Absurdity originated from French existentialism,and Martin Esslin,in categorizing Waiting for Godot as a theater of the absurd,ignores the positive aspects of Camus’s absurdism and regards that as an existential trag...Absurdity originated from French existentialism,and Martin Esslin,in categorizing Waiting for Godot as a theater of the absurd,ignores the positive aspects of Camus’s absurdism and regards that as an existential tragedy of mankind.However,the author Samuel Beckett himself did not approve of such a definition,believing that Esslin’s definition of theater of the absurd was too judgmental and pessimistic.Through the imagery of boots,ropes,hats and baggage in Waiting for Godot,Beckett reveals the rootlessness,constraint and agony of the minds of people born into absurdity in the early 20th century.The luck of Lucky is Beckett’s use of irony:people who have lost the ability to think for themselves escape the absurdity and dystopia of life and descend to slaves.Gogo and Didi,who are waiting and expecting,and thinking in the midst of absurdity,represent“Godot”,the symbol of hope.Their endurance in waiting,akin to Camus’s Sisyphus,underscores a form of existential defiance that challenges the notion of absolute pessimism in absurdist literature.展开更多
Several therapeutic procedures have been proposed as bridging treatments for patients with hepatocellular carcinoma(HCC)awaiting liver transplantation(LT).The most used treatments include transarterial chemoembolizati...Several therapeutic procedures have been proposed as bridging treatments for patients with hepatocellular carcinoma(HCC)awaiting liver transplantation(LT).The most used treatments include transarterial chemoembolization and radiofrequency ablation.Surgical resection has also been successfully used as a bridging procedure,and LT should be considered a rescue treatment in patients with previous HCC resection who experience tumor recurrence or post-treatment severe decompensation of liver function.The aims of bridging treatments include decreasing the waiting list dropout rate before transplantation,reducing HCC recurrence after transplantation,and improving post-transplant overall survival.To date,no data from prospective randomized studies are available;however,for HCC patients listed for LT within the Milan criteria,prolonging the waiting time over 6-12 mo is a risk factor for tumor spread.Bridging treatments are useful in containing tumor progression and decreasing dropout.Furthermore,the response to pre-LT treatments may represent a surrogate marker of tumor biological aggressiveness and could therefore be evaluated to prioritize HCC candidates for LT.Lastly,although a definitive conclusion can not be reached,the experiences reported to date suggest a positive impact of these treatments on both tumor recurrence and post-transplant patient survival.Advanced HCC may be downstaged to achieve and maintain the current conventional criteria for inclusion in the waiting list for LT.Recent studies have demonstrated that successfully downstaged patients can achieve a 5-year survival rate comparable to that of patients meeting the conventional criteria without requiring downstaging.展开更多
This paper considers a novel polling system with two classes of message which can experience an up-per bounded time before being served. The station serves these two classes with mixed service discipline, one class wi...This paper considers a novel polling system with two classes of message which can experience an up-per bounded time before being served. The station serves these two classes with mixed service discipline, one class with exhaustive service discipline, and the other with gated service discipline. Using iterative method, we have developed an approximation method to obtain the mean waiting time for each message class. The performance of approximation has been compared with the simulation results. The expression for the upper bound of waiting time is given too.展开更多
A field study and analysis about the thermal comfort was carried out in the waiting room at Beijing West Rail Station in Chinese cold region.Passengers' TSV(thermal sense vote)was obtained using statistical method...A field study and analysis about the thermal comfort was carried out in the waiting room at Beijing West Rail Station in Chinese cold region.Passengers' TSV(thermal sense vote)was obtained using statistical method on the basis of more than 1 200 questionnaires.The linear regression between TSV and indoor temperature indicates that thermal neutral temperature is 25.2 ℃.According to the percentage of satisfaction among all passengers under different indoor temperatures,the acceptable temperature range in the waiting room is 24.2~30.2℃.It is also found that passengers' temporary stay should be taken into consideration for the thermal comfort analysis.Passengers' TSV is not a constant value after they enter the waiting room.In fact,ΔTSV increases as passengers are waiting for the train,and the growing rate is dependent on indoor-outdoor temperature difference.The greater the temperature difference,the faster ΔTSV increases.At last,a linear regression between indoor comfortable temperature and outdoor temperature was generated as the adaptive comfort model.展开更多
Background: Numerous studies of tissues’ regeneration have confessed the recovery of damaged liver by hematopoietic stem cells. The cells act not only by cell replacement in the target organ but also by delivering tr...Background: Numerous studies of tissues’ regeneration have confessed the recovery of damaged liver by hematopoietic stem cells. The cells act not only by cell replacement in the target organ but also by delivering trophic factors that support endogenous liver regeneration. A little is known of how organ-derived signals recruit such committed cells into circulation. Objective: We investigated the roles of noninvasive mechanical percutaneous stress of cirrhotic human liver in numbers fluctuation of trophic, liver-specific alpha-fetoprotein-positive fraction of CD133-positive hematopoietic stem cells in lymphocytes of patients waiting for liver transplantation. Methods: To promote in blood the number of the alpha-fetoprotein-positive fraction of CD133-positive hematopoietic stem cells, committed to liver’ tissue, we activated mechanically the cirrhotic liver of patient by transcutaneous micro vibration received from skin-contacted electro-magnetic vibraphones generated mechanical pulses with amplitude 10 μm and smoothly changing frequency from 0.03 kHz to 18 kHz and back forth during one cycle duration 1 minute. The number of the alpha-fetoprotein-positive fraction of CD133-positive hematopoietic stem cells in lymphocytes of potential recipients was controlled by flow cytometry before and during daily sonication of skin area, which corresponds to liver projection on it. The 15 minutes cyclic sonication of the liver area performed daily for three weeks. Results: The sonication increased significantly averaged number of liver-specific alpha-fetoprotein-positive CD133-positive blood lymphocytes in 2 - 3 times compared to a base lane. The second similar sonication, the same zone after three weeks break showed differences with baseline, but it was statistically insignificant. The result was specifically related to the liver as it showed the control sonication of the backbone’s projection on the skin of a separate group of patients with cirrhotic liver from the waiting list. Conclusion: The stem cells committed to the liver recruit from the bone marrow into circulation, when organ mechanically stresses and secretes specific humoral signals to provoke of lymphopoiesis on host liver repair.展开更多
The Inspection Paradox refers to the fact that in a Renewal Process, the length of the interarrival period which contains a fixed time is stochastically larger than the length of a typical interarrival period. To prov...The Inspection Paradox refers to the fact that in a Renewal Process, the length of the interarrival period which contains a fixed time is stochastically larger than the length of a typical interarrival period. To provide a more complete understanding of this phenomenon, conditioning arguments are used to obtain the distributions and moments of the lengths of the interarrival periods other than the one containing this fixed time for the case of the time-homogeneous Poisson Process. Distributions of the waiting times for events that occur both before and after this fixed time are derived. This provides a fairly complete probabilistic analysis of the Inspection Paradox.展开更多
In renewal theory, the Inspection Paradox refers to the fact that an interarrival period in a renewal process which contains a fixed inspection time tends to be longer than one for the corresponding uninspected proces...In renewal theory, the Inspection Paradox refers to the fact that an interarrival period in a renewal process which contains a fixed inspection time tends to be longer than one for the corresponding uninspected process. We focus on the paradox for Bernoulli trials. Probability distributions and moments for the lengths of the interarrival periods are derived for the inspected process, and we compare them to those for the uninspected case.展开更多
Waiting for Godot is often regarded as Beckett's masterpiece. This paper is to explore the possible themes in the play.Waiting for the unrealizable tomorrow is a most dominant theme of the play. Through a brief an...Waiting for Godot is often regarded as Beckett's masterpiece. This paper is to explore the possible themes in the play.Waiting for the unrealizable tomorrow is a most dominant theme of the play. Through a brief analysis of the plot, the dominant theme can be demonstrated very clearly.展开更多
The aim of this of this experimental study to investigate the effect of 3 voluntary waiting periods (VWP) on health of dairy cows. A total of 100 lactations of 100 Holstein Friesian cows with high milk production (ave...The aim of this of this experimental study to investigate the effect of 3 voluntary waiting periods (VWP) on health of dairy cows. A total of 100 lactations of 100 Holstein Friesian cows with high milk production (average 9.442 ± 620 kg) were randomly (based on the ear tags digits of cows) distributed to 1 to 3 experimental groups with VWP of 50 (VWPG50;n = 32), 100 (VWPG100;n = 34) or 150 days (VWPG150;n = 34). Observations relating to diseases of the cows were made by the farm veterinarian and research personnel. Were defined eight disease: puerperal fever, retained fetal membranes, displaced abomasum, metritis, clinical ketosis, clinical mastitis, ovarian cysts, and claw diseases. The experimental days (ED) were from 4 days in milk (DIM) to 100 days after the next calving. The experiment was managed at Dairy Research Farm ?imnic-Craiova January 2018 to December 2022. A clear set of clinical signs were used to define a case at the diseases without the need for laboratory confirmation. Values of Lactational incidence risk (LIR) median postpartum days at diagnosis and pairwise comparison of proportion between VWPs were calculated. LIR for puerperal fiver, retained fetal membranes, displaced abomasum, clinical ketosis, clinical mastitis, ovarian cysts and claw disease were 4;5;2;8;8;and 4% respectively. Numerically, cows with VWP of 100 and150 days had more disease cases compared with VWP of 50 days. The differences between experimental groups of cows regarding proportions of cows with disease cases were not statistically significant. Any of the eight disorders reported in this study was analyzed independently to other health problems. For all enrolled cows (n = 100) VWP was extended until 100 or 150 days postpartum with no effect on the lactational incidence risk for the eight disorders analyzed.展开更多
AIM: To simulate a hypothetical increase of 50% in the number of pancreas-kidney (PK) transplantations using less-than-ideal donors by a mathematical model. METHODS: We projected the size of the waiting list by taking...AIM: To simulate a hypothetical increase of 50% in the number of pancreas-kidney (PK) transplantations using less-than-ideal donors by a mathematical model. METHODS: We projected the size of the waiting list by taking into account the incidence of new patients per year, the number of PK transplantations carried out in the year and the number of patients who died on the waiting list or were removed from the list for other reasons. These variables were treated using a model developed elsewhere. RESULTS: We found that the waiting list demand will meet the number of PK transplantation by the year 2022. CONCLUSION: In future years, it is perfectly possible to minimize the waiting list time for pancreas transplantation through expansion of the donor pool using less-than-ideal donors.展开更多
Since October 2008,China's social consumption of electricity had,for the first time,grown negatively compared to the same period of the previous year,and in November the negative growth range further expanded. The...Since October 2008,China's social consumption of electricity had,for the first time,grown negatively compared to the same period of the previous year,and in November the negative growth range further expanded. The major pressure faced by the electricity industry has now turned from the contradiction between coal and electricity to electricity quantity. This is undoubtedly a true and new test to electricity enterprises which get used to high growth but are now suffering great losses. The reform of electricity system has already been in great difficulties and now is getting into a more serious situation. In order to help readers improve their knowledge and understanding of the current tough situation faced by the electricity industry and discuss how to alleviate and get through the difficulty resulted from the economic crisis "encountered once every one hundred years" by joint efforts of all parties concerned,a Seminar on Crisis and Countermeasures for Electricity Industry was held on November 20,2008. Here are some extracts from the speeches of four experts.展开更多
Poetics by Aristotle sets the dogmas for literature,while Waiting for Godot,the representative of the Theater of the Ab⁃surd,violates the former’s principles to achieve certain effects.The thesis will analyze the vio...Poetics by Aristotle sets the dogmas for literature,while Waiting for Godot,the representative of the Theater of the Ab⁃surd,violates the former’s principles to achieve certain effects.The thesis will analyze the violation from the angle of Solidity or Authenticity of art and poetry,which are the likelinessandnecessity,and credibility.By digressing from the traditional rules,Wait⁃ing for Godot helps to create absurdity reflecting the inner loss of people after the war and to form a sense of alienation from reality.展开更多
As an important representative of the Theatre of Absurd, in his masterpiece Waiting for Godot, Beckett deserted the traditional dramatic form and adopted a new one that shows us the fragmentary characters and the absu...As an important representative of the Theatre of Absurd, in his masterpiece Waiting for Godot, Beckett deserted the traditional dramatic form and adopted a new one that shows us the fragmentary characters and the absurdity of the modern society. This paper demonstrates his artful creation of the language form from the following three aspects: The use of repetition, use of silence and pause and short sentences.展开更多
Thirty per cent of all colorectal tumours develop in the rectum.The location of the rectum within the bony pelvis and its proximity to vital structures presents significant therapeutic challenges when considering neoa...Thirty per cent of all colorectal tumours develop in the rectum.The location of the rectum within the bony pelvis and its proximity to vital structures presents significant therapeutic challenges when considering neoadjuvant options and surgical interventions.Most patients with early rectal cancer can be adequately managed by surgery alone.However,a significant proportion of patients with rectal cancer present with locally advanced disease and will potentially benefit from down staging prior to surgery.Neoadjuvant therapy involves a variety of options including radiotherapy,chemotherapy used alone or in combination.Neoadjuvant radiotherapy in rectal cancer has been shown to be effective in reducing tumour burden in advance of curative surgery.The gold standard surgical rectal cancer management aims to achieve surgical removal of the tumour and all draining lymph nodes,within an intact mesorectal package,in order to minimise local recurrence.It is critically important that all rectal cancer cases are discussed at a multidisciplinary meeting represented by all relevant specialties.Pre-operative staging including CT thorax,abdomen,pelvis to assess for distal disease and magnetic resonance imaging to assess local involvement is essential.Staging radiology and MDT discussion are integral in identifying patients who require neoadjuvant radiotherapy.While Neoadjuvant radiotherapy is potentially beneficial it may also result in morbidity and thus should be reserved for those patients who are at a high risk of local failure,which includes patients with nodal involvement,extramural venous invasion and threatened circumferential margin.The aim of this review is to discuss the role of neoadjuvant radiotherapy in the management of rectal cancer.展开更多
BACKGROUND: Emergency departments(EDs) face problems with overcrowding, access block, cost containment, and increasing demand from patients. In order to resolve these problems, there is rising interest to an approach ...BACKGROUND: Emergency departments(EDs) face problems with overcrowding, access block, cost containment, and increasing demand from patients. In order to resolve these problems, there is rising interest to an approach called "lean" management. This study aims to(1) evaluate the current patient flow in ED,(2) to identify and eliminate the non-valued added process, and(3) to modify the existing process.METHODS: It was a quantitative, pre- and post-lean design study with a series of lean management work implemented to improve the admission and blood result waiting time. These included structured re-design process, priority admission triage(PAT) program, enhanced communication with medical department, and use of new high sensitivity troponin-T(hsTnT) blood test. Triage waiting time, consultation waiting time, blood result time, admission waiting time, total processing time and ED length of stay were compared.RESULTS: Among all the processes carried out in ED, the most time consuming processes were to wait for an admission bed(38.24 minutes; SD 66.35) and blood testing result(mean 52.73 minutes, SD 24.03). The triage waiting time and end waiting time for consultation were significantly decreased. The admission waiting time of emergency medical ward(EMW) was significantly decreased from 54.76 minutes to 24.45 minutes after implementation of PAT program(P<0.05).CONCLUSION: The application of lean management can improve the patient flow in ED. Acquiescence to the principle of lean is crucial to enhance high quality emergency care and patient satisfaction.展开更多
Introduction: Studies have shown Emergency Department (ED) crowding contributes to reduced quality of patient care, delays in starting treatments, and increased number of patients leaving without being seen. This anal...Introduction: Studies have shown Emergency Department (ED) crowding contributes to reduced quality of patient care, delays in starting treatments, and increased number of patients leaving without being seen. This analysis shows how to theoretically and optimally align staffing to demand. Methods: The ED value stream was identified and mapped. Patients were stratified into three resource-driven care flow cells based on the severity indices. Time observations were conducted for each of the key care team members and the manual cycle times and service rate were calculated and stratified by severity indices. Using X32 Healthcare’s Online Staffing Optimization (OSO) tool, staffing inefficiencies were identified and an optimal schedule was created for each provider group. Results: Lower Severity Indices (higher acuity patient) led to longer times for providers, nurses, patient care assistants, and clerks. The patient length of stay varied from under one hour to over five hours. The flow of patients varied considerably over the 24 hours’ period but was similar by day of the week. Using flow data, we showed that we needed more nurses, more care team members during peak times of patient flow. Eight hour shifts would allow better flexibility. We showed that the additional salary hours added to the budget would be made up for by increased revenue recognized by decreasing the number of patients who leave without being seen. Conclusion: If implemented, these changes will improve ED flow by using lean tools and principles, ultimately leading to timeliness of care, reduced waits, and improved patient experience.展开更多
AIM: To determine parental knowledge about acute otitis media(AOM) and its antibiotic therapy, antibiotic resistance and the willingness to comply with the watchful waiting(WW) approach in primary care settings in sou...AIM: To determine parental knowledge about acute otitis media(AOM) and its antibiotic therapy, antibiotic resistance and the willingness to comply with the watchful waiting(WW) approach in primary care settings in southern Israel.METHODS: The study was conducted in 3 primary care clinics and the pediatric emergency room of Soroka University Medical Center. Questionnaires(20 questions on education background, previous AOM experience, knowledge on antimicrobial resistance and attitude vs the WW approach) were filled by 600 parents(150 at each centers) of children < 6 years of age.RESULTS: Mothers represented 69% of parents; 2% had an education of < 10 school years, 46% had high-school education and 17% had an academic degree. 69% parents reported previous experience with AOM and 56% thought that antibiotics represent the only treatment for AOM. Knowledge on bacterial resistance to antibiotics was reported by 57% of the parents; 86% parents were willing to accept/probably accept the WW approach for their children. Logistic regression analysis revealed a significant association between parental education and knowledge about bacterial resistance to antibiotics and that previous experience with AOM was significantly associated with reluctance to accept the WW approach. More parents with knowledge on bacterial resistance were willing to accept the WW approach compared with parents without such knowledge. No correlation was found between the education level and willingness to accept the WW approach. CONCLUSION: A significant correlation was found between previous parental education and experience with AOM and the knowledge about antibiotic use, bacterial resistance and acceptance of the WW approach.展开更多
The novel Waiting describes Kong Lin,a common,ordinary even pedantic military doctor waits for more than 18 years to have the divorce with his wife in the country in order to get married with his lover.By the author...The novel Waiting describes Kong Lin,a common,ordinary even pedantic military doctor waits for more than 18 years to have the divorce with his wife in the country in order to get married with his lover.By the author's vivid illustration about the personalities and fates of the three main characters,the novel emphasizes the misfortune of people in that era whose freedom and desire are restricted to the rules of the society at that moment and shows the view of waiting with regard to wisdom and philosophy,encouraging the reader to pay more attention to life,society and especially to the human nature.展开更多
This paper introduces the principle of ATM switch, and discusses queueing disciplines and their performances. Authors describe the method of input queueing, output queueing, central queueing, combined input/output que...This paper introduces the principle of ATM switch, and discusses queueing disciplines and their performances. Authors describe the method of input queueing, output queueing, central queueing, combined input/output queuing, combined input/shared queueing, and multistage queueing in detail. They also present the relations between mean waiting time and input load. The queueing disciplines can be used to design the architecture of Asynchronous Transfer Mode (ATM) switch.展开更多
文摘Absurdity originated from French existentialism,and Martin Esslin,in categorizing Waiting for Godot as a theater of the absurd,ignores the positive aspects of Camus’s absurdism and regards that as an existential tragedy of mankind.However,the author Samuel Beckett himself did not approve of such a definition,believing that Esslin’s definition of theater of the absurd was too judgmental and pessimistic.Through the imagery of boots,ropes,hats and baggage in Waiting for Godot,Beckett reveals the rootlessness,constraint and agony of the minds of people born into absurdity in the early 20th century.The luck of Lucky is Beckett’s use of irony:people who have lost the ability to think for themselves escape the absurdity and dystopia of life and descend to slaves.Gogo and Didi,who are waiting and expecting,and thinking in the midst of absurdity,represent“Godot”,the symbol of hope.Their endurance in waiting,akin to Camus’s Sisyphus,underscores a form of existential defiance that challenges the notion of absolute pessimism in absurdist literature.
文摘Several therapeutic procedures have been proposed as bridging treatments for patients with hepatocellular carcinoma(HCC)awaiting liver transplantation(LT).The most used treatments include transarterial chemoembolization and radiofrequency ablation.Surgical resection has also been successfully used as a bridging procedure,and LT should be considered a rescue treatment in patients with previous HCC resection who experience tumor recurrence or post-treatment severe decompensation of liver function.The aims of bridging treatments include decreasing the waiting list dropout rate before transplantation,reducing HCC recurrence after transplantation,and improving post-transplant overall survival.To date,no data from prospective randomized studies are available;however,for HCC patients listed for LT within the Milan criteria,prolonging the waiting time over 6-12 mo is a risk factor for tumor spread.Bridging treatments are useful in containing tumor progression and decreasing dropout.Furthermore,the response to pre-LT treatments may represent a surrogate marker of tumor biological aggressiveness and could therefore be evaluated to prioritize HCC candidates for LT.Lastly,although a definitive conclusion can not be reached,the experiences reported to date suggest a positive impact of these treatments on both tumor recurrence and post-transplant patient survival.Advanced HCC may be downstaged to achieve and maintain the current conventional criteria for inclusion in the waiting list for LT.Recent studies have demonstrated that successfully downstaged patients can achieve a 5-year survival rate comparable to that of patients meeting the conventional criteria without requiring downstaging.
基金Supported by the High Technology Research and Development Program of China(2002AA412010-08) and the National Natural Science Foundation of China(60474031).
文摘This paper considers a novel polling system with two classes of message which can experience an up-per bounded time before being served. The station serves these two classes with mixed service discipline, one class with exhaustive service discipline, and the other with gated service discipline. Using iterative method, we have developed an approximation method to obtain the mean waiting time for each message class. The performance of approximation has been compared with the simulation results. The expression for the upper bound of waiting time is given too.
基金Supported by National Natural Science Foundation of China(20676154)
文摘A field study and analysis about the thermal comfort was carried out in the waiting room at Beijing West Rail Station in Chinese cold region.Passengers' TSV(thermal sense vote)was obtained using statistical method on the basis of more than 1 200 questionnaires.The linear regression between TSV and indoor temperature indicates that thermal neutral temperature is 25.2 ℃.According to the percentage of satisfaction among all passengers under different indoor temperatures,the acceptable temperature range in the waiting room is 24.2~30.2℃.It is also found that passengers' temporary stay should be taken into consideration for the thermal comfort analysis.Passengers' TSV is not a constant value after they enter the waiting room.In fact,ΔTSV increases as passengers are waiting for the train,and the growing rate is dependent on indoor-outdoor temperature difference.The greater the temperature difference,the faster ΔTSV increases.At last,a linear regression between indoor comfortable temperature and outdoor temperature was generated as the adaptive comfort model.
文摘Background: Numerous studies of tissues’ regeneration have confessed the recovery of damaged liver by hematopoietic stem cells. The cells act not only by cell replacement in the target organ but also by delivering trophic factors that support endogenous liver regeneration. A little is known of how organ-derived signals recruit such committed cells into circulation. Objective: We investigated the roles of noninvasive mechanical percutaneous stress of cirrhotic human liver in numbers fluctuation of trophic, liver-specific alpha-fetoprotein-positive fraction of CD133-positive hematopoietic stem cells in lymphocytes of patients waiting for liver transplantation. Methods: To promote in blood the number of the alpha-fetoprotein-positive fraction of CD133-positive hematopoietic stem cells, committed to liver’ tissue, we activated mechanically the cirrhotic liver of patient by transcutaneous micro vibration received from skin-contacted electro-magnetic vibraphones generated mechanical pulses with amplitude 10 μm and smoothly changing frequency from 0.03 kHz to 18 kHz and back forth during one cycle duration 1 minute. The number of the alpha-fetoprotein-positive fraction of CD133-positive hematopoietic stem cells in lymphocytes of potential recipients was controlled by flow cytometry before and during daily sonication of skin area, which corresponds to liver projection on it. The 15 minutes cyclic sonication of the liver area performed daily for three weeks. Results: The sonication increased significantly averaged number of liver-specific alpha-fetoprotein-positive CD133-positive blood lymphocytes in 2 - 3 times compared to a base lane. The second similar sonication, the same zone after three weeks break showed differences with baseline, but it was statistically insignificant. The result was specifically related to the liver as it showed the control sonication of the backbone’s projection on the skin of a separate group of patients with cirrhotic liver from the waiting list. Conclusion: The stem cells committed to the liver recruit from the bone marrow into circulation, when organ mechanically stresses and secretes specific humoral signals to provoke of lymphopoiesis on host liver repair.
文摘The Inspection Paradox refers to the fact that in a Renewal Process, the length of the interarrival period which contains a fixed time is stochastically larger than the length of a typical interarrival period. To provide a more complete understanding of this phenomenon, conditioning arguments are used to obtain the distributions and moments of the lengths of the interarrival periods other than the one containing this fixed time for the case of the time-homogeneous Poisson Process. Distributions of the waiting times for events that occur both before and after this fixed time are derived. This provides a fairly complete probabilistic analysis of the Inspection Paradox.
文摘In renewal theory, the Inspection Paradox refers to the fact that an interarrival period in a renewal process which contains a fixed inspection time tends to be longer than one for the corresponding uninspected process. We focus on the paradox for Bernoulli trials. Probability distributions and moments for the lengths of the interarrival periods are derived for the inspected process, and we compare them to those for the uninspected case.
文摘Waiting for Godot is often regarded as Beckett's masterpiece. This paper is to explore the possible themes in the play.Waiting for the unrealizable tomorrow is a most dominant theme of the play. Through a brief analysis of the plot, the dominant theme can be demonstrated very clearly.
文摘The aim of this of this experimental study to investigate the effect of 3 voluntary waiting periods (VWP) on health of dairy cows. A total of 100 lactations of 100 Holstein Friesian cows with high milk production (average 9.442 ± 620 kg) were randomly (based on the ear tags digits of cows) distributed to 1 to 3 experimental groups with VWP of 50 (VWPG50;n = 32), 100 (VWPG100;n = 34) or 150 days (VWPG150;n = 34). Observations relating to diseases of the cows were made by the farm veterinarian and research personnel. Were defined eight disease: puerperal fever, retained fetal membranes, displaced abomasum, metritis, clinical ketosis, clinical mastitis, ovarian cysts, and claw diseases. The experimental days (ED) were from 4 days in milk (DIM) to 100 days after the next calving. The experiment was managed at Dairy Research Farm ?imnic-Craiova January 2018 to December 2022. A clear set of clinical signs were used to define a case at the diseases without the need for laboratory confirmation. Values of Lactational incidence risk (LIR) median postpartum days at diagnosis and pairwise comparison of proportion between VWPs were calculated. LIR for puerperal fiver, retained fetal membranes, displaced abomasum, clinical ketosis, clinical mastitis, ovarian cysts and claw disease were 4;5;2;8;8;and 4% respectively. Numerically, cows with VWP of 100 and150 days had more disease cases compared with VWP of 50 days. The differences between experimental groups of cows regarding proportions of cows with disease cases were not statistically significant. Any of the eight disorders reported in this study was analyzed independently to other health problems. For all enrolled cows (n = 100) VWP was extended until 100 or 150 days postpartum with no effect on the lactational incidence risk for the eight disorders analyzed.
基金Supported by LIMs 01 and 37-HCFMUSP, CNPq and FAPESP
文摘AIM: To simulate a hypothetical increase of 50% in the number of pancreas-kidney (PK) transplantations using less-than-ideal donors by a mathematical model. METHODS: We projected the size of the waiting list by taking into account the incidence of new patients per year, the number of PK transplantations carried out in the year and the number of patients who died on the waiting list or were removed from the list for other reasons. These variables were treated using a model developed elsewhere. RESULTS: We found that the waiting list demand will meet the number of PK transplantation by the year 2022. CONCLUSION: In future years, it is perfectly possible to minimize the waiting list time for pancreas transplantation through expansion of the donor pool using less-than-ideal donors.
文摘Since October 2008,China's social consumption of electricity had,for the first time,grown negatively compared to the same period of the previous year,and in November the negative growth range further expanded. The major pressure faced by the electricity industry has now turned from the contradiction between coal and electricity to electricity quantity. This is undoubtedly a true and new test to electricity enterprises which get used to high growth but are now suffering great losses. The reform of electricity system has already been in great difficulties and now is getting into a more serious situation. In order to help readers improve their knowledge and understanding of the current tough situation faced by the electricity industry and discuss how to alleviate and get through the difficulty resulted from the economic crisis "encountered once every one hundred years" by joint efforts of all parties concerned,a Seminar on Crisis and Countermeasures for Electricity Industry was held on November 20,2008. Here are some extracts from the speeches of four experts.
文摘Poetics by Aristotle sets the dogmas for literature,while Waiting for Godot,the representative of the Theater of the Ab⁃surd,violates the former’s principles to achieve certain effects.The thesis will analyze the violation from the angle of Solidity or Authenticity of art and poetry,which are the likelinessandnecessity,and credibility.By digressing from the traditional rules,Wait⁃ing for Godot helps to create absurdity reflecting the inner loss of people after the war and to form a sense of alienation from reality.
文摘As an important representative of the Theatre of Absurd, in his masterpiece Waiting for Godot, Beckett deserted the traditional dramatic form and adopted a new one that shows us the fragmentary characters and the absurdity of the modern society. This paper demonstrates his artful creation of the language form from the following three aspects: The use of repetition, use of silence and pause and short sentences.
基金Supported by NBCRI,Symptomatic Breast Unit,University Hospital Galway
文摘Thirty per cent of all colorectal tumours develop in the rectum.The location of the rectum within the bony pelvis and its proximity to vital structures presents significant therapeutic challenges when considering neoadjuvant options and surgical interventions.Most patients with early rectal cancer can be adequately managed by surgery alone.However,a significant proportion of patients with rectal cancer present with locally advanced disease and will potentially benefit from down staging prior to surgery.Neoadjuvant therapy involves a variety of options including radiotherapy,chemotherapy used alone or in combination.Neoadjuvant radiotherapy in rectal cancer has been shown to be effective in reducing tumour burden in advance of curative surgery.The gold standard surgical rectal cancer management aims to achieve surgical removal of the tumour and all draining lymph nodes,within an intact mesorectal package,in order to minimise local recurrence.It is critically important that all rectal cancer cases are discussed at a multidisciplinary meeting represented by all relevant specialties.Pre-operative staging including CT thorax,abdomen,pelvis to assess for distal disease and magnetic resonance imaging to assess local involvement is essential.Staging radiology and MDT discussion are integral in identifying patients who require neoadjuvant radiotherapy.While Neoadjuvant radiotherapy is potentially beneficial it may also result in morbidity and thus should be reserved for those patients who are at a high risk of local failure,which includes patients with nodal involvement,extramural venous invasion and threatened circumferential margin.The aim of this review is to discuss the role of neoadjuvant radiotherapy in the management of rectal cancer.
文摘BACKGROUND: Emergency departments(EDs) face problems with overcrowding, access block, cost containment, and increasing demand from patients. In order to resolve these problems, there is rising interest to an approach called "lean" management. This study aims to(1) evaluate the current patient flow in ED,(2) to identify and eliminate the non-valued added process, and(3) to modify the existing process.METHODS: It was a quantitative, pre- and post-lean design study with a series of lean management work implemented to improve the admission and blood result waiting time. These included structured re-design process, priority admission triage(PAT) program, enhanced communication with medical department, and use of new high sensitivity troponin-T(hsTnT) blood test. Triage waiting time, consultation waiting time, blood result time, admission waiting time, total processing time and ED length of stay were compared.RESULTS: Among all the processes carried out in ED, the most time consuming processes were to wait for an admission bed(38.24 minutes; SD 66.35) and blood testing result(mean 52.73 minutes, SD 24.03). The triage waiting time and end waiting time for consultation were significantly decreased. The admission waiting time of emergency medical ward(EMW) was significantly decreased from 54.76 minutes to 24.45 minutes after implementation of PAT program(P<0.05).CONCLUSION: The application of lean management can improve the patient flow in ED. Acquiescence to the principle of lean is crucial to enhance high quality emergency care and patient satisfaction.
文摘Introduction: Studies have shown Emergency Department (ED) crowding contributes to reduced quality of patient care, delays in starting treatments, and increased number of patients leaving without being seen. This analysis shows how to theoretically and optimally align staffing to demand. Methods: The ED value stream was identified and mapped. Patients were stratified into three resource-driven care flow cells based on the severity indices. Time observations were conducted for each of the key care team members and the manual cycle times and service rate were calculated and stratified by severity indices. Using X32 Healthcare’s Online Staffing Optimization (OSO) tool, staffing inefficiencies were identified and an optimal schedule was created for each provider group. Results: Lower Severity Indices (higher acuity patient) led to longer times for providers, nurses, patient care assistants, and clerks. The patient length of stay varied from under one hour to over five hours. The flow of patients varied considerably over the 24 hours’ period but was similar by day of the week. Using flow data, we showed that we needed more nurses, more care team members during peak times of patient flow. Eight hour shifts would allow better flexibility. We showed that the additional salary hours added to the budget would be made up for by increased revenue recognized by decreasing the number of patients who leave without being seen. Conclusion: If implemented, these changes will improve ED flow by using lean tools and principles, ultimately leading to timeliness of care, reduced waits, and improved patient experience.
文摘AIM: To determine parental knowledge about acute otitis media(AOM) and its antibiotic therapy, antibiotic resistance and the willingness to comply with the watchful waiting(WW) approach in primary care settings in southern Israel.METHODS: The study was conducted in 3 primary care clinics and the pediatric emergency room of Soroka University Medical Center. Questionnaires(20 questions on education background, previous AOM experience, knowledge on antimicrobial resistance and attitude vs the WW approach) were filled by 600 parents(150 at each centers) of children < 6 years of age.RESULTS: Mothers represented 69% of parents; 2% had an education of < 10 school years, 46% had high-school education and 17% had an academic degree. 69% parents reported previous experience with AOM and 56% thought that antibiotics represent the only treatment for AOM. Knowledge on bacterial resistance to antibiotics was reported by 57% of the parents; 86% parents were willing to accept/probably accept the WW approach for their children. Logistic regression analysis revealed a significant association between parental education and knowledge about bacterial resistance to antibiotics and that previous experience with AOM was significantly associated with reluctance to accept the WW approach. More parents with knowledge on bacterial resistance were willing to accept the WW approach compared with parents without such knowledge. No correlation was found between the education level and willingness to accept the WW approach. CONCLUSION: A significant correlation was found between previous parental education and experience with AOM and the knowledge about antibiotic use, bacterial resistance and acceptance of the WW approach.
文摘The novel Waiting describes Kong Lin,a common,ordinary even pedantic military doctor waits for more than 18 years to have the divorce with his wife in the country in order to get married with his lover.By the author's vivid illustration about the personalities and fates of the three main characters,the novel emphasizes the misfortune of people in that era whose freedom and desire are restricted to the rules of the society at that moment and shows the view of waiting with regard to wisdom and philosophy,encouraging the reader to pay more attention to life,society and especially to the human nature.
文摘This paper introduces the principle of ATM switch, and discusses queueing disciplines and their performances. Authors describe the method of input queueing, output queueing, central queueing, combined input/output queuing, combined input/shared queueing, and multistage queueing in detail. They also present the relations between mean waiting time and input load. The queueing disciplines can be used to design the architecture of Asynchronous Transfer Mode (ATM) switch.