Chronic Postsurgical Pain Following Lung Transplantation: Characteristics, Risk Factors, Treatment, and Prevention: A Narrative Review.

Chronic pain after lung transplantation (LTx) can substantially reduce quality of life (QoL), yet current consensus guidelines say little about how to prevent or manage it. Research on pain after LTx has tended to focus on acute rather than chronic pain, and it has not extensively examined the factors associated with onset or resolution of chronic pain, which differ from factors influencing chronic pain after general thoracic surgery. This narrative review explores what is known about the epidemiology and risk factors of chronic pain after LTx, as well as effective ways to treat or prevent it. The review identifies key questions and issues that should be the focus of future research.

Predictive modeling for identifying infection risk following spinal surgery: Optimizing patient management.

Infection is known to occur in a substantial proportion of patients following spinal surgery and predictive modeling may provide a useful means for identifying those at higher risk of complications and poor prognosis, which could help optimize pre- and postoperative management strategies. The outcome measure of the present study was to investigate the occurrence of all-cause infection during hospitalization following scoliosis surgery. To meet this aim, the present study retrospectively analyzed 370 patients who underwent surgery at the Second Affiliated Hospital, Zhejiang University School of Medicine (Hangzhou, China) between January 2016 and October 2022, and patients who either experienced or did not experience all-cause infection while in hospital were compared in terms of their clinicodemographic characteristics, surgical variables and laboratory test results. Logistic regression was subsequently applied to data from a subset of patients in order to build a model to predict infection, which was validated using another subset of patients. All-cause, in-hospital postoperative infections were found to have occurred in 66/370 patients (17.8%). The following variables were included in a predictive model: Sex, American Society of Anesthesiologists (ASA) classification, body mass index (BMI), diabetes mellitus, hypertension, preoperative levels of white blood cells and preoperative C-reactive protein (CRP) and duration of surgery. The model exhibited an area under the curve of 0.776 against the internal validation set. In conclusion, dynamic nomograms based on sex, ASA classification, BMI, diabetes mellitus, hypertension, preoperative levels of white blood cells and CRP and duration of surgery may have the potential to be a clinically useful predictor of all-cause infection following scoliosis. The predictive model constructed in the present study may potentially facilitate the real-time visualization of risk factors associated with all-cause infection following surgical procedures.

Individual cartoon video for alleviating perioperative anxiety and reducing emergence delirium in children: a prospective randomised trial.

BACKGROUND: Perioperative anxiety and emergence delirium (ED) in young children may cause a series of adverse events, which are worth investigating. Pharmacological treatments of anxiety and delirium remain uncertain, while non-pharmacological treatments lack personalization and pertinence. AIMS: The aim of study was to determine whether an individual cartoon video can alleviate perioperative anxiety and reduce ED in young children undergoing adenoidectomy and tonsillectomy. METHODS: Children between 3 and 7 years old undergoing adenoidectomy and tonsillectomy were randomly assigned to an individual cartoon video group (group V) or a control group (group C). In group V, an individual cartoon video of the child' s own choice was played throughout the whole waiting, anaesthesia induction and recovery periods. The children in group C were contacted through verbal conversation. The primary outcomes were anxiety measured by the Modified Yale Preoperative Anxiety Scale and ED assessed by the Paediatric Anaesthesia Emergence Delirium (PAED) scale. The secondary outcomes included cooperation during induction, postoperative pain and adverse events. RESULTS: The incidence of anxiety were comparable in group V and group C at the holding area (T0) (26% vs 22%, p=0.323), but the incidence of anxiety of group V were significantly lower than those of group C at the time of entering the operating room (T1), during the induction of anaesthesia (T2) and leaving the post anaesthesia care unit (T6) (p<0.001, p<0.001, p<0.001) after intervention. The peak PAED score in group V was significantly lower than that in group C (12.00 (9.00-13.00) vs 13.50 (10.00-15.00), p=0.016). We found no significant differences in cooperation during induction, postoperative pain or the incidence of adverse events between the groups (2.00 (0.00-4.00) vs 3.00 (1.25-4.00), p=0.110; F=0.059, Pgroup=0.808; 3 (7.5%) vs 4 (10), p=0.692). CONCLUSIONS: The individual cartoon video is an effective method of reducing perioperative anxiety and alleviating ED in children. TRIAL REGISTRATION NUMBER: ChiCTR2200062300 (https://www.chictr.org.cn/index.aspx).

Resolution Enhanced Array ECT Probe for Small Defects Inspection.

It is a continual and challenging problem to detect small defects in metallic structures for array eddy current testing (ECT) probes, which require the probe to have ultra-high resolution and sensitivity. However, the spatial resolution of an ECT array probe is limited by the size of the induction coils. Even if it is possible to increase the spatial resolution by using smaller coils, the sensitivity of the sensor also decreases. To obtain finer spatial resolution without sacrificing sensitivity, this paper proposes a resolution enhanced ECT array probe with four rows of coils attached to a flexible printed circuit board (FPCB). The distance between each two adjacent coils in a row is 2 mm and the position of each row is offset by 0.5 mm along the horizontal direction related to its prior row. The outputs of the four rows are aligned and interpolated in a line, and in this way the image resolution of the probe is increased to 0.5 mm. The probe is configured to operate with the differential setting, namely two differential coils operate simultaneously at each time. The currents in the two coils can be controlled to have the same flowing direction or opposite flowing direction, resulting in different distributions of the induced eddy current and two sets of output images. A patch-image model and an image fusion method based on discrete wavelet transforms are employed to suppress the noise and highlight the defects' indications. Experimental results show that small defects with dimensions as small as length × width × depth = 1 mm × 0.1 mm × 0.3 mm on a 304 stainless-steel sample can be detected from the fused image, demonstrating that the probe has super sensitivity for small defects inspection.

Tunnel Magnetoresistance Sensor with AC Modulation and Impedance Compensation for Ultra-Weak Magnetic Field Measurement.

Tunnel magnetoresistance (TMR) is a kind of magnetic sensor with the advantages of low cost and high sensitivity. For ultra-weak and low-frequency magnetic field measurement, the TMR sensor is affected by the 1/f noise. This paper proposes an AC modulation method with impedance compensation to improve the performance. The DC and AC characteristics of the sensors were measured and are presented here. It was found that both the equivalent resistance and capacitor of the sensors are affected by the external magnetic field. The TMR sensors are connected as a push-pull bridge circuit to measure the magnetic field. To reduce the common-mode noise, two similar bridge circuits form a magnetic gradiometer. Experimental results show that the sensor's sensitivity in the low-frequency range is obviously improved by the modulation and impedance compensation. The signal-to-noise ratio of the sensor at 1 Hz was increased about 25.3 dB by the AC modulation, impedance compensation, and gradiometer measurement setup. In addition, the sensitivity of the sensor was improved from 165.2 to 222.1 mV/V/mT. Ultra-weak magnetic signals, namely magnetocardiography signals of two human bodies, were measured by the sensor in an unshielded environment. It was seen that the R peak of MCG can be clearly visualized from the recorded signal.

A Novel Method for Accurate Quantification of Split Glomerular Filtration Rate Using Combination of Tc-99m-DTPA Renal Dynamic Imaging and Its Plasma Clearance.

PURPOSE: To precisely quantify split glomerular filtration rate by Tc-99m-DTPA renal dynamic imaging and plasma clearance in order to increase its consistency among doctors. METHODS: Tc-99m-DTPA renal dynamic imaging was performed according to the conventional radionuclide renal dynamic imaging by five double-blinded doctors independently and automatically calculated split GFR, namely, gGFR. Moreover, the conventional radionuclide renal dynamic imaging was assessed to only outline the kidney, blank background, and automatically calculated split GFR, gGFR'. The total GFR value of patients, tGFR, was obtained by the double-plasma method. According to the formula, Precise GFR (pGFR) = gGFR'/(gGFR' + gGFR') × tGFR. The precise GFR value of the divided kidney, pGFR, was calculated. The Kendall's W test was used to compare the consistency of gGFR and pGFR drawn by five physicians. RESULTS: According to Kendall's W consistency test, Kendall's coefficient of concordance was 0.834, p = 0.0001 using conventional method. The same five doctors used blank background again and the same standard Gates method to draw the kidneys, which automatically calculated gGFR'. Using input formula, the pGFR was calculated and Kendall's W consistency test (Kendall's coefficient of concordance = 0.956, p = 0.0001). CONCLUSION: The combination of Tc-99m-DTPA renal dynamic imaging combined with the double-plasma method could achieve accurate split GFR, and because of the omission of influence factors, the consistency of pGFR obtained by different doctors using this method was significantly higher than that of conventional Tc-99m-DTPA renal dynamic imaging.