Application of three-dimensional technology in video-assisted thoracoscopic surgery sublobectomy.

Background: Due to the widespread use of imaging techniques, the detection rate of early-stage lung cancer has increased. Video-assisted thoracoscopic surgery (VATS) sublobectomy has emerged as a prominent alternative to lobectomy, offering advantages like reduced resection range, better preservation of lung function, and enhanced postoperative quality of life. However, sublobectomy is more intricate than lobectomy, necessitating a higher level of surgical proficiency and anatomical understanding. Methods: Three electronic databases were searched to capture relevant studies from January 2016 to March 2023, which related to the application of three-dimensional(3D) technology in VATS sublobectomy. Results: Currently, clinical departments such as orthopedics, hepatobiliary surgery, and urology have started using 3D technology. This technology is expected to be widely used in thoracic surgery in future. Now 3D technology assists in preoperative planning, intraoperative navigation and doctor-patient communication. Conclusion: 3D technologies, instrumental in locating pulmonary nodules and identifying variations in target lung segmental vessels and bronchi, play pivotal roles in VATS sublobectomy, especially in preoperative planning, intraoperative navigation, and doctor-patient communication. The limitations of 3D technology in clinical application are analyzed, and the future direction of existing 3D technology development is prospected.

Solar-Driven Production Of Hydrogen Peroxide And Benzaldehyde In Two-Phase System By An Interface-Engineered Co9 S8 -CoZnIn2 S4 Heterostructure.

Coupling the photoproduction of solar fuel and value-added chemicals is highly attractive, as it maximizes the utilization of incident sunlight and the economic value of photocatalytic reactions. Constructing intimate semiconductor heterojunction for these reactions is highly desirable due to accelerated charge separation at the interfacial contact, but is challenged by material synthesis. Here, an active heterostructure bearing intimate interface, consisting of discrete Co9 S8 nanoparticles anchored on cobalt doped ZnIn2 S4 using a facile in situ one-step strategy, can drive photocatalytic co-production of H2 O2 and benzaldehyde from a two-phase water/benzyl alcohol system with spatial product separation is reported. The heterostructure yields a high production amount of 49.5 and 55.8 mmol L-1 for H2 O2 and benzaldehyde under visible-light soaking, respectively. The synchronous elemental Co doping and intimate heterostructure establishment substantially improve the overall reaction kinetics. Mechanism studies reveal that H2 O2 generated in the aqueous phase undergoes photodecomposition forming hydroxyl radical, which is subsequently transferred into the organic phase to oxidize benzyl alcohol into benzaldehyde. This study offers fertile guidelines for creating integrated semiconductors and broadens the avenue toward the coupled production of solar fuels and industrially important chemicals.

Photothermal-enabled single-atom catalysts for high-efficiency hydrogen peroxide photosynthesis from natural seawater.

Hydrogen peroxide (H2O2) is a powerful industrial oxidant and potential carbon-neutral liquid energy carrier. Sunlight-driven synthesis of H2O2 from the most earth-abundant O2 and seawater is highly desirable. However, the solar-to-chemical efficiency of H2O2 synthesis in particulate photocatalysis systems is low. Here, we present a cooperative sunlight-driven photothermal-photocatalytic system based on cobalt single-atom supported on sulfur doped graphitic carbon nitride/reduced graphene oxide heterostructure (Co-CN@G) to boost H2O2 photosynthesis from natural seawater. By virtue of the photothermal effect and synergy between Co single atoms and the heterostructure, Co-CN@G enables a solar-to-chemical efficiency of more than 0.7% under simulated sunlight irradiation. Theoretical calculations verify that the single atoms combined with heterostructure significantly promote the charge separation, facilitate O2 absorption and reduce the energy barriers for O2 reduction and water oxidation, eventually boosting H2O2 photoproduction. The single-atom photothermal-photocatalytic materials may provide possibility of large-scale H2O2 production from inexhaustible seawater in a sustainable way.

Effect of high-copper diet on transference of bla CTX-M genes among Escherichia coli strains in rats' intestine.

Both ceftiofur (CTO) and high copper are widely utilized in animal production in China, and the occurrence of CTX-M-carrying Escherichia coli in food-producing animals is increasing. There are some specific associations between in-feed high-level copper and antibiotic resistance, but research in Gram-negative bacteria such as E. coli remains scarce. This study aimed to evaluate the effect of high-copper diet on the horizontal transfer of bla CTX-M-1 among E. coli. A total of 32 male SPF rats aged 21 days were randomly assigned to the following four groups: control (6 mg/kg in-feed copper, C-), high copper (240 mg/kg in-feed copper, H-), CTO (6 mg/kg in-feed copper with oral CTO administration, C+), and high copper plus CTO (240 mg/kg in-feed copper with oral CTO administration, H+). All rats were orally inoculated with an E. coli strain harboring a conjugative plasmid carrying bla CTX-M-1, and the C+ and H+ groups were given 10 mg/kg of body weight (BW) CTO hydrochloride at 26, 27, and 28 days, while the C- and H- groups were given salad oil at the same dose. Fecal samples collected at different time points were used for the enumeration of E. coli on Mac plates or for molecular analysis using PCR, pulsed-field gel electrophoresis (PFGE), S1-PFGE, and Southern-blot hybridization. The results showed that the number of the bla CTX-M-1 gene in the H- group was higher and that the loss speed of this gene was slower compared with the C- group. After administration of CTO, the counts of cefotaxime-resistant E. coli were significantly higher in the C+ group than that in the corresponding control group (C+ vs. C-; H+ vs. H-). In the in vitro test, the results showed that the transfer rates of the conjugation induced by the H- (12 mmol/L) group were significantly higher than that of low copper (2 mmol/L) group. The indigenous sensitive isolates, which were homologous to the bla CTX-M-positive isolates of rat feces, were found by PFGE. The further analysis of S1-PFGE and Southern-blot hybridization confirmed that the bla CTX-M-1 gene in new transconjugants was derived from the inoculated strain. Taken together, high-copper diet facilitates the horizontal transfer and maintenance of the resistant genes in the intestine of rats, although the effects of antibiotics on bacterial resistance appearance and maintenance are more obvious.

Optimising the measurement of intra-bladder pressure in patients with predicted severe acute pancreatitis.

BACKGROUND: Measuring intra-abdominal pressure (IAP) is important for management of patients with severe acute pancreatitis (SAP). Intra-bladder pressure (IBP) is an indirect index that reflects IAP, but measuring techniques vary. We sought to optimise IBP measuring techniques in predicted SAP patients. METHODS: Predicted SAP patients consecutively admitted between June 2018 and January 2020 were scrutinised. Eligible patients had their IBP monitored for the first 72 h at 6-h intervals, and were then sequentially allocated into three research scenarios: (1) in the supine position along with head of bed elevation(HoBE)of 0, 15 and 30° at various points including the iliac crest the midaxillary line, pubic symphysis, and right atrium level, instilled with 25 mL normal saline (NS) at room temperature (RT); (2) NS instillation volume from 0, 10, 25, 40-50 mL at the iliac crest with HoBE15 at RT; and (3) NS instillation (25 mL) at either RT or 37 °C with HoBE15. RESULTS: The dynamic IBP values measured at the pubic symphysis and iliac crest were fairly similar between HoBE0 and HoBE15 (all P > 0.05), but greatly increased at HoBE30 (all P < 0.01). IBP was significantly increased with escalating instillation volumes of NS (all P < 0.01 versus 0 mL NS), while there was no significant difference between 25 mL and 10 mL (P = 0.055). IBP was similar between NS at RT and under 37 °C (P = 0.643). CONCLUSION: In predicted SAP patients, measuring IBP at the iliac crest with HoBE15 after instilling 10 mL of NS seems to be appropriate for monitoring IAP.

Analysis of Resilience, Coping Style, Anxiety, and Depression Among Rescue Nurses on EMTs During the Disaster Preparedness Stage in Sichuan, China: A Descriptive Cross-Sectional Survey.

OBJECTIVE: The purpose of this study was to investigate the current situation and influencing factors of resilience, coping style, anxiety, and depression among rescue nurses on Emergency Medical Teams (EMTs) during the disaster preparedness stage, and to explore the relationship between resilience, coping style, anxiety, and depression. METHODS: A descriptive cross-sectional survey was used. The convenience sampling method was used to select rescue nurses from 4 national EMTs in Sichuan Province, China. CD-RISC, SCSQ, Zung SAS, and SDS were used as research tools. RESULTS: A total of 197 valid questionnaires were returned, with a 98.5% response rate. The results of multiple regression analysis showed that average monthly income, depression level, and coping style were the main factors affecting nurses' resilience. Resilience was significantly and positively correlated with coping style and negatively correlated with anxiety and depression. There were significant differences in SCSQ, Zung SAS, and SDS scores among Clusters. CONCLUSION: In the disaster preparedness stage, rescue nurses on EMTs have a medium level of resilience and good coping styles, but their levels of anxiety and depression are high. It is suggested that more attention should be devoted to the target population to formulate effective intervention plans, reduce psychological pressures, and improve their capacity for coping with disasters.

A meta-analysis and trial sequential analysis of high intensity focused ultrasound ablation combined with transhepatic arterial chemotherapy and embolization for hepatoma.

Objective: The efficacy of High Intensity Focused Ultrasound Ablation(HIFU) combined with Transhepatic Arterial Chemotherapy And Embolization(TACE) versus TACE alone in the treatment of hepatoma was evaluated by meta-analysis and trial sequential analyses(TSA). Methods: Pubmed, Cochrane, Embase, Web of Science, Scoups and CNKI, CQVIP, Wanfang Data(China National Knowledge Infrastructure) databases were searched from database construction to April 2022, and randomized controlled trials were included. Revman and Stata software were used for meta-analysis of tumor changes, survival rate, laboratory indicators and adverse reactions in the included studies, and TSA0.9 was used for sequential analysis. Grade Pro was also used to evaluate the included indicators. Results: Twelve studies were included with a sample size of 1025 cases. Meta-analysis showed that the tumor response rate in the combined treatment group was 1.54 times higher than that in TACE alone (OR: 2.54; 95%CI:1.81-3.57) and the 6-month to 5-year survival rate was 1-4 times higher, with statistically significant differences (P<0.05). Subgroup analysis showed that country, pathological type and study type were the sources of heterogeneity. Egger results showed that there was no publication bias (95%CI: -1.333, 3.552; Ppublication=0.276), and the sensitivity analysis results were reliable. TSA results suggest that there may be false positive results, which need to be further confirmed by more studies. Grade evaluation results indicated that the quality of evidence for response rate and one-year survival was low. Conclusion: HIFU combined with TACE has better efficacy in the treatment of hepatoma, which is worthy of promotion. However, there may be false positive results in this study, which needs to be further verified by more extensive and more tests.

Linking Exercise Intention to Exercise Action: The Moderating Role of Self-Efficacy.

As physical exercise benefits both physical and psychological health of college students, it is important to promote the habit of physical exercise among them. This study adopted the Health Action Process Approach (HAPA) model to understand the exercise intention-action link and determine the moderating role of self-efficacy. We recruited 242 students from a university in China and asked them to complete a six-wave survey. The survey results indicated that exercise intention was positively related to both coping planning and action planning, which pave the way to performing the action of exercise. However, such mediation effects varied under conditions of self-efficacy. Participants with high self-efficacy exhibited stronger relationships between intention and planning, and between planning and action. The study results suggest that planning has a time-lagged mediation effect in the relationship between intention and action. Additionally, the findings shed light on the moderating role of self-efficacy, which can be useful in developing health-promotion strategies for college students.

Clinical Characteristics of Acute Pancreatitis Patients with Multidrug-Resistant Bacterial Infection.

Background: There are few published reports describing the clinical characteristics of acute pancreatitis (AP) patients with multidrug-resistant organism (MDRO) infection. Methods: This was a retrospective analysis of AP patients with MDRO infection in West China Hospital between July 2015 and June 2020. Basic clinical data, disease progression states, and prognoses of the MDRO and non-MDRO infection groups were compared and analyzed. Logistic regression analysis was performed to explore the related risk factors for MDRO infection. The prognoses of different MDRO infection types were compared. Results: In total, 9812 AP patients were included, 2436 (24.83%) of whom had healthcare-associated infections (641 [26.31%] MDRO infections and 1795 [73.69%] non-MDRO infections). The main MDRO strain was carbapenem-resistant Acinetobacter baumannii (CRAB) (400/62.40%). The rate of discharge against doctor's advice, mortality, hospitalization expenses, and hospitalization days was higher in the MDRO infection group than in the noninfection group. By logistic regression analysis, the independent risk factors associated with MDRO infection included male sex (OR 1.36, 95% CI 1.09~1.70), severity (OR 1.40, 95% CI 1.10~1.78), ICU referral (OR 2.48, 95% CI 1.79~3.44), abdominal puncture (OR 2.78, 95% CI 1.93~4.02), fiberoptic bronchoscopy (OR 1.95, CI 1.35~2.81), and PICC/CVC placement (OR 1.48, CI 1.06~2.06). Compared with biliary and hypertriglyceridemia (HTG) (OR 0.94, 95% CI 0.73~1.23), alcohol (OR 0.30, 95% CI 0.19~0.47) and other etiologies (OR 0.58, 95% CI 0.41~0.81) conferred a lower risk of MDRO infection. The carbapenem-resistant Klebsiella pneumoniae (CRKP) infection rate was highest in the patients who died. Conclusion: The CRAB proportion was highest in AP patients with MDRO infection. MDRO infection is related to many factors, has a poor prognosis, and increases the patient burden. CRKP infection is directly related to poor prognosis.

Stabilizing Ultrasmall Ceria-Cluster Nanozyme for Antibacterial and Antibiofouling Applications.

The generation of undesired biofouling in medical and engineering applications results in a reduction in function and durability. Copying functionalities of natural enzymes to combat biofouling by artificial nanomaterials is highly attractive but still challenged by the inferior catalytic activity and specificity principally because of low densities of active sites. Here, an innovate strategy is demonstrated to stabilize high-density ultrasmall ceria clusters on zirconia for biofouling prevention. Benefiting from the unique structure, CeO2 @ZrO2 nanozyme can significantly enhance the haloperoxidase-mimicking activity in catalyzing the oxidation of bromide with H2 O2 into biocidal hypobromous acid as a result of abundant defects and surface strong acidity sites, inducing impressive antibacterial and antibiofouling capacity compared with that of pristine CeO2 . This work is expected to open a new avenue for the rational design of cluster catalysts for various targeting catalytic applications.

Atomic Chromium Coordinated Graphitic Carbon Nitride for Bioinspired Antibiofouling in Seawater.

Artificial nanozymes exerting enzyme functionality are recognized as promising alternatives of natural enzymes in biomimetic chemistry. Natural haloperoxidases that utilize hydrogen peroxide (H2 O2 ) to catalytically convert halide into strong biocidal hypohalous acid hold great promise for thwarting biofouling, while their practical application remains highly questionable as instability of natural enzymes and inadequate H2 O2 . Herein a semiconducting nanozyme consisting of chromium single atoms coordinated on carbon nitride (Cr-SA-CN) that performs bifunctional roles of nonsacrificial H2 O2 photosynthesis and haloperoxidase-mimicking activity for antibiofouling is constructed. Such nanozyme is capable of generating H2 O2 from water and O2 upon visible-light illumination, and then sustainably self-supplying H2 O2 for haloperoxidase-mimicking reaction in a sequential manner. This dual-activity Cr-SA-CN overcomes H2 O2 dilemma and yields hypobromous acid continuously, inducing remarkable bactericidal capability. When used as an eco-friendly coating additive, it is successfully demonstrated that Cr-SA-CN enables an inert surface against marine biofouling. Thereby, this study not only illustrates an attractive strategy for antibiofouling but also opens an avenue to construct valuable nanoplatform with multifunctionality for future applications.

Overestimate of remediation efficiency due to residual sodium persulfate in PAHs contaminated soil and a solution.

Oxidation remediation is a commonly used technology for PAHs contaminated soil presently, but the overestimate of efficiency due to ongoing remediation by residual oxidants during extraction and testing has not been paid enough attention. In this study, persulfate was activated by Fe(II) to investigate the effects of residual oxidants on PAHs removal during detection process and the elimination effects of adding Na2SO3 and extending sampling time on residual oxidants. Results verified that the residual oxidants removed PAHs in extraction process, making the results lower than the actual values: the detection recovery rate η of ∑PAHs and 3-6 ring PAHs ranged from 24.3% (25% Na2S2O8 treatment) to 87.4% (5% Na2S2O8+4/4Fe2+ treatment), 20.1%-99.0%, 28.9%-87.9%, 20.8%-89.4%, and 18.6%-76.9%, respectively. After adding Na2SO3, the accuracy of detection results increased significantly: the η of ∑PAHs and 3-6 ring PAHs increased to 64.1%-96.5%, 58.8%-95.5%, 73.8%-114.4%, 60.6%-95.6%, and 45.4%-77.1%, respectively. After 49 days of adding oxidants, residual oxidants had no considerable effect on the detection of PAHs, indicating it was appropriate to start soil remediation verification sampling49 days after the remediation was completed. The observed results will help scientific evaluation of the remediation effects of chemical oxidation on organic contaminated soil.

Predictive value of the unplanned extubation risk assessment scale in hospitalized patients with tubes.

BACKGROUND: Critical patients often had various types of tubes, unplanned extubation of any kind of tube may cause serious injury to the patient, but previous reports mainly focused on endotracheal intubation. The limitations or incorrect use of the unplanned extubation risk assessment tool may lead to improper identification of patients at a high risk of unplanned extubation and cause delay or non-implementation of unplanned extubation prevention interventions. To effectively identify and manage the risk of unplanned extubation, a comprehensive and universal unplanned extubation risk assessment tool is needed. AIM: To assess the predictive value of the Huaxi Unplanned Extubation Risk Assessment Scale in inpatients. METHODS: This was a retrospective validation study. In this study, medical records were extracted between October 2020 and September 2021 from a tertiary comprehensive hospital in southwest China. For patients with tubes during hospitalization, the following information was extracted from the hospital information system: age, sex, admission mode, education, marital status, number of tubes, discharge mode, unplanned extubation occurrence, and the Huaxi Unplanned Extubation Risk Assessment Scale (HUERAS) score. Only inpatients were included, and those with indwelling needles were excluded. The best cut-off value and the area under the curve (AUC) of the Huaxi Unplanned Extubation Risk Assessment Scale were been identified. RESULTS: A total of 76033 inpatients with indwelling tubes were included in this study, and 26 unplanned extubations occurred. The patients' HUERAS scores were between 11 and 30, with an average score of 17.25 ± 3.73. The scores of patients with or without unplanned extubation were 22.85 ± 3.28 and 17.25 ± 3.73, respectively (P < 0.001). The results of the correlation analysis showed that the correlation coefficients between each characteristic and the total score ranged from 0.183 to 0.843. The best cut-off value was 21, and there were 14135 patients with a high risk of unplanned extubation, accounting for 18.59%. The Cronbach's α, sensitivity, specificity, positive predictive value, and negative predictive value of the Huaxi Unplanned Extubation Risk Assessment Scale were 0.815, 84.62%, 81.43%, 0.16%, and 99.99%, respectively. The AUC of HUERAS was 0.851 (95%CI: 0.783-0.919, P < 0.001). CONCLUSION: The HUERAS has good reliability and predictive validity. It can effectively identify inpatients at a high risk of unplanned extubation and help clinical nurses carry out risk screening and management.

Physical Activity under Stress: A Perspective of HAPA and Individual Differences.

AIMS: Physical activity is an effective way for people to cope with stress. However, people often decrease their physical activity in response to stressors. Therefore, we aimed to understand the relationship between perceived stress and physical activity from an outcome expectancies perspective and investigated the moderating role of future orientation in this relationship. METHODS: This study recruited 425 students who completed a three-wave survey at six-week intervals. A moderated mediation model was used to examine the mediating effects of outcome expectancies and the moderating effects of future orientation. RESULTS: The results indicated that outcome expectancies mediated the relationship between perceived stress and physical activity. This relationship was moderated by future orientation. In particular, the mediating effects were significant for people with a high future orientation, but not for those with a low future orientation. CONCLUSION: Our results demonstrate the adaptive function of future orientation in response to general stress. Importantly, the link between perceived stress and reduced physical activity could be mitigated by encouraging people to focus on future consequences. Future studies should consider developing intervention strategies that help those struggling with stressful contexts.

A study of three-dimensional reconstruction and printing models in two cases of soft tissue sarcoma of the thigh.

PURPOSE: The aim of our study was to demonstrate the value of three-dimensional (3D) reconstruction and three-dimensional printing (3DP) models in two cases of soft tissue sarcoma (STS) of the thigh. MATERIALS AND METHODS: Two patients with STS were recruited and underwent enhanced CT and MRI scans. Then, the 3D models were reconstructed and printed using the obtained data, and five experts were invited to assess the segmentation quality. In addition, 34 junior, intermediate and senior general surgeons were recruited to demonstrate the value of 3D models in preoperative planning and invited five surgeons to complete the assessment of 3D models-assisted intraoperative navigation. Finally, 32 interns were enrolled to explore the significance of 3D models in medical education. RESULTS: All experts agree with the accuracy of the 3D models. The application of 3D models in preoperative planning improved the understanding of general surgeons (P = 0.000, P = 0.000, P = 0.000). After the planning tools were exchanged between the two groups, senior surgeons in group A showed more significant improvements in performance than junior and intermediate surgeons in group A (P = 0.001, P = 0.006). Surgeons unanimously agree on the value of 3D models in intraoperative navigation. When applied for the education of medical interns, these models could enhance their understanding of pathologic anatomies (P = 0.036). CONCLUSION: In two operations for STS of the thigh with complex adjacencies, our study demonstrates that 3D models are of great value for preoperative planning, intraoperative navigation and medical education. More importantly, these models were more helpful to senior general surgeons.

Joint tracking and equalization scheme for multi-polarization effects in coherent optical communication systems.

We propose a joint multi-polarization-effect tracking and equalization method based on two extended Kalman filters, which can cope with state of polarization (SOP) tracing, polarization demultiplexing, equalization for polarization dependent loss (PDL) and polarization mode dispersion (PMD) in PDM-M-QAM coherent optical communication system. The mathematical model of the proposed method is given and analyzed in detail. Through simulation, the proposed method is proved to be very effective in a 28 Gbaud/s PDM-16QAM system. With the proposed method, SOP tracing speed is up to 110 Mrad/s for azimuth angle and 1200 krad/s for phase angle, respectively, and PDL and PMD can be equalized simultaneously in the values of 10 dB and more than half of the symbol period.