Non-orthogonal multiple access(NOMA)is viewed as a key technique to improve the spectrum efficiency and solve the issue of massive connectivity.However,for power domain NOMA,the required overall transmit power should ...Non-orthogonal multiple access(NOMA)is viewed as a key technique to improve the spectrum efficiency and solve the issue of massive connectivity.However,for power domain NOMA,the required overall transmit power should be increased rapidly with the increasing number of users in order to ensure that the signal-to-interference-plus-noise ratio reaches a predefined threshold.In addition,since the successive interference cancellation(SIC)is adopted,the error propagation would become more serious as the order of SIC increases.Aiming at minimizing the total transmit power and satisfying each user’s service requirement,this paper proposes a novel framework with group-based SIC for the deep integration between power domain NOMA and multi-antenna technology.Based on the proposed framework,a joint optimization of power control and equalizer design is investigated to minimize transmit power consumption for uplink multi-antenna NOMA system with error propagations.Based on the relationship between the equalizer and the transmit power coefficients,the original problem is transformed to a transmit power optimization problem,which is further addressed by a parallel iteration algorithm.It is shown by simulations that,in terms of the total power consumption,the proposed scheme outperforms the conventional OMA and the existing cluster-based NOMA schemes.展开更多
Grouping nodes gives better performance to the whole network by diminishing the average network delay and avoiding unnecessary message forwarding and additional overhead. Many routing protocols for ad-hoc and sensor n...Grouping nodes gives better performance to the whole network by diminishing the average network delay and avoiding unnecessary message forwarding and additional overhead. Many routing protocols for ad-hoc and sensor networks have been designed but none of them are based on groups. In this paper, we will start defining group-based topologies, and then we will show how some wireless ad hoc sensor networks (WAHSN) routing protocols perform when the nodes are arranged in groups. In our proposal connections between groups are established as a function of the proximity of the nodes and the neighbor's available capacity (based on the node's energy). We describe the architecture proposal, the messages that are needed for the proper operation and its mathematical description. We have also simulated how much time is needed to propagate information between groups. Finally, we will show a comparison with other architectures.展开更多
This paper studies a class of strategic games,where players often collaborate with other players to form a group when making decisions,and the payoff functions of players in such games are presented as vector function...This paper studies a class of strategic games,where players often collaborate with other players to form a group when making decisions,and the payoff functions of players in such games are presented as vector functions.First,using the semi-tensor product(STP)method,it is proved that a finite game with vector payoffs is potential if and only if its potential equation has solution.By adding a suitable weight vector to the vector payoffs of each player,a finite game with vector payoffs that is not potential can be converted into a potential game.Second,as a natural generalization,the authors consider the verification problem of the group-based potential games with vector payoffs.By solving a linear potential equation,a simple formula is obtained to calculate the corresponding potential function.Finally,some examples are presented and discussed in detail to illustrate the theoretical results.展开更多
Internet of Things(IoT)technology is widely used in various fields,and its application in elderly care services has been highlighted in recent years.This study aims to explore how IoT technology can improve the effici...Internet of Things(IoT)technology is widely used in various fields,and its application in elderly care services has been highlighted in recent years.This study aims to explore how IoT technology can improve the efficiency of group-based elderly care services.The concept,characteristics,and current application status of IoT technology in elderly care services were introduced.Secondly,the characteristics and needs of group elderly care services were analyzed,including advantages and challenges,as well as the expectations and needs of the elderly for elderly care services.The evaluation methods and future development directions of IoT technology in improving the efficiency of group elderly care services were discussed,including data collection and analysis methods,selection and measurement of efficiency evaluation indicators,challenges,and development directions.展开更多
Background:Septic shock has a high incidence and mortality rate in Intensive Care Units(ICUs).Earlier intravenous fluid resuscitation can significantly improve outcomes in septic patients but easily leads to fluid ove...Background:Septic shock has a high incidence and mortality rate in Intensive Care Units(ICUs).Earlier intravenous fluid resuscitation can significantly improve outcomes in septic patients but easily leads to fluid overload(FO),which is associated with poor clinical outcomes.A single point value of fluid cannot provide enough fluid information.The aim of this study was to investigate the impact of fluid balance(FB)latent trajectories on clinical outcomes in septic patients.Methods:Patients were diagnosed with septic shock during the first 48 h,and sequential fluid data for the first 3 days of ICU admission were included.A group-based trajectory model(GBTM)which is designed to identify groups of individuals following similar developmental trajectories was used to identify latent subgroups of individuals following a similar progression of FB.The primary outcomes were hospital mortality,organ dysfunction,major adverse kidney events(MAKE)and severe respiratory adverse events(SRAE).We used multivariable Cox or logistic regression analysis to assess the association between FB trajectories and clinical outcomes.Results:Nine hundred eighty-six patients met the inclusion criteria and were assigned to GBTM analysis,and three latent FB trajectories were detected.64(6.5%),841(85.3%),and 81(8.2%)patients were identified to have decreased,low,and high FB,respectively.Compared with low FB,high FB was associated with increased hospital mortality[hazard ratio(HR)=1.63,95%CI 1.22–2.17],organ dysfunction[odds ratio(OR)=2.18,95%CI 1.22–3.42],MAKE(OR=1.80,95%CI 1.04–2.63)and SRAE(OR=2.33,95%CI 1.46–3.71),and decreasing FB was significantly associated with decreased MAKE(OR=0.46,95%CI 0.29–0.79)after adjustment for potential covariates.Conclusion:Latent subgroups of septic patients followed a similar FB progression.These latent fluid trajectories were associated with clinical outcomes.The decreasing FB trajectory was associated with a decreased risk of hospital mortality and MAKE.展开更多
To improve separation efficiency of the photogenerated electron-hole pairs,constructing a heterojunction is considered to be a promising strategy.However,the fabrication of heterojunction via a facile route to achieve...To improve separation efficiency of the photogenerated electron-hole pairs,constructing a heterojunction is considered to be a promising strategy.However,the fabrication of heterojunction via a facile route to achieve a substantial improvement in photocatalytic performance is still challenging.In this work,a well-designed nanosheet-based rodlike step-scheme(S-scheme)heterojunction Bi_(4)O_(5)I_(2)/Bi_(4)O_(5)Br_(2) with rich oxygen vacancies(OVs)(Bi_(4)O_(5)I_(2)/Bi_(4)O_(5)Br_(2)-OV)was easily synthesized by calcining BiOAc0.6Br0.2I0.2(Ac-=CH3 COO-)precursor.The as-prepared Bi4O5I2/Bi4O5Br2-OV exhibited excellent visible light photocatalytic performance towards antibiotic tetracycline(TC)and dye rhodamine B(Rh B)degradation and removal rate reached 90.2% and 97.0%within 120 min,respectively,which was higher than those of Bi4O5I2-OV(56.8% and 71.8%),Bi4O5Br2-OV(47.4%and 68.4%),solid solution BiOAc0.6Br0.2I0.2(67.0% and 84.0%)and Bi_(4)O_(5)I_(2)/Bi_(4)O_(5)Br_(2) with poor oxygen vacancies(Bi4O5I2/Bi4O5Br2-P)(30.6%and 40.4%).Owing to the release of heat and generation of reducing carbon during calcining the precursor with Ac-,it could not only reduce the generation temperature of Bi-rich bismuth oxyhalides,which thus decreased particle size and increased surface areas,but also introduce surface OVs,which could trap photoelectrons and inhibit the recombination of carriers.In addition,the calcination of single solid solution precursor benefited to the formation of well-alloyed interfaces with larger contact areas between 2D/2D nanosheet-like materials,which facilitates charge carriers transfer at the interfaces.The Bi4O5I2/Bi4O5Br2-OV also shows the desirable removal rate for TC and Rh B in actual wastewater or in the presence of some electrolytes.This study provides an effective and simple strategy for designing OVs modified Bi-rich oxyhalides heterojunctions.展开更多
Millimeter-wave communications are suitable for application to massive multiple-input multiple-output systems in order to satisfy the ever-growing data traffic demands of the next-generation wireless communication.How...Millimeter-wave communications are suitable for application to massive multiple-input multiple-output systems in order to satisfy the ever-growing data traffic demands of the next-generation wireless communication.However,their practical deployment is hindered by the high cost of complex hardware,such as radio frequency(RF)chains.To this end,operation in the beamspace domain,through beam selection,is a viable solution.Generally,the conventional beam selection schemes focus on the feedback and exhaustive search techniques.In addition,since the same beam in the beamspace may be assigned to a different user,conventional beam selection schemes suffer serious multi-user interference.In addition,some RF chains may be wasted,since they do not contribute to the sum-rate performance.Thus,a fingerprint-based beam selection scheme is proposed to solve these problems.The proposed scheme conducts offline group-based fingerprint database construction and online beam selection to mitigate multi-user interference.In the offline phase,the contributing users with the same best beam are grouped.After grouping,a fingerprint database is created for each group.In the online phase,beam selection is performed for purposes of interference mitigation using the information contained in the group-based fingerprint database.The simulation results confirm that the proposed beam selection scheme can achieve a signal-to-interference-plus-noise ratio and sum-rate performance which is close to those of a fully digital system,and having much higher energy efficiency.展开更多
In eukaryotes,protein phosphorylation is specifically catalyzed by numerous protein kinases(PKs),faithfully orchestrates various biological processes,and reversibly determines cellular dynamics and plasticity.Here we ...In eukaryotes,protein phosphorylation is specifically catalyzed by numerous protein kinases(PKs),faithfully orchestrates various biological processes,and reversibly determines cellular dynamics and plasticity.Here we report an updated algorithm of Group-based Prediction System(GPS)5.0 to improve the performance for predicting kinase-specific phosphorylation sites(p-sites).Two novel methods,position weight determination(PWD)and scoring matrix optimization(SMO),were developed.Compared with other existing tools,GPS 5.0 exhibits a highly competitive accuracy.Besides serine/threonine or tyrosine kinases,GPS 5.0 also supports the prediction of dual-specificity kinase-specific p-sites.In the classical module of GPS 5.0,617 individual predictors were constructed for predicting p-sites of 479 human PKs.To extend the application of GPS5.0,a species-specific module was implemented to predict kinase-specific p-sites for 44,795 PKs in161 eukaryotes.The online service and local packages of GPS 5.0 are freely available for academic research at http://gps.biocuckoo.cn.展开更多
Background:To identify the distinct trajectories of the Sequential Organ Failure Assessment(SOFA)scores at 72 h for patients with sepsis in the Medical Information Mart for Intensive Care(MIMIC)-IV database and determ...Background:To identify the distinct trajectories of the Sequential Organ Failure Assessment(SOFA)scores at 72 h for patients with sepsis in the Medical Information Mart for Intensive Care(MIMIC)-IV database and determine their effects on mortality and adverse clinical outcomes.Methods:A retrospective cohort study was carried out involving patients with sepsis from the MIMIC-IV database.Group-based trajectory modeling(GBTM)was used to identify the distinct trajectory groups for the SOFA scores in patients with sepsis in the intensive care unit(ICU).The Cox proportional hazards regression model was used to investigate the relationship between the longitudinal change trajectory of the SOFA score and mortality and adverse clinical outcomes.Results:A total of 16,743 patients with sepsis were included in the cohort.The median survival age was 66 years(interquartile range:54-76 years).The 7-day and 28-day in-hospital mortality were 6.0%and 17.6%,respectively.Five different trajectories of SOFA scores according to the model fitting standard were determined:group 1(32.8%),group 2(30.0%),group 3(17.6%),group 4(14.0%)and group 5(5.7%).Univariate and multivariate Cox regression analyses showed that,for different clinical outcomes,trajectory group 1 was used as the reference,while trajectory groups 2-5 were all risk factors associated with the outcome(P<0.001).Subgroup analysis revealed an interaction between the two covariates of age and mechanical ventilation and the different trajectory groups of patients’SOFA scores(P<0.05).Conclusion:This approach may help identify various groups of patients with sepsis,who may be at different levels of risk for adverse health outcomes,and provide subgroups with clinical importance.展开更多
Background: Although various therapies have been developed to treat malalignment in osteoarthritic knees, the pattern of malalignment progression is still unclear. This study aimed to identify homogeneous subgroups wi...Background: Although various therapies have been developed to treat malalignment in osteoarthritic knees, the pattern of malalignment progression is still unclear. This study aimed to identify homogeneous subgroups with distinct trajectories of malalignment progression in subjects with symptomatic knee osteoarthritis (KOA) and to determine corresponding risk factors.Methods: Eight-year follow-up (from 2004 to 2012) data on 1252 participants with symptomatic KOA from the Osteoarthritis Initiative were included. Varus/valgus angle progression was characterized by group-based trajectory models. Time-varying covariates were introduced into the model to investigate how they affected trajectories. Multinomial logistic regression for trajectory group membership was applied to ascertain risk factors.Results: Five subgroups were identified. Participants in the varus worsening trajectory (n = 166) or valgus worsening trajectory (n = 118) proceeded to worsen malalignment over time. The neutral trajectory (n = 378), varus stable trajectory (n = 328), and valgus stable trajectory (n = 262) maintained close to the initial varus/valgus angle over 8 years. Higher baseline Kellgren and Lawrence grade (odds ratio [OR] = 4.35,P < 0.001 for varus;OR= 3.85,P < 0.001 for valgus) and "severe" baseline malalignment (OR = 13.57,P < 0.001 for varus;OR = 23.04,P < 0.001 for valgus) were risk factors for worsening trajectories. The cutoff point of the baseline varus/valgus angle to discriminate between stable or worsening trajectory was -4.5° for varus and 3.6° for valgus.Conclusions: This study identified the malalignment progression pattern - minor malalignment (-4.5° to +3.6°) tends to remain stable, while major baseline malalignment is likely to progress. This provides a reference for therapy to prevent malalignment from deteriorating and emphasizes the necessity of determining the trigger factors for malalignment onset.展开更多
基金supported in part by the National Natural Science Foundation of China under Grant 62171235 and Grant 62171237in part by the Qinglan Project of Jiangsu Provincein part by the Open Research Foundation of National Mobile Communications Research Laboratory of Southeast University under Grant 2023D01.
文摘Non-orthogonal multiple access(NOMA)is viewed as a key technique to improve the spectrum efficiency and solve the issue of massive connectivity.However,for power domain NOMA,the required overall transmit power should be increased rapidly with the increasing number of users in order to ensure that the signal-to-interference-plus-noise ratio reaches a predefined threshold.In addition,since the successive interference cancellation(SIC)is adopted,the error propagation would become more serious as the order of SIC increases.Aiming at minimizing the total transmit power and satisfying each user’s service requirement,this paper proposes a novel framework with group-based SIC for the deep integration between power domain NOMA and multi-antenna technology.Based on the proposed framework,a joint optimization of power control and equalizer design is investigated to minimize transmit power consumption for uplink multi-antenna NOMA system with error propagations.Based on the relationship between the equalizer and the transmit power coefficients,the original problem is transformed to a transmit power optimization problem,which is further addressed by a parallel iteration algorithm.It is shown by simulations that,in terms of the total power consumption,the proposed scheme outperforms the conventional OMA and the existing cluster-based NOMA schemes.
文摘Grouping nodes gives better performance to the whole network by diminishing the average network delay and avoiding unnecessary message forwarding and additional overhead. Many routing protocols for ad-hoc and sensor networks have been designed but none of them are based on groups. In this paper, we will start defining group-based topologies, and then we will show how some wireless ad hoc sensor networks (WAHSN) routing protocols perform when the nodes are arranged in groups. In our proposal connections between groups are established as a function of the proximity of the nodes and the neighbor's available capacity (based on the node's energy). We describe the architecture proposal, the messages that are needed for the proper operation and its mathematical description. We have also simulated how much time is needed to propagate information between groups. Finally, we will show a comparison with other architectures.
基金the National Natural Science Foundation of China under Grant Nos.61903236,62073202,and 61803240Shandong Provincial National Science Foundation under Grant No.ZR2018BF021China Postdoctoral Science Foundation under Grant No.2017M622262。
文摘This paper studies a class of strategic games,where players often collaborate with other players to form a group when making decisions,and the payoff functions of players in such games are presented as vector functions.First,using the semi-tensor product(STP)method,it is proved that a finite game with vector payoffs is potential if and only if its potential equation has solution.By adding a suitable weight vector to the vector payoffs of each player,a finite game with vector payoffs that is not potential can be converted into a potential game.Second,as a natural generalization,the authors consider the verification problem of the group-based potential games with vector payoffs.By solving a linear potential equation,a simple formula is obtained to calculate the corresponding potential function.Finally,some examples are presented and discussed in detail to illustrate the theoretical results.
基金National Innovation and Entrepreneurship Training Project“Time Bay-A Group Elderly Care Service Platform Based on Internet of Things Technology”(S202013836008X)Chongqing Education Commission Science and Technology Research Program Youth Project 2021(KJQN202105501)。
文摘Internet of Things(IoT)technology is widely used in various fields,and its application in elderly care services has been highlighted in recent years.This study aims to explore how IoT technology can improve the efficiency of group-based elderly care services.The concept,characteristics,and current application status of IoT technology in elderly care services were introduced.Secondly,the characteristics and needs of group elderly care services were analyzed,including advantages and challenges,as well as the expectations and needs of the elderly for elderly care services.The evaluation methods and future development directions of IoT technology in improving the efficiency of group elderly care services were discussed,including data collection and analysis methods,selection and measurement of efficiency evaluation indicators,challenges,and development directions.
基金supported by the National Science and Technology Supporting Plan of the Ministry of Science and Technology of China(2012BAI11B05)。
文摘Background:Septic shock has a high incidence and mortality rate in Intensive Care Units(ICUs).Earlier intravenous fluid resuscitation can significantly improve outcomes in septic patients but easily leads to fluid overload(FO),which is associated with poor clinical outcomes.A single point value of fluid cannot provide enough fluid information.The aim of this study was to investigate the impact of fluid balance(FB)latent trajectories on clinical outcomes in septic patients.Methods:Patients were diagnosed with septic shock during the first 48 h,and sequential fluid data for the first 3 days of ICU admission were included.A group-based trajectory model(GBTM)which is designed to identify groups of individuals following similar developmental trajectories was used to identify latent subgroups of individuals following a similar progression of FB.The primary outcomes were hospital mortality,organ dysfunction,major adverse kidney events(MAKE)and severe respiratory adverse events(SRAE).We used multivariable Cox or logistic regression analysis to assess the association between FB trajectories and clinical outcomes.Results:Nine hundred eighty-six patients met the inclusion criteria and were assigned to GBTM analysis,and three latent FB trajectories were detected.64(6.5%),841(85.3%),and 81(8.2%)patients were identified to have decreased,low,and high FB,respectively.Compared with low FB,high FB was associated with increased hospital mortality[hazard ratio(HR)=1.63,95%CI 1.22–2.17],organ dysfunction[odds ratio(OR)=2.18,95%CI 1.22–3.42],MAKE(OR=1.80,95%CI 1.04–2.63)and SRAE(OR=2.33,95%CI 1.46–3.71),and decreasing FB was significantly associated with decreased MAKE(OR=0.46,95%CI 0.29–0.79)after adjustment for potential covariates.Conclusion:Latent subgroups of septic patients followed a similar FB progression.These latent fluid trajectories were associated with clinical outcomes.The decreasing FB trajectory was associated with a decreased risk of hospital mortality and MAKE.
文摘To improve separation efficiency of the photogenerated electron-hole pairs,constructing a heterojunction is considered to be a promising strategy.However,the fabrication of heterojunction via a facile route to achieve a substantial improvement in photocatalytic performance is still challenging.In this work,a well-designed nanosheet-based rodlike step-scheme(S-scheme)heterojunction Bi_(4)O_(5)I_(2)/Bi_(4)O_(5)Br_(2) with rich oxygen vacancies(OVs)(Bi_(4)O_(5)I_(2)/Bi_(4)O_(5)Br_(2)-OV)was easily synthesized by calcining BiOAc0.6Br0.2I0.2(Ac-=CH3 COO-)precursor.The as-prepared Bi4O5I2/Bi4O5Br2-OV exhibited excellent visible light photocatalytic performance towards antibiotic tetracycline(TC)and dye rhodamine B(Rh B)degradation and removal rate reached 90.2% and 97.0%within 120 min,respectively,which was higher than those of Bi4O5I2-OV(56.8% and 71.8%),Bi4O5Br2-OV(47.4%and 68.4%),solid solution BiOAc0.6Br0.2I0.2(67.0% and 84.0%)and Bi_(4)O_(5)I_(2)/Bi_(4)O_(5)Br_(2) with poor oxygen vacancies(Bi4O5I2/Bi4O5Br2-P)(30.6%and 40.4%).Owing to the release of heat and generation of reducing carbon during calcining the precursor with Ac-,it could not only reduce the generation temperature of Bi-rich bismuth oxyhalides,which thus decreased particle size and increased surface areas,but also introduce surface OVs,which could trap photoelectrons and inhibit the recombination of carriers.In addition,the calcination of single solid solution precursor benefited to the formation of well-alloyed interfaces with larger contact areas between 2D/2D nanosheet-like materials,which facilitates charge carriers transfer at the interfaces.The Bi4O5I2/Bi4O5Br2-OV also shows the desirable removal rate for TC and Rh B in actual wastewater or in the presence of some electrolytes.This study provides an effective and simple strategy for designing OVs modified Bi-rich oxyhalides heterojunctions.
基金The Ministry of Science and ICT(MSIT),Korea,under the Information Technology Research Center(ITRC)support program(IITP-2020-2016-0-00314)supervised by the Institute for Information&communications Technology Planning&Evaluation(IITP)was supported by the National Research Foundation of Korea(NRF)grant funded by the Korea government(MSIT:Ministry of Science and ICT)(2018R1A2B6002255 and 2020R1I1A1A01073948).
文摘Millimeter-wave communications are suitable for application to massive multiple-input multiple-output systems in order to satisfy the ever-growing data traffic demands of the next-generation wireless communication.However,their practical deployment is hindered by the high cost of complex hardware,such as radio frequency(RF)chains.To this end,operation in the beamspace domain,through beam selection,is a viable solution.Generally,the conventional beam selection schemes focus on the feedback and exhaustive search techniques.In addition,since the same beam in the beamspace may be assigned to a different user,conventional beam selection schemes suffer serious multi-user interference.In addition,some RF chains may be wasted,since they do not contribute to the sum-rate performance.Thus,a fingerprint-based beam selection scheme is proposed to solve these problems.The proposed scheme conducts offline group-based fingerprint database construction and online beam selection to mitigate multi-user interference.In the offline phase,the contributing users with the same best beam are grouped.After grouping,a fingerprint database is created for each group.In the online phase,beam selection is performed for purposes of interference mitigation using the information contained in the group-based fingerprint database.The simulation results confirm that the proposed beam selection scheme can achieve a signal-to-interference-plus-noise ratio and sum-rate performance which is close to those of a fully digital system,and having much higher energy efficiency.
基金Special Project on Precision Medicine under the National Key R&D Program of China(Grant Nos.2017YFC0906600 and 2018YFC0910500)National Natural Science Foundation of China(Grant Nos.31671360,81701567,and 31801095)+2 种基金National Program for Support of Top-Notch Young Professionals,Changjiang Scholars Program of Chinasupported by the program for HUST Academic Frontier Youth Team,Fundamental Research Funds for the Central Universities,China(Grant Nos.2017KFXKJC001 and 2019kfy RCPY043)China Postdoctoral Science Foundation(Grant Nos.2018M642816 and 2018M632870)
文摘In eukaryotes,protein phosphorylation is specifically catalyzed by numerous protein kinases(PKs),faithfully orchestrates various biological processes,and reversibly determines cellular dynamics and plasticity.Here we report an updated algorithm of Group-based Prediction System(GPS)5.0 to improve the performance for predicting kinase-specific phosphorylation sites(p-sites).Two novel methods,position weight determination(PWD)and scoring matrix optimization(SMO),were developed.Compared with other existing tools,GPS 5.0 exhibits a highly competitive accuracy.Besides serine/threonine or tyrosine kinases,GPS 5.0 also supports the prediction of dual-specificity kinase-specific p-sites.In the classical module of GPS 5.0,617 individual predictors were constructed for predicting p-sites of 479 human PKs.To extend the application of GPS5.0,a species-specific module was implemented to predict kinase-specific p-sites for 44,795 PKs in161 eukaryotes.The online service and local packages of GPS 5.0 are freely available for academic research at http://gps.biocuckoo.cn.
文摘Background:To identify the distinct trajectories of the Sequential Organ Failure Assessment(SOFA)scores at 72 h for patients with sepsis in the Medical Information Mart for Intensive Care(MIMIC)-IV database and determine their effects on mortality and adverse clinical outcomes.Methods:A retrospective cohort study was carried out involving patients with sepsis from the MIMIC-IV database.Group-based trajectory modeling(GBTM)was used to identify the distinct trajectory groups for the SOFA scores in patients with sepsis in the intensive care unit(ICU).The Cox proportional hazards regression model was used to investigate the relationship between the longitudinal change trajectory of the SOFA score and mortality and adverse clinical outcomes.Results:A total of 16,743 patients with sepsis were included in the cohort.The median survival age was 66 years(interquartile range:54-76 years).The 7-day and 28-day in-hospital mortality were 6.0%and 17.6%,respectively.Five different trajectories of SOFA scores according to the model fitting standard were determined:group 1(32.8%),group 2(30.0%),group 3(17.6%),group 4(14.0%)and group 5(5.7%).Univariate and multivariate Cox regression analyses showed that,for different clinical outcomes,trajectory group 1 was used as the reference,while trajectory groups 2-5 were all risk factors associated with the outcome(P<0.001).Subgroup analysis revealed an interaction between the two covariates of age and mechanical ventilation and the different trajectory groups of patients’SOFA scores(P<0.05).Conclusion:This approach may help identify various groups of patients with sepsis,who may be at different levels of risk for adverse health outcomes,and provide subgroups with clinical importance.
基金funded by the grants from the National Natural Science Foundation of China(No.81974347)China Postdoctoral Science Foundation(No.2021M702351)+2 种基金Post-Doctor Research Project,West China Hospital,Sichuan University(No.2020HXBH081)Medical cience and Technology Project of Health Commission of Sichuan Provincial(No.21PJ040)Sichuan University Postdoctoral Interdisciplinary Innovation Fund.
文摘Background: Although various therapies have been developed to treat malalignment in osteoarthritic knees, the pattern of malalignment progression is still unclear. This study aimed to identify homogeneous subgroups with distinct trajectories of malalignment progression in subjects with symptomatic knee osteoarthritis (KOA) and to determine corresponding risk factors.Methods: Eight-year follow-up (from 2004 to 2012) data on 1252 participants with symptomatic KOA from the Osteoarthritis Initiative were included. Varus/valgus angle progression was characterized by group-based trajectory models. Time-varying covariates were introduced into the model to investigate how they affected trajectories. Multinomial logistic regression for trajectory group membership was applied to ascertain risk factors.Results: Five subgroups were identified. Participants in the varus worsening trajectory (n = 166) or valgus worsening trajectory (n = 118) proceeded to worsen malalignment over time. The neutral trajectory (n = 378), varus stable trajectory (n = 328), and valgus stable trajectory (n = 262) maintained close to the initial varus/valgus angle over 8 years. Higher baseline Kellgren and Lawrence grade (odds ratio [OR] = 4.35,P < 0.001 for varus;OR= 3.85,P < 0.001 for valgus) and "severe" baseline malalignment (OR = 13.57,P < 0.001 for varus;OR = 23.04,P < 0.001 for valgus) were risk factors for worsening trajectories. The cutoff point of the baseline varus/valgus angle to discriminate between stable or worsening trajectory was -4.5° for varus and 3.6° for valgus.Conclusions: This study identified the malalignment progression pattern - minor malalignment (-4.5° to +3.6°) tends to remain stable, while major baseline malalignment is likely to progress. This provides a reference for therapy to prevent malalignment from deteriorating and emphasizes the necessity of determining the trigger factors for malalignment onset.