Development and Validation of a Predictive Model for Intraoperative Hypothermia in Elderly Patients Undergoing Craniocerebral Tumor Resection: A Retrospective Cohort Study.

OBJECTIVE: Timely identification of elderly patients who are at risk of developing intraoperative hypothermia (IH) is imperative to enable appropriate interventions. This study aimed to develop a nomogram for predicting the risk of IH in elderly patients undergoing resection of craniocerebral tumor, and to validate its effectiveness. METHODS: Elderly patients who underwent craniocerebral tumor resection at a large tertiary hospital in eastern China between January 2019 and December 2022 were included (n = 988). The study population was divided into a training set and a validation set by time period. Risk factors identified through the Least Absolute Shrinkage and Selection Operator method and logistic regression analysis were used to establish the nomogram. The model was validated internally by Bootstrap method and externally by validation set through receiver operating characteristic curve analysis, Hosmer-Lemeshow test, and decision curve analysis. RESULTS: A total of 273 (27.6%) patients developed IH. Duration of anesthesia (P < 0.001), blood loss (P < 0.001), preoperative temperature (P < 0.001), tumor location (P < 0.001), age (P < 0.05), and mean arterial pressure (P < 0.05) were identified as independent risk factors for IH. A nomogram integrating these 6 factors was constructed. The area under the curve was 0.773 (95% confidence interval: 0.735-0.811) (70.5% specificity and 75.0% sensitivity), indicating good predictive performance. The decision curve analysis demonstrated the clinical benefit of using the nomogram. CONCLUSIONS: Our model showed good performance in identifying elderly patients who are at high risk of developing IH during craniocerebral tumor resection. The nomogram can help inform timely preventive interventions.

Hydroxyl-functionalized three-dimensional covalent organic framework for selective and rapid extraction of organophosphorus pesticides.

The wide utilization of organophosphorus pesticides (OPPs) results in a potential threat to ecosystem and human health. The essential extraction process in practical OPPs analysis always suffers from the low efficiency due to the limited accessible active sites and interactions in the adsorbents. Here, we report a rational design and synthesis of a novel hydroxyl-functionalized three-dimensional covalent organic framework (3D COF-OH) named JNU-6 with ordered porous structure and multiple interactions as the adsorbent for rapid and selective dispersive solid phase extraction (DSPE) of OPPs. The 3D COF-OH based DSPE was coupled with gas chromatography-flame thermionic detection (GC-FTD) for the determination of four selected OPPs with low limits of detection of 0.15-0.39 ng mL-1, wide linear range of 1-1100 ng mL-1. The developed method gave good precision (relative standard deviation of 1.6-8.5% (n = 5)) and recoveries of 86-106% for the determination of OPPs in complicated fruit and vegetable samples. This work reveals the high practical potential of functionalized 3D COFs as adsorbents for effective extraction of trace contaminants in complicated samples.

Engineering linkage as functional moiety into irreversible thiourea-linked covalent organic framework for ultrafast adsorption of Hg(II).

Development of novel functionalized covalent organic frameworks (COFs) as adsorbent for removal of mercury from environment is of great significance, but the conventional strategies for functionalizing COFs always sacrifice porous properties and suppress the exposure of functional sites, which goes against the rapid adsorption of Hg(II). Here, we show the rational design and preparation of the first thiourea-linked COFs via engineering the COFs linkage as functional moiety for ultrafast and selective adsorption of Hg(II). Two thiourea-linked COFs JNU-3 and JNU-4 were prepared via tautomerism reaction of 1,3,5-triformylphloroglucinol with 1,4-phenylenebis(thiourea) and 1,4-biphenylenebis(thiourea), respectively. The thiourea serves as not only linkage to connect the building block into irreversible crystalline structure, but also functional moiety to give no occupation of the COF pore and full exposure to Hg(II) with strong affinity, offering the JNU-3 and JNU-4 large adsorption capacity (960 and 561 mg g-1, respectively) and ultrafast kinetics (equilibrium time of 10 s) for Hg(II). The proposed strategy for the design of functional COFs with inherent linkage as functional moiety largely promotes the performance of COFs for diverse applications.

Risk factors for incorrect surgical count during surgery: An observational study.

BACKGROUND: Incorrect surgical counts are closely related to retained surgical items, which pose a threat to patients. However, the risk factors for incorrect surgical counts have not been identified yet. AIM: To identify the risk factors associated with incorrect surgical counts during surgery in a tertiary hospital. DESIGN: An observational case-control study. METHODS: Seventy cases of incorrect surgical counts were reviewed in this study. Data were collected from January 1, 2014, to April 4, 2019. For each case, we included four randomly selected control cases involving the same surgical procedures by the same surgeon within a 6-month period for comparison. The medical data of these cases were extracted for further statistical analysis. RESULTS: A higher incidence of incorrect surgical counts was observed among surgical counts performed between 8:00 a.m. to 12:00 a.m., emergency operations, prolonged procedures, and/or after addition of surgical items. CONCLUSION: Prolonged surgical procedures, emergency operations, time of occurrence, and addition of surgical items were the risk factors related to incorrect surgical counts during surgery.