BACKGROUND Hypotension is a frequent complication in the intensive care unit(ICU)after adult cardiac surgery.AIM To describe frequency of hypotension in the ICU following adult cardiac surgery and its relation to the ...BACKGROUND Hypotension is a frequent complication in the intensive care unit(ICU)after adult cardiac surgery.AIM To describe frequency of hypotension in the ICU following adult cardiac surgery and its relation to the hospital outcomes.METHODS A retrospective study of post-cardiac adult surgical patients at a tertiary academic medical center in a two-year period.We abstracted baseline demographics,comorbidities,and all pertinent clinical variables.The primary predictor variable was the development of hypotension within the first 30 min upon arrival to the ICU from the operating room(OR).The primary outcome was hospital mortality,and other outcomes included duration of mechanical ventilation(MV)in hours,and ICU and hospital length of stay in days.RESULTS Of 417 patients,more than half(54%)experienced hypotension within 30 min upon arrival to the ICU.Presence of OR hypotension immediately prior to ICU transfer was significantly associated with ICU hypotension(odds ratio=1.9;95%confidence interval:1.21-2.98;P<0.006).ICU hypotensive patients had longer MV,5(interquartile ranges 3,15)vs 4 h(interquartile ranges 3,6),P=0.012.The patients who received vasopressor boluses(n=212)were more likely to experience ICU drop-off hypotension(odds ratio=1.45,95%confidence interval:0.98-2.13;P=0.062),and they experienced longer MV,ICU and hospital length of stay(P<0.001,for all).CONCLUSION Hypotension upon anesthesia-to-ICU drop-off is more frequent than previously reported and may be associated with adverse clinical outcomes.展开更多
Although the pick-up/drop-off(PUDO)strategy in carpooling offers the convenience of short-distance walking for passengers during boarding and disembarking,there is a noticeable hesitancy among commuters to adopt this ...Although the pick-up/drop-off(PUDO)strategy in carpooling offers the convenience of short-distance walking for passengers during boarding and disembarking,there is a noticeable hesitancy among commuters to adopt this travel method,despite its numerous benefits.Here,this paper establishes a tripartite evolutionary game theory(EGT)model to verify the evolutionary stability of choosing the PUDO strategy of drivers and passengers and offering subsidies strategy of carpooling platforms in carpooling system.The model presented in this paper serves as a valuable tool for assessing the dissemination and implementation of PUDO strategy and offering subsidies strategy in carpooling applications.Subsequently,an empirical analysis is conducted to examine and compare the sensitivity of the parameters across various scenarios.The findings suggest that:firstly,providing subsidies to passengers and drivers,along with deductions for drivers through carpooling platforms,is an effective way to promote wider adoption of the PUDO strategy.Then,the decision-making process is divided into three stages:initial stage,middle stage,and mature stage.PUDO strategy progresses from initial rejection to widespread acceptance among drivers in the middle stage and,in the mature stage,both passengers and drivers tend to adopt it under carpooling platform subsidies;the factors influencing the costs of waiting and walking times,as well as the subsidies granted to passengers,are essential determinants that require careful consideration by passengers,drivers,and carpooling platforms when choosing the PUDO strategy.Our work provides valuable insight into the PUDO strategy’s applicability and the declared results provide implications for traffic managers and carpooling platforms to offer a suitable incentive.展开更多
文摘BACKGROUND Hypotension is a frequent complication in the intensive care unit(ICU)after adult cardiac surgery.AIM To describe frequency of hypotension in the ICU following adult cardiac surgery and its relation to the hospital outcomes.METHODS A retrospective study of post-cardiac adult surgical patients at a tertiary academic medical center in a two-year period.We abstracted baseline demographics,comorbidities,and all pertinent clinical variables.The primary predictor variable was the development of hypotension within the first 30 min upon arrival to the ICU from the operating room(OR).The primary outcome was hospital mortality,and other outcomes included duration of mechanical ventilation(MV)in hours,and ICU and hospital length of stay in days.RESULTS Of 417 patients,more than half(54%)experienced hypotension within 30 min upon arrival to the ICU.Presence of OR hypotension immediately prior to ICU transfer was significantly associated with ICU hypotension(odds ratio=1.9;95%confidence interval:1.21-2.98;P<0.006).ICU hypotensive patients had longer MV,5(interquartile ranges 3,15)vs 4 h(interquartile ranges 3,6),P=0.012.The patients who received vasopressor boluses(n=212)were more likely to experience ICU drop-off hypotension(odds ratio=1.45,95%confidence interval:0.98-2.13;P=0.062),and they experienced longer MV,ICU and hospital length of stay(P<0.001,for all).CONCLUSION Hypotension upon anesthesia-to-ICU drop-off is more frequent than previously reported and may be associated with adverse clinical outcomes.
基金the National Natural Science Foundation of China under Grant Nos.72171172 and 62088101the Shanghai Municipal Science and Technology,China Major Project under Grant No.2021SHZDZX0100the Shanghai Municipal Commission of Science and Technology,China Project under Grant No.19511132101.
文摘Although the pick-up/drop-off(PUDO)strategy in carpooling offers the convenience of short-distance walking for passengers during boarding and disembarking,there is a noticeable hesitancy among commuters to adopt this travel method,despite its numerous benefits.Here,this paper establishes a tripartite evolutionary game theory(EGT)model to verify the evolutionary stability of choosing the PUDO strategy of drivers and passengers and offering subsidies strategy of carpooling platforms in carpooling system.The model presented in this paper serves as a valuable tool for assessing the dissemination and implementation of PUDO strategy and offering subsidies strategy in carpooling applications.Subsequently,an empirical analysis is conducted to examine and compare the sensitivity of the parameters across various scenarios.The findings suggest that:firstly,providing subsidies to passengers and drivers,along with deductions for drivers through carpooling platforms,is an effective way to promote wider adoption of the PUDO strategy.Then,the decision-making process is divided into three stages:initial stage,middle stage,and mature stage.PUDO strategy progresses from initial rejection to widespread acceptance among drivers in the middle stage and,in the mature stage,both passengers and drivers tend to adopt it under carpooling platform subsidies;the factors influencing the costs of waiting and walking times,as well as the subsidies granted to passengers,are essential determinants that require careful consideration by passengers,drivers,and carpooling platforms when choosing the PUDO strategy.Our work provides valuable insight into the PUDO strategy’s applicability and the declared results provide implications for traffic managers and carpooling platforms to offer a suitable incentive.
