Effectiveness of Combined Application of Shock Index and Early Warning Scoring System in Patients with Acute Gastrointestinal Hemorrhage

Objective:To explore the effect of the combined application of the Shock Index(SI)and the Early Warning Score(EWS)in patients with acute gastrointestinal bleeding.Methods:Seventy patients with acute gastrointestinal bleeding admitted to a hospital from June 2022 to May 2024 were selected and randomly divided into two groups:the control group and the observation group,with 35 patients in each group.The control group received conventional emergency care measures,while the observation group received SI combined with NEWS emergency care measures.The treatment effects in both groups were compared.Results:The observation group had shorter waiting times for consultation(4.45±1.59 minutes),intravenous access establishment(6.79±2.52 minutes),hemostasis time(4.41±1.52 hours),and hospital stays(8.39±2.13 days)compared to the control group,which had times of 5.46±1.34 minutes,8.41±2.16 minutes,5.16±1.47 hours,and 10.26±2.98 days,respectively.The differences were statistically significant(P<0.05).Before management,there were no significant differences in the levels of hemoglobin,prealbumin,and serum protein between the two groups(P>0.05).However,after systematic emergency management,the serum indexes in both groups significantly improved,with the observation group showing greater improvement than the control group,and these differences were statistically significant(P<0.05).In the observation group,only one case of cardiovascular complications occurred during the rescue period,with an incidence rate of 2.86%.In contrast,the control group experienced eight cases of complications,including hemorrhagic shock,anemia,multi-organ failure,cardiovascular complications,and gastrointestinal rebleeding,with an incidence rate of 22.85%.The difference between the groups was statistically significant(P<0.05).Conclusion:The application of SI combined with EWS emergency care measures in patients with acute gastrointestinal hemorrhage can effectively improve serum indexes,shorten resuscitation time and hospital stay,and reduce the risk of complications such as hemorrhagic shock,anemia,infection,multi-organ failure,cardiovascular complications,acute renal failure,and gastrointestinal rebleeding.This approach has positive clinical application value.

Comparing 11 early warning scores and three shock indices in early sepsis prediction in the emergency department

BACKGROUND:This study aimed to evaluate the discriminatory performance of 11 vital sign-based early warning scores(EWSs)and three shock indices in early sepsis prediction in the emergency department(ED).METHODS:We performed a retrospective study on consecutive adult patients with an infection over 3 months in a public ED in Hong Kong.The primary outcome was sepsis(Sepsis-3 definition)within 48 h of ED presentation.Using c-statistics and the DeLong test,we compared 11 EWSs,including the National Early Warning Score 2(NEWS2),Modified Early Warning Score,and Worthing Physiological Scoring System(WPS),etc.,and three shock indices(the shock index[SI],modified shock index[MSI],and diastolic shock index[DSI]),with Systemic Inflammatory Response Syndrome(SIRS)and quick Sequential Organ Failure Assessment(qSOFA)in predicting the primary outcome,intensive care unit admission,and mortality at different time points.RESULTS:We analyzed 601 patients,of whom 166(27.6%)developed sepsis.NEWS2 had the highest point estimate(area under the receiver operating characteristic curve[AUROC]0.75,95%CI 0.70-0.79)and was significantly better than SIRS,qSOFA,other EWSs and shock indices,except WPS,at predicting the primary outcome.However,the pooled sensitivity and specificity of NEWS2≥5 for the prediction of sepsis were 0.45(95%CI 0.37-0.52)and 0.88(95%CI 0.85-0.91),respectively.The discriminatory performance of all EWSs and shock indices declined when used to predict mortality at a more remote time point.CONCLUSION:NEWS2 compared favorably with other EWSs and shock indices in early sepsis prediction but its low sensitivity at the usual cut-off point requires further modification for sepsis screening.

Integrated water risk early warning framework of the semi-arid transitional zone based on the water environmental carrying capacity (WECC)

Water risk early warning systems based on the water environmental carrying capacity(WECC)are powerful and effective tools to guarantee the sustainability of rivers.Existing work on the early warning of WECC has mainly concerned the comprehensive evaluation of the status quo and lacked a quantitative prejudgement and warning of future overload.In addition,existing quantitative methods for short-term early warning have rarely focused on the integrated change trends of the early warning indicators.Given the periodicity of the socioeconomic system,however,the water environmental system also follows a trend of cyclical fluctuations.Thus,it is meaningful to monitor and use this periodicity for the early warning of the WECC.In this study,we first adopted and improved the prosperity index method to develop an integrated water risk early warning framework.We also constructed a forecast model to qualitatively and quantitatively prejudge and warn about the development trends of the water environmental system.We selected the North Canal Basin(an essential connection among the Beijing-Tianjin-Hebei region)in China as a case study and predicted the WECC in 25 water environmental management units of the basin in 2018–2023.We found that the analysis of the prosperity index was helpful in predicting the WECC,to some extent.The result demonstrated that the early warning system provided reliable prediction(root mean square error of 0.0651 and mean absolute error of 0.1418),and the calculation results of the comprehensive early warning index(CEWI)conformed to the actual situation and related research in the river basin.From 2008 to 2023,the WECC of most water environmental management units in the basin had improved but with some spatial differences:the CEWI was generally poor in areas with many human disturbances,while it was relatively good in the upstream regions with higher forest and grass covers as well as in the downstream areas with larger water volume.Finally,through a sensitivity analysis of the indicators,we proposed specific management measures for the sustainability of the water environmental system in the North Canal Basin.Overall,the integrated water risk early warning framework could provide an appropriate method for the water environmental administration department to predict the WECC of the basin in the future.This framework could also assist in implementing corresponding management measures in advance,especially for the performance evaluation and the arrangement of key short-term tasks in the River Chief System in China.

Prediction and Early Warning Indicators of Short-term Severe Convection Weather in Ulanqab City

Based on the disaster reports,NCEP2.5X2.5 reanalysis data and radiosonde data of 11 national stations in Ulanqab region from June to August during 2012-2017,the weather situation classification and warning indicators of thunderstorm and gale,hail and short-term heavy rainfall were studied.The results show that the cold vortex weather situation was easy to produce hail,and the falling area of severe convection could be found in the downstream of the cold vortex,the intersection area of jet stream at 200 and 500 hPa,and the wet area side of the 700 hPa main line.The cold trough type weather situation was easy to produce thunderstorm and gale,and the falling area of severe convection appeared on the right side of the upper jet stream axis,the left side of the lower jet stream axis,the wet side of the 700 hPa main line,and the east of the shear line at 700 hPa.The weather situation of the low trough and subtropical high type was dominated by short-term rainstorm,and the falling area of severe convection was on the right side of upper jet stream at 200 hPa,the left side of the low southeast jet stream,and the wet side of the 700 hPa main line.The warning index thresholds of the total index,the temperature change at 850-500 hPa with height,the height of 0 and-20℃layer,lifting condensation height,temperature dew point difference and mixing ratio were highly reliable.

Designing of Commercial Bank Loans Risk Early Warning System Based on BP Neural Networks

According to the index early warning method, a commercial bank loans risk early warning system based on BP neural networks is proposed. The warning signal is mainly involved with the financial situation signal of loaning corporation. Except the structure description of the system structure the demonstration of attemptive designing is also elaborated.

The Innovation Research of Financial Early-Warning Index Measurement

The period economic fluctuation is vital for an enterprise to exist and further develop, it directly affect the enterprise financial health. So, it is significant to build up financial early-warning index and measure the warning condition that the enterprise faces and take the effective measures to eliminate. We criticize Altman’sZ calculating model and build up some new indexes for enterprise financial early-warning condition measuring and making sound decision.

Geo-hazards risk zonation and warning system based on GIS in Anshan City of Liaoning

Debris flow and Karst collapse are the main parts of geological disasters in Anshan, which have affected on the construction and development of the social economy of Anshan. In order to enhance the studies of rules of disaster and give scientific estimation and alarm ahead of schedule warning, we established the warning system of Anshan and investigated the corresponding software, which are based on the deep discussions about the crisis estimation and methods of prediction of disasters. In this paper, the foundation of model used in estimating the alarm ahead of schedule for disaster and the methods of appraisal for the alarm ahead of schedule are discussed. This system for warning and evaluating is the combination of the models of warning and GIS fiat roof, with so many virtues, such as complete functions, convenience, applicability, which has considered the output of data, analyses of space, chooses of model, output of production, report of information for warning and the statements and help of system.

Extension Multi-factorial Evaluation Method on Water Quality Early-warning

Extension multi-factorial evaluation method was used in water quality early-earning in Yincungang River based on MATLAB. The results showed that water quality in summer was safe,while that in other three seasons were in pre-warning state with the order of winter > spring > autumn.

A new early warning method for dam displacement behavior based on non-normal distribution function

Traditional methods for early warning of dam displacements usually assume that residual displacements follow a normal distribution.This assumption deviates from the reality,thereby affecting the reliability of early warning results and leading to misjudgments of dam displacement behavior.To solve this problem,this study proposed an early warning method using a non-normal distribution function.A new early warning index was developed using cumulative distribution function(CDF)values.The method of kernel density estimation was used to calculate the CDF values of residual displacements at a single point.The copula function was used to compute the CDF values of residual displacements at multiple points.Numerical results showed that,with residual displacements in a non-normal distribution,the early warning method proposed in this study accurately reflected the dam displacement behavior and effectively reduced the frequency of false alarms.This method is expected to aid in the safe operation of dams.

大型危岩体崩塌灾害早期监测预警技术研究综述

作为中国常见的一种地质灾害,大型危岩崩塌成因复杂、分布范围广、隐蔽性和突发性强、危害性大,其早期预警一直难以实现。通过总结岩体崩塌灾害失稳机理与预警模型可知,开展岩桥结构面损伤识别及静力学-动力学-环境量参量(SDEI)的综合性监测技术研究是实现大型危岩体崩塌灾害早期监测预警的关键所在,而基于分离破坏前兆识别的早期预警机制研究是提高崩塌灾害预警时效性的有效手段之一。随着微机电系统与云边融合技术的发展,在未来有望形成一套稳定性动态评价、失稳工况预测与失稳时间预测模型实时联动的多元预警新范式。与此同时,还需通过不断丰富大型危岩崩塌等脆性破坏灾害预警技术体系,实现危岩体预警等级、稳定性状态、失稳工况、失稳时间的实时分析,进而有效解决大型危岩体崩塌灾害科学精准防控与智慧化应急决策的双重难题。最后,针对目前崩塌灾害早期监测预警研究中存在的技术瓶颈问题,提出具体的发展策略与应对措施,以期为中国地质灾害高风险区更好地应对大型危岩体崩塌灾害提供一些参考。

督导式预警性护理模式对Ⅱ型呼吸衰竭患者的作用效果

目的探讨督导式预警性护理模式在Ⅱ型呼吸衰竭患者中的应用价值。方法选取南阳市第一人民医院2022年1月至2023年3月就诊的136例Ⅱ型呼吸衰竭患者,根据护理方法分为研究组(68例)和常规组(68例)。常规组接受常规护理干预,研究组在常规组基础上联合督导式预警性护理模式,比较两组血气指标[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))]、肺功能[第1秒用力呼气容积(FEV_(1))、用力肺活量(FVC)、最大通气量(MVV)]、负性情绪[焦虑自评量表(SAS)、抑郁自评量表(SDS)]、睡眠质量[匹兹堡睡眠质量量表(PSQI)]、运动恐惧[恐动坦帕评分(TSK)]、并发症发生率。结果干预后研究组PaO_(2)、FEV_(1)、FVC、MVV高于常规组,研究组PaCO_(2)低于常规组(P<0.05);干预后研究组SAS、TSK、SDS、PSQI评分低于常规组(P<0.05);研究组并发症总发生率低于常规组(P<0.05)。结论督导式预警性护理模式可减轻Ⅱ型呼吸衰竭患者运动恐惧、负性情绪,改善患者血气指标、肺功能,提升患者睡眠质量,降低并发症发生率。

基于熵值法和功效系数法的林业企业财务风险预警机制——以福建省永安林业(集团)股份有限公司为例

林业是关系到国计民生的重要支柱产业,承担着促进国民经济发展、改善生态环境、提高民生福祉的多重使命。在以中国式现代化全面推进中华民族伟大复兴的背景下,林业正在积极进行产业结构化调整,建构循环经济的现代林业产业体系。林业企业在做出战略选择时,应当时刻关注自身的财务状况。文中以2015—2022年永安年报数据为基础,运用熵值法从21个财务指标中筛选出7个最能反映永安林业财务状况的指标,并赋予指标权重,最后运用功效系数法进行绩效评价及风险预警;在此基础上,提出林业企业防范财务风险的相关建议:1)积极寻求政策扶持;2)健全风险评估体系;3)做好产业转型的准备;4)优化资本结构;5)加强技术投资。

基于智能索引算法的集控设备事故辅助预警方法研究

为了保障电力集控中心设备正常运转,针对信息检索效率较差、电压偏差控制效果较差的问题,研究基于智能索引算法的集控设备事故辅助预警方法。利用R-树索引算法检索集控设备运行数据集内设备事故数据;计算集控设备事故数据状态向量间的相似度,将该相似度组成相似度向量后,利用滑动窗口算法计算集控设备事故辅助预警阈值,当集控设备事故数据状态向量相似度低于该阈值时,则向用户发出设备事故辅助报警。实验结果表明,该方法采集集控设备电压偏差仅为0.05 V左右,可有效采集集控设备运行数据;检索设备事故信息较为迅速和准确。

基于节点重要性和改进效能环的防空反导预警体系能力评估

针对防空反导预警体系能力评估中存在的现实性较弱、考虑异质特性较少和能力计算不够全面等问题,提出基于节点重要性和改进效能环的体系能力评估方法。依托超网络模型对体系结构进行抽象建模,给出具有现实意义的效能环模型。从网络全局和局部节点的重要性出发,根据节点之间相互影响关系对效能边进行分析,并结合节点的重要性和可靠性提出体系的能力期望,从而改进基于效能环的体系能力评估方法。反导预警作战的案例仿真分析结果表明:新方法具有可行性与合理性,充分考虑了防空反导预警体系的现实特性和装备的异质特征,能够较全面地评估体系作战能力,为体系的能力评估和结构优化提供理论支撑。

电动汽车与充电设备充电安全预警研究综述

随着全球新能源技术的大力发展,电动汽车及其配套充电设施日益普及化。电动汽车自燃事故与充电安全问题也备受关注。文中从充电安全因素的视角出发,深入地梳理总结了近年来电动汽车与充电设备安全预警研究方法。首先,对充电安全影响因素进行了详细的分类,并对现有的充电安全预警方法成熟度进行了总结与探讨。然后,归纳了预警模型精度与预警误差等评估指标。接着,基于真实的充电订单数据与工单数据对现有模型进行了整体评估与对比分析。最后,对电动汽车与充电设备充电安全预警的后续研究工作进行了展望。

不同评估工具对急性肺栓塞病人预后的预测价值比较

目的:比较改良早期预警评分(MEWS)、简化肺栓塞严重指数(sPESI)、日内瓦预后评估指数(Geneva评分)、生理评分系统(PSS)4种评估工具对急性肺栓塞(APE)病人预后的预测价值。方法:回顾性分析2016年1月1日—2020年1月1日在宁夏医科大学总医院呼吸与危重症医学科住院的325例急性肺栓塞病人资料,根据其预后分为好转组与死亡组,分别统计其上述4种临床评分,采用受试者工作特征(ROC)曲线比较4种评估工具对急性肺栓塞病人预后的预测价值。结果:325例病人的病死率为10.46%。死亡组MEWS、sPESI、Geneva评分、PSS评分均高于好转组(P<0.05);MEWS、sPESI、Geneva评分、PSS的ROC曲线下面积分别为0.754,0.682,0.794,0.627;其中,Geneva评分的ROC曲线下面积最大(P<0.05)。结论:MEWS、sPESI、Geneva评分、PSS 4种评估工具对急性肺栓塞病人早期预后的评估均具有一定应用价值;其中,Geneva评分预测效能优于MEWS、sPESI、PSS。

基于道路监控的高速公路作业区碰撞风险预警

为了更及时地掌握高速公路作业区车辆碰撞风险态势,提出基于闭路电视监控的作业区碰撞风险预警方法.采用计算机视觉技术进行车辆检测、坐标转换和车辆3D形态估计,获取作业区交通流和车辆信息.以改进事故时间指数(ITA)为上游过渡段的碰撞风险量化指标,依据警告区起点的交通流特征,实现上游过渡段的碰撞风险预测.通过集成一维卷积神经网络(1D CNN)、长短期记忆网络(LSTM)和注意力机制,构建基于1D CNN+LSTM+Attention (CLA)框架的碰撞风险预测模型.结果表明:所提数据采集方法满足碰撞风险预测的需求.相较其他冲突指标,ITA在风险量化中具有更适宜的敏感度.相较LSTM和1D CNN+LSTM,基于CLA的预警模型准确度更高,其拟合优度确定系数和均方根误差分别为0.805和0.359.所提方法能够提前90 s为作业区提供碰撞风险预警.

盾构法隧洞工程的施工进度预警方法

隧洞盾构施工投资金额大,施工难度高,项目管理任务复杂,工期延误会带来巨大经济损失,因此,科学有效的施工进度预警能极大地为隧洞工程节省时间和造价成本.首先根据工程实际情况设立施工进度预警指标和警度标准,并建立了施工进度延误预警模型,通过计算当前的工程施工进度延误程度,判断出未来的影响趋势,并根据延误程度的轻重结合警度预报给出不同的预警信号.进一步采用BIM软件构建该隧洞的三维模型,并对隧洞进行4D施工进度模拟,以不同颜色展示警度差异,可实现施工进度预警的可视化管理.将此模型应用到西霞院灌区工程穿沁隧洞典型盾构施工段中,计算出该隧洞已完工部分的施工进度延误程度以及影响趋势,并通过BIM模型直观显示了预警结果.

基于ARIMA模型的矿井灾害预测方法研究

矿井灾害频发是影响我国煤炭产业发展的重要问题之一,灾前预警技术是目前应对这一问题的主要方法。为进一步提升矿井灾害监测预警能力,提出了基于ARIMA模型的矿井灾害预测方法研究。通过确立灾害风险监测指标构建了安全态势评估指标体系,基于时序预测法建立了灾害预测评估模型,经模型定阶及训练等过程确定最佳ARIMA预测模型参数。通过研究模型残差的正态性分布从而得到预测模型可靠度,将ARIMA(10,0,0)模型与时间序列拟合后进行自相关图和偏自相关图分析,得到了风险灾害未来短期预测结果;提出了“红橙黄蓝绿”5级灾害预警等级和准则,并进行了现场应用试验,结果证明,ARIMA模型对未来值的预测具有较高准确性,系统能及时对灾害进行预测和分级响应,可实现对矿井灾害的风险判别和预测预警。

基于休哈特控制图的评估预警系统在医疗器械相关性压力损伤中应用研究

目的:探究基于休哈特控制图的评估及预警系统预防医疗器械相关性压力损伤(MDRPI)效果。方法:选取河北省人民医院2020年1月至2021年12月收治的152例重症监护室的危重患者,根据评估MDRPI风险方式不同,将其分为对照组和观察组,每组76例。对照组使用Braden评估量评估患者MDRPI风险,观察组采用基于休哈特控制图安全预警系统评估患者MDRPI风险程度,根据两组患者MDRPI风险等级采取护理措施。比较两组患者MDRPI不良事件发生情况、护理安全质量和护理综合质量评分。结果:观察组患者头颈面部MDRPI不良事件发生率及MDRPI不良事件总发生率均低于对照组,差异有统计学意义(x^(2)=4.802、5.758,P<0.05);重症监护室护士对观察组的护理安全质量与护理综合质量评分均高于对照组,差异有统计学意义(t=6.654、7.172,P<0.05)。结论:在临床护理管理中运用基于休哈特控制图的评估预警系统,能够有效减少MDRPI不良事件的发生,提升护理安全质量与护理综合质量。