1% total dislocation rate without any clinically significant leg length discrepancies.

Core-Shell Gold Nanoparticles@Pd-Loaded Covalent Organic Framework for In Situ Surface-Enhanced Raman Spectroscopy Monitoring of Catalytic Reactions.

A core-shell nanostructure of gold nanoparticles@covalent organic framework (COF) loaded with palladium nanoparticles (AuNPs@COF-PdNPs) was designed for the rapid monitoring of catalytic reactions with surface-enhanced Raman spectroscopy (SERS). The nanostructure was prepared by coating the COF layer on AuNPs and then in situ synthesizing PdNPs within the COF shell. With the respective SERS activity and catalytic performance of the AuNP core and COF-PdNPs shell, the nanostructure can be directly used in the SERS study of the catalytic reaction processes. It was shown that the confinement effect of COF resulted in the high dispersity of PdNPs and outstanding catalytic activity of AuNPs@COF-PdNPs, thus improving the reaction rate constant of the AuNPs@COF-PdNPs-catalyzed hydrogenation reduction by 10 times higher than that obtained with Au/Pd NPs. In addition, the COF layer can serve as a protective shell to make AuNPs@COF-PdNPs possess excellent reusability. Moreover, the loading of PdNPs within the COF layer was found to be in favor of avoiding intermediate products to achieve a high total conversion rate. AuNPs@COF-PdNPs also showed great catalytic activities toward the Suzuki-Miyaura coupling reaction. Taken together, the proposed core-shell nanostructure has great potential in monitoring and exploring catalytic processes and interfacial reactions.

Efficacy of the Craniopharyngioma Resection via Expanded Endoscopic Endonasal Transsphenoidal Approach in the Treatment of Complex Craniopharyngioma and Its Effect on Pituitary Function and Complications of Patients.

Surgical resection is the most effective method for craniopharyngioma, with complex operations and a high incidence of complications, especially for complex craniopharyngioma. The study focuses on selecting a proper surgical method to treat complex craniopharyngioma. A clinical study was conducted in this direction to explore the efficacy of expanded endoscopic endonasal transsphenoidal approach (EETS) and transcranial approach (TCA) in the treatment of complex craniopharyngioma and their effects on pituitary function and complications of patients. The clinical data of 73 patients with complex craniopharyngioma in Baoding No.2 Central Hospital from December 2017 to December 2022 were retrospectively analyzed. 13 patients who did not meet the admission criteria were excluded, and 60 patients were finally included. The included patients were divided into the TCA and EETS groups according to the treatment method. The surgical conditions, total tumor resection rate, clinical remission rate, and complications of patients in two groups were compared. The pituitary function of all patients, including thyroid stimulating hormone (TSH), adrenocorticotropic hormone (ACTH), and human growth hormone (hGH), was compared. A total of 60 patients were finally included in the study, including 30 cases in the EETS group and 30 cases in the TCA group. The two groups had no statistical difference in baseline demographic characteristics and pathological types (p > 0.05). Compared with the TCA group, the EETS group had less intraoperative blood loss, operation time, tumor resection time, and hospitalization time (p < 0.001) and had a significantly higher total tumor resection rate and clinical remission rate (p < 0.05). The EETS group had higher ACTH and hGH levels than the TCA group (p < 0.05). There was no statistical difference between the two groups incidence of complications and disease recurrence rate (p > 0.05). The craniopharyngioma resection via EETS has a significant therapeutic effect in complex craniopharyngioma with a high total tumor resection rate and clinical remission rate, which can protect the pituitary function of patients and provide more benefits for patients.

Numerical modelling and experimental validation on the discharging performance of paraffin/graphite matrix composite with various configurations of bulk density and wall temperature

Graphite material in the form of expanded has proven to be an effective material to remedy the low thermal conductivity of paraffin storage medium. The present work focuses on the solidification performance of carbon-based approach via graphite matrix composite with phase change to eliminate the bottleneck of low thermal conductivity issue of phase change materials for thermal energy storage applications beyond the current literature. Paraffin/graphite matrix composites with various bulk density values of 0 kg/m3 (Case 1), 23 kg/m3 (Case 2), 50 kg/m3 (Case 3), 100 kg/m3 (Case 4), and 143 kg/m3 (Case 5) under various operating conditions of wall temperature (Twall: 15 °C, 25 °C, 35 °C, and 45 °C), which mimic real applications' fluid temperature, are performed numerically in detail. The numerical model was validated with experimental outputs performed by the authors. Numerical results show that paraffin/graphite matrix composites have a great potential for the solidification/discharging process to recover the heat stored in the charging/melting period. Uniform and rapid solidification behaviour is achieved with the paraffin/graphite matrix composite in terms of conduction-dominated heat transfer via abundant thermal bridges compared to the pure paraffin case. Higher bulk density values and lower cold surface temperatures present superior performance in solidification rate and thermal energy recovery rate. However, the effect of the bulk density is slowed down with the beyond of certain value of bulk density (100 kg/m3). For 100 kg/m3 (Case 4) at Twall = 15 °C, the heat recovery rate is enhanced by 31.17 times and 3.84 times compared to the 0 kg/m3 and 23 kg/m3. The heat recovery rate of 100 kg/m3 is improved by 350.8 % for Twall = 15 °C in comparison with Twall = 45 °C. The total solidification rate (t = 17.5 min) increased by 90.94 % and 62.94 % for 100 kg/m3 at Twall = 35 °C compared to 0 kg/m3 and 23 kg/m3, respectively.

Assessing the Impact of COVID-19 on Amateur Runners' Performance: An Analysis through Monitoring Devices.

This retrospective study aimed to analyze the return to running of non-professional runners after experiencing asymptomatic or mild COVID-19. Participants aged 18-55 years who maintained a training load of ≥10 km/week for at least three months prior to diagnosis and utilized Garmin/Polar apps were included. From these devices, parameters such as pace, distance, total running time, cadence, and heart rate were collected at three intervals: pre-COVID, immediately post-COVID, and three months after diagnosis. The Wilcoxon signed rank test was used for analysis (significance was set at ≤0.05). Twenty-one participants (57.1% male; mean age 35.0 ± 9.8 years) were included. The results revealed a significant decrease in running duration and distance two weeks after diagnosis, without significant changes in other parameters. Three months after infection, no differences were observed compared to pre-infection data, indicating a return to the pre-disease training load. These findings underscore the transient impact of COVID-19 on training performance among non-professional runners with mild or asymptomatic symptoms, highlighting the importance of tailored strategies for resuming running after infection.

Variant-specific effects of GBA1 mutations on dopaminergic neuron proteostasis.

Glucocerebrosidase 1 (GBA1) mutations are the most important genetic risk factors for Parkinson's disease (PD). Clinically, mild (e.g., p.N370S) and severe (e.g., p.L444P and p.D409H) GBA1 mutations have different PD phenotypes, with differences in age at disease onset, progression, and the severity of motor and non-motor symptoms. We hypothesize that GBA1 mutations cause the accumulation of α-synuclein by affecting the cross-talk between cellular protein degradation mechanisms, leading to neurodegeneration. Accordingly, we tested whether mild and severe GBA1 mutations differentially affect the degradation of α-synuclein via the ubiquitin-proteasome system (UPS), chaperone-mediated autophagy (CMA), and macroautophagy and differentially cause accumulation and/or release of α-synuclein. Our results demonstrate that endoplasmic reticulum (ER) stress and total ubiquitination rates were significantly increased in cells with severe GBA1 mutations. CMA was found to be defective in induced pluripotent stem cell (iPSC)-derived dopaminergic neurons with mild GBA1 mutations, but not in those with severe GBA1 mutations. When examining macroautophagy, we observed reduced formation of autophagosomes in cells with the N370S and D409H GBA1 mutations and impairments in autophagosome-lysosome fusion in cells with the L444P GBA1 mutation. Accordingly, severe GBA1 mutations were found to trigger the accumulation and release of oligomeric α-synuclein in iPSC-derived dopaminergic neurons, primarily as a result of increased ER stress and defective macroautophagy, while mild GBA1 mutations affected CMA, which is mainly responsible for the degradation of the monomeric form of α-synuclein. Overall, our findings provide new insight into the molecular basis of the clinical variability in PD associated with different GBA1 mutations.

Development and validation of the hospice professional coping scale among Chinese nurses

BackgroundHospice care professionals often experience trauma patient deaths and multiple patient deaths in a short period of time (more so than other nurses). This repeated exposure to the death process and the death of patients leads to greater psychological pressure on hospice care professionals. But at present, people pay more attention to the feelings and care burden of the family members of dying patients but pay less attention to medical staff. Thus, this study aimed to develop a scale on the burden of care for hospice care providers and assess the coping capacity of hospice professionals. Raising awareness of the psychological burden of hospice professionals.MethodsThrough a literature review, research group discussion, Delphi method and a pre-survey of professional coping skills among nurses, 200 hospice professionals who had received training in hospice care from pilot institutions engaged in or providing hospice care were selected for investigation. Cronbach’s α coefficient and split-half reliability were used to test the internal consistency of the scale, and content validity and explore factor analysis (EFA) were used to test the construct validity of the scale.ResultsTwo rounds of Delphi methods were carried out, and the effective recovery rate was 100%. The expert authority coefficients of the two rounds were 0.838 and 0.833, respectively. The Kendall’s W coefficient of experts in the first round was 0.121 ~ 0.200 (P < 0.05), and the Kendall’s W coefficient of the second round was 0.115–0.136 (P < 0.05), indicating a good level of expert coordination. The final survey scale for the care burden of hospice professionals included four dimensions—working environment (9 items), professional roles (8 items), clinical nursing (9 items) and psychological burden (7 items)—with a total of 33 items. The total Cronbach’s α coefficient of the scale was 0.963, and the Cronbach’s α coefficients of the working environment, professional roles, clinical nursing and psychological burden dimensions were 0.920, 0.889, 0.936 and 0.910, respectively. The total split-half reliability of the scale was 0.927, and the split-half reliability of each dimension was 0.846, 0.817, 0.891, and 0.832. The content validity of the scale items ranged from 0.90 to 1.00. Exploratory factor analysis revealed 5 common factors, with a total cumulative contribution rate of 68.878%. The common degree of each item in the scale was > 0.4, and the factor loading of each item was also > 0.4.ConclusionThe scale is an open-access, short, easy-to-administer scale. And which for assessing hospice care burden among hospice professionals developed in this study demonstrated strong reliability and validity. This tool can serve as a dependable instrument for evaluating the burden of hospice care for terminally ill patients by professionals in the hospice setting.

Application of pocket-first technique for implantation of totally implantable venous access ports.

While vascular puncture is always performed before making port pocket in the implantation of totally implantable venous access ports (TIVAP), some surgeons preferred to make port pocket first. This study seeks to verify the safety and feasibility for the pocket-first technique. The study retrospectively reviewed 447 patients who undergone TIVAP implantation from July 2017 to November 2022. All the patients were divided into two groups based on vascular puncture first or making port pocket first. The general information, operation information and post-operative complications were reviewed and analyzed. All the operations were performed successfully. No difference was observed in the sex, age, height, weight, BMI, port location and total complication rate between the two groups. The operation time of the Puncture Group and the Pocket Group were 46.9 ± 22.4min and 33.8 ± 13.6min ( P<0.00001 ). In the patients of SCV approach, the operation time between the two groups were 37.4 ± 14.8min and 33.5 ± 10.9min ( P<0.05 ). Multivariate analysis showed the variable BMI and first procedure were independent prognostic factors for operation time. In the cases using SCV/AxV approach the variable first procedure was the only independent prognostic factor for operation time (P = 0.002). The pocket-first technique can be considered as a safe, feasible and convenient technique for TIVAP implantation. The time consuming is significantly shortened compared with the puncture-first technique and this advantage may be more obvious when using SCV/AxV approach.