Research on the prognostic value of adjusting intraperitoneal three-dimensional quality evaluation mode in laparoscopic cholecystectomy patients

BACKGROUND

Benign gallbladder diseases have become a high-prevalence condition not only in China but also worldwide. The main types of benign gallbladder diseases include gallbladder polyps, acute and chronic cholecystitis, and gallstones, with gallstones being the most common, accounting for over 70% of cases. Although the mortality rate of benign gallbladder diseases is low, they carry obvious potential risks. Studies have shown that an increased incidence of benign gallbladder diseases can increase the risk of cardiovascular diseases and gallbladder cancer, resulting in a substantial disease burden on patients and their families.

AIM

To assess the medical utility of the Configuration-Procedure-Consequence (CPC) three-dimensional quality evaluation model in modulating the prognosis of laparoscopic cholecystectomy patients.

METHODS

A total of 98 patients who underwent laparoscopic cholecystectomy in our hospital from February 2020 to January 2022 were selected as the subjects. According to the random number table method, they were divided into a study group and a control group, with 49 patients in each group. The control group received routine perioperative care, while the study group had the addition of the CPC three-dimensional quality evaluation. The postoperative recovery-related indicators (time to first flatus, time to oral intake, time to ambulation, hospital stay), stress indicators (cortisol and adrenaline levels), distinctions in anxiety and depression status, and the incidence of perioperative complications were compared.

RESULTS

The time to first flatus, time to oral intake, time to ambulation, and hospital stay of the study group patients were obviously lower than those of the control group patients, with statistical significance (P < 0.05). On the 1st day after admission, there were no obvious distinctions in cortisol and adrenaline levels in blood samples, as well as in the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) scores between the study group and the control group (P > 0.05). However, on the 3rd day after surgery, the cortisol and adrenaline levels, as well as SAS and SDS scores of the study group patients, were obviously lower than those of the control group patients (P < 0.05). The study group had 2 cases of incisional infection and 1 case of pulmonary infection, with a total incidence of complications of 6.12% (3/49), which was obviously lower than the 20.41% (10/49) in the control group (P < 0.05).

CONCLUSION

Implementing the CPC three-dimensional quality evaluation model for patients undergoing laparoscopic cholecystectomy can help accelerate their perioperative recovery process, alleviate perioperative stress symptoms, mitigate anxiety, depression, and other adverse emotions, and to some extent, reduce the incidence of perioperative complications.

A model based on a multivariate classification for assessing impacts on water quality in a DOCE river watershed after the Fundão tailings dam failure

The main purpose of this study was to build multivariate classification models using water quality monitoring data for the hydrographic basin of the Gualaxo do Norte River, Minas Gerais state, Brazil, which was impacted in 2015 by the rupture of a containment structure for iron ore tailings. A total of 27 points were evaluated, covering areas affected and unaffected by the disaster, with monitoring of chemical, physical, and microbiological variables during the period from July 2016 to June 2017. Multivariate classification techniques were applied to the data, with the aim of developing models to determine when the impacted locations would present characteristics equivalent to those existing prior to the rupture. Classification models constructed using PLS-DA and LDA were able to predict three classes: unaffected main river, affected main river, and tributaries. The first technique was able to clearly differentiate the three classes for the data evaluated, achieving averages corresponding to 90% accuracy. The second method was consistent with the first, identifying the chloride content, conductivity, turbidity, and alkalinity as discriminatory variables, among those monitored, with the relationships among the parameters being coherent with the environmental conditions of the region. The model, with a correct classification rate of 91.67%, enabled identification of the behavior of new samples, using only these easily measured variables. In summary, application of the multivariate statistical tools allowed the development of models capable of providing information about the recovery process of an ecosystem impacted by the greatest environmental disaster to have occurred in Brazil.

A hypothetical model of multi-layered cost-effective wastewater treatment plant integrating microbial fuel cell and nanofiltration technology: A comprehensive review on wastewater treatment and sustainable remediation

Wastewater management has emerged as an uprising concern that demands immediate attention from environmentalists worldwide. Indiscriminate and irrational release of industrial and poultry wastes, sewage, pharmaceuticals, mining, pesticides, fertilizers, dyes and radioactive wastes, contribute immensely to water pollution. This has led to the aggravation of critical health concerns as evident from the uprising trends of antimicrobial resistance, and the presence of xenobiotics and pollutant traces in humans and animals due to the process of biomagnification. Therefore, the development of reliable, affordable and sustainable technologies for the supply of fresh water is the need of the hour. Conventional wastewater treatment often involves physical, chemical, and biological processes to remove solids from the effluent, including colloids, organic matter, nutrients, and soluble pollutants (metals, organics). Synthetic biology has been explored in recent years, incorporating both biological and engineering concepts to refine existing wastewater treatment technologies. In addition to outlining the benefits and drawbacks of the current technologies, this review addresses novel wastewater treatment techniques, especially those using dedicated rational design and engineering of organisms and their constituent parts. Furthermore, the review hypothesizes designing a multi-bedded wastewater treatment plant that is highly cost-efficient, sustainable and requires easy installation and handling. The novel setup envisages removing all the major wastewater pollutants, providing water fit for household, irrigation and storage purposes.

Finger movement functions remain in the ipsilesional hemisphere and compensation by the contralesional hemisphere might not be expected after hemispherotomy -pre- and post-hemispherotomy evaluations in 8 cases

BACKGROUND

We hypothesized that fine finger motor functions are controlled by the ipsilesional hemisphere, and that gross motor functions are compensated for by the contralesional hemisphere after brain injury in humans. The purpose of this study was to compare finger movements before and after hemispherotomy that defunctionated the ipsilesional hemisphere for patients with hemispherical lesions.

METHODS

We statistically compared Brunnstrom stage of the fingers, arm (upper extremity), and leg (lower extremity) before and after hemispherotomy. Inclusion criteria for this study were: 1) hemispherotomy for hemispherical epilepsy; 2) a ≥ 6-month history of hemiparesis; 3) post-operative follow-up ≥ 6 months; 4) complete freedom from seizures without aura; and 5) application of our protocol for hemispherotomy.

RESULTS

Among 36 patients who underwent multi-lobe disconnection surgeries, 8 patients (2 girls, 6 boys) met the study criteria. Mean age at surgery was 6.38 years (range, 2-12 years; median, 6 years; standard deviation, 3.5 years). Paresis of the fingers was significantly exacerbated (p = 0.011) compared to pre-operatively, whereas that of the upper limbs (p = 0.07) and lower limbs (p = 0.103) was not.

CONCLUSION

Finger movement functions tend to remain in the ipsilesional hemisphere after brain injury, whereas gross motor movement functions such as those of the arms and legs are compensated for by the contralesional hemisphere in humans.

Recovery of anammox process performance after substrate inhibition: Reactor performance, sludge morphology, and microbial community

Most of the current studies have focused on the inhibition of anaerobic ammonium oxidation (anammox) by substrates, however, little attention has been paid to the recovery process of the reactor after inhibition. Therefore, we investigated the changes in reactor performance, granular sludge structure, and microbial community during the recovery phase after being inhibited by a high nitrogen load for 15 d. The nitrogen removal rate of the reactorwasrestored to pre-inhibition levels after 75 d of recovery, and the stoichiometric ratio converged to the theoretical value. The surface of the granular sludge developed into a broccoli-like structure, and the Ca and P contents of the granules increased from 6.88% and 4.39% to 24.42% and 13.88%, respectively. The abundance of the anammox bacterium Candidatus brocadia increased from 5.86% to 12.10%, and network analysis indicated that SMA102 and SBR1031 were positively correlated with the occurrence of Candidatus brocadia.

Public health response and medical management of internal contamination in past radiological or nuclear incidents: A narrative review

Following a radiological or nuclear emergency, workers, responders and the public may be internally contaminated with radionuclides. Screening, monitoring and assessing any internal contamination and providing necessary medical treatment, especially when a large number of individuals are involved, is challenging. Experience gained and lessons learned from the management of previous incidents would help to identify gaps in knowledge and capabilities on preparedness for and response to radiation emergencies. In this paper, eight large-scale and five workplace radiological and nuclear incidents are reviewed cross 14 technical areas, under the broader topics of emergency preparedness, emergency response and recovery processes. The review findings suggest that 1) new strategies, algorithms and technologies are explored for rapid screening of large populations; 2) exposure assessment and dose estimation in emergency response and dose reconstruction in recovery process are supported by complementary sources of information, including 'citizen science'; 3) surge capacity for monitoring and dose assessment is coordinated through national and international laboratory networks; 4) evidence-based guidelines for medical management and follow-up of internal contamination are urgently needed; 5) mechanisms for international and regional access to medical countermeasures are investigated and implemented; 6) long-term health and medical follow up programs are designed and justified; and 7) capabilities and capacity developed for emergency response are sustained through adequate resource allocation, routine non-emergency use of technical skills in regular exercises, training, and continuous improvement.

A priori design of new natural deep eutectic solvent for lutein recovery from microalgae

Lutein is an important functional food ingredient. However, its recovery processes developed so far seem to fail in sustainability criteria, regarding the urgent need for improved extraction ability while maintaining stability. This work aimed to study the design and application of natural deep eutectic solvent (NADES) for lutein recovery from Scenedesmus sp with the aid of COSMO-RS. The performance of the novel fenchyl alcohol/thymol-based system was studied comprehensively under different extraction parameters. Furthermore, thermal, light and storage stability of lutein in NADES were investigated. It was found that lutein recovery from microalgae should be performed using equimolar hydrogen-bond acceptor/donor at 60 °C within 70 min. The NADES could increase lutein yield compared with the conventional methodology using organic solvents. Besides, it significantly enhanced the lutein stability under various conditions. Hydrogen bond and Van der Waals interaction play crucial roles during target processing, elucidated by theoretical calculations and nuclear magnetic resonance.

Cost-benefit analysis of waste photovoltaic module recycling in China

With the rapid development of renewable energy, the impact on environment and resource caused by waste photovoltaic modules has been realized gradually. To solve the problem, recycling becomes an effectual way. Therefore, the aim of this paper was to assess the economic feasibility of the photovoltaic modules recycling project in China by using cost-benefit analysis. It was found that, under the estimated treatment quantity will generate in China in 2020-2034, the recovery cost per kilowatt (kW) of photovoltaic modules will be 25.11 USD, the unit benefit is 25.68 USD/kW, and the unit net benefit is 0.57 USD/kW. The net present value (NPV) and benefit-cost ratio (BCR) are 21.14 million USD and 1.023. The sensitivity analysis indicated that the sale benefits of recycled materials and tax were the most sensitive factors affecting the project's economy. Finally, we proposed ways to improve the economy for the government and related enterprises.

Scintigraphic evaluation of remote pre-conditioning protection against unilateral renal ischemia/reperfusion injury in rats: a longitudinal study

PURPOSE

To determine the role of remote perconditioning (RPeC) on renal function and histology in an animal model of unilateral renal ischemia and reperfusion (IR) injury.

METHODS

Rats were subjected to 60 min unilateral renal ischemia. RPeC protocol was the application of four cycles of 5 min IR of left femoral artery during renal ischemia. Assessments of histological changes and renal function were made 24 h, 1 week, or 3 weeks later. 99mTc-DMSA scan was performed using a small-animals SPECT system.

RESULTS

24-h reperfusion decreased the 99mTc-DMSA uptake in the left kidney compared to the intact kidney of control animals. RPeC group has higher uptake compared to the IR group. After 1 week and 3 weeks, uptakes were gradually increased in both groups and no differences were observed. Severe morphological changes in the ischemic kidneys of both groups were observed after 24 h which attenuated after 1 week and 3 weeks. Moreover, no differences in creatinine and BUN levels between IR-treated and intact animals were observed.

CONCLUSION

These data suggest that RPeC exerts a partially transient improvement in the renal function in the first day after reperfusion. However, long-term follow-up study showed no beneficial effects of RPeC. Moreover, noninvasive 99mTc-DMSA scan revealed a suitable tool in the follow-up evaluation of recovery process in the unilateral renal IR injury models.

Analysis of optimal timing of tourism demand recovery policies from natural disaster using the contingent behavior method

This paper examines the applicability of contingent behavior (hereafter, CB) method for analyzing dynamic processes and efficient policies in tourism demand recovery. The CB questionnaires used for this study used a hypothetical disaster situation of bird flu in Kyoto, Japan. Safety, event, visitor information, and price discounting policies were designed accordingly. Respondents were then asked about their willingness to travel time. The results showed the optimal timing for devising pertinent policies during the year. We found that the first step requires a safety information announcement, within one week, immediately after disaster site decontamination. The second step is the implementation of event information policy within 24th to 36th week after the disaster. The third step constitutes announcing visitor information within the 37th to 52nd week after the second step. The final step is the implementation of price discounting policy, until the 52nd week, immediately after the third step.

Relationship between the change of language symptoms and the change of regional cerebral blood flow in the recovery process of two children with acquired aphasia

OBJECTIVE

This study aimed to investigate the relationship between the change of language symptoms and the change of regional cerebral blood flow (rCBF) in the recovery process of two children with acquired aphasia caused by infarctions from Moyamoya disease with an onset age of 8years.

METHODS

We compared the results for the Standard Language Test of Aphasia (SLTA) with rCBF changes in 7 language regions in the left hemisphere and their homologous regions in the right hemisphere at 4 time points from 3weeks for up to 5years after the onset of aphasia, while controlling for the effect of age.

RESULTS

In both cases, strong correlations were seen within a hemisphere between adjacent regions or regions that are connected by neuronal fibers, and between some language regions in the left hemisphere and their homologous regions in the right hemisphere. Conversely, there were differences between the two cases in the time course of rCBF changes during their recovery process.

CONCLUSION

Consistent with previous studies, the current study suggested that both hemispheres were involved in the long-term recovery of language symptoms in children with acquired aphasia. We suggest that the differences between both cases during their recovery process might be influenced by the brain states before aphasia, by which hemisphere was affected, and by the timing of the surgical revascularization procedure. However, the changes were observed in the data obtained for rCBF with strong correlations with the changes in language performance, so it is possible that rCBF could be used as a biomarker for language symptom changes.

Factors affecting one-leg standing time in patients with end-stage knee osteoarthritis and the age-related recovery process following total knee arthroplasty

Background

The aims of the present study were to investigate the factors affecting one-leg standing (OLS) time in patients with end-stage knee osteoarthritis (OA) and to clarify the age-related recovery process following total knee arthroplasty (TKA) in the early postoperative period.

Methods

A total of 80 knees of 40 patients with knee OA were enrolled. They were asked to perform relaxed standing on one leg for as long as possible. First, OLS time was measured. Second, age, body mass index, knee flexion angle during (KFA) OLS, femorotibial angle (FTA) during OLS, and a visual analogue scale (VAS) for pain were evaluated. Multiple regression analysis was done to identify the factors affecting OLS time. In addition, the recovery process was compared between older and younger patients after TKA.

Results

A larger KFA during OLS, older age, and larger FTA were significantly associated with shorter OLS time. After TKA, postoperative OLS time in older patients did not improve significantly by postoperative day 20, while the time in younger patients improved significantly from postoperative day 19.

Conclusions

Even if subjective knee pain and KFA during OLS improved, longer rehabilitation was required to improve OLS time in older patients in the early postoperative period.

Temperature effect on the recovery process in stretched Bombyx mori silk fibers

The recovery process in stretched Bombyx mori silk fibers at different strain levels from 3% to 17% was investigated at room conditions during long period of time from 5min to 20days and more. How the temperature affects the recovery process in the silk fibers stretched at room conditions was examined at temperatures from 25 to 125°C. The results of the recovery process at 25°C revealed that although the recovery process from strain values higher than 3% strain continued slowly which caused quite high remaining deformation, a complete recovery from 3% strain was observed after 3days. However, better recovery process was observed with increasing temperature which led to lower remaining deformations. For instance, a complete recovery from 6% strain was observed after 144h and 3h for the recovery process at 100°C and 125°C, respectively which indicates an important result that the deformations induced by stretching the silk fibers up to 6% strain are reversible and increasing temperature affects the velocity of this process significantly. The recovery process expressed in the strain (ε) and logarithm time coordinates showed a linear dependence for which a linear equation was proposed. Thus, this linear equation enables to estimate the required time for a complete recovery from different strain levels and remaining deformation at any stage of the recovery at different temperatures. The ATR-FTIR spectra of the stretched silk fibers during the recovery process revealed some changes in the absorbance ratios and shifts in the positions of the bands assigned to Cα-C, N-H stretching vibrations, and the Amide III mode. It was suggested that new formation of the hydrogen bonds between polypeptide chains especially in amorphous regions and the changes in the intra-sheet hydrogen bonds in β-sheet crystalline regions greatly contribute to the recovery process.

Increased binding of 5-HT1A receptors in a dissociative amnesic patient after the recovery process

Dissociative amnesia is characterized by an inability to retrieve information already saved in memories. 5-HT has some role in neural regulatory control and may be related to the recovery from dissociative amnesia. To examine the role of 5-HT1A receptors in the recovery from dissociative amnesia, we performed two positron emission tomography (PET) scans on a 30-year-old patient of dissociative amnesia using [(11)C]WAY-100635, the first at amnesic state, and the second at the time he had recovered. Exploratory voxel-based analysis (VBA) was performed using SPM software. 5-HT1A BPND images were compared between the patient at amnesic and recovery states and healthy subjects (14 males, mean age 29.8 ± 6.45) with Jack-knife analysis. 5-HT1A receptor bindings of the patient at the recovery state were significantly higher than those of healthy subjects in the right superior and middle frontal cortex, left inferior frontal and orbitofrontal cortex and bilateral inferior temporal cortex. The increase in BPND values of recovery state was beyond 10% of those of amnesia state in these regions except in the right superior frontal cortex. We considered that neural regulatory control by the increase of 5-HT1A receptors in cortical regions played a role in the recovery from dissociative amnesia.