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Introduction: The elderly population experiences more postoperative complications. A comprehensive geriatric assessment, which is multidimensional and coordinated, could help reduce these unfavorable outcomes. However, its effectiveness is still uncertain. Methods: We searched multiple online databases, including Medline, PubMed, Web of Science, Cochrane Library, Embase, CINAL, ProQuest, and Wiley, for relevant literature from their inception to October 2023. We included randomized trials of individuals aged 65 and older undergoing surgery. These trials compared comprehensive geriatric assessment with usual surgical care and reported on postoperative outcomes. Two researchers independently screened the literature, extracted data, and assessed the certainty of evidence from the identified articles. We conducted a meta-analysis using RevMan 5.3 to calculate the Odds Ratio (OR) and Mean Difference (MD) of the pooled data. Results: The study included 1325 individuals from seven randomized trials. Comprehensive geriatric assessment reduced the rate of postoperative delirium (28.5% vs. 37.0%; OR: 0.63; CI: 0.47–0.85; I2: 54%; P = 0.003) based on pooled data. However, it did not significantly improve other parameters such as length of stay (MD: -0.36; 95% CI: -0.376, 3.05; I2: 96%; P = 0.84), readmission rate (18.6% vs. 15.4%; OR: 1.26; CI: 0.86–1.84; I2: 0%; P = 0.24), and ADL function (MD: -0.24; 95% CI: -1.27, 0.19; I2: 0%; P = 0.64). Conclusions: Apart from reducing delirium, it is still unclear whether comprehensive geriatric assessment improves other postoperative outcomes. More evidence from higher-quality randomized trials is needed. [ABSTRACT FROM AUTHOR]

Backgrounds: Cognitive frailty, a clinical syndrome with physical frailty and cognitive impairment, leads to mortality and other adverse health outcomes in older adults. This study aimed to investigate the prevalence of cognitive frailty, and its influencing factors, and follow its impact on short‐term mortality in elderly chronic obstructive pulmonary disease patients, to provide a theoretical scientific reference basis for clinical intervention and management of cognitive frailty. Methods: A sample of 243 elderly chronic obstructive pulmonary disease patients in the respiratory department of a tertiary care hospital was conveniently sampled from November 2021 to February 2023, and the prevalence of cognitive frailty was investigated using the General Information Survey Scale, the Fried Phenotype Scale, the Mini‐Mental State Examination, the Anxiety Self‐Rating Scale, the Brief Geriatric Depression Scale, and the Mortality Record. The mortality was recorded by telephone follow‐up after 6 months. A database was created and statistical analysis such as one‐way analysis of variance, logistic regression analysis, Kaplan–Meier, and Cox survival analysis were used to analyze the data. Results: A total of 47 patients (19.3%) had cognitive frailty; there were statistical differences in the prevalence of cognitive frailty by medical payment type, physical exercise, and sleeping time (P < 0.05). During a 6‐month follow‐up, 38 patients (15.6%) died. Cox survival analysis showed that the risk of death in elderly chronic obstructive pulmonary disease patients in the cognitive frailty group was 3.212 times higher than that in the normal cognitive function and non‐frailty group (95% CI 1.646–6.270, P = 0.001), and 5.266 times higher than that in the normal cognitive function and frailty group (95% CI 3.159–8.778, P < 0.001). Conclusions: The prevalence of cognitive frailty in elderly chronic obstructive pulmonary disease patients is high, and clinical staff should pay attention to patients' medical burden and financial ability, and reduce the incidence of cognitive frailty by instructing patients to perform physical exercise and arrange sleep time. Cognitive frailty is an important risk factor for mortality within 6 months in elderly chronic obstructive pulmonary disease patients, and early intervention should be emphasised to reduce or delay cognitive frailty and mortality. [ABSTRACT FROM AUTHOR]

Replacing the sluggish oxygen evolution reaction with the oxidation of benzyl alcohol to construct the hybrid water electrolysis system has been attractive for its merits of environmentally friendly and economically efficient. However, the activity of the catalyst to oxidize alcohols needs to be further improved. Tailoring the d-band center (E d) has been proven as an effective method to promote the hydrogen evolution reaction (HER). How feasible is this strategy in the oxidation of benzyl alcohol? Here, using Co 2 C as a research platform, the doping nonmetal heteroatom (P, S, N) engineering is adopted to promote its electrocatalytic BA oxidation and HER performance. The results of electrochemical tests show that the P-doped Co 2 C (P–Co 2 C) only requires a low potential of 1.33 and 1.38 V vs. RHE to achieve current densities of 20 and 100 mA cm−2 for BA oxidation, which is superior to that of S–Co 2 C, N–Co 2 C, and pristine Co 2 C. The conversation and faradaic efficiency for BA is up to 98.1% and 93.8% during ten consecutive cycle tests. The P–Co 2 C also exhibited outstanding activity and stability toward HER. The density functional theory (DFT) calculation revealed that specified P doping could modify the d-band center of Co 2 C approaching the peak of the volcano map (electrochemical overpotentials ∼ E d). The Gibbs free energy of the BA oxidation was also reduced, thus optimizing the adsorption and desorption process of intermediates. On the other hand, the catalyst surface physical properties of Co 2 C such as hydrophilicity was promoted by the doped heteroatoms which was favorable for the gas-liquid-solid triphase electrocatalytic reaction. This work offers a facial perception of regulating the d-band to design advanced bifunctional electrocatalysts for organic matter oxidation and HER. The d-band center engineering was employed to boost the bifunctional electrocatalytic performance of X–Co 2 C (X = P, S, N). [Display omitted] • The X-doped Co 2 C (X = P, S, N) electrocatalysts were designed for BA oxidation and HER. • Among the prepared samples, the P–Co 2 C exhibited superior hydrophilicity and catalytic performance. • The P doping could change the d-band center of Co 2 C and optimize the adsorption/desorption process of intermediates. • The Gibbs free energy derived from the DFT was consistent with the order of electrochemical activity. [ABSTRACT FROM AUTHOR]

Superconducting nanowire single-photon detectors (SNSPDs) made of ultrathin δ-NbN films have been widely applied in both visible and infrared wavelengths. For mid-infrared (MIR) wavelengths, SNSPDs made of tungsten silicide films with a lower critical temperature were reported up to 9.9 μm wavelength. In this study, we demonstrate the potential of NbN-SNSPDs for use in MIR applications. SNSPDs made of γ-Nb4N3 films (critical temperature of 5.1 K for 6.5 nm thick films) instead of δ-NbN films were fabricated. The dependence of the normalized detection efficiency on the bias current indicated a clear trend toward a saturated plateau for wavelengths up to 2145 nm. The calculated cut-off wavelengths indicated the possibility of using γ-Nb4N3 SNSPDs for longer MIR wavelengths. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the efficacy and safety of retrograde intrarenal surgery (RIRS) for the treatment of pediatric patients.Materials and Methods: A total of 45 patients with upper urinary stones treated using flexible ureteroscopy combined with holmium laser lithotripsy at our department between June 2015 and January 2017 were examined in this study.Results: The operative success rate of treatment using holmium laser lithotripsy via flexible ureteroscopy was 97.8% (44/45); one patient (1/45, 2.2%) was converted to laparoscopic pyelolithotomy, and the calculus was successfully removed. Lithotripsy via flexible ureteroscopy was successful during the first phase in 38 patients (38/45, 84.4%), and second or third phase lithotripsy was needed for six patients (6/45, 13.3%). Intraoperative ureteral fracture in the middle and lower sections occurred in one pediatric patient who was converted to laparoscopic pyelolithotomy and ureter bladder reimplantation. This patient was discharged after recovery at 2 weeks postoperative and showed no significant renal dysfunction over the 12-month follow-up period. Severe postoperative gross hematuria occurred in one patient, who improved after hemostasis and other symptomatic treatments. High fever occurred in two patients (body temperature >39°C), who later improved. These pediatric patients were discharged after active anti-infection and other conservative treatments for 4 days. All of the included patients were followed up for 2-15 months, with an average follow-up period of 8 months. The total calculus clearance rate was 100% (45/45), with no recurrence of the calculus.Conclusion: In this study, most upper urinary stones in children and infants were treated successfully with holmium laser lithotripsy applied via flexible ureteroscopy. [ABSTRACT FROM AUTHOR]

The electrocatalytic overall urea splitting can achieve the dual goals of urea treatment and hydrogen energy acquisition. Herein, we exploited the principle of precipitation dissolution equilibrium to obtain bimetallic phosphide FeP/Cu 3 P/CF for the simultaneous oxidation of urea and reduction of water and comprehensively reveal the inherent molecular thermodynamic mechanisms on the surface of catalysts. The excellent electrochemical performance can be derived from the super water affinity and synergistic effect. Especially, the theoretical calculation unveils that the synergistic effect between FeP and Cu 3 P can lower the activation energy required for urea electrooxidation, thereby promoting urea splitting. In situ differential electrochemical mass spectrometry (in situ DEMS) measurements further demonstrated that urea oxidation on FeP/Cu 3 P/CF proceeded according to the intramolecular mechanism. This work has laid the foundation for constructing highly efficient superhydrophilic bifunctional electrocatalysts.

Mid-infrared (MIR) single-photon detection is emerging as an important technology for various applications. Superconducting nanowire single photon detectors (SNSPDs) fabricated with superconducting films with energy gaps of a few meV are natural broadband single-photon detectors. Recently, extending SNSPDs' operation wavelengths into the MIR region is highly attractive. γ-Nb 4 N 3 has a reduced N content and lower energy gap than the commonly used δ-NbN, making SNSPDs based on γ-Nb 4 N 3 film more sensitive to low energy photons. We report on a Nb 4 N 3 -SNSPD based on 62-nm wide nanowire, with an optical absorption enhancement design and an optimized device package for efficient ZBLAN fiber coupling and dark count filtering. The developed device has a unity intrinsic detection efficiency (IDE) in the 1.5-4 µm wavelength region, and the device detection efficiency at 2.95 µm was measured to be 32.5%, with an uncertainty of 12.7%. Furthermore, we reduced the device geometry, and measured 3-10 µm photon response of a device based on 5-nm film and 42-nm nanowire, with an IDE of 95%, 81%, 40%, and 6% for 4.8, 6, 8, and 10 µm, respectively.

Purpose: To investigate the efficacy and safety of retrograde intrarenal surgery (RIRS) for the treatment of pediatric patients., Materials and Methods: A total of 45 patients with upper urinary stones treated using flexible ureteroscopy combined with holmium laser lithotripsy at our department between June 2015 and January 2017 were examined in this study., Results: The operative success rate of treatment using holmium laser lithotripsy via flexible ureteroscopy was 97.8% (44/45); one patient (1/45, 2.2%) was converted to laparoscopic pyelolithotomy, and the calculus was successfully removed. Lithotripsy via flexible ureteroscopy was successful during the first phase in 38 patients (38/45, 84.4%), and second or third phase lithotripsy was needed for six patients (6/45, 13.3%). Intraoperative ureteral fracture in the middle and lower sections occurred in one pediatric patient who was converted to laparoscopic pyelolithotomy and ureter bladder reimplantation. This patient was discharged after recovery at 2 weeks postoperative and showed no significant renal dysfunction over the 12-month follow-up period. Severe postoperative gross hematuria occurred in one patient, who improved after hemostasis and other symptomatic treatments. High fever occurred in two patients (body temperature >39°C), who later improved. These pediatric patients were discharged after active anti-infection and other conservative treatments for 4 days. All of the included patients were followed up for 2-15 months, with an average follow-up period of 8 months. The total calculus clearance rate was 100% (45/45), with no recurrence of the calculus., Conclusion: In this study, most upper urinary stones in children and infants were treated successfully with holmium laser lithotripsy applied via flexible ureteroscopy.