Mental health changes in elderly patients undergoing non-cardiac surgery during the COVID-19 pandemic in China.

BACKGROUND: The COVID-19 pandemic has a heavy impact on the mental health of elderly surgical patients worldwide. In particular, the elderly patients faced considerable psychological stress due to various environmental and medical factors during the outbreak. This study aims to examine changes in mental health trends among non-cardiac surgical patients aged 65 and above in China during the COVID-19 pandemic. METHODS: This multi-center, convenient sampling, longitudinal observational study was conducted from April 1, 2020 to April 30, 2022. Primary outcome was the prevalence of postoperative depression. Secondary outcome was the prevalence of postoperative anxiety. Follow-up was conducted separately at 7 days and 30 days after surgery. Depression symptoms were assessed using the Patient Health Questionnaire 9 (PHQ-9) scale. Anxiety symptoms were assessed using Generalized Anxiety Disorder-7 (GAD-7) scale, with scores of ≥5 defining positive depression or anxiety symptoms. Multivariate logistic regression analysis was used to investigate risk factors of mental health status in more elderly patients undergoing non-cardiac surgery. RESULTS: A total of 4639 patients were included, of whom 2279 (46.0 %) were male, 752 (15.2 %) were over the age of 75, and 4346 (93.7 %) were married. The monthly prevalence trends demonstrated that compared to the outbreak period, a significant reduction in the prevalence of depression and anxiety symptoms in elderly patients who underwent surgery during the post-pandemic period. In post-pandemic period, a statistically significant decrease in the prevalence of all severity depression and anxiety patients was noted at the 7-day follow-up, but no significant decrease was observed for severe depression and anxiety in the 30-day follow-up. In COVID-19 low-risk area, a significant overall decrease in prevalence of mental health was observed during the post-pandemic period compared to the outbreak period, including 7-day depression, 7-day anxiety, 30-day depression, and 30-day anxiety (all with P < 0.001). Female and patients with ≥2 comorbidities appeared to be more susceptible to postoperative depression and anxiety during the pandemic. LIMITATION: The absence of data from the early days of the COVID-19 outbreak. CONCLUSIONS: This study analyzed the prevalence of depression and anxiety in elderly non-cardiac patients during and after the COVID-19 pandemic, focusing on dimensions such as severity, risk-areas, gender, and comorbidity. Our findings revealed a significant decrease in the prevalence of depression and anxiety in elderly surgery patients during the post-pandemic period.

Preoperative Frailty Assessment Predicts Postoperative Mortality, Delirium and Pneumonia in Elderly Lung Cancer Patients: A Retrospective Cohort Study.

BACKGROUND: The purpose of this study was to investigate the predictive value of the 5-factor modified frailty index (mFI-5) for postoperative mortality, delirium and pneumonia in patients over 65 years of age undergoing elective lung cancer surgery. METHODS: Data were collected from a single-center retrospective cohort study conducted in a general tertiary hospital from January 2017 to August 2019. In total, the study included 1372 elderly patients aged over 65 who underwent elective lung cancer surgery. They were divided into frail group (mFI-5, 2-5), prefrail group (mFI-5, 1) and robust group (mFI-5, 0) on the basis of mFI-5 classification. The primary outcome was postoperative 1-year all-cause mortality. Secondary outcomes were postoperative pneumonia and postoperative delirium. RESULTS: Frailty group had the highest incidence of postoperative delirium (frailty 31.2% versus prefrailty 1.6% versus robust 1.5%, p < 0.001), postoperative pneumonia (frailty 23.5% versus prefrailty 7.2% versus robust 7.7%, p < 0.001), and postoperative 1-year mortality (frailty 7.0% versus prefrailty 2.2% versus robust 1.9%. p < 0.001). Frail patients have significantly longer length of hospitalization than those in the robust group and prefrail patients (p < 0.001). Multivariate analysis showed a clear link between frailty and increased risk of postoperative delirium (aOR 2.775, 95% CI 1.776-5.417, p < 0.001), postoperative pneumonia (aOR 3.291, 95% CI 2.169-4.993, p < 0.001) and postoperative 1-year mortality (aOR 3.364, 95% CI, 1.516-7.464, p = 0.003). CONCLUSIONS: mFI-5 has potential clinical utility in predicting postoperative death, delirium and pneumonia incidence in elderly patients undergoing radical lung cancer surgery. Frailty screening of patients (mFI-5) may provide benefits in risk stratification, targeted intervention efforts, and assist physicians in clinical decision-making.

2D-Material-integrated hydrogels as multifunctional protective skins for soft robots.

Soft robots provide compliant object-machine interactions, but they exhibit insufficient material stability, which restricts them from working in harsh environments. Herein, we developed a class of soft robotic skins based on two-dimensional materials (2DMs) and gelatin hydrogels, featuring skin-like multifunctionality (stretchability, thermoregulation, threat protection, and strain sensing). The 2DM-integrated hydrogel (2DM/H) skins enabled soft robots to execute designated missions in the presence of high levels of heat and various environmental threats while maintaining mild machine temperatures. Via adopting different 2DMs (graphene oxide (GO), montmorillonite (MMT), and titanium carbide (MXene)), the 2DM/H-protected robots were able to perform soft grasping in organic liquids (GO/H) and open fire (MMT/H), and in the presence of electromagnetic radiation and biocontamination (MXene/H). Through blending MXene nanosheets into gelatin, the MXene-blended hydrogel (M-H) skin became strain sensitive, and a GO/M-H gripper exhibited the high-level integration of skin-mimicking capabilities. Finally, we incorporated 2DM/H skins onto an origami-inspired walker robot and a soft batoid-like robot to execute vision-guided searching in fire and underwater locomotion/navigation in chemical spills.

Shared and specific patterns of structural and functional thalamo-frontal disturbances in manic and euthymic pediatric bipolar disorder.

Bipolar disorder (BD) is clinically defined by alternating depressive and manic episodes with a separated period of euthymia. Thalamo-frontal loop plays vital role in psychotic symptoms, altered motor control and executive difficulties in BD. It remains unclear that structural and functional alterations of thalamo-frontal loop among the different mood states in BD, especially in pediatric BD(PBD).Twenty manic PBD (mPBD), 20 euthymic PBD (ePBD) and 19 healthy controls (HCs) were included in the study. By analyzing the T1 images and fMRI signals, thalamus volume and frontal grey matter cortical thickness were tested, and functional connectivity (FC) between bilateral thalamus and frontal cortex was calculated. Relationship between clinical indices and thalamo-frontal FC was also evaluated in mPBD and ePBD adolescents.Compared to HCs, the cortical thickness of left middle frontal gyrus (MFG), bilateral superior frontal gyrus (SFG) was significantly decreased in both mPBD and ePBD patients, and volume of left thalamus and cortical thickness of right MFG significantly decreased in mPBD patients. Compared to that of the HCs and ePBD subjects, thalamo-frontal hyperconnectivity with MFG was found in mPBD, and compared with that of HCs, thalamo-frontal hypoconnectivity with precentral gyrus/SFG was found in ePBD. In ePBD patients, episode times positively correlated with FC values between thalamus and precentral gyrus.The findings of the present study demonstrate detailed knowledge regarding shared and specific structural and functional disruption in thalamo-frontal loop in mPBD and ePBD subjects. Thalamo-frontal abnormalities reported in adult BD subjects were also observed in adolescent BD patients, and thalamo-frontal dysfunction may be a crucial treatment target in BD.

Electrically connected spin-torque oscillators array for 2.4 GHz WiFi band transmission and energy harvesting.

The mutual synchronization of spin-torque oscillators (STOs) is critical for communication, energy harvesting and neuromorphic applications. Short range magnetic coupling-based synchronization has spatial restrictions (few µm), whereas the long-range electrical synchronization using vortex STOs has limited frequency responses in hundreds MHz (<500 MHz), restricting them for on-chip GHz-range applications. Here, we demonstrate electrical synchronization of four non-vortex uniformly-magnetized STOs using a single common current source in both parallel and series configurations at 2.4 GHz band, resolving the frequency-area quandary for designing STO based on-chip communication systems. Under injection locking, synchronized STOs demonstrate an excellent time-domain stability and substantially improved phase noise performance. By integrating the electrically connected eight STOs, we demonstrate the battery-free energy-harvesting system by utilizing the wireless radio-frequency energy to power electronic devices such as LEDs. Our results highlight the significance of electrical topology (series vs. parallel) while designing an on-chip STOs system.

Investigation and Modeling of Capacitive Human Body Communication.

This paper presents a systematic investigation of the capacitive human body communication (HBC). The measurement of HBC channels is performed using a novel battery-powered system to eliminate the effects of baluns, cables and instruments. To verify the measured results, a numerical model incorporating the entire HBC system is established. Besides, it is demonstrated that both the impedance and path gain bandwidths of HBC channels is affected by the electrode configuration. Based on the analysis of the simulated electric field distribution, an equivalent circuit model is proposed and the circuit parameters are extracted using the finite element method. The transmission capability along the human body is also studied. The simulated results using the numerical and circuit models coincide very well with the measurement, which demonstrates that the proposed circuit model can effectively interpret the operation mechanism of the capacitive HBC.

Wireless Power Transfer Strategies for Implantable Bioelectronics.

Neural implants have emerged over the last decade as highly effective solutions for the treatment of dysfunctions and disorders of the nervous system. These implants establish a direct, often bidirectional, interface to the nervous system, both sensing neural signals and providing therapeutic treatments. As a result of the technological progress and successful clinical demonstrations, completely implantable solutions have become a reality and are now commercially available for the treatment of various functional disorders. Central to this development is the wireless power transfer (WPT) that has enabled implantable medical devices (IMDs) to function for extended durations in mobile subjects. In this review, we present the theory, link design, and challenges, along with their probable solutions for the traditional near-field resonant inductively coupled WPT, capacitively coupled short-ranged WPT, and more recently developed ultrasonic, mid-field, and far-field coupled WPT technologies for implantable applications. A comparison of various power transfer methods based on their power budgets and WPT range follows. Power requirements of specific implants like cochlear, retinal, cortical, and peripheral are also considered and currently available IMD solutions are discussed. Patient's safety concerns with respect to electrical, biological, physical, electromagnetic interference, and cyber security from an implanted neurotech device are also explored in this review. Finally, we discuss and anticipate future developments that will enhance the capabilities of current-day wirelessly powered implants and make them more efficient and integrable with other electronic components in IMDs.

Enabling wireless powering and telemetry for peripheral nerve implants.

Wireless power delivery and telemetry have enabled completely implantable neural devices. Current day implants are controlled, monitored, and powered wirelessly, eliminating the need for batteries and prolonging the lifetime. A brief overview of wireless platforms for such implantable devices is presented in this paper alongside an in-depth discussion of wireless platform for peripheral nerve implants covering design requirements, link design, and safety. Initial acute studies on the performance of the wireless power and data links in rodents are also presented.

Role of dipole elongation in orientationally ordered liquids.

A recent study shows that the dipole elongation in the extended dipole model plays a significant role in the phase transitions of liquid crystal phases. In this paper, molecular dynamics (MD) simulations were performed for the dipole model with different distances between the two charges keeping the total dipole moment the same. The potential energy consists of the Lennard-Jones potential and the site-site electrostatic contribution of partial charges. Detailed analyses were made with respect to the average order parameters (P(1)) and (P(2)) as functions of density along with other thermodynamic properties. When the reduced dipole elongations are 0.16 and 0.32, respectively, it is shown that the chainlike structures in the low density regime, liquid phases with columnar and smectic orders, and solid phases are formed; the phase with nematic order is not present anymore. At 0.64, the phases with antiferroelectric order were favored. The transition is found at the reduced elongation 0.55. It shows that the phase transitions are quite sensitive to the molecular charge distribution; this simple system could exhibit rather rich phase behaviors, which represents a significant advance in identifying molecular and state parameters of the future ferroelectric liquids.

[Study for phagaquosonogram acquisition module based on DSP].

In this paper, a phagaquosonogram acquisition, a module with TMS320C6713 as a core, and USB as communicating pattern is introduced based on VC++6.0. The structure of the module, hardware configuration, software design and the experiment of the real phagaquosonogram signal collection are presented. It is shown that the module can extract human phagaquosonogram signal reliably and availably.

[Short time ECG signal analysis based on the reconstruction of phase space].

Based on the reconstruction of two-dimension phase space of time series of short ECG signals, the variation of the strange attractor geometry is described and two indices, VMI and VAI, are derived in this paper. The two indices can distinguish clearly the ECG signals of sinus rhythm, tachycardia and ventricular fibrillation. Stable results of VMI and VAI can be obtained by analyzing ECG signals of several seconds. They are expected to be used in the development of medical instruments for a fast realtime display of analysis results.

[Development of an ECG signals analysis service system based on B/S].

An online ECG signals analysis service system based on the network has been established and is introduced in this paper which integrates the advantages of the network, database and ECG analysis tools, providing on-line ECG signal analysis service. Users with the knowledge of general operation of a browser, can process the ECG data and get a real-time display of analysis results.

Molecular dynamics simulations of dipolar fluids in orientationally ordered phases.

It has been established that the strongly interacting dipoles form orientationally ordered liquid phases. However, most of the computer simulations adapt the point dipole model. In this paper, we report molecular dynamics simulations of orientationally order phases formed by extended dipoles, where the potential energy consists of the site-site Lennard-Jones potential and electrostatic contribution of partial charges. The calculations were performed for a range of densities along an isotherm and for different temperatures at the same reduced densities. It is found that orientationally ordered phases are present in the wide density regime, the extended dipole tends to form chains at low density, and the isotropic liquid phase is not seen in the density regime studied for a specific temperature.

[The collecting and processing system of the sound signal of larynx].

This paper presents a new kind of collecting and processing system of the sound signal of larynx where double sound cards and software filter are used. The installation of the double sound cards and processing proposal of software are mainly discussed and a new kind of ADC method of dual-channel sound signal is put forward in this paper. This system has the feature of reliable performance, simple installation and easy maintenance.