Association between pediatric postoperative delirium and regional cerebral oxygen saturation: a prospective observational study.

BACKGROUND: Postoperative delirium (POD) represents a prevalent and noteworthy complication in the context of pediatric surgical interventions. In recent times, a hypothesis has emerged positing that cerebral ischemia and regional cerebral oxygen desaturation might serve as potential catalysts in the pathogenesis of POD. The primary aim of this study was to methodically examine the potential relationship between POD and regional cerebral oxygen saturation (rSO2) and to assess the predictive and evaluative utility of rSO2 in the context of POD. METHODS: This prospective observational study was conducted at the Children's Hospital, Zhejiang University School of Medicine, Zhejiang, China, spanning the period from November 2020 to March 2021. The research cohort comprised children undergoing surgical procedures within this clinical setting. To measure rSO2 dynamics, cerebral near-infrared spectroscopy (NIRS) was used to monitor rSO2 levels both before and after surgery. In addition, POD was assessed in the paediatric patients according to the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) criteria. The analysis of the association between the rSO2 index and the incidence of POD was carried out through the application of either the independent samples t-test or the nonparametric rank-sum test. To ascertain the threshold value of the adjusted rSO2 index for predictive and evaluative purposes regarding POD in the pediatric population, the Receiver Operating Characteristics (ROC) curve was employed. RESULTS: A total of 211 cases were included in this study, of which 61 (28.9%) developed POD. Participants suffering delirium had lower preoperative rSO2mean, lower preoperative rSO2min, and lower postoperative rSO2min, higher ∆rSO2mean, higher amount of ∆rSO2mean, lower ∆rSO2min (P < 0.05). Preoperative rSO2mean (AUC = 0.716, 95%CI 0.642-0.790), ∆rSO2mean (AUC = 0.694, 95%CI 0.614-0.774), amount of ∆rSO2mean (AUC = 0.649, 95%CI 0.564-0.734), preoperative rSO2min (AUC = 0.702, 96%CI 0.628-0.777), postoperative rSO2min (AUC = 0.717, 95%CI 0.647-0.787), and ∆rSO2min (AUC = 0.714, 95%CI 0.638-0.790) performed well in sensitivity and specificity, and the best threshold were 62.05%, 1.27%, 2.41%, 55.68%, 57.36%, 1.29%. CONCLUSIONS: There is a close relationship between pediatric POD and rSO2. rSO2 could be used as an effective predictor of pediatric POD. It might be helpful to measure rSO2 with NIRS for early recognizing POD and making it possible for early intervention.

Preparation and application of halogen-free and efficient Si/P/N-containing flame retardants on cotton fabrics.

Cotton fabric is extensively utilized due to its numerous applications, but the flammability associated with cotton fabric poses potential security risks to individuals. A halogen-free efficient flame retardant named poly [(tetramethylcyclosiloxyl spirocyclic pentaerythritol)-piperazin phosphate] (PCPNTSi) was developed to consolidate the fire retardance of cotton fabrics. After PCPNTSi treatment, the limiting oxygen index (LOI) of cotton fabric with 30 % weight gain (CP3) was raised to 32.8 %. In the vertical flammability test (VFT), CP3 has self-extinguished performance with a char length of 8.7 cm. The heat release rate (HRR) of cotton fabric with 20 % weight gain (CP2) is 78.8 % lower than that of pure cotton fabric (CP0). In addition, the total smoke release (TSP) of CP2 is 41.7 % lower than that of CP0, indicating PCPNTSi gives cotton fabric a good capability to inhibit smoke release. Finally, the possible flame retardant mechanism was discussed by the data of scanning electron microscope (SEM), energy dispersive spectrometer (EDS), X-ray photoelectron spectroscopy (XPS), Fourier Transform infrared spectroscopy (FT-IR) and thermogravimetric infrared spectroscopy (TG-IR). The results show that PCPNTSi is an intumescent flame retardant acting in both gas phase and solid phase.

Association between quality of life and resilience in infertile patients: a systematic review.

This systematic review was carried out to describe QoL and resilience in infertile patients, as well as the relationship between them, and to give a theoretical foundation for clinical practice. The databases of CNKI, Wanfang data, VIP database, PubMed, Web of Science, and Embase were searched without a time limit. A narrative synthesis of relevant articles was undertaken. This systematic review was registered on PROSPERO in advance. Of 21 studies eligible for inclusion in this review, 13 focused on the relationship between QoL and resilience, 5 on QoL influencing factors (resilience included), and 3 on mediation effect analysis on mental health (resilience as a mediator). Resilience can significantly predict the QoL of infertile patients. It seems plausible that more resilient couples will be less vulnerable to the stress of infertility. A global consortium of infertile population research could make cross-cultural comparisons of QoL and resilience possible. Future research should focus on resilience therapies. Systematic review registration: This systematic review was registered on PROSPERO in advance (CRD42023414706).

Compensation machining of freeform based on fast tool servo system.

With the advantages of large field of view, low cost and simple structure, the freeform optical system has extensive requirements in space exploration and other fields. However, the current machining methods for freeform are difficult to meet the requirements of optical use. Based on a developed fast servo tool (FTS) device, this paper proposes an error compensation turning method for freeforms. Firstly, the Zernike polynomial fitting method is used to reconstruct the freeform surface shape error obtained from off-line measurement, and the offset compensation is used to correct the tool path. Then, the compensation processing physical system is built to simulate the off-line compensation processing of the workpiece to verify the feasibility of compensation processing. Finally, the turning compensation processing of convex freeform aluminum mirror is carried out, and the surface accuracy of the workpiece meets the requirements of visible band. The research results have important practical significance for realizing the fast response machining of free-form surface mirror.

Knowledge, attitudes and practices of enhanced recovery after surgery among paediatric surgical nurses in China: A Cross-Sectional study.

AIM: To investigate paediatric surgical nurses' knowledge, attitudes and practices (KAP) regarding enhanced recovery after surgery (ERAS). DESIGN: A cross-sectional study. METHODS: A 34-question survey was developed. An electronic version of the questionnaire was distributed to nurses working in paediatric surgical departments of 22 tertiary hospitals from 14 provinces of China by means of convenience sampling from February to April 2021. A total of 855 nurses' data was used as the final sample. The statistical analysis included nonparametric test, Spearman's correlation and multiple linear regression. RESULTS: There is still room for improvement regarding the KAP of paediatric surgical nurses, especially in the knowledge of "postoperative recovery" and "preoperative preparation". The influencing factors of KAP were educational level, geographical region (South, Central, North, Northwest), years of work experience, hospital category (general hospital, women and children's hospital), and familiarity with ERAS.

A Novel Fast Servo Tool Device with Double Piezoelectric Driving.

The fast tool servo (FTS) technology has unique advantages in the machining of complex surfaces such as special-shaped targets and free-form surfaces. In view of the shortcomings in the performance of the existing FTS device, this paper puts forward a novel FTS which uses two piezoelectric ceramics instead of flexure hinges to provide restoring force. Firstly, the feasibility of the double-drive principle is verified theoretically, and the corresponding mechanism is optimized accordingly. Then, the system control hysteresis model is established and identified, and the appropriate control strategy is designed. Finally, the performances of the proposed FTS device are tested, and a typical microstructure is machined based on the device and ultra-precision lathe. The results indicate that the proposed device effectively improves the performance of the FTS system, which is useful for the processing of microstructures and free-form surfaces.

Anxiety, depression and post-traumatic stress disorder and related factors among Chinese population during the COVID-19 pandemic: A cross-sectional study.

The sudden outbreak of coronavirus disease 2019 (COVID-19) has deep and wide negative mental impacts on the public, and studies on the impact of COVID-19 on social and mental well-being are necessary. This study aimed to evaluate mental distress, including anxiety, depression, and post-traumatic stress disorder (PTSD), and its related risk factors in Chinese adults in the early stages of the COVID-19 pandemic. This study used a large-scale cross-sectional design. A total of 2067 adult participants completed the online survey via REDcap from 1st to 15th of March 2020 during the COVID-19 outbreak in China. Anxiety, depression, PTSD, and related risk factors, including self-efficacy, coping style, and social support, were measured using valid and reliable instruments. The data were analyzed using multiple linear regression. We found that 201 (9.7%) participants reported moderate-to-severe anxiety, 669 (33.8%) reported depression, and 368 (17.8%) reported symptoms of PTSD. Self-efficacy, coping style, and social support significantly affected anxiety, depression, and PTSD symptoms. Participants' sociodemographic characteristics, COVID-19 pandemic-related factors, low self-efficacy, low social support, and negative coping were predictors of mental distress during the COVID-19 pandemic. Our study will help healthcare professionals carry out early predictions and identification of high-risk groups and provide appropriate interventions to target groups during public health emergencies that plague the world.

Development and validation of a postoperative delirium prediction model for pediatric patients: A prospective, observational, single-center study.

ABSTRACT: Postoperative delirium is a serious complication that relates to poor outcomes. A risk prediction model could help the staff screen for children at high risk for postoperative delirium. Our study aimed to establish a postoperative delirium prediction model for pediatric patients and to verify the sensitivity and specificity of this model.Data were collected from a total of 1134 children (0-16yr) after major elective surgery between February 2020 to June 2020. Demographic and clinical data were collected to explore the risk factors. Multivariate logistic regression analysis was used to develop the model, and we assessed the predictive ability of the model by using the area under the receiver operating characteristics curve (AUROC). Further data were collected from another 100 patients in October 2020 to validate the model.Prevalence of postoperative delirium in this sample was 11.1%. The model consisted of 5 predictors, namely, age, developmental delay, type of surgery, pain, and dexmedetomidine. The AUROC was 0.889 (P < .001, 95% confidence interval (CI):0.857-0.921), with sensitivity and specificity of 0.754 and 0.867, and the Youden of 0.621. The model verification results showed the sensitivity of 0.667, the specificity of 0.955.Children undergoing surgery are at risk for developing delirium during the postoperative period, young age, developmental delay, otorhinolaryngology surgery, pain, and exposure to dexmedetomidine were associated with increased odds of delirium. Our study established a postoperative delirium prediction model for pediatric patients, which may be a base for development of strategies to prevent and treat postoperative delirium in children.

Different Reaction Patterns of Caregivers of Children With Imperforate Anus: A Latent Profile Analysis.

AIM: This study aimed to explore how different dimensions of caregivers' reaction shape their caring experience, and the factors associated with different reaction patterns. DESIGN: A second analysis of a multisite cross-sectional study were conducted. Caregivers of children with imperforate anus (IA) were enrolled in three tertiary children's hospitals in Eastern China between November 2018 and February 2019. METHODS: The caregiver's experience, stigma feeling, social support level and perception of uncertainty were assessed by Caregiver Reaction Assessment, Parent Stigma Scale, Social Support Scale and Parent's Perception of Uncertainty Scale accordingly. The demographic information of caregivers as well as the children's clinical data were collected. Latent profile analysis was conducted to determine different patterns of caregiver's reaction, and logistics analysis was used to explore the associated factors of the reaction pattern. FINDINGS: A total number of 229 caregivers (median age = 30, quartiles: 28, 36) were included. Three distinguishable caregiving reaction types were identified (Class 1: low burden and high benefit, 4.8%; Class 2: moderate burden and benefit, 48.9%; Class 3: high burden and low benefit, 46.3%). In logistics analysis, the Class 1 and Class 2 were combined as one group due to the low population in Class 1. The marital status of caregiver (OR = 0.067, 95% CI: 0.006, 0.700, P = 0.024), IA type (OR = 1.745, 95% CI: 1.198, 2.541, P = 0.004), children aged > 2 years (OR = 3.219, 95% CI: 1.364, 7.597, P = 0.008), social support (OR = 0.907, 95% CI: 0.865, 0.951, P < 0.001) and perception of uncertainty (OR = 1.054, 95% CI: 1.026, 1.083, P < 0.001) were associated with different caregiver reaction patterns. CONCLUSION: Nearly half of the caregivers of children with IA experience reaction of high burden and low benefit, but considerable proportion of caregivers could benefit from the caregiving rather than burden from. Married caregivers may have more negative reaction, especially when children > 2 years and diagnosed with intermediate or high type of IA. However, increasing caregiver's social support and reducing perception of uncertainty may have the potential to modify their reaction pattern.

Relationships between sleep quality, mindfulness and work-family conflict in Chinese nurses: A cross-sectional study.

BACKGROUND: To improve nursing quality and safety, it is essential to better understand relationships between sleep quality, mindfulness, and work-family conflict among nurses. PURPOSE: To examine the relationships among sleep quality, mindfulness and work-family conflict, and the mediating effect of mindfulness. METHODS: A cross-sectional study was conducted using survey data from five comprehensive tertiary first-class hospitals in Xiamen. Two thousand three hundred seventy-two nurses' data were used as the final sample. Spearman correlations were calculated, bootstrapping analysis, path analysis was conducted. FINDINGS: The sleep quality of nurses was not optimal. Work-family conflict was positively correlated with the Pittsburgh Sleep Quality Index (PSQI) score, while mindfulness level was negatively associated with it. Mindfulness played a mediating role in the prediction of sleep quality based on work-family conflict. CONCLUSIONS: To improve nursing quality, interventions are needed to enhance nurses' sleep quality through mindfulness and work-family conflict improvement.