This review examines the application of continuous renal replacement therapy(CRRT)in patients with sepsis-associated acute kidney injury(S-AKI),with a particular focus on the timing of CRRT initiation.This review addr...This review examines the application of continuous renal replacement therapy(CRRT)in patients with sepsis-associated acute kidney injury(S-AKI),with a particular focus on the timing of CRRT initiation.This review addresses the controversy surrounding initiation timing and proposes future research directions.Through a systematic review of recent literature on CRRT for S-AKI,working principles,therapeutic mechanisms,initiation timing of CRRT,and related meta-analyses were summarized.Current studies indicate that the optimal timing for CRRT initiation in S-AKI patients remains inconclusive,with ongoing debate regarding whether early initiation significantly improves patient survival and renal function.This lack of consensus reflects the heterogeneity of the S-AKI patient population and the limitations of existing research methodologies.Future studies should focus on advancing the application of precision medicine in S-AKI and developing individualized treatment strategies by integrating multidimensional information to optimize CRRT utilization and improve patient outcomes.展开更多
To gain a competitive edge within the international and compet让ive setting of coal markets, coal producers must find new ways of reducing costs. Increasing bench drilling efficiency and performance in open-cast coal ...To gain a competitive edge within the international and compet让ive setting of coal markets, coal producers must find new ways of reducing costs. Increasing bench drilling efficiency and performance in open-cast coal mines has the potential to generate savings. Specifically, monitoring, analyzing, and optimizing the drilling operation can reduce drilling costs. For example, determining the optimal drill bit replacement time will help to achieve the desirable penetration rate. This paper presents a life data analysis of drill bits to fit a statistical distribution using failure records. These results are then used to formulate a cost minimization problem to estimate the drill bit replacement time using the evolutionary algorithm. The effect of cost on the uncertainty associated with replacement time is assessed through Monte-Carlo simulation. The relationship between the total expected replacement cost and replacement time is also presented. A case study shows that the proposed approach can be used to assist with designing a drill bit replacement schedule and minimize costs in open-cast coal mines.展开更多
Objective To investigate the surgical technique and outcomes of replacement of chordae tendineae in mitral valve repair,and evaluate the value of real-time three-di-mensional transesophageal echocardiography in the pe...Objective To investigate the surgical technique and outcomes of replacement of chordae tendineae in mitral valve repair,and evaluate the value of real-time three-di-mensional transesophageal echocardiography in the perioperative period. Methods Thirty-one patients with mitral valve prolapse underwent mitral valve repair using chordae tendineae replacement concomitant with implantation展开更多
Periodical inspections and an age-based preventive replacement( APR) model were proposed based on a two-stage failure process for a single component system. Inspection activities were performed at regular intervals. O...Periodical inspections and an age-based preventive replacement( APR) model were proposed based on a two-stage failure process for a single component system. Inspection activities were performed at regular intervals. Once the system was identified to be at defective state by inspection,a maintenance decision needed to be made that whether to replace the defective system immediately or wait till the preset APR time. So a threshold was introduced into the model and called as inspection-based preventive replacement( IPR) threshold. If the distance from the defect identification point to the APR time was longer than the threshold, a preventive replacement( PR) action was made; otherwise PR action was to wait till the APR time. Two models were proposed and compared,and a numerical example was conducted to illustrate the applicability of the model.展开更多
The exponential growth of agricultural wastes such as Balanite seed pod has resulted in waste management issues and finding alternatives through waste recycling is an interesting area of research.Balanite seed pods we...The exponential growth of agricultural wastes such as Balanite seed pod has resulted in waste management issues and finding alternatives through waste recycling is an interesting area of research.Balanite seed pods were collected in Yobe state,washed,dried,crushed.Balanite endocarp pod ash(BEPA)was calcined at 600°C for 3 hours in a muffle furnace and the biomass was characterized with X-ray fluorescence spectrometer to determine its chemical composition.The analysis showed that the ash composed of silica,alumina and ferric oxide(74.24 wt.%)indicated a strong pozzolan based on American Standard.The BEPA possessed a high loss on ignition of 8.24 wt.%owing to the presence of unburnt carbon in the ash.The ash obtained was sieved with 75µm sieve and cement was replaced with ash between 2.5 wt.%~12.5 wt.%at interval of 2.5 wt.%to assess its impact on cement properties such as setting time,consistence,mortar strength and water absorption.Results showed that as percentage replacement increases,the water absorption increased while the mortar strength diminished whereas as the curing days progressed its strength improved despite clinker diminution due to cement hydration.60 days strength for below 10 wt.%BEPA cement blend produced enhanced strength compared with control which is evidence of slow pozzolanic reactions.The optimum percentage replacement with BEPA was obtained at 7.5 wt.%replacement beyond which significantly affected the cement properties especially its strength.It could be agreed that BEPA has potentials to be considered and employed as a cement replacement material.展开更多
Several researches have been done to provide better alternative to the existing replacement models, but the research works did not adequately address the replacement problem for items that fail suddenly. Hence, a modi...Several researches have been done to provide better alternative to the existing replacement models, but the research works did not adequately address the replacement problem for items that fail suddenly. Hence, a modified replacement model for items that fail suddenly has been proposed using the knowledge of probability distribution of failure times as well as that of variable replacement cost. The modified cost functions for implementing both individual and group replacements were derived. The modified cost functions were minimized using the principle of classical optimization in order to find the age at which replacement of items would be appropriate. Conditions under which the individual and group replacement policies should be adopted were derived. Two real data sets on failure time of LED bulbs and their replacement costs were used to validate the theoretical claims of this work. In essence, goodness-of-fit test was used to select appropriate probability distribution of failure times as well as that of replacement costs for data sets I and II respectively. The goodness-of-fit results showed that failure times of LED bulbs follow the Smallest Extreme Value and Laplace distributions for data sets I and II respectively. Similarly, it was observed that individual replacement cost followed the two-parameter Gamma and Largest Extreme Value distributions for data sets I and II respectively. Further, the group replacement cost was found to follow the log-normal and two-parameter Weibull distributions for data sets I and II respectively. Based on the empirical study, we observed that individual replacement policy is better than group replacement policy in terms of cost minimization for both existing model and the proposed model. In view of the results, the proposed replacement policy was recommended over the existing one because it yielded lower replacement costs than the existing replacement model.展开更多
Acute kidney injury remains a serious condition with a high mortality risk. In the absence of any new drugs, renal replacement therapy (RRT) is the most important treatment option. Randomized controlled trials have co...Acute kidney injury remains a serious condition with a high mortality risk. In the absence of any new drugs, renal replacement therapy (RRT) is the most important treatment option. Randomized controlled trials have concluded that in critically ill patients without an emergency indication for RRT, a watchful waiting strategy is safe;however, further delays in RRT did not seem to confer any benefit, rather was associated with potential harm. During this process, balancing the risks of complications due to an unnecessary intervention with the risk of not correcting a potentially life-threatening complication remains a challenge. Dynamic renal function assessment, especially dynamic assessment of renal demand-capacity matching, combined with renal biomarkers such as neutrophil gelatinase-associated lipocalin and furosemide stress test, is helpful to identify which patients and when the patients may benefit from RRT.展开更多
目的探索照顾者基于时机理论指导下的健康教育应用在老年髋关节置换术后护理中的效果。方法采用方便取样法将行髋关节置换术的80例老年患者分为对照组和观察组,每组40例,对照组给予骨科常规护理,观察组在骨科常规护理的基础上基于时机理...目的探索照顾者基于时机理论指导下的健康教育应用在老年髋关节置换术后护理中的效果。方法采用方便取样法将行髋关节置换术的80例老年患者分为对照组和观察组,每组40例,对照组给予骨科常规护理,观察组在骨科常规护理的基础上基于时机理论(total hip replacement,TIR)指导下的健康管理。采用髋关节功能评分量表、日常生活活动能力评定量表(Barthel指数)、照顾者负担问卷、家属照顾者照顾能力测量进行比较并评价2组照顾者的健康教育在老年髋关节置换术后护理中的应用效果。结果分别观察出院后1个月和3个月患者髋关节功能评分和日常生活活动能力评定指数,观察组显著高于对照组(P<0.01);出院时,出院后1个月和3个月观察组家属照顾者照顾能力测量评分(P<0.01)和照顾者负担问卷评分(P<0.01)显著低于对照组。结论基于时机理论指导下的健康教育能够有效减轻照顾者的照顾负担,增强照顾者的照顾能力,提高患者的康复效果,改善患者的生活质量。展开更多
基金Wenzhou Science and Technology Project(Grant No.Y2020536)。
文摘This review examines the application of continuous renal replacement therapy(CRRT)in patients with sepsis-associated acute kidney injury(S-AKI),with a particular focus on the timing of CRRT initiation.This review addresses the controversy surrounding initiation timing and proposes future research directions.Through a systematic review of recent literature on CRRT for S-AKI,working principles,therapeutic mechanisms,initiation timing of CRRT,and related meta-analyses were summarized.Current studies indicate that the optimal timing for CRRT initiation in S-AKI patients remains inconclusive,with ongoing debate regarding whether early initiation significantly improves patient survival and renal function.This lack of consensus reflects the heterogeneity of the S-AKI patient population and the limitations of existing research methodologies.Future studies should focus on advancing the application of precision medicine in S-AKI and developing individualized treatment strategies by integrating multidimensional information to optimize CRRT utilization and improve patient outcomes.
文摘To gain a competitive edge within the international and compet让ive setting of coal markets, coal producers must find new ways of reducing costs. Increasing bench drilling efficiency and performance in open-cast coal mines has the potential to generate savings. Specifically, monitoring, analyzing, and optimizing the drilling operation can reduce drilling costs. For example, determining the optimal drill bit replacement time will help to achieve the desirable penetration rate. This paper presents a life data analysis of drill bits to fit a statistical distribution using failure records. These results are then used to formulate a cost minimization problem to estimate the drill bit replacement time using the evolutionary algorithm. The effect of cost on the uncertainty associated with replacement time is assessed through Monte-Carlo simulation. The relationship between the total expected replacement cost and replacement time is also presented. A case study shows that the proposed approach can be used to assist with designing a drill bit replacement schedule and minimize costs in open-cast coal mines.
文摘Objective To investigate the surgical technique and outcomes of replacement of chordae tendineae in mitral valve repair,and evaluate the value of real-time three-di-mensional transesophageal echocardiography in the perioperative period. Methods Thirty-one patients with mitral valve prolapse underwent mitral valve repair using chordae tendineae replacement concomitant with implantation
基金National Natural Science Foundation of China(NSFC)(No.71231001)China Postdoctoral Science Foundation Funded Project(No.2013M530531)+1 种基金the Fundamental Research Funds for the Central Universities of China(Nos.FRF-M P-13-009A,FRF-TP-13-026A)the MOE PhD Supervisor Fund,China(No.20120006110025)
文摘Periodical inspections and an age-based preventive replacement( APR) model were proposed based on a two-stage failure process for a single component system. Inspection activities were performed at regular intervals. Once the system was identified to be at defective state by inspection,a maintenance decision needed to be made that whether to replace the defective system immediately or wait till the preset APR time. So a threshold was introduced into the model and called as inspection-based preventive replacement( IPR) threshold. If the distance from the defect identification point to the APR time was longer than the threshold, a preventive replacement( PR) action was made; otherwise PR action was to wait till the APR time. Two models were proposed and compared,and a numerical example was conducted to illustrate the applicability of the model.
文摘The exponential growth of agricultural wastes such as Balanite seed pod has resulted in waste management issues and finding alternatives through waste recycling is an interesting area of research.Balanite seed pods were collected in Yobe state,washed,dried,crushed.Balanite endocarp pod ash(BEPA)was calcined at 600°C for 3 hours in a muffle furnace and the biomass was characterized with X-ray fluorescence spectrometer to determine its chemical composition.The analysis showed that the ash composed of silica,alumina and ferric oxide(74.24 wt.%)indicated a strong pozzolan based on American Standard.The BEPA possessed a high loss on ignition of 8.24 wt.%owing to the presence of unburnt carbon in the ash.The ash obtained was sieved with 75µm sieve and cement was replaced with ash between 2.5 wt.%~12.5 wt.%at interval of 2.5 wt.%to assess its impact on cement properties such as setting time,consistence,mortar strength and water absorption.Results showed that as percentage replacement increases,the water absorption increased while the mortar strength diminished whereas as the curing days progressed its strength improved despite clinker diminution due to cement hydration.60 days strength for below 10 wt.%BEPA cement blend produced enhanced strength compared with control which is evidence of slow pozzolanic reactions.The optimum percentage replacement with BEPA was obtained at 7.5 wt.%replacement beyond which significantly affected the cement properties especially its strength.It could be agreed that BEPA has potentials to be considered and employed as a cement replacement material.
文摘Several researches have been done to provide better alternative to the existing replacement models, but the research works did not adequately address the replacement problem for items that fail suddenly. Hence, a modified replacement model for items that fail suddenly has been proposed using the knowledge of probability distribution of failure times as well as that of variable replacement cost. The modified cost functions for implementing both individual and group replacements were derived. The modified cost functions were minimized using the principle of classical optimization in order to find the age at which replacement of items would be appropriate. Conditions under which the individual and group replacement policies should be adopted were derived. Two real data sets on failure time of LED bulbs and their replacement costs were used to validate the theoretical claims of this work. In essence, goodness-of-fit test was used to select appropriate probability distribution of failure times as well as that of replacement costs for data sets I and II respectively. The goodness-of-fit results showed that failure times of LED bulbs follow the Smallest Extreme Value and Laplace distributions for data sets I and II respectively. Similarly, it was observed that individual replacement cost followed the two-parameter Gamma and Largest Extreme Value distributions for data sets I and II respectively. Further, the group replacement cost was found to follow the log-normal and two-parameter Weibull distributions for data sets I and II respectively. Based on the empirical study, we observed that individual replacement policy is better than group replacement policy in terms of cost minimization for both existing model and the proposed model. In view of the results, the proposed replacement policy was recommended over the existing one because it yielded lower replacement costs than the existing replacement model.
文摘Acute kidney injury remains a serious condition with a high mortality risk. In the absence of any new drugs, renal replacement therapy (RRT) is the most important treatment option. Randomized controlled trials have concluded that in critically ill patients without an emergency indication for RRT, a watchful waiting strategy is safe;however, further delays in RRT did not seem to confer any benefit, rather was associated with potential harm. During this process, balancing the risks of complications due to an unnecessary intervention with the risk of not correcting a potentially life-threatening complication remains a challenge. Dynamic renal function assessment, especially dynamic assessment of renal demand-capacity matching, combined with renal biomarkers such as neutrophil gelatinase-associated lipocalin and furosemide stress test, is helpful to identify which patients and when the patients may benefit from RRT.
文摘目的探索照顾者基于时机理论指导下的健康教育应用在老年髋关节置换术后护理中的效果。方法采用方便取样法将行髋关节置换术的80例老年患者分为对照组和观察组,每组40例,对照组给予骨科常规护理,观察组在骨科常规护理的基础上基于时机理论(total hip replacement,TIR)指导下的健康管理。采用髋关节功能评分量表、日常生活活动能力评定量表(Barthel指数)、照顾者负担问卷、家属照顾者照顾能力测量进行比较并评价2组照顾者的健康教育在老年髋关节置换术后护理中的应用效果。结果分别观察出院后1个月和3个月患者髋关节功能评分和日常生活活动能力评定指数,观察组显著高于对照组(P<0.01);出院时,出院后1个月和3个月观察组家属照顾者照顾能力测量评分(P<0.01)和照顾者负担问卷评分(P<0.01)显著低于对照组。结论基于时机理论指导下的健康教育能够有效减轻照顾者的照顾负担,增强照顾者的照顾能力,提高患者的康复效果,改善患者的生活质量。
