Portal vein pulsatility:An important sonographic tool assessment of systemic congestion for critical ill patients

In this editorial we comment on the article by Kuwahara et al,published in the recent issue of the World Journal of Cardiology.In this interesting paper,the authors showed a correlation between portal vein pulsatility ratio,examined by bedside ultrasonography,and prognosis of hospitalized patients with acute heart failure.Systemic congestion is being notoriously underdetected in the acutely ill population with conventional methods like clinical examination,biomarkers,central venous pressure estimation and X-rays.However,congestion should be a key therapeutic target due to its deleterious effects to end organ function and subsequently patient prognosis.Doppler flow assessment of the abdominal veins is gaining popularity worldwide,as a valuable tool in estimating comprehensively congestion and giving a further insight into hemodynamics and patient management.

Smart Parking Management System “MOTAH”

With a surge in the university’s student and staff population, parking problems and congestion have rapidly intensified. The recent inclusion of women drivers, particularly during official working hours, has exacerbated these challenges. This pressing issue underscores the critical necessity for a structured approach to managing university entries and overseeing parking at the gates. The proposed smart parking management system aims to address these concerns by introducing a design concept that restricts unauthorized access and provides exclusive parking privileges to authorized users. Through image processing, the system identifies available parking spaces, relaying real-time information to users via a mobile application. This comprehensive solution also generates detailed reports (daily, weekly, and monthly), aiding university safety authorities in future gate management decisions.

A Study on How Urban Rail Operators Can Secure New Growth Engines for the Future Approach: The Case of Underground Urban Logistics System

Seoul Metro is Seoul’s leading metro company, transporting up to 3 billion people annually. However, future ridership is expected to plummet due to an aging and shrinking population with one of the fastest declining total fertility rates in the world. The COVID-19 pandemic in 2019 accelerated this phenomenon. On the contrary, the e-commerce and home delivery industries have developed significantly since COVID-19. Seoul’s current logistics infrastructure cannot handle it. Under the inflection point of declining passenger transportation demand and increasing urban logistics demand, urban rail operators need new growth engines. Therefore, it is necessary to consider the introduction of an UULS (underground urban logistics system) that transports parcels instead of passengers through urban railways. If the UULS becomes a reality, it can be expected to secure scarce logistics land in cities, protect the environment and prevent traffic congestion by operating eco-friendly mass urban transportation, and acquire new revenue sources for urban rail operators. The UULS’s B/C ratio is 1.32. The sensitivity analysis shows that the ratio is above 1 in most cases where the unit cost of transportation is not significantly reduced.

Impact of erythropoietin therapy on cardiorenal syndrome:A systematic review with meta-analysis

BACKGROUND Heart and kidney dysfunction frequently coexist in patients with acute heart failure due to the overlap between these two organ systems.Cardiorenal syndrome(CRS)results from pathology occurring in the heart and kidneys along with the consequences of dysfunction in one organ contributing to dysfunction in the other and vice versa.AIM To evaluate the use of erythropoietin(EPO)in patients with CRS and its effects on hemoglobin(Hb),major cardiovascular(CV)events,and hospitalization rates.METHODS On February 24,2022,searches were conducted using PubMed,MEDLINE,and EMBASE,and 148 articles were identified.A total of nine studies were considered in this systematic review.We assessed the included articles based on the National Heart,Lung,and Blood Institute quality assessment tools for controlled intervention and observational cohort or cross-sectional studies.An assessment of bias risk was conducted on the chosen studies,and data relevant to our review was extracted.RESULTS The systematic review of these studies concluded that most existing literature indicates that EPO improves baseline Hb levels and decreases myocardial remodeling and left ventricular dysfunction without reducing CV mortality.In addition,the effect of EPO on the hospitalization rate of patients with CRS needs to be further studied since this relationship is unknown.Future studies,such as randomized controlled clinical trials and prospective cohort studies,should be conducted to enhance the literature on the potential of EPO therapy in patients with CRS.CONCLUSION Our systematic review suggests that EPO therapy may have a significant role in managing CRS.The review highlights the potential benefits of EPO in improving baseline Hb levels,reducing the risk of major CV events,improving cardiac remodeling,myocardial function,New York Heart Association class,and B-type natriuretic peptide levels.However,the effect of EPO treatment on hospitalization remains unclear and needs further exploration.

An Intelligent Adaptive Dynamic Algorithm for a Smart Traffic System

Due to excessive car usage,pollution and traffic have increased.In urban cities in Saudi Arabia,such as Riyadh and Jeddah,drivers and air quality suffer from traffic congestion.Although the government has implemented numerous solutions to resolve this issue or reduce its effect on the environment and residents,it still exists and is getting worse.This paper proposes an intelligent,adaptive,practical,and feasible deep learning method for intelligent traffic control.It uses an Internet of Things(IoT)sensor,a camera,and a Convolutional Neural Network(CNN)tool to control traffic in real time.An image segmentation algorithm analyzes inputs from the cameras installed in designated areas.This study considered whether CNNs and IoT technologies could ensure smooth traffic flow in high-speed,high-congestion situations.The presented algorithm calculates traffic density and cars’speeds to determine which lane gets high priority first.A real case study has been conducted on MATLAB to verify and validate the results of this approach.This algorithm estimates the reduced average waiting time during the red light and the suggested time for the green and red lights.An assessment between some literature works and the presented algorithm is also provided.In contrast to traditional traffic management methods,this intelligent and adaptive algorithm reduces traffic congestion,automobile waiting times,and accidents.

Hybrid Algorithm-Driven Smart Logistics Optimization in IoT-Based Cyber-Physical Systems

Effectively managing complex logistics data is essential for development sustainability and growth,especially in optimizing distribution routes.This article addresses the limitations of current logistics path optimization methods,such as inefficiencies and high operational costs.To overcome these drawbacks,we introduce the Hybrid Firefly-Spotted Hyena Optimization(HFSHO)algorithm,a novel approach that combines the rapid exploration and global search abilities of the Firefly Algorithm(FO)with the localized search and region-exploitation skills of the Spotted Hyena Optimization Algorithm(SHO).HFSHO aims to improve logistics path optimization and reduce operational costs.The algorithm’s effectiveness is systematically assessed through rigorous comparative analyses with established algorithms like the Ant Colony Algorithm(ACO),Cuckoo Search Algorithm(CSA)and Jaya Algo-rithm(JA).The evaluation also employs benchmarking methodologies using standardized function sets covering diverse objective functions,including Schwefel’s,Rastrigin,Ackley,Sphere and the ZDT and DTLZ Function suite.HFSHO outperforms these algorithms,achieving a minimum path distance of 546 units,highlighting its prowess in logistics path optimization.This comprehensive evaluation authenticates HFSHO’s exceptional performance across various logistic optimization scenarios.These findings emphasize the critical significance of selecting an appropriate algorithm for logistics path navigation,with HFSHO emerging as an efficient choice.Through the synergistic use of FO and SHO,HFSHO achieves a 15%improvement in convergence,heightened operational efficiency and substantial cost reductions in logistics operations.It presents a promising solution for optimizing logistics paths,offering logistics planners and decision-makers valuable insights and contributing substantively to sustainable sectoral growth.

Venous Doppler flow patterns,venous congestion,heart disease and renal dysfunction:A complex liaison

The World Journal of Cardiology published an article written by Kuwahara et al that we take the pleasure to comment on.We focused our attention on venous congestion.In intensive care settings,it is now widely accepted that venous congestion is an important clinical feature worthy of investigation.Evaluating venous Doppler profile abnormalities at multiple sites could suggest adequate treatment and monitor its efficacy.Renal dysfunction could trigger or worsen fluid overload in heart disease,and cardio-renal syndrome is a well-characterized spectrum of disorders describing the complex interactions between heart and kidney diseases.Fluid overload and venous congestion,including renal venous hypertension,are major determinants of acute and chronic renal dysfunction arising in heart disease.Organ congestion from venous hypertension could be involved in the development of organ injury in several clinical situations,such as critical diseases,congestive heart failure,and chronic kidney disease.Ultrasonography and abnormal Doppler flow patterns diagnose clinically significant systemic venous congestion.Cardiologists and nephrologists might use this valuable,noninvasive,bedside diagnostic tool to establish fluid status and guide clinical choices.

OPTIMIZATION OF AIRPORT TAXIING PLANNING DURING CONGESTED HOURS BASED ON IMMUNE CLONAL SELECTION ALGORITHM

In order to ease congestion and ground delays in major hub airports, an aircraft taxiing scheduling optimization model is proposed with schedule time as the object function. In the new model, the idea of a classical job shop-schedule problem is adopted and three types of special aircraft-taxi conflicts are considered in the constraints. To solve such nondeterministic polynomial time-complex problems, the immune clonal selection algorithm（ICSA） is introduced. The simulation results in a congested hour of Beijing Capital International Airport show that, compared with the first-come-first-served（FCFS） strategy, the optimization-planning strategy reduces the total scheduling time by 13.6 min and the taxiing time per aircraft by 45.3 s, which improves the capacity of the runway and the efficiency of airport operations.

An Adaptive Congestion Control Optimization Strategy in SDN-Based Data Centers

The traffic within data centers exhibits bursts and unpredictable patterns.This rapid growth in network traffic has two consequences:it surpasses the inherent capacity of the network’s link bandwidth and creates an imbalanced network load.Consequently,persistent overload situations eventually result in network congestion.The Software Defined Network(SDN)technology is employed in data centers as a network architecture to enhance performance.This paper introduces an adaptive congestion control strategy,named DA-DCTCP,for SDN-based Data Centers.It incorporates Explicit Congestion Notification(ECN)and Round-Trip Time(RTT)to establish congestion awareness and an ECN marking model.To mitigate incorrect congestion caused by abrupt flows,an appropriate ECN marking is selected based on the queue length and its growth slope,and the congestion window(CWND)is adjusted by calculating RTT.Simultaneously,the marking threshold for queue length is continuously adapted using the current queue length of the switch as a parameter to accommodate changes in data centers.The evaluation conducted through Mininet simulations demonstrates that DA-DCTCP yields advantages in terms of throughput,flow completion time(FCT),latency,and resistance against packet loss.These benefits contribute to reducing data center congestion,enhancing the stability of data transmission,and improving throughput.

Ultrasound unveiling:Decoding venous congestion in heart failure for precision management of fluid status

This editorial discusses the manuscript by Di Maria et al,published in the recent issue of the World Journal of Cardiology.We here focus on the still elusive pathophysiological mechanisms underlying cardio-renal syndrome(CRS),despite its high prevalence and the substantial worsening of both kidney function and heart failure.While the measure of right atrial pressure through right cardiac catheterization remains the most accurate albeit invasive and costly procedure,integrating bedside ultrasound into diagnostic protocols may substantially enhance the staging of venous congestion and guide therapeutic decisions.In particular,with the assessment of Doppler patterns across multiple venous districts,the Venous Excess Ultrasound(VExUS)score improves the management of fluid overload and provides insight into the underlying factors contributing to cardio-renal interactions.Integrating specific echocardiographic parameters,particularly those concerning the right heart,may thus improve the VExUS score sensitivity,offering perspective into the nuanced comprehension of cardio-renal dynamics.A multidisciplinary approach that consistently incorporates the use of ultrasound is emerging as a promising advance in the understanding and management of CRS.

Real-Time Prediction of Urban Traffic Problems Based on Artificial Intelligence-Enhanced Mobile Ad Hoc Networks(MANETS)

Traffic in today’s cities is a serious problem that increases travel times,negatively affects the environment,and drains financial resources.This study presents an Artificial Intelligence(AI)augmentedMobile Ad Hoc Networks(MANETs)based real-time prediction paradigm for urban traffic challenges.MANETs are wireless networks that are based on mobile devices and may self-organize.The distributed nature of MANETs and the power of AI approaches are leveraged in this framework to provide reliable and timely traffic congestion forecasts.This study suggests a unique Chaotic Spatial Fuzzy Polynomial Neural Network(CSFPNN)technique to assess real-time data acquired from various sources within theMANETs.The framework uses the proposed approach to learn from the data and create predictionmodels to detect possible traffic problems and their severity in real time.Real-time traffic prediction allows for proactive actions like resource allocation,dynamic route advice,and traffic signal optimization to reduce congestion.The framework supports effective decision-making,decreases travel time,lowers fuel use,and enhances overall urban mobility by giving timely information to pedestrians,drivers,and urban planners.Extensive simulations and real-world datasets are used to test the proposed framework’s prediction accuracy,responsiveness,and scalability.Experimental results show that the suggested framework successfully anticipates urban traffic issues in real-time,enables proactive traffic management,and aids in creating smarter,more sustainable cities.

Time varying congestion pricing for multi-class and multi-mode transportation system with asymmetric cost functions

This paper considers the problem of time varying congestion pricing to determine optimal time-varying tolls at peak periods for a queuing network with the interactions between buses and private cars.Through the combined applications of the space-time expanded network（STEN） and the conventional network equilibrium modeling techniques,a multi-class,multi-mode and multi-criteria traffic network equilibrium model is developed.Travelers of different classes have distinctive value of times（VOTs）,and travelers from the same class perceive their travel disutility or generalized costs on a route according to different weights of travel time and travel costs.Moreover,the symmetric cost function model is extended to deal with the interactions between buses and private cars.It is found that there exists a uniform（anonymous） link toll pattern which can drive a multi-class,multi-mode and multi-criteria user equilibrium flow pattern to a system optimum when the system＇s objective function is measured in terms of money.It is also found that the marginal cost pricing models with a symmetric travel cost function do not reflect the interactions between traffic flows of different road sections,and the obtained congestion pricing toll is smaller than the real value.

Congestive Heart Failure: Treatment of Symptoms or Causes

This paper is based on the author’s 20+ years of experience treating patients with congestive heart failure (CHF) as a cardiologist. In the 20+ years, 64 patients were treated, including both with reduced and preserved left ventricular function. Most patients had a 4 - 5 days hospitalization in their first admission with one readmission (1.6%) over seven years. This paper will help us understand the physiology and pathophysiology of congestive heart failure, especially how to use beta blockers and diuretics. It will shorten the length of hospitalization and lower the readmission rate and cost of CHF treatment. This paper will help us to open another research direction for CHF.

Sound waves and solutions:Point-of-care ultrasonography for acute kidney injury in cirrhosis

This article delves into the intricate challenges of acute kidney injury(AKI)in cirrhosis,a condition fraught with high morbidity and mortality.The complexities arise from distinguishing between various causes of AKI,particularly hemodynamic AKI,in cirrhotic patients,who experience hemodynamic changes due to portal hypertension.The term"hepatocardiorenal syndrome"is introduced to encapsulate the intricate interplay among the liver,heart,and kidneys.The narrative emphasizes the often-overlooked aspect of cardiac function in AKI assessments in cirrhosis,unveiling the prevalence of cirrhotic cardiomyopathy marked by impaired diastolic function.The conventional empiric approach involving volume expansion and vasopressors for hepatorenal syndrome is critically analyzed,highlighting potential risks and variable patient responses.We advocate for a nuanced algorithm for AKI evaluation in cirrhosis,prominently featuring point-of-care ultrasonography(POCUS).POCUS applications encompass assessing fluid tolerance,detecting venous congestion,and evaluating cardiac function.

Point-of-care ultrasonography spotlight:Could venous excess ultrasound serve as a shared language for internists and intensivists?

Point-of-care ultrasonography(POCUS),particularly venous excess ultrasound(VExUS)is emerging as a valuable bedside tool to gain real-time hemodynamic insights.This modality,derived from hepatic vein,portal vein,and intrarenal vessel Doppler patterns,offers a scoring system for dynamic venous congestion assessment.Such an assessment can be crucial in effective management of patients with heart failure exacerbation.It facilitates diagnosis,quantification of congestion,prognostication,and monitoring the efficacy of decongestive therapy.As such,it can effectively help to manage cardiorenal syndromes in various clinical settings.Extended or eVExUS explores additional veins,potentially broadening its applications.While VExUS demonstrates promising outcomes,challenges persist,particularly in cases involving renal and liver parenchymal disease,arrhythmias,and situations of pressure and volume overload overlap.Proficiency in utilizing spectral Doppler is pivotal for clinicians to effectively employ this tool.Hence,the integration of POCUS,especially advanced applications like VExUS,into routine clinical practice necessitates enhanced training across medical specialties.

Investigating the Correlation between Patient Education on Web-Based Portal Functionality and the Reduction in 30-Day Hospital Readmission Rates

Background: The growing use of web-based patient portals offers patients valuable tools for accessing health information, communicating with healthcare providers, and engaging in self-management. However, the influence of educating patients on these portals’ functionality on clinical outcomes, such as all-cause readmission rates, remains underexplored. Objective: This research proposal tested the hypothesis that educating a subset of patients with Chronic Obstructive Pulmonary Disease (COPD) and Congestive Heart Failure (CHF), on how to effectively access and utilize the functionality of web-based patient portals can reduce all-cause readmission rates. Methods: We performed a prospective, quasi-experimental study at Bon Secours St. Mary’s Hospital in Richmond, Virginia, USA;dividing participants into an intervention group, receiving education about accessing and navigating “My Chart”, the Bon Secours Web based portal, and a control group, receiving standard care. We then compared 30-day readmission rates, patient engagement, and self-management behaviors between the groups. Data was analyzed using statistical tests to assess the intervention’s impact. Results: We projected that educated patients will exhibit lower readmission rates, improved engagement, and better self-management. The results of the study showed that there was a significant decrease in 30-day readmissions in the intervention group in comparison with the control group (22.7% and 40.9%, respectively). This reduction of 18. 2% of readmissions evaluated here for a trial of meaningful clinical effect is statistically insignificant (p = 0. 184). The practical significance of the intervention is considered small-to-moderate (Cramer V = 0. 20) suggesting that the observed difference has a potential clinical importance even though the difference was not statistically significant. Conclusion: These results imply that the proposed educational intervention might have a positive impact on readmissions;nonetheless, the patient’s characteristics that make him or her capable of readmission cannot be changed and are assessed by the RoR (Risk of Readmission) score. The potential impact of the intervention may be offset, in part, by these baseline risk factors. The study’s power may be limited by sample size, potentially affecting the detection of significant differences. Future studies with larger, multi-center samples and longer follow-up periods are recommended to confirm these findings.

Congestion Control Algorithms for the Internet-A Secondary Publication

In the last five years,there has been a V-shaped recovery in the number of papers on congestion control algorithms on the Internet.In this paper,congestion problems on the Internet are discussed,such as congestion collapse and bufferbloat from the perspective of the necessity of congestion control algorithms.The typical congestion control algorithms are introduced,and the research areas and methods of congestion control algorithms are described.Recent research trends and future prospects of congestion control algorithms are also presented.

An Effective Optimization Algorithm for Ant Colony Vehicular Congestion Management

Adaptability and dynamicity are special properties of social insects derived from the decentralized behavior of the insects. Authors have come up with designs for software solution that can regulate traffic congestion in a network transportation environment. The effectiveness of various researches on traffic management has been verified through appropriate metrics. Most of the traffic management systems are centered on using sensors, visual monitoring and neural networks to check for available parking space with the aim of informing drivers beforehand to prevent traffic congestion. There has been limited research on solving ongoing traffic congestion in congestion prone areas like car park with any of the common methods mentioned. This study focus however is on a motor park, as a highly congested area when it comes to traffic. The car park has two entrance gate and three exit gates which is divided into three Isle of parking lot where cars can park. An ant colony optimization algorithm (ACO) was developed as an effective management system for controlling navigation and vehicular traffic congestion problems when cars exit a motor park. The ACO based on the nature and movement of the natural ants, simulates the movement of cars out of the car park through their nearest choice exit. A car park simulation was also used for the mathematical computation of the pheromone. The system was implemented using SIMD because of its dual parallelization ability. The result showed about 95% increase on the number of vehicles that left the motor park in one second. A clear indication that pheromones are large determinants of the shortest route to take as cars followed the closest exit to them. Future researchers may consider monitoring a centralized tally system for cars coming into the park through a censored gate being.

Research of Fly over as a Solution to Congestion of Intersection Junction(Case Study:Jalan Jatingaleh Semarang)

In the next few years traffic will happen most of the time.This was triggered by the growing rate of vehicles against the road capacity which is not balance.All the time the congestion in the city of Semarang has been occurred at peak hours.Congestion also occurred in between Teuku Umar and Setia Budi road Jatingaleh because of a plot intersection(Kesatrian intersection,PLN intersection and Jatingaleh intersection)with the Toll Road.Jatingaleh is located in the southern city of Semarang which is a central meeting point between the upper and lower Semarang where the vehicle flows in through a combination of local current and regional traffic,and the flow of vehicles coming in and out from highway.The main cause of the problems that occurred in the area of Jatingaleh is due to the numbers of vehicles movement that occurs at the intersections.With the above issues,it is necessary to analyse the existing conditions and look into some solutions.Before carrying out an analysis a field surveys at peak hours for example morning(06:00 to 08:00 am)and for the afternoon(04:00 to 06:00 pm)should be conducted,then the number of vehicles is counted manually with“short-breakcounting”according to types of vehicles.From the analysis we found that the degree of saturation(DS)is 1.61 between Teuku Umar and Setia Budi road during the morning peak hours and 1.56 during the afternoon peak hours.This means that the capacity of the existing road is no longer able to accommodate the traffic flow.One of the solutions for the congestion that occurs at the intersection of Jatingaleh is to apply the efficiency of the intersection that is not in a plot with a Fly over,Underpass and the combination of Fly Over-Underpass.Base on the flow reduction calculation with 3 comparative modeling it shows that the Fly Over is the most technically efficient to be applied in this research.

Network-based products detection system:congestion control and self diagnosis

The problems that arise while developing a real-time distributed information-processing software system are studied. And based on the TCP/IP protocols and socket, for its facility in client/server （C/S） model networking programming, a prototype is designed for data transmission between the server and clients and it is applied on an on-line products automatic detection system. The probability analysis on network congestion was also made. A proper mechanism based on the ARCC （adapted RTT congestion control） algorithm is employed for detecting and resolving congestion, the purpose of which is mainly to achieve congestion avoidance under the particular conditions in this network-based system and reach the desired performance. Furthermore, a method is proposed for a client to diagnose automatically the connection status between the server and the client and to re-connect to the server when the disconnection is detected.