Science Progress最新文献

Background: Epistaxis is a recurring cause for referral to emergency departments. Its management can be complex; hence, it is critical to provide appropriate support to Otolaryngology-Head and Neck Surgery (OHNS) residents to develop clinical reasoning skills to manage such cases. Learning-by-Concordance (LbC) is a recently developed educational tool that encourages learners to think through simulated clinical scenarios. A panel of ENTs provides insightful feedback to residents, reflecting a diversity of opinions about practice. Our study aimed to assess LbC's feasibility and perceived value for training OHNS residents in epistaxis management.

Methods: In this qualitative study, three OHNS surgeons, including two faculty members and one resident, wrote the LbC scenarios. The LbC tool was made available to participants through an online platform. A panel of four OHNS faculty provided feedback on answers to LbC questions. Otolaryngology-Head and Neck Surgery residents participated and provided their opinion on the value of this educational tool through an online questionnaire.

Results: A total of 10 one-hour sessions were required to create and upload the training tool. To provide insightful feedback embedded in the learning tool, the four panelists needed 60 min each. Of the 37 participating residents, 25 (68%) completed the training. Overall satisfaction was high: 88% appreciated the training method, and 92% wanted to use this type of training again. Most residents felt the training enabled them to improve their clinical reasoning when encountering a patient with epistaxis (92%) and their knowledge about epistaxis (96%).

Conclusion: Findings suggest that OHNS residents could benefit from clinical reasoning exercises with panelist feedback using the LbC approach for clinical presentations that require complex approaches to manage conditions such as epistaxis.

Metal lithium negative electrodes are considered the "holy grail" of lithium battery negative electrodes due to their ultra-high energy density and low overpotential. However, the arbitrary growth of lithium dendrites during the cycling process hindered its industrialization process. We prepared porous carbon doped with zinc oxide nanoparticles (ZNC-MOF-5) by high-temperature carbonization of MOF-5, and coated ZNC-MOF-5 on the surface of commercial membranes (ZNC-MOF-5@PP). Used to improve the cycling stability of metal lithium negative electrodes. Zinc oxide nanoparticles in ZNC-MOF-5 have good lithium affinity and can promote Li⁺ deposition. The porous structure with a high specific surface area endows the electrode with high lithium loading capacity, reduces local current density, and obtains a dendrite-free metal lithium negative electrode. The electrochemical cycling performance of Li/Cu batteries indicates that, ZNC-MOF-5@PP. The separator can prevent the growth of dendrites and improve cycling stability, proving that ZNC-MOF-5 can effectively guide the deposition of Li and solve dendrite problems.

Microbial relationships with roots influence many ecosystem functions and nutrient fluxes, including their sometimes-profound effects on plant health and productivity. Fine roots were often classified with a diameter less than 2 mm, but fine roots under that size perform distinct functional roles in the environment. Importantly, two broad functional categories of fine roots are absorptive and transportive, with absorptive fine roots acting as metabolic hotspots for root activity. In two of our recent studies, we have shown that several microbial community characteristics differ between absorptive and transportive fine roots, including composition, abundance, and function, as well as the root metabolome. This highlights a growing recognition within microbial ecology that we must consider fine-scale environmental variability, such as root physiology and morphology, when interpreting microbial patterns. In this commentary, we summarize the findings of our latest article, further speculate on some of these patterns, and suggest future studies for examining decomposition and applying cutting-edge single-cell sequencing techniques.

Purpose: Patients admitted to the intensive care unit (ICU) after cardiac surgery are at high risk of delirium due to a variety of factors. This study aimed to identify the incidence of postoperative delirium in adult patients with cardiac surgery and its risk factors, such as characteristics of subjects, disease and treatment-related, as well as nursing-related characteristics. Methods: The study was performed on adult patients who underwent cardiac surgery at Y University Hospital in D city; a total of 195 patients met the inclusion criteria. Results: The results of this study determined that 67 of 195 adult cardiac surgery patients had postoperative delirium, 53.7% of which occurred in the ICU and 46.3% in the general ward. Risk factors of postoperative delirium were postoperative symptoms of inflammation (odds ratio [OR] = 10.18, p = 0.002), continuous renal replacement therapy application after surgery (OR = 9.05, p = 0.006), postoperative sleep disorder (OR = 8.98, p < 0.001), age (OR = 6.23, p = 0.006), length of stay in the ICU (OR = 3.83, p = 0.031), history of stroke (OR = 3.71, p = 0.033), the number of postoperative catheter retention (OR = 1.53, p = 0.065), Acute Physiology and Chronic Health Evaluation Ⅱ score (OR = 1.12, p = 0.006), and time of operation (OR = 1.01, p = 0.042). Conclusion: This study confirmed that after cardiac surgery, postoperative delirium occurred in patients during their ICU stay and after their transfer to a general ward. Considering that after cardiac surgery ICU-related factors affect the incidence of delirium in the general ward, there is a need for continuous monitoring of ICU-related factors after the patient gets transferred to a general ward.

Objective: Serum albumin (ALB) plays a vital role in maintaining oncotic pressure and contributing to hemodynamic stability, with low levels associated with adverse outcomes in critically ill patients. This study aimed to assess the association between serum ALB concentrations and poor outcomes and the possible benefits of ALB supplementation.

Methods: A retrospective study involving 300 intensive care unit (ICU) patients. Albumin levels were recorded upon admission and throughout the stay, and patients were categorized based on a cutoff of 2.49 g/dl. The associations between low ALB levels and mortality were assessed using regression analysis. Additionally, it investigated the association of albumin supplementation with patient outcomes and mortality in specific patient populations.

Results: The mean age was 54.9 years, with 68% having sepsis. Patients with low baseline ALB concentrations exhibited higher overall mortality (71% vs. 52%) and 28-day mortality (50% vs. 39%). Adjusted analyses confirmed associations with mortality. Albumin supplementation was administered to 53% of the patients. Its use demonstrated potential benefits, particularly in reducing mortality, when given to specific groups, such as sepsis and hypoalbuminemia patients.

Discussion: The study confirms that low serum albumin levels are strongly associated with higher mortality rates in ICU patients. Albumin supplementation showed potential benefits, particularly in patients with sepsis and low albumin levels. Further analyses explored the dosage-response relationship and identified potential groups that would benefit from albumin supplementation.

Conclusion: Albumin can play a major role in predicting mortality in critically ill patients. Moreover, ALB supplementation may improve survival, especially in resource-limited settings. Future research should refine protocols through clinical trials for optimal survival in critically ill patients.

When the vehicle is in motion, the elastic deformation of the flexible subframe significantly influences ride comfort. Therefore, it is crucial to investigate the impact of flexible subframes on vehicle ride comfort. In order to enhance the reliability and optimization efficiency of our research, this paper incorporates the concept of elastic deformation in the flexible subframe into the investigation of vehicle ride comfort, and proposes a multi-objective optimization approach to enhance the overall vehicle ride comfort. The vibration mathematical model elucidates how flexible subframes affect vehicle ride comfort and establishes a rigid-flexible coupling model for a specific vehicle with a flexible subframe to analyze the impact of its elastic deformation on vehicle ride comfort through simulation experiments. Subsequently, a radial basis function approximation model is established, and the multi-objective particle swarm optimization and non-dominated sorting genetic algorithm II algorithms are employed to conduct multi-objective optimization of the stiffness of the subframe bushing with the aim of enhancing vehicle ride comfort. The findings indicate that the flexible subframe has a significant impact on vehicle ride comfort. Specifically, on bump roads, peak values of vertical and longitudinal seat accelerations decrease while lateral seat acceleration increases. On random roads, peak values of longitudinal and lateral seat accelerations increase while vertical acceleration decreases. Furthermore, the stiffness of the subframe bushing optimized by the non-dominated sorting genetic algorithm II algorithm further enhances vehicle ride comfort and aligns more closely with the optimization requirements in this study.

In this study, we focus on the analysis and prediction of urban logistics traffic flow, a field that is gaining increasing attention due to the acceleration of global urbanization and heightened environmental awareness. Existing forecasting methods face challenges in processing large and complex datasets, particularly when extracting and analyzing valid information from these data, often hindered by noise and outliers. In this context, time series analysis, as a key technique for predicting future trends, becomes crucial for supporting real-time traffic management and long-term traffic planning. To this end, we propose a composite network model that integrates gated recurrent unit (GRU), autoregressive integrated moving average (ARIMA), and temporal fusion transformer (TFT), namely the GRU-ARIMA-TFT network model, to enhance prediction accuracy and efficiency. Through the analysis of experimental results on different datasets, we demonstrate the significant advantages of this model in improving prediction accuracy and understanding complex traffic patterns. This research not only theoretically expands the boundaries of urban logistics traffic flow prediction but also holds substantial practical significance in real-world applications, especially in optimizing urban traffic planning and logistics distribution strategies during peak periods and under complex traffic conditions. Our study provides a robust tool for addressing real-world issues in the urban logistics domain and offers new perspectives and methodologies for future urban traffic management and logistics system planning.

The limited physical and mechanical properties of polymethyl methacrylate (PMMA), the current gold standard, necessitates exploring improved denture base materials. While three-dimensional (3D) printing offers accuracy, efficiency, and patient comfort advantages, achieving superior mechanics in 3D-printed denture resins remains challenging despite good biocompatibility and esthetics. This review investigates the potential of innovative materials to address the limitations of 3D-printed denture base materials. Thus, this article is organized to provide a comprehensive overview of recent efforts to enhance 3D-printed denture base materials, highlighting advancements. It critically examines the impact of incorporating various nanoparticles (zirconia, titania, etc.) on these materials' physical and mechanical properties. Additionally, it delves into recent strategies for nanofiller surface treatment and biocompatibility evaluation and explores potential future directions for polymeric composites in denture applications. The review finds that adding nanoparticles significantly improves performance compared to unmodified resins, and properties can be extensively enhanced through specific modifications, particularly silanized nanoparticles. Optimizing 3D-printed denture acrylics requires a multifaceted approach, with future research prioritizing novel nanomaterials and surface modification techniques for a novel generation of superior performance, esthetically pleasing, and long-lasting dentures.

Perclose ProGlide were created as preferred for puncture site closure of femoral artery. Femoral artery occlusion is one of the serious device-related complications. This report presents a continuous endovascular technique combined with peripheral cutting balloon (PCB) treatment for a case of a 32s woman diagnosed with lower extremity ischaemia caused by right superficial femoral artery (SFA) occlusion following the use of the Perclose ProGlide system in minimally invasive cardiac surgery. During the primary operation, limb ischaemia symptoms were relieved with vessel perfusion and reconstruction after regular balloon dilatation. A secondary operation was conducted 6 weeks later, and the obstructive lesions were recanalised without residual stenosis after PCB dilatation. No vessel-related adverse events such as dissection, rupture or distal embolisation occurred during the perioperative period. The patient recovered uneventfully after the operation, with complete alleviation of symptoms. Follow-up computed tomography angiography 3 month post-operatively revealed an undeformed shape and excellent patency of the right SFA.