Introduction: In spite of the use of the less and less invasive and the more and more effective techniques and the use of fast rehabilitation conditions of the patients in surgery, the post-operative complications (PO...Introduction: In spite of the use of the less and less invasive and the more and more effective techniques and the use of fast rehabilitation conditions of the patients in surgery, the post-operative complications (POC) stay the main reasons of admission in resuscitation service. Objective: To determine the post-operative outcome of the patients admitted in resuscitation. Patient and method: It was about a retrospective and transverse survey from June 2017 to May 2018 in the service of polyvalent resuscitation of the academic hospital center of Gabriel Touré. Have been included the patients operated for surgical or obstetric gynecology—pathologies admitted in resuscitation for post-operative complications established or potential precocious or late. The used statistical test was the Chi2 with p Results: During the period, 514 patients have been admitted in resuscitation of which 140 cases of post-operatively represented 27.2% of the admissions. Under hospitalization 35.7% of patients have presented a complication. The middle age of patients was 37.72 ± 20.9 years. The sex ratio was 0.70. The middle length of interventions was 122 ± 83 min with extremes going from 20 to 434 min. The predominant admission motive was hemodynamic instability. The delay of appearance intervening of the complications was 3 days in 94%. The predominant complications were: respiratory (32%), infectious (28%) and Cardiovascular (20%). The middle length of hospitalization was of 3.36 ± 2.90 days. The death rate was 15%. The complications were related age, the class of Alteme?er, the ASA, and the perioperative undesirable events with p Conclusion: The post-operative admissions in resuscitation are frequent including several factors of morbi-mortality. A better management per and postoperative of the patients operated would reduce the death rate. The profile mark is the one of a patient admitted for hemodynamic instability.展开更多
BACKGROUND The need for an emergency upgrade of a hospitalized trauma patient from the floor to the trauma intensive care unit(ICU)is an unanticipated event with possible life-threatening consequences.Unplanned ICU ad...BACKGROUND The need for an emergency upgrade of a hospitalized trauma patient from the floor to the trauma intensive care unit(ICU)is an unanticipated event with possible life-threatening consequences.Unplanned ICU admissions are associated with increased morbidity and mortality and are an indicator of trauma service quality.Two different types of unplanned ICU admissions include upgrades(patients admitted to the floor then moved to the ICU)and bounce backs(patients admitted to the ICU,discharged to the floor,and then readmitted to the ICU).Previous studies have shown that geriatric trauma patients are at higher risk for unfavorable outcomes.AIM To analyze the characteristics,management and outcomes of trauma patients who had an unplanned ICU admission during their hospitalization.METHODS This institutional review board approved,retrospective cohort study examined 203 adult trauma patients with unplanned ICU admission at an urban level 1 trauma center over a six-year period(2017-2023).This included 134 upgrades and 69 bounce backs.Analyzed variables included:(1)Age;(2)Sex;(3)Comorbidities;(4)Mechanism of injury(MOI);(5)Injury severity score(ISS);(6)Glasgow Coma Scale(GCS);(7)Type of injury;(8)Transfusions;(9)Consultations;(10)Timing and reason for unplanned admission;(11)Intubations;(12)Surgical interventions;(13)ICU and hospital lengths of stay;and(14)Mortality.RESULTS Unplanned ICU admissions comprised 4.2%of total ICU admissions.Main MOI was falls.Mean age was 70.7 years,ISS was 12.8 and GCS was 13.9.Main injuries were traumatic brain injury(37.4%)and thoracic injury(21.7%),and main reason for unplanned ICU admission was respiratory complication(39.4%).The 47.3%underwent a surgical procedure and 46.8%were intubated.Average timing for unplanned ICU admission was 2.9 days.Bounce backs occurred half as often as upgrades,however had higher rates of transfusions(63.8%vs 40.3%,P=0.002),consultations(4.8 vs 3.0,P<0.001),intubations(63.8%vs 38.1%%,P=0.001),longer ICU lengths of stay(13.2 days vs 6.4 days,P<0.001)and hospital lengths of stay(26.7 days vs 13.0 days,P<0.001).Mortality was 25.6%among unplanned ICU admissions,31.9%among geriatric unplanned ICU admissions and 11.9%among all trauma ICU patients.CONCLUSION Unplanned ICU admissions constituted 4.2%of total ICU admissions.Respiratory complications were the main cause of unplanned ICU admissions.Bounce backs occurred half as often as upgrades,but were associated with worse outcomes.展开更多
Introduction and Problem Statement: Many medication errors occur during the community and hospital transition. Indeed, the World Health Organization launched the international “High 5S” project to implement medicati...Introduction and Problem Statement: Many medication errors occur during the community and hospital transition. Indeed, the World Health Organization launched the international “High 5S” project to implement medication reconciliation in healthcare facilities to reduce them and ensure patients a safe, high-quality healthcare pathway. Objective: This study aimed to detect medication errors by reconciling drug treatments and assess the relevance and feasibility of this standardized practice within the Medical Emergency Unit of the Teaching Pediatric Hospital of Ouagadougou (Burkina Faso). Methods: Patients whose parents gave their consent at their entrance were enrolled. For each patient, the pharmacy team completed a reconciliation form that included the patient’s usual treatment, which was taken and in progress and received upon admission to the medical emergency unit. Patients’ treatments were reviewed to detect and characterize discrepancies. The data of each form were reported and analyzed using KoboCollect, an Android application. Results: 135 records and 412 medication lines were captured over six weeks. The average time of treatment reconciliation per patient was 57 minutes. One thousand one hundred ninety-eight (1198) intentional discrepancies were detected, of which 6.09% were documented. Seventy-one (71) unintentional discrepancies were collected, including 39 omissions, 24 regimen dosing errors, and 8 pharmaceutical form dosage errors. Forty-nine (49) unintentional discrepancies, or 69.01%, were corrected by formulated pharmaceutical interventions toward physicians. Conclusion: Medical treatment reconciliation during hospital admission is critical because discrepancies can compromise the efficacy and/or safety of the patient’s hospital medication.展开更多
Acute cholangitis(AC)is a heterogeneous disease with considerable variation in clinical presentation and high medical costs.Although the overall mortality rate is decreasing.However,the mortality in severe AC ranged f...Acute cholangitis(AC)is a heterogeneous disease with considerable variation in clinical presentation and high medical costs.Although the overall mortality rate is decreasing.However,the mortality in severe AC ranged from 10%-30%due to sepsis,multi-organ failure,and systemic inflammatory response syndrome.Assessing the predictors of poor outcomes,including mortality,intensive care unit(ICU)admission,and hospital stay,is vital for early and effective intervention.We assessed the predictors of mortality and ICU admission in patients with AC.We conducted a literature search in PubMed/MEDLINE,Google Scholar,and Cochrane Library for relevant articles.The keywords used were acute cholangitis,biliary cholangitis,predictors,mortality,ICU admission,and Hospital stay.In addition,we assessed the role of early vs late endoscopic retrograde cholangiopancreatography on the outcomes.Old age,end-organ failure,red cell distribution width to albumin ratio,neutrophil-to-lymphocyte ratio,platelet-lymphocyte ratio,the need for ventilator support,diabetes,electrolyte imbalance,procalcitonin-to-albumin ratio,C-reactive protein-to-albumin,Glasgow Coma Scale,and systolic hypertension are predictors of poor outcomes in AC of varying etiology,and concurrent acute pancreatitis was not associated with ICU admission.展开更多
BACKGROUND Post-operative infection is a common and serious complication following drugeluting trans arterial chemo embolization(D-TACE)in patients with hepatocellular carcinoma(HCC),potentially compromising treatment...BACKGROUND Post-operative infection is a common and serious complication following drugeluting trans arterial chemo embolization(D-TACE)in patients with hepatocellular carcinoma(HCC),potentially compromising treatment efficacy and increasing morbidity.AIM To investigate the risk factors associated with post-operative infection in HCC patients undergoing D-TACE,and to provide evidence for clinical prevention and targeted intervention strategies.METHODS Clinical data of 77 primary HCC patients who underwent D-TACE in our hospital from January 2022 to December 2023 were retrospectively analyzed.Patient demographics,laboratory test results,tumor characteristics,and surgery-related parameters were collected.Univariate and multivariate logistic regression analyses were performed to identify risk factors for post-operative infection.RESULTS Post-operative infection occurred in 20 cases(25.97%)among the 77 patients.Univariate analysis showed that age≥65 years,Child-Pugh grade B,tumor diameter≥5 cm,operation time≥120 minutes,preoperative albumin<35 g/L,and comorbid diabetes were significantly associated with post-operative infection(P<0.05).Multivariate logistic regression analysis identified Child-Pugh grade B(OR=2.851,95%CI:1.426-5.698),operation time≥120 minutes(OR=2.367,95%CI:1.238-4.523),and preoperative albumin<35 g/L(OR=2.156,95%CI:1.147-4.052)as independent risk factors for post-operative infection.CONCLUSION Liver function status,operation time,and preoperative albumin level are significant factors affecting post-operative infection in HCC patients undergoing D-TACE.For high-risk patients,enhanced perioperative management,appropriate timing of surgery,and active improvement of nutritional status should be implemented to reduce the risk of post-operative infection.展开更多
Exertional heat stroke (EHS) is a life-threatening condition characterized by profound central nervous system (CNS)dysfunction and core temperature typically>40°C.^([1])This condition involves complex pathophy...Exertional heat stroke (EHS) is a life-threatening condition characterized by profound central nervous system (CNS)dysfunction and core temperature typically>40°C.^([1])This condition involves complex pathophysiological processes in which heat triggers a cascade of dysregulated inflammatory responses,endothelial dysfunction,coagulation abnormalities,and muscle damage.These processes can lead to multiorgan failure,significantly increasing the risk of mortality.^([2])Given the severity of EHS,early identification and timely intervention are crucial.However,there are no specific diagnostic markers for EHS,^([1])highlighting the need to identify reliable clinical parameters that can assist early decision-making.展开更多
BACKGROUND Blood glucose and serum albumin have been associated with cardiovascular disease prognosis,but the impact of admission-blood-glucose-to-albumin ratio(AAR)on adverse outcomes in critical ill coronary artery ...BACKGROUND Blood glucose and serum albumin have been associated with cardiovascular disease prognosis,but the impact of admission-blood-glucose-to-albumin ratio(AAR)on adverse outcomes in critical ill coronary artery disease(CAD)patients was not investigated.METHODS Patients diagnosed with CAD were non-consecutively selected from the MIMIC-IV database and categorized into quartiles based on their AAR.The primary outcome was 1-year mortality,and secondary endpoints were in-hospital mortality,acute kidney injury(AKI),and renal replacement therapy(RRT).A restricted cubic splines model and Cox proportional hazard models assessed the association between AAR and adverse outcomes in CAD patients.Kaplan-Meier survival analysis determined differences in endpoints across subgroups.RESULTS A total of 8360 patients were included.There were 726 patients(8.7%)died in the hospital and 1944 patients(23%)died at 1 year.The incidence of AKI and RRT was 63%and 4.3%,respectively.High AAR was markedly associated with in-hospital mortality(HR=1.587,P=0.003),1-year mortality(HR=1.502,P<0.001),AKI incidence(HR=1.579,P<0.001),and RRT(HR=1.640,P<0.016)in CAD patients in the completely adjusted Cox proportional hazard model.Kaplan-Meier survival analysis noted substantial differences in all endpoints based on AAR quartiles.Stratified analysis and interaction test demonstrated stable correlations between AAR and outcomes.CONCLUSIONS The results highlight that AAR may be a potential indicator for assessing in-hospital mortality,1-year mortality,and adverse renal prognosis in critical CAD patients.展开更多
In this paper, a novel admission scheme is proposed which provides high degrees of quality of service (QoS) guarantees for multimedia traffic carried in mobile networks. The proposed scheme combines the admission cont...In this paper, a novel admission scheme is proposed which provides high degrees of quality of service (QoS) guarantees for multimedia traffic carried in mobile networks. The proposed scheme combines the admission control and bandwidth reservation to guarantee QoS requirements. It considers both local information and remote information to determine whether to accept or reject a connection. In order to embody the characteristics of the algorithms proposed in the article, two traditional algorithms of admission control are used for comparison. In the end of the paper the simulation analyses are given and the results show that the proposed algorithm can adjust the bandwidth according to the current status of networks and decrease the probability of connections forcibly dropped. The most important thing is that the algorithm is based on the multimedia communications and can guarantee the QoS of real time connections through decreasing the bandwidth of non real time connections.展开更多
This study mainly uses the move and step analysis to conduct a contrastive genre analysis on the selected 20 Chinese ad-mission brochures(CABs) and 20 American admission brochures(AABs).Differences in moves,move seque...This study mainly uses the move and step analysis to conduct a contrastive genre analysis on the selected 20 Chinese ad-mission brochures(CABs) and 20 American admission brochures(AABs).Differences in moves,move sequences and step arrange-ments have revealed themselves in this comparison.Firstly,Chinese university admission brochures cast more focus on basic infor-mation about the university,the application procedure and admission criteria,while American universities,besides offering such in-formation,also emphasize the promotional function of the admission brochures.They use appealing and creative moves to commer-cially‘sell'advantages of the university to the potential applicants.Secondly,based on Kress & van Leeuwen's visual grammarsymbolic meaning,images and colors in admission brochures are also explored and analyzed as language.For one thing,after count-ing the frequency of the four categories of images,namely portrait,campus scenery,campus life pictures and graphs,it is foundthat,compared with CABs,AABs have a highly more obvious tendency in using images.The images are used as an effective tool toincrease the sense of credibility,identity-recognition,attract reader's attention,and help understanding,making the facts and in-formation more intuitive.For another thing,the main colors used in the brochures are yet another noticeable feature.Especially inAmerican brochures,universities tend to use their‘traditional colors' in the brochure to achieve a sense of consistency.Some Chi-nese brochures also follow this promotional strategy,yet a large percentage of them do not use any recognizable colors other thanthe printed black and white.Based on these differences,suggestions are put forward from perspectives including choice of movesand steps to improve the quality of CABs,hopefully raising their acceptance in the international level.展开更多
BACKGROUND:The influence of surgical delay on mortality and morbidity has been studied extensively among elderly hip fracture patients.However,most studies only focus on the timing of surgery when patients have alread...BACKGROUND:The influence of surgical delay on mortality and morbidity has been studied extensively among elderly hip fracture patients.However,most studies only focus on the timing of surgery when patients have already been hospitalized,without considering pre-admission waiting time.Therefore,the present study aims to explore the infl uence of admission delay on surgical outcomes.METHODS:In this retrospective study,we recorded admission timing and interval from admission to surgery for included patient.Other covariates were also collected to control confounding.The primary outcome was 1-year mortality.The secondary outcomes were 1-month mortality,3-month mortality,ICU admission and postoperative pneumonia.We mainly used multivariate logistic regression to determine the effect of admission timing on postoperative outcomes.An additional survival analysis was also performed to assess the impact of admission delay on survival status in the fi rst year after operation.RESULTS:The proportion of patients hospitalized on day 0,day 1,day 2 after injury was 25.4%,54.7%and 66.3%,respectively.And 12.6%patients visited hospital one week later after injury.Mean time from admission to surgery was 5.2 days(standard deviation 2.8 days).Hospitalization at one week after injury was a risk factor for 1-year mortality(OR 1.762,95%CI 1.026–3.379,P=0.041).CONCLUSION:Admission delay of more than one week is signifi cantly associated with higher 1-year mortality.As a supplement to the current guidelines which emphasizes early surgery after admission,we also advocate early admission once patients get injured.展开更多
Objective To investigate the association between ambient air pollution and hospital emergency admissions in Beijing. Methods In this study, a semi-parametric generalized additive model （GAM） was used to evaluate the...Objective To investigate the association between ambient air pollution and hospital emergency admissions in Beijing. Methods In this study, a semi-parametric generalized additive model （GAM） was used to evaluate the specific influences of air pollutants （PM10, SO2, and NO2） on hospital emergency admissions with different lag structures from 2009 to 2011, the sex and age specific influences of air pollution and the modifying effect of seasons on air pollution to analyze the possible interaction. Results It was found that a 10μg/m3 increase in concentration of PMlo at lag 03 day, SO2 and NO2 at lag 0 day were associated with an increase of 0.88%, 0.76%, and 1.82% respectively in overall emergency admissions. A 10 lag/m3 increase in concentration of PM10, SO2 and NO2 at lag 5 day were associated with an increase of 1.39%, 1.56%, and 1.18% respectively in cardiovascular disease emergency admissions. For lag 02, a 10 μg/m3 increase in concentration of PM10, SO2 and NO2 were associated with 1.72%, 1.34%, and 2.57% increases respectively in respiratory disease emergency admissions. Conclusion This study further confirmed that short-term exposure to ambient air pollution was associated with increased risk of hospital emergency admissions in Beijing.展开更多
Objective The study is to investigate the associations between visibility, major air pollutants and daily counts of hospital admission in Shanghai, China. Methods Daily data on hospital admission, visibility, and air ...Objective The study is to investigate the associations between visibility, major air pollutants and daily counts of hospital admission in Shanghai, China. Methods Daily data on hospital admission, visibility, and air pollution during 2005‐2008 were obtained from the Shanghai Insurance Bureau （SHIB）, Shanghai Meteorological Bureau, and Shanghai Environmental Monitoring Center, respectively. The generalized additive model （GAM） with penalized splines was used to examine the associations between daily visibility and hospital admission. Results Among various pollutants, PM 2.5 showed strongest correlation with visibility. Decreased visibility was significantly associated with increased risk of hospital admission in Shanghai. An inter‐quartile range decrease in the 2‐day （L01） moving average of visibility corresponded to 3.66% （95%CI： 1.02%, 6.31%）, 4.06% （95%CI： 0.84%, 7.27%）, and 4.32% （95%CI： 1.67%, 6.97%） increase of total, cardiovascular, and respiratory hospitalizations, respectively. Conclusion Our analyses provide the first piece of evidence in China, demonstrating that decreased visibility has an effect on hospital admission, and this finding strengthens the rationale for further limiting air pollution levels in Shanghai.展开更多
Objective Post-operative cognitive dysfunction(POCD)and post-operative delirium(POD)are two common post-operative cerebral complications.The current meta-analysis was to systematically review the effects of penehyclid...Objective Post-operative cognitive dysfunction(POCD)and post-operative delirium(POD)are two common post-operative cerebral complications.The current meta-analysis was to systematically review the effects of penehyclidine hydrochloride(PHC)on POCD and POD in surgical patients.Methods Electronic databases were searched to identify all randomized controlled trials comparing PHC with atropine/scopolamine/placebo on POCD and POD in surgical patients.Primary outcomes of interest included the incidences of POCD and POD;the secondary outcomes of interest included peri-operative minimental state examination(MMSE)scores.Two authors independently extracted peri-operative data,including patients'baseline characteristics,surgical variables,and outcome data.For dichotomous data(POCD and POD occurrence),treatment effects were calculated as odds ratio(OR)and 95%confidential interval(Cl).Each outcome was tested for heterogeneity,and randomized-effects or fixed-effects model was used in the presence or absence of significant heterogeneity.For continuous variables(MMSE scores),treatment effects were calculated as weighted mean difference(WMD)and 95%CI.Statistical significance was defined as P<0.05.Results Our search yielded 33 studies including 4017 patients.Meta-analysis showed that,the incidence of POCD in PHC group was comparable to that in saline group(OR=0.97;95%Ck 0.S8-1.64;P=0.92),scopolamine group(OR=0.78;95%CI:0.48-1.27;P=0.32)and atropine group(0R=1.20;95%Ch 0.86-1.67;P=0.29).The incidence of POD in PHC group was comparable to that in saline group(OR=1.53;95%CI:0.81-2.90;P=0.19)and scopolamine group(OR=0.53;95%CI:0.06-4.56;P=0.56),but higher than that in atropine group(OR=4.49;95%CI:1.34-15.01;P=0.01).Conclusions PHC premedication was not associated with increased incidences of POCD or POD as compared to either scopolamine or placebo.展开更多
The turbine in an LH2/LOX rocket engine is designed as a two-stage supersonic partialadmission turbine. Three-dimensional steady and unsteady simulations were conducted to analyze turbine performance and aerodynamic f...The turbine in an LH2/LOX rocket engine is designed as a two-stage supersonic partialadmission turbine. Three-dimensional steady and unsteady simulations were conducted to analyze turbine performance and aerodynamic forces on rotor blades. Different configurations were employed to investigate the effects of the axial gap and nozzle distribution on the predicted performance and aerodynamic forces. Rotor blades experience unsteady aerodynamic forces because of the partial admission. Aerodynamic forces show periodicity in the admission region, and are close to zero after leaving the admission region. The unsteady forces in frequency domain indicate that components exist in a wide frequency region, and the admission passing frequency is dominant.Those multiples of the rotational frequency which are multiples of the nozzle number in a fulladmission turbine are notable components. Results show that the turbine efficiency decreases as the axial gap between nozzles and the 1 st stage rotor（rotor 1） increases. Fluctuation of the circumferential aerodynamic force on rotor 1 blades decreases with the axial gap increasing. The turbine efficiency decreases as the circumferential spacing between nozzles increases. Fluctuations of the circumferential and axial aerodynamic forces increase as the circumferential spacing increases. As for the non-equidistant nozzle distribution, it produces similar turbine performance and amplitudefrequency characteristics of forces to those of the normal configuration, when the mean spacing is equal to that of the normal case.展开更多
Avionics full duplex switched ethernet（AFDX） is a switched interconnection technology developed to provide reliable data exchange with strong data transmission time guarantees in internal communication of the spacec...Avionics full duplex switched ethernet（AFDX） is a switched interconnection technology developed to provide reliable data exchange with strong data transmission time guarantees in internal communication of the spacecraft or aircraft.Virtual link（VL） is an important concept of AFDX to meet quality of service（QoS） requirements in terms of end-to-end message deadlines.A VL admission control algorithm in AFDX network under hard real-time（HRT） constraints is studied.Based on the scheduling prin-ciple of AFDX protocol,a packet scheduling scheme under HRT constraints is proposed,and after that an efficient VL admission control algorithm is presented.Analytical proof that the algorithm can effectively determine whether VL should be admitted is given.Finally simulative examples are presented to promote the conclusion.展开更多
Propose a new degradation call admission control（DCAC）scheme, which can be used in wideband code division multiple access communication system. So-called degradation is that non-real time call has the characteristic...Propose a new degradation call admission control（DCAC）scheme, which can be used in wideband code division multiple access communication system. So-called degradation is that non-real time call has the characteristic of variable bit rate, so decreasing its bit rate can reduce the load of the system, consequently the system can admit new call which should be blocked when the system is close to full load, therefore new call＇s access probability increases. This paper brings forward design project and does system simulation, simulation proves that DCAC can effectively decrease calls＇ blocking probability and increase the total number of the on-line users.展开更多
Objective： To investigate the relationship between post-operative cognitive dysfunction（POCD） and regional cerebral oxygen saturation（rSO2） and β-amyloid protein（Aβ） in patients undergoing laparoscopic pancre...Objective： To investigate the relationship between post-operative cognitive dysfunction（POCD） and regional cerebral oxygen saturation（rSO2） and β-amyloid protein（Aβ） in patients undergoing laparoscopic pancreaticoduodenectomy. Methods： Fifty patients undergoing elective laparoscopic pancreaticoduodenectomy received five groups of neuropsychological tests 1 d pre-operatively and 7 d post-operatively, with continuous monitoring of rSO2 intra-operatively. Before anesthesia induction（t0）, at the beginning of laparoscopy（t1）, and at the time of pneumoperitoneum 120 min（t2）, pneumoperitoneum 240 min（t3）, pneumoperitoneum 480 min（t4）, the end of pneumoperitoneum（t5）, and 24 h after surgery, jugular venous blood was drawn respectively for the measurement of Aβ by enzyme-linked immunosorbent assay（ELISA）. Results： Twenty-one cases of the fifty patients suffered from POCD after operation. We found that the maximum percentage drop in rSO2（rSO2, %max） was significantly higher in the POCD group than in the non-POCD group. The rSO2, %max value of over 10.2% might be a potential predictor of neurocognitive injury for those patients. In the POCD group, the plasma Aβ levels after 24 h were significantly higher than those of pre-operative values（P〈0.01）. After 24 h, levels of plasma Aβ in the POCD group were significantly higher than those in the non-POCD group（P〈0.01）. Conclusions： The development of POCD in patients undergoing laparoscopic pancreaticoduodenectomy is associated with alterations of rSO2 and Aβ. Monitoring of rSO2 might be useful in the prediction of POCD, and Aβ might be used as a sensitive biochemical marker to predict the occurrence of POCD.展开更多
Power efficiency and link reliability are of great impor- tance in hierarchical wireless sensor networks （HWSNs）, espe- cially at the key level, which consists of sensor nodes located only one hop away from the sink...Power efficiency and link reliability are of great impor- tance in hierarchical wireless sensor networks （HWSNs）, espe- cially at the key level, which consists of sensor nodes located only one hop away from the sink node called OHS. The power and admission control problem in HWSNs is comsidered to improve its power efficiency and link reliability. This problem is modeled as a non-cooperative game in which the active OHSs are con- sidered as players. By applying a double-pricing scheme in the definition of OHSs＇ utility function, a Nash Equilibrium solution with network properties is derived. Besides, a distributed algorithm is also proposed to show the dynamic processes to achieve Nash Equilibrium. Finally, the simulation results demonstrate the effec- tiveness of the proposed algorithm.展开更多
As device-to-device(D2D) communications usually reuses the resource of cellular networks, call admission control(CAC) and power control are crucial problems. However in most power control schemes, total data rates or ...As device-to-device(D2D) communications usually reuses the resource of cellular networks, call admission control(CAC) and power control are crucial problems. However in most power control schemes, total data rates or throughput are regarded as optimization criterion. In this paper, a combining call admission control(CAC) and power control scheme under guaranteeing QoS of every user equipment(UE) is proposed. First, a simple CAC scheme is introduced. Then based on the CAC scheme, a combining call admission control and power control scheme is proposed. Next, the performance of the proposed scheme is evaluated. Finally, maximum DUE pair number and average transmitting power is calculated. Simulation results show that D2 D communications with the proposed combining call admission control and power control scheme can effectively improve the maximum DUE pair number under the premise of meeting necessary QoS.展开更多
OBJECTIVE:Admission hyperglycemia in acute myocardial infarction (MI) is related with increased in-hospital and long term mortality and major cardiac adverse events。 We aimed to investigate how admission hyperglycemi...OBJECTIVE:Admission hyperglycemia in acute myocardial infarction (MI) is related with increased in-hospital and long term mortality and major cardiac adverse events。 We aimed to investigate how admission hyperglycemia affects the short and long term outcomes in elderly patients >65 years) after primary percutaneous coronary intervention for ST elevation myocardial infarction。 METHODS:We retrospectively analyzed 677 consecutive elderly patients (mean age 72.2 ±5.4)。 Patients were divided into two groups according to admission blood glucose levels。 Group : low glucose group (LLG), glucose < 168 mg/dL; and Group 2: high glucose group (HGG), glucose >168 mg/dL。 RESULTS:In-hospital, long term mortality and in-hospital major adverse cardiac events were higher in the high admission blood glucose group (P <0.001)。 Multivariate regression analysis showed: Killip > 1, post-thrombolysis in MI <3 and admission blood glucose levels were independent predictors of in-hospital adverse cardiac events (P <0.001)。 CONCLUSIONS:Admission hyperglycemia in elderly patients presented with ST elevation myocardial infarction is an independent predictor of in-hospital major adverse cardiac events and is associated with in-hospital and long term mortality。展开更多
文摘Introduction: In spite of the use of the less and less invasive and the more and more effective techniques and the use of fast rehabilitation conditions of the patients in surgery, the post-operative complications (POC) stay the main reasons of admission in resuscitation service. Objective: To determine the post-operative outcome of the patients admitted in resuscitation. Patient and method: It was about a retrospective and transverse survey from June 2017 to May 2018 in the service of polyvalent resuscitation of the academic hospital center of Gabriel Touré. Have been included the patients operated for surgical or obstetric gynecology—pathologies admitted in resuscitation for post-operative complications established or potential precocious or late. The used statistical test was the Chi2 with p Results: During the period, 514 patients have been admitted in resuscitation of which 140 cases of post-operatively represented 27.2% of the admissions. Under hospitalization 35.7% of patients have presented a complication. The middle age of patients was 37.72 ± 20.9 years. The sex ratio was 0.70. The middle length of interventions was 122 ± 83 min with extremes going from 20 to 434 min. The predominant admission motive was hemodynamic instability. The delay of appearance intervening of the complications was 3 days in 94%. The predominant complications were: respiratory (32%), infectious (28%) and Cardiovascular (20%). The middle length of hospitalization was of 3.36 ± 2.90 days. The death rate was 15%. The complications were related age, the class of Alteme?er, the ASA, and the perioperative undesirable events with p Conclusion: The post-operative admissions in resuscitation are frequent including several factors of morbi-mortality. A better management per and postoperative of the patients operated would reduce the death rate. The profile mark is the one of a patient admitted for hemodynamic instability.
文摘BACKGROUND The need for an emergency upgrade of a hospitalized trauma patient from the floor to the trauma intensive care unit(ICU)is an unanticipated event with possible life-threatening consequences.Unplanned ICU admissions are associated with increased morbidity and mortality and are an indicator of trauma service quality.Two different types of unplanned ICU admissions include upgrades(patients admitted to the floor then moved to the ICU)and bounce backs(patients admitted to the ICU,discharged to the floor,and then readmitted to the ICU).Previous studies have shown that geriatric trauma patients are at higher risk for unfavorable outcomes.AIM To analyze the characteristics,management and outcomes of trauma patients who had an unplanned ICU admission during their hospitalization.METHODS This institutional review board approved,retrospective cohort study examined 203 adult trauma patients with unplanned ICU admission at an urban level 1 trauma center over a six-year period(2017-2023).This included 134 upgrades and 69 bounce backs.Analyzed variables included:(1)Age;(2)Sex;(3)Comorbidities;(4)Mechanism of injury(MOI);(5)Injury severity score(ISS);(6)Glasgow Coma Scale(GCS);(7)Type of injury;(8)Transfusions;(9)Consultations;(10)Timing and reason for unplanned admission;(11)Intubations;(12)Surgical interventions;(13)ICU and hospital lengths of stay;and(14)Mortality.RESULTS Unplanned ICU admissions comprised 4.2%of total ICU admissions.Main MOI was falls.Mean age was 70.7 years,ISS was 12.8 and GCS was 13.9.Main injuries were traumatic brain injury(37.4%)and thoracic injury(21.7%),and main reason for unplanned ICU admission was respiratory complication(39.4%).The 47.3%underwent a surgical procedure and 46.8%were intubated.Average timing for unplanned ICU admission was 2.9 days.Bounce backs occurred half as often as upgrades,however had higher rates of transfusions(63.8%vs 40.3%,P=0.002),consultations(4.8 vs 3.0,P<0.001),intubations(63.8%vs 38.1%%,P=0.001),longer ICU lengths of stay(13.2 days vs 6.4 days,P<0.001)and hospital lengths of stay(26.7 days vs 13.0 days,P<0.001).Mortality was 25.6%among unplanned ICU admissions,31.9%among geriatric unplanned ICU admissions and 11.9%among all trauma ICU patients.CONCLUSION Unplanned ICU admissions constituted 4.2%of total ICU admissions.Respiratory complications were the main cause of unplanned ICU admissions.Bounce backs occurred half as often as upgrades,but were associated with worse outcomes.
文摘Introduction and Problem Statement: Many medication errors occur during the community and hospital transition. Indeed, the World Health Organization launched the international “High 5S” project to implement medication reconciliation in healthcare facilities to reduce them and ensure patients a safe, high-quality healthcare pathway. Objective: This study aimed to detect medication errors by reconciling drug treatments and assess the relevance and feasibility of this standardized practice within the Medical Emergency Unit of the Teaching Pediatric Hospital of Ouagadougou (Burkina Faso). Methods: Patients whose parents gave their consent at their entrance were enrolled. For each patient, the pharmacy team completed a reconciliation form that included the patient’s usual treatment, which was taken and in progress and received upon admission to the medical emergency unit. Patients’ treatments were reviewed to detect and characterize discrepancies. The data of each form were reported and analyzed using KoboCollect, an Android application. Results: 135 records and 412 medication lines were captured over six weeks. The average time of treatment reconciliation per patient was 57 minutes. One thousand one hundred ninety-eight (1198) intentional discrepancies were detected, of which 6.09% were documented. Seventy-one (71) unintentional discrepancies were collected, including 39 omissions, 24 regimen dosing errors, and 8 pharmaceutical form dosage errors. Forty-nine (49) unintentional discrepancies, or 69.01%, were corrected by formulated pharmaceutical interventions toward physicians. Conclusion: Medical treatment reconciliation during hospital admission is critical because discrepancies can compromise the efficacy and/or safety of the patient’s hospital medication.
文摘Acute cholangitis(AC)is a heterogeneous disease with considerable variation in clinical presentation and high medical costs.Although the overall mortality rate is decreasing.However,the mortality in severe AC ranged from 10%-30%due to sepsis,multi-organ failure,and systemic inflammatory response syndrome.Assessing the predictors of poor outcomes,including mortality,intensive care unit(ICU)admission,and hospital stay,is vital for early and effective intervention.We assessed the predictors of mortality and ICU admission in patients with AC.We conducted a literature search in PubMed/MEDLINE,Google Scholar,and Cochrane Library for relevant articles.The keywords used were acute cholangitis,biliary cholangitis,predictors,mortality,ICU admission,and Hospital stay.In addition,we assessed the role of early vs late endoscopic retrograde cholangiopancreatography on the outcomes.Old age,end-organ failure,red cell distribution width to albumin ratio,neutrophil-to-lymphocyte ratio,platelet-lymphocyte ratio,the need for ventilator support,diabetes,electrolyte imbalance,procalcitonin-to-albumin ratio,C-reactive protein-to-albumin,Glasgow Coma Scale,and systolic hypertension are predictors of poor outcomes in AC of varying etiology,and concurrent acute pancreatitis was not associated with ICU admission.
文摘BACKGROUND Post-operative infection is a common and serious complication following drugeluting trans arterial chemo embolization(D-TACE)in patients with hepatocellular carcinoma(HCC),potentially compromising treatment efficacy and increasing morbidity.AIM To investigate the risk factors associated with post-operative infection in HCC patients undergoing D-TACE,and to provide evidence for clinical prevention and targeted intervention strategies.METHODS Clinical data of 77 primary HCC patients who underwent D-TACE in our hospital from January 2022 to December 2023 were retrospectively analyzed.Patient demographics,laboratory test results,tumor characteristics,and surgery-related parameters were collected.Univariate and multivariate logistic regression analyses were performed to identify risk factors for post-operative infection.RESULTS Post-operative infection occurred in 20 cases(25.97%)among the 77 patients.Univariate analysis showed that age≥65 years,Child-Pugh grade B,tumor diameter≥5 cm,operation time≥120 minutes,preoperative albumin<35 g/L,and comorbid diabetes were significantly associated with post-operative infection(P<0.05).Multivariate logistic regression analysis identified Child-Pugh grade B(OR=2.851,95%CI:1.426-5.698),operation time≥120 minutes(OR=2.367,95%CI:1.238-4.523),and preoperative albumin<35 g/L(OR=2.156,95%CI:1.147-4.052)as independent risk factors for post-operative infection.CONCLUSION Liver function status,operation time,and preoperative albumin level are significant factors affecting post-operative infection in HCC patients undergoing D-TACE.For high-risk patients,enhanced perioperative management,appropriate timing of surgery,and active improvement of nutritional status should be implemented to reduce the risk of post-operative infection.
基金funded by Research Fund of Zhejiang Provincial Health Commission (2025KY8662025)。
文摘Exertional heat stroke (EHS) is a life-threatening condition characterized by profound central nervous system (CNS)dysfunction and core temperature typically>40°C.^([1])This condition involves complex pathophysiological processes in which heat triggers a cascade of dysregulated inflammatory responses,endothelial dysfunction,coagulation abnormalities,and muscle damage.These processes can lead to multiorgan failure,significantly increasing the risk of mortality.^([2])Given the severity of EHS,early identification and timely intervention are crucial.However,there are no specific diagnostic markers for EHS,^([1])highlighting the need to identify reliable clinical parameters that can assist early decision-making.
基金supported by the National Nature Science Foundation of China(No.82370336&No.82330014)the Key Research and Development Plan of Heilongjiang Province(2022ZX06C23&JD2023SJ44)the Research Project of the First Affiliated Hospital of Harbin Medical University(No.2021M19).
文摘BACKGROUND Blood glucose and serum albumin have been associated with cardiovascular disease prognosis,but the impact of admission-blood-glucose-to-albumin ratio(AAR)on adverse outcomes in critical ill coronary artery disease(CAD)patients was not investigated.METHODS Patients diagnosed with CAD were non-consecutively selected from the MIMIC-IV database and categorized into quartiles based on their AAR.The primary outcome was 1-year mortality,and secondary endpoints were in-hospital mortality,acute kidney injury(AKI),and renal replacement therapy(RRT).A restricted cubic splines model and Cox proportional hazard models assessed the association between AAR and adverse outcomes in CAD patients.Kaplan-Meier survival analysis determined differences in endpoints across subgroups.RESULTS A total of 8360 patients were included.There were 726 patients(8.7%)died in the hospital and 1944 patients(23%)died at 1 year.The incidence of AKI and RRT was 63%and 4.3%,respectively.High AAR was markedly associated with in-hospital mortality(HR=1.587,P=0.003),1-year mortality(HR=1.502,P<0.001),AKI incidence(HR=1.579,P<0.001),and RRT(HR=1.640,P<0.016)in CAD patients in the completely adjusted Cox proportional hazard model.Kaplan-Meier survival analysis noted substantial differences in all endpoints based on AAR quartiles.Stratified analysis and interaction test demonstrated stable correlations between AAR and outcomes.CONCLUSIONS The results highlight that AAR may be a potential indicator for assessing in-hospital mortality,1-year mortality,and adverse renal prognosis in critical CAD patients.
文摘In this paper, a novel admission scheme is proposed which provides high degrees of quality of service (QoS) guarantees for multimedia traffic carried in mobile networks. The proposed scheme combines the admission control and bandwidth reservation to guarantee QoS requirements. It considers both local information and remote information to determine whether to accept or reject a connection. In order to embody the characteristics of the algorithms proposed in the article, two traditional algorithms of admission control are used for comparison. In the end of the paper the simulation analyses are given and the results show that the proposed algorithm can adjust the bandwidth according to the current status of networks and decrease the probability of connections forcibly dropped. The most important thing is that the algorithm is based on the multimedia communications and can guarantee the QoS of real time connections through decreasing the bandwidth of non real time connections.
文摘This study mainly uses the move and step analysis to conduct a contrastive genre analysis on the selected 20 Chinese ad-mission brochures(CABs) and 20 American admission brochures(AABs).Differences in moves,move sequences and step arrange-ments have revealed themselves in this comparison.Firstly,Chinese university admission brochures cast more focus on basic infor-mation about the university,the application procedure and admission criteria,while American universities,besides offering such in-formation,also emphasize the promotional function of the admission brochures.They use appealing and creative moves to commer-cially‘sell'advantages of the university to the potential applicants.Secondly,based on Kress & van Leeuwen's visual grammarsymbolic meaning,images and colors in admission brochures are also explored and analyzed as language.For one thing,after count-ing the frequency of the four categories of images,namely portrait,campus scenery,campus life pictures and graphs,it is foundthat,compared with CABs,AABs have a highly more obvious tendency in using images.The images are used as an effective tool toincrease the sense of credibility,identity-recognition,attract reader's attention,and help understanding,making the facts and in-formation more intuitive.For another thing,the main colors used in the brochures are yet another noticeable feature.Especially inAmerican brochures,universities tend to use their‘traditional colors' in the brochure to achieve a sense of consistency.Some Chi-nese brochures also follow this promotional strategy,yet a large percentage of them do not use any recognizable colors other thanthe printed black and white.Based on these differences,suggestions are put forward from perspectives including choice of movesand steps to improve the quality of CABs,hopefully raising their acceptance in the international level.
文摘BACKGROUND:The influence of surgical delay on mortality and morbidity has been studied extensively among elderly hip fracture patients.However,most studies only focus on the timing of surgery when patients have already been hospitalized,without considering pre-admission waiting time.Therefore,the present study aims to explore the infl uence of admission delay on surgical outcomes.METHODS:In this retrospective study,we recorded admission timing and interval from admission to surgery for included patient.Other covariates were also collected to control confounding.The primary outcome was 1-year mortality.The secondary outcomes were 1-month mortality,3-month mortality,ICU admission and postoperative pneumonia.We mainly used multivariate logistic regression to determine the effect of admission timing on postoperative outcomes.An additional survival analysis was also performed to assess the impact of admission delay on survival status in the fi rst year after operation.RESULTS:The proportion of patients hospitalized on day 0,day 1,day 2 after injury was 25.4%,54.7%and 66.3%,respectively.And 12.6%patients visited hospital one week later after injury.Mean time from admission to surgery was 5.2 days(standard deviation 2.8 days).Hospitalization at one week after injury was a risk factor for 1-year mortality(OR 1.762,95%CI 1.026–3.379,P=0.041).CONCLUSION:Admission delay of more than one week is signifi cantly associated with higher 1-year mortality.As a supplement to the current guidelines which emphasizes early surgery after admission,we also advocate early admission once patients get injured.
基金supported by the Gong-Yi Program of China Meteorological Administration(GYHY201106034)the Fundamental Research Funds for the Central Universities(lzuibky-2013-m03)+2 种基金National Natural Science Foundation of China(41075103)National Natural Science Foundation of China(41075102)National Natural Science Foundation of China(41305105)
文摘Objective To investigate the association between ambient air pollution and hospital emergency admissions in Beijing. Methods In this study, a semi-parametric generalized additive model （GAM） was used to evaluate the specific influences of air pollutants （PM10, SO2, and NO2） on hospital emergency admissions with different lag structures from 2009 to 2011, the sex and age specific influences of air pollution and the modifying effect of seasons on air pollution to analyze the possible interaction. Results It was found that a 10μg/m3 increase in concentration of PMlo at lag 03 day, SO2 and NO2 at lag 0 day were associated with an increase of 0.88%, 0.76%, and 1.82% respectively in overall emergency admissions. A 10 lag/m3 increase in concentration of PM10, SO2 and NO2 at lag 5 day were associated with an increase of 1.39%, 1.56%, and 1.18% respectively in cardiovascular disease emergency admissions. For lag 02, a 10 μg/m3 increase in concentration of PM10, SO2 and NO2 were associated with 1.72%, 1.34%, and 2.57% increases respectively in respiratory disease emergency admissions. Conclusion This study further confirmed that short-term exposure to ambient air pollution was associated with increased risk of hospital emergency admissions in Beijing.
基金funded by the National Basic Research Program (973 program) of China (2011CB503802)Gong‐Yi Program of China Ministry of Environmental Protection (200809109)+3 种基金National Natural Science Foundation of China (30800892)Shanghai Pu Jiang Program (09PJ1401700)Program for New Century Excellent Talents in University (NCET‐09‐0314)and National High Technology Research and Development Program of China (863 Program) (2007AA06Z409)
文摘Objective The study is to investigate the associations between visibility, major air pollutants and daily counts of hospital admission in Shanghai, China. Methods Daily data on hospital admission, visibility, and air pollution during 2005‐2008 were obtained from the Shanghai Insurance Bureau （SHIB）, Shanghai Meteorological Bureau, and Shanghai Environmental Monitoring Center, respectively. The generalized additive model （GAM） with penalized splines was used to examine the associations between daily visibility and hospital admission. Results Among various pollutants, PM 2.5 showed strongest correlation with visibility. Decreased visibility was significantly associated with increased risk of hospital admission in Shanghai. An inter‐quartile range decrease in the 2‐day （L01） moving average of visibility corresponded to 3.66% （95%CI： 1.02%, 6.31%）, 4.06% （95%CI： 0.84%, 7.27%）, and 4.32% （95%CI： 1.67%, 6.97%） increase of total, cardiovascular, and respiratory hospitalizations, respectively. Conclusion Our analyses provide the first piece of evidence in China, demonstrating that decreased visibility has an effect on hospital admission, and this finding strengthens the rationale for further limiting air pollution levels in Shanghai.
文摘Objective Post-operative cognitive dysfunction(POCD)and post-operative delirium(POD)are two common post-operative cerebral complications.The current meta-analysis was to systematically review the effects of penehyclidine hydrochloride(PHC)on POCD and POD in surgical patients.Methods Electronic databases were searched to identify all randomized controlled trials comparing PHC with atropine/scopolamine/placebo on POCD and POD in surgical patients.Primary outcomes of interest included the incidences of POCD and POD;the secondary outcomes of interest included peri-operative minimental state examination(MMSE)scores.Two authors independently extracted peri-operative data,including patients'baseline characteristics,surgical variables,and outcome data.For dichotomous data(POCD and POD occurrence),treatment effects were calculated as odds ratio(OR)and 95%confidential interval(Cl).Each outcome was tested for heterogeneity,and randomized-effects or fixed-effects model was used in the presence or absence of significant heterogeneity.For continuous variables(MMSE scores),treatment effects were calculated as weighted mean difference(WMD)and 95%CI.Statistical significance was defined as P<0.05.Results Our search yielded 33 studies including 4017 patients.Meta-analysis showed that,the incidence of POCD in PHC group was comparable to that in saline group(OR=0.97;95%Ck 0.S8-1.64;P=0.92),scopolamine group(OR=0.78;95%CI:0.48-1.27;P=0.32)and atropine group(0R=1.20;95%Ch 0.86-1.67;P=0.29).The incidence of POD in PHC group was comparable to that in saline group(OR=1.53;95%CI:0.81-2.90;P=0.19)and scopolamine group(OR=0.53;95%CI:0.06-4.56;P=0.56),but higher than that in atropine group(OR=4.49;95%CI:1.34-15.01;P=0.01).Conclusions PHC premedication was not associated with increased incidences of POCD or POD as compared to either scopolamine or placebo.
文摘The turbine in an LH2/LOX rocket engine is designed as a two-stage supersonic partialadmission turbine. Three-dimensional steady and unsteady simulations were conducted to analyze turbine performance and aerodynamic forces on rotor blades. Different configurations were employed to investigate the effects of the axial gap and nozzle distribution on the predicted performance and aerodynamic forces. Rotor blades experience unsteady aerodynamic forces because of the partial admission. Aerodynamic forces show periodicity in the admission region, and are close to zero after leaving the admission region. The unsteady forces in frequency domain indicate that components exist in a wide frequency region, and the admission passing frequency is dominant.Those multiples of the rotational frequency which are multiples of the nozzle number in a fulladmission turbine are notable components. Results show that the turbine efficiency decreases as the axial gap between nozzles and the 1 st stage rotor（rotor 1） increases. Fluctuation of the circumferential aerodynamic force on rotor 1 blades decreases with the axial gap increasing. The turbine efficiency decreases as the circumferential spacing between nozzles increases. Fluctuations of the circumferential and axial aerodynamic forces increase as the circumferential spacing increases. As for the non-equidistant nozzle distribution, it produces similar turbine performance and amplitudefrequency characteristics of forces to those of the normal configuration, when the mean spacing is equal to that of the normal case.
基金National Natural Science Foundation of China (60879024)
文摘Avionics full duplex switched ethernet（AFDX） is a switched interconnection technology developed to provide reliable data exchange with strong data transmission time guarantees in internal communication of the spacecraft or aircraft.Virtual link（VL） is an important concept of AFDX to meet quality of service（QoS） requirements in terms of end-to-end message deadlines.A VL admission control algorithm in AFDX network under hard real-time（HRT） constraints is studied.Based on the scheduling prin-ciple of AFDX protocol,a packet scheduling scheme under HRT constraints is proposed,and after that an efficient VL admission control algorithm is presented.Analytical proof that the algorithm can effectively determine whether VL should be admitted is given.Finally simulative examples are presented to promote the conclusion.
文摘Propose a new degradation call admission control（DCAC）scheme, which can be used in wideband code division multiple access communication system. So-called degradation is that non-real time call has the characteristic of variable bit rate, so decreasing its bit rate can reduce the load of the system, consequently the system can admit new call which should be blocked when the system is close to full load, therefore new call＇s access probability increases. This paper brings forward design project and does system simulation, simulation proves that DCAC can effectively decrease calls＇ blocking probability and increase the total number of the on-line users.
基金Project supported by the Shandong Science and Technology Development Project(No.2011YD18070),China
文摘Objective： To investigate the relationship between post-operative cognitive dysfunction（POCD） and regional cerebral oxygen saturation（rSO2） and β-amyloid protein（Aβ） in patients undergoing laparoscopic pancreaticoduodenectomy. Methods： Fifty patients undergoing elective laparoscopic pancreaticoduodenectomy received five groups of neuropsychological tests 1 d pre-operatively and 7 d post-operatively, with continuous monitoring of rSO2 intra-operatively. Before anesthesia induction（t0）, at the beginning of laparoscopy（t1）, and at the time of pneumoperitoneum 120 min（t2）, pneumoperitoneum 240 min（t3）, pneumoperitoneum 480 min（t4）, the end of pneumoperitoneum（t5）, and 24 h after surgery, jugular venous blood was drawn respectively for the measurement of Aβ by enzyme-linked immunosorbent assay（ELISA）. Results： Twenty-one cases of the fifty patients suffered from POCD after operation. We found that the maximum percentage drop in rSO2（rSO2, %max） was significantly higher in the POCD group than in the non-POCD group. The rSO2, %max value of over 10.2% might be a potential predictor of neurocognitive injury for those patients. In the POCD group, the plasma Aβ levels after 24 h were significantly higher than those of pre-operative values（P〈0.01）. After 24 h, levels of plasma Aβ in the POCD group were significantly higher than those in the non-POCD group（P〈0.01）. Conclusions： The development of POCD in patients undergoing laparoscopic pancreaticoduodenectomy is associated with alterations of rSO2 and Aβ. Monitoring of rSO2 might be useful in the prediction of POCD, and Aβ might be used as a sensitive biochemical marker to predict the occurrence of POCD.
基金supported by the National Natural Science Foundation of China (7070102571071105)+2 种基金the Program for New Century Excellent Talents in Universities of China (NCET-08-0396)the National Science Fund for Distinguished Young Scholars of China (70925005)the Program for Changjiang Scholars and Innovative Research Team in University (IRT/028)
文摘Power efficiency and link reliability are of great impor- tance in hierarchical wireless sensor networks （HWSNs）, espe- cially at the key level, which consists of sensor nodes located only one hop away from the sink node called OHS. The power and admission control problem in HWSNs is comsidered to improve its power efficiency and link reliability. This problem is modeled as a non-cooperative game in which the active OHSs are con- sidered as players. By applying a double-pricing scheme in the definition of OHSs＇ utility function, a Nash Equilibrium solution with network properties is derived. Besides, a distributed algorithm is also proposed to show the dynamic processes to achieve Nash Equilibrium. Finally, the simulation results demonstrate the effec- tiveness of the proposed algorithm.
基金supported in part by the Project of National Natural Science Foundation of China (61301110)Project of Shanghai Key Laboratory of Intelligent Information Processing, China [grant number IIPL-2014-005]+1 种基金the Project funded by the Priority Academic Program Development of Jiangsu Higher Education Institutionsthe Project of Jiangsu Overseas Research & Training Program for University Prominent Young & Middle-Aged Teachers and Presidents
文摘As device-to-device(D2D) communications usually reuses the resource of cellular networks, call admission control(CAC) and power control are crucial problems. However in most power control schemes, total data rates or throughput are regarded as optimization criterion. In this paper, a combining call admission control(CAC) and power control scheme under guaranteeing QoS of every user equipment(UE) is proposed. First, a simple CAC scheme is introduced. Then based on the CAC scheme, a combining call admission control and power control scheme is proposed. Next, the performance of the proposed scheme is evaluated. Finally, maximum DUE pair number and average transmitting power is calculated. Simulation results show that D2 D communications with the proposed combining call admission control and power control scheme can effectively improve the maximum DUE pair number under the premise of meeting necessary QoS.
文摘OBJECTIVE:Admission hyperglycemia in acute myocardial infarction (MI) is related with increased in-hospital and long term mortality and major cardiac adverse events。 We aimed to investigate how admission hyperglycemia affects the short and long term outcomes in elderly patients >65 years) after primary percutaneous coronary intervention for ST elevation myocardial infarction。 METHODS:We retrospectively analyzed 677 consecutive elderly patients (mean age 72.2 ±5.4)。 Patients were divided into two groups according to admission blood glucose levels。 Group : low glucose group (LLG), glucose < 168 mg/dL; and Group 2: high glucose group (HGG), glucose >168 mg/dL。 RESULTS:In-hospital, long term mortality and in-hospital major adverse cardiac events were higher in the high admission blood glucose group (P <0.001)。 Multivariate regression analysis showed: Killip > 1, post-thrombolysis in MI <3 and admission blood glucose levels were independent predictors of in-hospital adverse cardiac events (P <0.001)。 CONCLUSIONS:Admission hyperglycemia in elderly patients presented with ST elevation myocardial infarction is an independent predictor of in-hospital major adverse cardiac events and is associated with in-hospital and long term mortality。
