Effects of Preoperative Anxiety on Postoperative Outcomes and Sleep Quality in Patients Undergoing Laparoscopic Gynecological Surgery.

OBJECTIVE: Preoperative anxiety is a psychological state that commonly occurs before surgery and may have a negative impact on postoperative outcomes. This study aimed to investigate the effects of preoperative anxiety on postoperative sleep quality and recovery outcomes among patients undergoing laparoscopic gynecological surgery. METHODS: The study was conducted as a prospective cohort study. A total of 330 patients were enrolled and underwent laparoscopic gynecological surgery. After assessing the patient's preoperative anxiety score on the APAIS scale, 100 patients were classified into the preoperative anxiety (PA) group (preoperative anxiety score > 10) and 230 patients into the non-preoperative-anxiety (NPA) group (preoperative anxiety score ≤ 10). The Athens Insomnia Scale (AIS) was assessed on the night before surgery (Sleep Pre 1), the first night after surgery (Sleep POD 1), the second night after surgery (Sleep POD2), and the third night after surgery (Sleep POD 3). Postoperative pain was evaluated by the Visual Analog Scale (VAS), and the postoperative recovery outcomes and adverse effects were also recorded. RESULT: The AIS score in the PA group was higher than that of the NPA group at Sleep-pre 1, Sleep POD 1, Sleep POD 2, and Sleep POD 3 (p < 0.05). The VAS score was higher in the PA group than in the NPA group within 48 h postoperatively (p < 0.05). In the PA group, the total dosage of sufentanil was significantly higher, and more rescue analgesics were required. Patients with preoperative anxiety showed a higher incidence of nausea, vomiting, and dizziness than those without preoperative anxiety. However, there was no significant difference in the satisfaction rate between the two groups. CONCLUSION: The perioperative sleep quality of patients with preoperative anxiety is worse than that of patients without preoperative anxiety. Moreover, high preoperative anxiety is related to more severe postoperative pain and an increased requirement for analgesia.

A bilayer solar evaporator with all-in-one design for efficient seawater desalination.

Bilayer solar evaporator combines high photothermal conversion capacity and low heat loss, has become the new darling in interfacial solar steam generation (ISSG). However, the bilayer structure generally achieved by introducing a photothermal coating on the substrate is not conducive to long-term use due to the poor stability of coating. Herein, a fully biomass-based bilayer evaporator is all-in-one designed, using chitosan (CS) as building blocks and CS derived N, S - doped porous carbon (NSPC) as fillers via pre-freezing and freeze-drying. This facile method could realise the quantitative addition of photothermal materials and controllably regulate the structure of the bilayer evaporator, making the structural optimisation readily available. The optimised evaporator exhibits a remarkable evaporation rate of 2.51 kg m-2h-1. After 1000 times of pressing, it still maintains at 2.42 kg m-2h-1. Additionally, the evaporator displays outstanding long-lasting stability, excellent salt-resistant and degradability. More importantly, a solar desalination device is fabricated for harvesting freshwater outdoor. The daily water production per unit area (4.55 kg) meets the consumption of two adults. This work provides a controllable synthesis strategy of bilayer evaporators for handling global freshwater shortages.

Roles of Exosomes and Exosomal MicroRNAs in Postoperative Sleep Disturbance.

Postoperative sleep disturbance (PSD) often occurs in elderly patients after major surgery and exerts harmful effects on postoperative recovery. PSD may increase the incidence of postoperative fatigue, severe anxiety and depression, pain sensitivity, and cognitive dysfunction, which can cause or aggravate neurodegenerative diseases via amyloid aggregation and tau accumulation. Exosomes are important carriers that mediate the transfer of active substances and genetic information among cells. Recent evidence has shown that exosomes are involved in the pathogenesis of end-organ morbidity caused by sleep disorders via increasing amyloid plaque formation, transmitting tau protein, regulating neuroinflammation, and increasing blood-brain barrier permeability. Additionally, exosomes may be useful for delivering therapeutic genetic materials, such as microRNAs (miRNAs) and proteins, to exert neuroprotective effects and reduce cognitive impairment. However, the molecular mechanisms underlying this process remain to be fully elucidated. This review focuses on exosome-related pathways and the modulatory role of exosomal miRNAs on the pathogenesis of sleep disturbance and neurodegeneration. Moreover, we discuss the advantages of reducing neurotoxic proteins via exosomal intervention and miRNA regulation. Future research in exosome administration may offer new insights into PSD-related pathomechanisms and therapeutics.