RESUMEN
BACKGROUND: Postoperative delirium (POD) is a common complication among elderly patients after surgery. The Naples Prognostic Score (NPS), a novel prognostic marker based on immune-inflammatory and nutritional status, was widely used in the assessment of the prognosis of surgical patients. However, no study has evaluated the relationship between NPS and POD. The aim of this article was to investigate the association between NPS and POD and test the predictive efficacy of preoperative NPS for POD in elderly patients with gastrointestinal tumors. MATERIALS AND METHODS: In the present study, we retrospectively collected perioperative data of 176 patients (≥ 60 years) who underwent elective gastrointestinal tumor surgery from June 2022 to September 2023. POD was defined according to the chart-based method and the NPS was calculated for each patient. We compared all the demographics and laboratory data between POD and non-POD groups. Univariate and multivariate logistic regression analysis was used to explore risk factors of POD. Moreover, the accuracy of NPS in predicting POD was further assessed by utilizing receiver operating characteristic (ROC) curves. RESULTS: 20 had POD (11.4%) in a total of 176 patients, with a median age of 71 (65-76). The outcomes by univariate analysis pointed out that age, ASA status ≥ 3, creatinine, white blood cell count, fasting blood glucose (FBG), and NPS were associated with the risk of POD. Multivariate logistic regression analysis further showed that age, ASA grade ≥ 3, FBG and NPS were independent risk factors of POD. Additionally, the ROC curves revealed that NPS allowed better prognostic capacity for POD than other variables with the largest area under the curve (AUC) of 0.798, sensitivity of 0.800 and specificity of 0.667, respectively. CONCLUSION: Age, ASA grade ≥ 3, and FBG were independent risk factors for POD in the elderly underwent gastrointestinal tumor surgery. Notably, the preoperative NPS was a more effective tool in predicting the incidence of POD, but prospective trials were still needed to further validate our conclusion. TRIAL REGISTRATION: The registration information for the experiment was shown below. (date: 3rd January 2024; number: ChiCTR2400079459).
Asunto(s)
Neoplasias Gastrointestinales , Complicaciones Posoperatorias , Humanos , Masculino , Femenino , Anciano , Neoplasias Gastrointestinales/cirugía , Neoplasias Gastrointestinales/complicaciones , Estudios Retrospectivos , Pronóstico , Complicaciones Posoperatorias/diagnóstico , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiología , Delirio/diagnóstico , Delirio/etiología , Delirio/epidemiología , Valor Predictivo de las Pruebas , Factores de Riesgo , Persona de Mediana Edad , Curva ROCRESUMEN
Due to the minimization of interface area caused by surface tension, the stabilization of liquid in complex and precise nonequilibrium shapes is challenging. In this work, a simple, surfactant-free, and covalent strategy to stabilize liquid in precise nonequilibrium shapes via fast interfacial polymerization (FIP) of highly reactive n-butyl cyanoacrylate (BCA) monomer triggered by water-soluble nucleophiles is described. Full interfacial coverage can be achieved instantly, and the resultant polyBCA film anchored at the interface can support the unequal interface stress, which allows the production of non-spherical droplets with complex shapes. Notably, the formulation of internal aqueous phase is nearly unaffected since no specific additive is required. Moreover, considering the excellent biocompatibility of BCA and polyBCA, the produced droplets can be used as micro-bioreactor for enzyme catalysis and even bacterial culture, which well mimic the morphology of cells and bacteria to achieve the biochemical reaction in non-spherical droplets. The present work not only opens a new sight for the stabilization of liquid in nonequilibrium shapes, but may also promote the development of synthetic biology based on non-spherical droplets, and tremendous potential applications are anticipated.
RESUMEN
Very recently, the poor contact between the perovskite and carrier selective layer has been regarded as a critical issue for improving the performance and stability of perovskite solar cells (PSCs). In this study, the buried interface of regularly structured PSCs has been targeted. Glutathione-coated gold nanoparticles (GSH-AuNPs) are used as double-sided passivating agents to improve the quality of the perovskite films. It has been demonstrated that the GSH-AuNPs interact strongly with the SnO2 underlayer and the upper perovskite layer, significantly reducing the defect densities of this interface. Thus, the power conversion efficiency (PCE) of the PSCs can be increased from 20.46% (control, 19.38%, IPCE corrected) to 22.22% (GSH-AuNPs modified, 21.10%, IPCE corrected) with notable enhancement in Voc and FF. Moreover, the strong interaction between the CâO groups of GSH-AuNPs and the undercoordinated Pb2+ species of the perovskite films inhibits the formation of metallic Pb0. As a result, the unencapsulated GSH-AuNPs-modified devices retained 80% of their initial PCEs after 1000 h at ambient conditions, with a relative humidity (RH) of 60 ± 5%. UV-resistant PSCs have also been demonstrated after introducing GSH-AuNPs. Therefore, our findings demonstrate the bidirectional therapy strategy as a feasible approach for achieving efficient and UV-resistant PSCs.