AIM To reduce readmissions and improve patient outcomes in cirrhotic patients through better understanding of readmission predictors.METHODS We performed a single-center retrospective study of patients admitted with d...AIM To reduce readmissions and improve patient outcomes in cirrhotic patients through better understanding of readmission predictors.METHODS We performed a single-center retrospective study of patients admitted with decompensated cirrhosis from January 1, 2011 to December 31, 2013(n = 222). Primary outcomes were time to first readmission and 30-d readmission rate due to complications of cirrhosis. Clinical and demographic data were collected to help describe predictors of readmission, along with care coordination measures such as post-discharge status and outpatient follow-up. Univariate and multivariateanalyses were performed to describe variables associated with readmission.RESULTS One hundred thirty-two patients(59.4%) were readmitted at least once during the study period. Median time to first and second readmissions were 54 and 93 d, respectively. Thirty and 90-d readmission rates were 20.7 and 30.1 percent, respectively. Predictors of 30-d readmission included education level, hepatic encephalopathy at index, ALT more than upper normal limit and Medicare coverage. There were no statistically significant differences in readmission rates when stratified by discharge disposition, outpatient follow-up provider or time to first outpatient visit.CONCLUSION Readmissions are challenging aspect of care for cirrhotic patients and risk continues beyond 30 d. More initiatives are needed to develop enhanced, longitudinal post-discharge systems.展开更多
To illuminate the necessity of model evolvement and reuse, dynamics of injection molding machine＇s product models are analyzed. The performance knowledge is used to support the model evolvement and reuse. The driven ...To illuminate the necessity of model evolvement and reuse, dynamics of injection molding machine＇s product models are analyzed. The performance knowledge is used to support the model evolvement and reuse. The driven factors of mechanical product model are concluded. The dynamic characteristics of reuse. Finally, HT1800X1N series injection molding machines are taken as examples to illuminate that the arithmetic is correct and practical.展开更多
Achieving simultaneous reduction of NOx,CO and unburned hydrocarbon(UHC) emissions without compromising engine performance at part loads is the current focus of dual fuel engine research.The present work focuses on an...Achieving simultaneous reduction of NOx,CO and unburned hydrocarbon(UHC) emissions without compromising engine performance at part loads is the current focus of dual fuel engine research.The present work focuses on an experimental investigation conducted on a dual fuel(diesel-natural gas) engine to examine the simultaneous effect of inlet air pre-heating and exhaust gas recirculation(EGR) ratio on performance and emission characteristics at part loads.The use of EGR at high levels seems to be unable to improve the engine performance at part loads.However,it is shown that EGR combined with pre-heating of inlet air can slightly increase thermal efficiency,resulting in reduced levels of both unburned hydrocarbon and NOx emissions.CO and UHC emissions are reduced by 24% and 31%,respectively,The NOx emissions decrease by 21% because of the lower combustion temperature due to the much inert gas brought by EGR and decreased oxygen concentration in the cylinder.展开更多
A flow control method based on an active jet is developed to restart hypersonic inlets. The dynamic restarting process is numerically reproduced by unsteady Reynolds averaged Navier-Stokes(RANS) modeling to verify the...A flow control method based on an active jet is developed to restart hypersonic inlets. The dynamic restarting process is numerically reproduced by unsteady Reynolds averaged Navier-Stokes(RANS) modeling to verify the effectiveness and reveal the influence of jet conditions. The active jet improves the inlet unstart status by drawing the high-pressure separation bubble from the internal compression duct and performing a full expansion to alleviate the adverse pressure gradient. Moreover, the favorable pressure gradient in the inlet caused by jet expansion allows for a successful restart after turning off the jet. The influence of the jet momentum ratio is then analyzed to guide the design of the active jet control method and choose the proper momentum ratios. A low jet momentum does not eliminate the high-pressure separation bubble, whereas an excessive jet momentum causes severe momentum loss due to the induced shock. The general rule in restarting the inlet using an active jet is to allow a full jet expansion downstream of the jet slot while avoiding excessive momentum loss upstream and preventing the thick low-speed layer.展开更多
文摘AIM To reduce readmissions and improve patient outcomes in cirrhotic patients through better understanding of readmission predictors.METHODS We performed a single-center retrospective study of patients admitted with decompensated cirrhosis from January 1, 2011 to December 31, 2013(n = 222). Primary outcomes were time to first readmission and 30-d readmission rate due to complications of cirrhosis. Clinical and demographic data were collected to help describe predictors of readmission, along with care coordination measures such as post-discharge status and outpatient follow-up. Univariate and multivariateanalyses were performed to describe variables associated with readmission.RESULTS One hundred thirty-two patients(59.4%) were readmitted at least once during the study period. Median time to first and second readmissions were 54 and 93 d, respectively. Thirty and 90-d readmission rates were 20.7 and 30.1 percent, respectively. Predictors of 30-d readmission included education level, hepatic encephalopathy at index, ALT more than upper normal limit and Medicare coverage. There were no statistically significant differences in readmission rates when stratified by discharge disposition, outpatient follow-up provider or time to first outpatient visit.CONCLUSION Readmissions are challenging aspect of care for cirrhotic patients and risk continues beyond 30 d. More initiatives are needed to develop enhanced, longitudinal post-discharge systems.
基金the National Natural Science Foundation(No50505044,60573175)the Key Technology Research and Development of China(No2006BAF01A37)+1 种基金the National High Technology Research and Development Programe of China(No2007AA04Z190)the Key Scientific and Techological Research Program of Zhejiang Province(No2008C11013)
文摘To illuminate the necessity of model evolvement and reuse, dynamics of injection molding machine＇s product models are analyzed. The performance knowledge is used to support the model evolvement and reuse. The driven factors of mechanical product model are concluded. The dynamic characteristics of reuse. Finally, HT1800X1N series injection molding machines are taken as examples to illuminate that the arithmetic is correct and practical.
文摘Achieving simultaneous reduction of NOx,CO and unburned hydrocarbon(UHC) emissions without compromising engine performance at part loads is the current focus of dual fuel engine research.The present work focuses on an experimental investigation conducted on a dual fuel(diesel-natural gas) engine to examine the simultaneous effect of inlet air pre-heating and exhaust gas recirculation(EGR) ratio on performance and emission characteristics at part loads.The use of EGR at high levels seems to be unable to improve the engine performance at part loads.However,it is shown that EGR combined with pre-heating of inlet air can slightly increase thermal efficiency,resulting in reduced levels of both unburned hydrocarbon and NOx emissions.CO and UHC emissions are reduced by 24% and 31%,respectively,The NOx emissions decrease by 21% because of the lower combustion temperature due to the much inert gas brought by EGR and decreased oxygen concentration in the cylinder.
基金supported by the National Key Research and Development Program of China (No.2021YFA0719204)the National Natural Science Foundation of China (No.12272387)。
文摘A flow control method based on an active jet is developed to restart hypersonic inlets. The dynamic restarting process is numerically reproduced by unsteady Reynolds averaged Navier-Stokes(RANS) modeling to verify the effectiveness and reveal the influence of jet conditions. The active jet improves the inlet unstart status by drawing the high-pressure separation bubble from the internal compression duct and performing a full expansion to alleviate the adverse pressure gradient. Moreover, the favorable pressure gradient in the inlet caused by jet expansion allows for a successful restart after turning off the jet. The influence of the jet momentum ratio is then analyzed to guide the design of the active jet control method and choose the proper momentum ratios. A low jet momentum does not eliminate the high-pressure separation bubble, whereas an excessive jet momentum causes severe momentum loss due to the induced shock. The general rule in restarting the inlet using an active jet is to allow a full jet expansion downstream of the jet slot while avoiding excessive momentum loss upstream and preventing the thick low-speed layer.
