Relationships of hospitalization outcomes and timing to endoscopy in non-variceal upper gastrointestinal bleeding:A nationwide analysis

BACKGROUND The optimal timing of esophagogastroduodenoscopy(EGD)and the impact of clinico-demographic factors on hospitalization outcomes in non-variceal upper gastrointestinal bleeding(NVUGIB)remains an area of active research.AIM To identify independent predictors of outcomes in patients with NVUGIB,with a particular focus on EGD timing,anticoagulation(AC)status,and demographic features.METHODS A retrospective analysis of adult patients with NVUGIB from 2009 to 2014 was performed using validated ICD-9 codes from the National Inpatient Sample database.Patients were stratified by EGD timing relative to hospital admission(≤24 h,24-48 h,48-72 h,and>72 h)and then by AC status(yes/no).The primary outcome was all-cause inpatient mortality.Secondary outcomes included healthcare usage.RESULTS Of the 1082516 patients admitted for NVUGIB,553186(51.1%)underwent EGD.The mean time to EGD was 52.8 h.Early(<24 h from admission)EGD was associated with significantly decreased mortality,less frequent intensive care unit admission,shorter length of hospital stays,lower hospital costs,and an increased likelihood of discharge to home(all with P<0.001).AC status was not associated with mortality among patients who underwent early EGD(aOR 0.88,P=0.193).Male sex(OR 1.30)and Hispanic(OR 1.10)or Asian(aOR 1.38)race were also independent predictors of adverse hospitalization outcomes in NVUGIB.CONCLUSION Based on this large,nationwide study,early EGD in NVUGIB is associated with lower mortality and decreased healthcare usage,irrespective of AC status.These findings may help guide clinical management and would benefit from prospective validation.

Magnetic Applications to Subsurface and Groundwater Investigations: A Case Study from Wadi El Assiuti, Egypt

Wadi El Assiuti represents a promising area for agricultural development and building new communities far from the overpopulated areas in the Nile Val-ley. An integrated approach of satellite-based data and geophysical data with borehole data was used for defining the area of interest, the sediment thick-ness, delineating the subsurface structures, and mapping the depth to the basement rocks, and defining the groundwater aquifers. Findings are: 1) Dramatic changes are detected in the anthropogenic activities at the entrance area of the wadi, making stress and heavy exploitation of the groundwater resources. However, the central and northeastern regions show no development;2) Several structural trends in the directions of NNW, NW, NE, and E-W are cutting the basement rocks and sedimentary cover;3) The depth to the basement rocks is increasing eastward from ~2.24 km to ~4.84 km;4) Three groundwater-bearing reservoirs are represented by the shallow Qua-ternary, the fractured limestone, and the deep Nubian sandstone aquifers;5) The deep-seated faults are affecting the area and rising groundwater from the deeper Nubian aquifer along its sub-vertical trend;and 6) The results are in-formative and used to define the suitable sites for water well drilling.

Modelling and Simulation of an Ohmic Heating Process

Ohmic Heating (OH) is one of the emerging thermal technologies used in food processing which can produce rapid and uniform heating with close to 100% energy transfer efficiency. Although mathematical modelling for OH processes has been studied by many researchers in recent years, systematic simulations of OH have not been developed for model-based control of the processes. In this paper, mathematical model for a Colinear Ohmic Heater is presented, analyzed, and studied based on the selected configuration. A numerical solution for the mathematical equations has been defined and proposed. MATLAB/Simulink model is hence developed and validated against the available data. Simulation results have shown that MATLAB/Simulink model can produce robust outputs at low computational costs with an accuracy of up to 99.6% in comparison to the analytical solution. This model can be used in further studies for analysis of the OH processes and development of advanced controllers.

Towards a standardisation for digital inputs and outputs of protection functions in IEC 60255 series

Fully digitalized substations using IEC 61850 process bus are being introduced all over the world.Numerous utilities have featured pilot projects,demonstrators or even industrial scale deployment of these Fully Digital Protection,Auto-mation and Control Systems(FD-PACS).Product standards such as profiles for Instrument Transformers have been developed and published(IEC 61869-6 and IEC 61869-9 by TC 38-Instrument Transformers).This raises the question about the standards for digitally interfaced protection functions.In 2016,IEC TC 95(Measuring relays and protection equipment)charged a working group to investigate this subject and to elaborate recommendations concerning requirements and testing of protection IED with digital inputs and outputs for protection standards(IEC 60255-1xx series).For protection functions,publisher/subscriber based data streams are supposed to comply with IEC 61850 and IEC 61869 standards.This holds in particular for Sampled Values(SV)representing energising inputs of the protection function,and is also applicable to Generic Object Oriented Substation Event(GOOSE)which can be used for input or output of protection functions.Quality attributes of published data depend on the operational and connection status of the function and the hosting IED.In addition,protection functions have to take into account the information regarding the time synchronisation of the received SV and other parameters.This paper gives an overview of these features and the proposed way to take them into account in the IEC 60255 standard series.It describes the progress of WG 2 and relates it to existing standardization documents.