A simple control method to suppress traffic congestion is proposed for the car-following model.The stability conditions are derived by using the control method,and the feedback signals,which act on our traffic system,...A simple control method to suppress traffic congestion is proposed for the car-following model.The stability conditions are derived by using the control method,and the feedback signals,which act on our traffic system,are extended to the car-following model.The control signals will play an effect only if the traffic is congested.The corresponding numerical simulation results agree well with our theoretical analysis,and our control method can successfully suppress traffic jams.展开更多
目的探讨急救系统风险预测模型(development and validation of risk-adjusted outcomes for systems of emergency medical care,DAVROS)和改良早期预警评分(modified early warning score,MEWS)对急诊危重患者短期病死率的预测价值,...目的探讨急救系统风险预测模型(development and validation of risk-adjusted outcomes for systems of emergency medical care,DAVROS)和改良早期预警评分(modified early warning score,MEWS)对急诊危重患者短期病死率的预测价值,并进行比较研究.方法对急诊抢救室1143例危重患者进行DAVROS评分和MEWS评分,以入抢救室后7日病死率作为研究终点,比较两种评分模型预测患者短期死亡风险的准确性.结果入抢救室患者中,循环系统疾病占比为35.3%,7日内实际病死率为15.5%.生存组和死亡组患者主要病理生理学数据间差异有统计学意义.死亡组DAVROS评分[3.39(0.94~10.79)vs.0.58(0.24~1.41)]、MEWS评分[4.00(3.00~6.00)vs.2.00(1.00~4.00)]和DAVROS评分预测患者7日病死率77.2%[(48.9%~91.5%)vs.36.7%(19.4%~58.4%)]高于生存组,差异均有统计学意义(P<0.001).DAVROS评分和MEWS评分预测患者短期死亡风险的ROC曲线下面积分别为0.774(95%CI0.736~0.812)和0.723(95%CI0.683~0.763),两者差异有统计学意义(Z=2.591,P=0.0096).结论DAVROS评分用于预测急诊危重患者短期病死率的准确性优于MEWS评分,两者联合预测急诊患者死亡风险的准确性尚需进一步研究证实.展开更多
Based on the optimal velocity(OV)model,a new car-following model for traffic flow with the consideration of the driver's forecast effect(DFE)was proposed by Tang et al.,which can be used to describe some complex t...Based on the optimal velocity(OV)model,a new car-following model for traffic flow with the consideration of the driver's forecast effect(DFE)was proposed by Tang et al.,which can be used to describe some complex traffic phenomena better.Using an asymptotic approximation between the headway and density,we obtain a new macro continuum version of the car-following model with the DFE.The linear stability theory is applied to derive the neutral stability condition.The Korteweg–de Vries equation near the neutral stability line is given by nonlinear analysis and the corresponding solution for the traffic density wave is derived.展开更多
目的住院肿瘤患者由于放化疗及其疾病等原因成为跌倒的高危人群。本研究分析住院肿瘤患者跌倒状况,探讨影响住院肿瘤患者发生跌倒的危险因素,为临床准确筛查高危跌倒肿瘤患者提供依据。方法检索2014-03-31-2016-07-12在山东省肿瘤医院...目的住院肿瘤患者由于放化疗及其疾病等原因成为跌倒的高危人群。本研究分析住院肿瘤患者跌倒状况,探讨影响住院肿瘤患者发生跌倒的危险因素,为临床准确筛查高危跌倒肿瘤患者提供依据。方法检索2014-03-31-2016-07-12在山东省肿瘤医院信息管理系统(hospital information system,HIS)中医疗不良事件上报的跌倒患者,共检索出142例发生跌倒的患者,根据患者住院号在医院病案系统内检索患者信息。分析住院肿瘤跌倒患者的跌倒状况及影响因素。结果 142例跌倒患者中,男81例(57.0%),女61例(43.0%);≥60岁75例,<60岁67例。单因素分析结果表明,年龄(χ~2=7.953,P=0.048)、自理能力(P=0.046)、既往病史(χ~2=4.182,P=0.041)、脑血管病史(χ~2=9.837,P=0.002)、肿瘤有无转移(χ~2=4.401,P=0.036)、是否多发转移(χ~2=3.957,P=0.047)、骨转移(χ~2=4.263,P=0.038)、治疗方式(P=0.039)、镇静阿片类止痛或利尿药使用(χ~2=4.152,P=0.041),以及血常规检查是否正常(χ~2=10.369,P=0.001)是跌倒伤害程度的影响因素;非条件多因素Logistic回归分析结果显示,血常规异常(OR=3.167,95%CI为1.143～9.537,P=0.003)、肿瘤转移(OR=1.720,95%CI为0.386～6.015,P=0.005)和年龄≥60岁(OR=1.591,95%CI为0.191～5.422,P=0.030)是影响患者跌倒伤害的危险因素。结论对住院肿瘤患者的跌倒管理有待提高,在护理过程中要加强对年龄、肿瘤转移、血常规异常的关注,制定具有针对性的护理措施,减少不良事件的发生,提高护理质量。展开更多
Background Pulmonary embolism （PE） is rare and seldom considered in adolescent patients; however it occurs with a greater frequency than is generally recognized, and it is a potentially fatal condition. The aim of t...Background Pulmonary embolism （PE） is rare and seldom considered in adolescent patients; however it occurs with a greater frequency than is generally recognized, and it is a potentially fatal condition. The aim of the current study was to understand its epidemiology, clinical features and the cause of delay of its diagnosis in adolescents. Methods A retrospective analysis of nine adolescents with acute PE admitted to the Peking University Third Hospital over the past 16-year period was performed. The epidemiology, clinical features and risk factors of the adolescents were described and compared with those of adults and elderly patients. The time to diagnosis and misdiagnosed diseases were analyzed. Pretest probability of PE was assessed retrospectively by the Wells score and revised Geneva score. Results The incidence of PE was 43.6 per 100 000 hospitalized adolescents in our hospital. The incidence of PE in adolescents was much lower than that in adults and PE is diagnosed in about 1/50 of elderly people. The clinical features in adolescents were similar to those in adults. But fever and chest pain were more common in adolescents （P〈0.05）. The major risk factors included surgery, systemic lupus erythematosus （SLE）, thrombocytopenia, long-term oral glucocorticoids and trauma. The mean diagnostic time was （7.8±8.4） days. Six cases had a delayed diagnosis. The mean delay time from symptom onset to diagnosis was （11.0±8.8） days. The time of presentation to diagnosis in patients initially admitted to the emergency department was less than one day, and was much shorter than the time in outpatients, （9.4±7.5） days. Most of the patients were initially misdiagnosed with a respiratory tract infection. Most patients＇ values of Wells score or revised Geneva score were in the moderate or high clinical probability categories; 88% by Well score vs. 100% by revised Geneva score. Conclusions PE was seldom considered in the adolescent patients by physicians, especially outpatient physicians, so the diagnosis was often delayed. If adolescent patients complain of dyspnea or chest pain or syncope with/without fever, and they had risk factors such as surgery, thrombocytopenia and trauma, PE should be considered and included in the differential diagnosis.展开更多
基金Supported by the National Basic Research Program of China under Grant No 2012CB725404the National Natural Sci-ence Foundation of China under Grant No 11072117+3 种基金the Scientific Research Fund of Zhejiang Provincial Education Department(Nos Z201119278 and Y201016044)the Natural Science Foundation of Ningbo(2011A610170)the K.C.Wong Magna Fund in Ningbo Universitythe Research Grant Council,Government of the Hong Kong Administrative Region,China under Grant No CityU118708.
文摘A simple control method to suppress traffic congestion is proposed for the car-following model.The stability conditions are derived by using the control method,and the feedback signals,which act on our traffic system,are extended to the car-following model.The control signals will play an effect only if the traffic is congested.The corresponding numerical simulation results agree well with our theoretical analysis,and our control method can successfully suppress traffic jams.
文摘目的探讨急救系统风险预测模型(development and validation of risk-adjusted outcomes for systems of emergency medical care,DAVROS)和改良早期预警评分(modified early warning score,MEWS)对急诊危重患者短期病死率的预测价值,并进行比较研究.方法对急诊抢救室1143例危重患者进行DAVROS评分和MEWS评分,以入抢救室后7日病死率作为研究终点,比较两种评分模型预测患者短期死亡风险的准确性.结果入抢救室患者中,循环系统疾病占比为35.3%,7日内实际病死率为15.5%.生存组和死亡组患者主要病理生理学数据间差异有统计学意义.死亡组DAVROS评分[3.39(0.94~10.79)vs.0.58(0.24~1.41)]、MEWS评分[4.00(3.00~6.00)vs.2.00(1.00~4.00)]和DAVROS评分预测患者7日病死率77.2%[(48.9%~91.5%)vs.36.7%(19.4%~58.4%)]高于生存组,差异均有统计学意义(P<0.001).DAVROS评分和MEWS评分预测患者短期死亡风险的ROC曲线下面积分别为0.774(95%CI0.736~0.812)和0.723(95%CI0.683~0.763),两者差异有统计学意义(Z=2.591,P=0.0096).结论DAVROS评分用于预测急诊危重患者短期病死率的准确性优于MEWS评分,两者联合预测急诊患者死亡风险的准确性尚需进一步研究证实.
基金by the National Natural Science Foundation of China under Grant Nos 11072117,10802042 and 60904068the Natural Science Foundation of Zhejiang Province under Grant Nos Y6110007 and Y6110502+1 种基金the K.C.Wong Magna Fund in Ningbo Universitythe Research Grant Council,Government of the Hong Kong Administrative Region,China,under Grant No CityU118708.
文摘Based on the optimal velocity(OV)model,a new car-following model for traffic flow with the consideration of the driver's forecast effect(DFE)was proposed by Tang et al.,which can be used to describe some complex traffic phenomena better.Using an asymptotic approximation between the headway and density,we obtain a new macro continuum version of the car-following model with the DFE.The linear stability theory is applied to derive the neutral stability condition.The Korteweg–de Vries equation near the neutral stability line is given by nonlinear analysis and the corresponding solution for the traffic density wave is derived.
文摘目的住院肿瘤患者由于放化疗及其疾病等原因成为跌倒的高危人群。本研究分析住院肿瘤患者跌倒状况,探讨影响住院肿瘤患者发生跌倒的危险因素,为临床准确筛查高危跌倒肿瘤患者提供依据。方法检索2014-03-31-2016-07-12在山东省肿瘤医院信息管理系统(hospital information system,HIS)中医疗不良事件上报的跌倒患者,共检索出142例发生跌倒的患者,根据患者住院号在医院病案系统内检索患者信息。分析住院肿瘤跌倒患者的跌倒状况及影响因素。结果 142例跌倒患者中,男81例(57.0%),女61例(43.0%);≥60岁75例,<60岁67例。单因素分析结果表明,年龄(χ~2=7.953,P=0.048)、自理能力(P=0.046)、既往病史(χ~2=4.182,P=0.041)、脑血管病史(χ~2=9.837,P=0.002)、肿瘤有无转移(χ~2=4.401,P=0.036)、是否多发转移(χ~2=3.957,P=0.047)、骨转移(χ~2=4.263,P=0.038)、治疗方式(P=0.039)、镇静阿片类止痛或利尿药使用(χ~2=4.152,P=0.041),以及血常规检查是否正常(χ~2=10.369,P=0.001)是跌倒伤害程度的影响因素;非条件多因素Logistic回归分析结果显示,血常规异常(OR=3.167,95%CI为1.143～9.537,P=0.003)、肿瘤转移(OR=1.720,95%CI为0.386～6.015,P=0.005)和年龄≥60岁(OR=1.591,95%CI为0.191～5.422,P=0.030)是影响患者跌倒伤害的危险因素。结论对住院肿瘤患者的跌倒管理有待提高,在护理过程中要加强对年龄、肿瘤转移、血常规异常的关注,制定具有针对性的护理措施,减少不良事件的发生,提高护理质量。
文摘Background Pulmonary embolism （PE） is rare and seldom considered in adolescent patients; however it occurs with a greater frequency than is generally recognized, and it is a potentially fatal condition. The aim of the current study was to understand its epidemiology, clinical features and the cause of delay of its diagnosis in adolescents. Methods A retrospective analysis of nine adolescents with acute PE admitted to the Peking University Third Hospital over the past 16-year period was performed. The epidemiology, clinical features and risk factors of the adolescents were described and compared with those of adults and elderly patients. The time to diagnosis and misdiagnosed diseases were analyzed. Pretest probability of PE was assessed retrospectively by the Wells score and revised Geneva score. Results The incidence of PE was 43.6 per 100 000 hospitalized adolescents in our hospital. The incidence of PE in adolescents was much lower than that in adults and PE is diagnosed in about 1/50 of elderly people. The clinical features in adolescents were similar to those in adults. But fever and chest pain were more common in adolescents （P〈0.05）. The major risk factors included surgery, systemic lupus erythematosus （SLE）, thrombocytopenia, long-term oral glucocorticoids and trauma. The mean diagnostic time was （7.8±8.4） days. Six cases had a delayed diagnosis. The mean delay time from symptom onset to diagnosis was （11.0±8.8） days. The time of presentation to diagnosis in patients initially admitted to the emergency department was less than one day, and was much shorter than the time in outpatients, （9.4±7.5） days. Most of the patients were initially misdiagnosed with a respiratory tract infection. Most patients＇ values of Wells score or revised Geneva score were in the moderate or high clinical probability categories; 88% by Well score vs. 100% by revised Geneva score. Conclusions PE was seldom considered in the adolescent patients by physicians, especially outpatient physicians, so the diagnosis was often delayed. If adolescent patients complain of dyspnea or chest pain or syncope with/without fever, and they had risk factors such as surgery, thrombocytopenia and trauma, PE should be considered and included in the differential diagnosis.
