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Among the elderly, depression is one of the most common mental disorders, which seriously affects their physical and mental health and quality of life, and their suicide rate is particularly high. Depression in the elderly is strongly associated with surgery. In this study, we aimed to explore the risk factors and establish a predictive model of depressive symptoms 1 month after video-assisted thoracoscopic surgery (VATS) in elderly patients. The study participants included 272 elderly patients (age > 65 years) undergoing VATS from April 2020 to May 2021 at 1 of 18 medical centers in China. The patients were divided into a depression group and a nondepression group according to the Chinese version of the nine-item Patient Health Questionnaire (PHQ-9). The patients' pre- and postoperative characteristics and questionnaires were collected and compared. Then, binary logistic regression was used to determine the risk factors that affect postoperative depressive symptoms, and the predictive model was constructed. The prediction efficiency of the model was evaluated by drawing the receiver operating characteristic curve (ROC), and the area under the curve (AUC) was calculated to evaluate the value of the predictive model. Among all of the included patients, 16.54% (45/272) suffered from depressive symptoms after VATS. The results of the univariate analysis showed that body mass index (BMI), chronic pain, leukocyte count, fibrinogen levels, prothrombin time, ASA physical status, infusion volume, anxiety, sleep quality, and postoperative pain were related to postoperative depressive symptoms (all p < 0.05). The results of multivariate logistic regression analysis showed that a high fibrinogen level (OR = 2.42), postoperative anxiety (OR = 12.05), poor sleep quality (OR = 0.61), and pain (OR = 2.85) were risk factors of postoperative depressive symptoms. A predictive model was constructed according to the regression coefficient of each variable, the ROC curve was drawn, and the AUC value was calculated to be 0.889. The prediction model may help medical personnel identify older patients at risk of developing depressive disorders associated with VATS and may be useful for clinical purposes. [ABSTRACT FROM AUTHOR]

Xiong'an New Area, located in the middle of the North China Plain, will have been built as a "city of the future." Urban planning and construction need to comprehensively consider the constraints of hydrogeological conditions such as aquifer structure and parameters. As the main aquifer in this area, the paleo-channel is heterogeneous and anisotropic, and the two-dimensional hydraulic conductivity in each horizontal direction cannot be obtained from aquifer tests. Therefore, this study adopts a chemical kinetics method to calculate the ionic activity and mineral saturation indices of shallow groundwater, determine the groundwater chemical potential field, and construct a horizontal two-dimensional groundwater chemical kinetics model. This model is used to calculate the hydraulic conductivity, flow rate and retention time of groundwater in areas of different chemical kinetics, as well as evaluate horizontal heterogeneity of the Quaternary paleo-channel aquifer. The results indicate that the groundwater chemical potential field can reflect the characteristics of the groundwater seepage field in each horizontal direction. The paleo-channel is the main channel of groundwater circulation, which shows the statistical difference of its permeability. Alluvial and lacustrine strata affect groundwater circulation due to their different hydrogeological structures and permeability. The groundwater chemical kinetics results of hydraulic conductivity along the paleo-channel are approximately consistent with traditional hydrogeological calculation results derived from aquifer test data. Hydraulic conductivity is higher in the extension direction of the paleo-channel, and lower if the path crosscuts multiple paleo-channels. This feature can be used to build a hydrogeological structure model combined with drilling data. Furthermore, excessive groundwater exploitation will change the actual flow rate and retention time of groundwater, thereby affecting the groundwater circulation conditions. This study of groundwater circulation in Xiong'an New Area by means of chemical kinetics makes up for the deficiency in the study of the unconsolidated sedimentary aquifer anisotropy within the paleo-channel. [ABSTRACT FROM AUTHOR]