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
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
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
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
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
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
This paper considers an M/G/1 queue with Poisson rate lambda > 0 and service time distribution G(t) which is supposed to have finite mean 1/mu. The following questions are first studied: (a) The closed bounds of th...This paper considers an M/G/1 queue with Poisson rate lambda > 0 and service time distribution G(t) which is supposed to have finite mean 1/mu. The following questions are first studied: (a) The closed bounds of the probability that waiting time is more than a fixed value; (b)The total busy time of the server, which including the distribution, probability that are more than a fixed value during a given time interval (0, t], and the expected value. Some new and important results are obtained by theories of the classes of life distributions and renewal process.展开更多
Aim: To investigate the waiting times in the emergency department of both private and public hospitals. Methods: The study employs theoretical, qualitative, and quantitative approaches to come up with conclusions that...Aim: To investigate the waiting times in the emergency department of both private and public hospitals. Methods: The study employs theoretical, qualitative, and quantitative approaches to come up with conclusions that are reliable. A total of 473 participants who had a direct interaction with the emergency department were asked to provide data on the waiting time, the kind of hospital they went to, the symptoms they had, and their gender for evaluation purposes. Common symptoms identified to the patients visiting the emergency department are related to head and neck, chest, abdominal pains, genitals, limbs, and back. It was found that more patients visited public hospitals over private hospitals. Additionally, more patients had symptoms related to abdominal than any other of the common symptoms and more males than females participated in the research. Data recording is done in tables using MS Excel and data presented through analysis using bar graphs for comparative purposes. Conclusion: Based on the results of the research, it was concluded that the efficiency of the emergency department is below the recommended standards. Finally, the recommendations made from the research findings included an audit of the emergency departments, increasing the staff in the department, and more research should be conducted throughout the country to come up with a more reliable record that is more inclusive.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
<b><span style="font-family:Verdana;">Introduction: </span></b><span style="font-family:;" "=""><span style="font-family:Verdana;">Emerg...<b><span style="font-family:Verdana;">Introduction: </span></b><span style="font-family:;" "=""><span style="font-family:Verdana;">Emergency medicine is a critical component of quality public health service. In fact length of stay and waiting times in the Emergency department are key indicators of quality. The aim of this study was to determine </span><span style="font-family:Verdana;">waiting times and determinants of prolonged length of stay (LOS) in the</span><span style="font-family:Verdana;"> Princess Marina Hospital Emergency Department. </span><b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:Verdana;">This was a retrospective observational study. It was done at Princess Marina, a referral hospital </span><span style="font-family:Verdana;">in Gaborone, Botswana. Triage forms of patients who presented between</span><span style="font-family:Verdana;"> 19/11/</span></span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">2018 and 18/12/2018 were reviewed. Data from patient files was used to determine time duration from triage to being reviewed by a doctor, time duration from review by emergency doctor to patients’ disposition and the time </span><span style="font-family:Verdana;">duration from patient’s triage to disposition (length of stay). Prolonged</span><span style="font-family:Verdana;"> length </span><span><span style="font-family:Verdana;">of stay was defined as duration > 6 hours. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">A total of 1052 files</span></span><span style="font-family:Verdana;"> repre</span></span><span style="font-family:Verdana;">- </span><span style="font-family:Verdana;">senting patients seen over a 1-month period were reviewed. 72.5% of the patients had a prolonged length of stay. The median emergency doctor waiting time was 4.5 hours (IQR 1.6 - 8.3 hours) and the maximum was 27.1 hours. The median length of stay in the emergency department was 9.6 hours (IQR 5.8 - 14.6 hours</span><span style="font-family:Verdana;">)</span><span style="font-family:;" "=""><span style="font-family:Verdana;"> and the maximum was 45.9 hours. Patient’s age (AOR 1.01), mental status (AOR 0.61), admission to internal medicine service (AOR 5.12) </span><span style="font-family:Verdana;">and pediatrics admissions (AOR 0.11) were significant predictors of pro</span><span style="font-family:Verdana;">longed </span><span><span style="font-family:Verdana;">length of stay in the emergency department. </span><b><span style="font-family:Verdana;">Conclusion</span></b><span style="font-family:Verdana;">: Princess Marina</span></span><span style="font-family:Verdana;"> Hospital emergency department waiting times and length of stay are long. Age, </span></span><span style="font-family:Verdana;">normal </span><span style="font-family:;" "=""><span style="font-family:Verdana;">mental status and internal medicine admission were independent predictors of prolonged stay (>6 hours). Admission to the pediatrics service was associated with shorter length of stay. There is a need for interven</span><span style="font-family:Verdana;">tions to address the long waiting times and length of stay. Interventions</span><span style="font-family:Verdana;"> should particularly focus on the identified predictors.</span></span>展开更多
We study waiting time problems for first-order Markov dependent trials via conditional probability generating functions. Our models involve α frequency cells and β run cells with prescribed quotas and an additional ...We study waiting time problems for first-order Markov dependent trials via conditional probability generating functions. Our models involve α frequency cells and β run cells with prescribed quotas and an additional γ slack cells without quotas. For any given and , in our Model I we determine the waiting time until at least frequency cells and at least run cells reach their quotas. For any given τ ≤ α + β, in our Model II we determine the waiting time until τ cells reach their quotas. Computer algorithms are developed to calculate the distributions, expectations and standard deviations of the waiting time random variables of the two models. Numerical results demonstrate the efficiency of the algorithms.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
To maximize the number of vehicles passing by the stop-line in a cycle and improve the operation efficiency of intersection in China, the settlement of left-turn lane waiting-zone is becoming prevailing. Based on conf...To maximize the number of vehicles passing by the stop-line in a cycle and improve the operation efficiency of intersection in China, the settlement of left-turn lane waiting-zone is becoming prevailing. Based on conflicting-point method, the internal mechanism of left-turn flow after stopping line was analyzed through taking postposition left-turn lane waiting-zone intersection for instance. The relationship between the first left-turn vehicle and the last vehicle of previous phase passing the conflicting point was expounded. According to the time of successive arriving of two vehicle flows at conflicting-point, the reasonable layout for waiting area of left-turn vehicles was researched when the clearance index was less than O. The results suggest that the appropriate layout for waiting area of left-turning vehicles can improve the operation efficiency of intersections.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
Background: Mortality and morbidity due to trauma are a significant public health challenge. There is paucity of data on the waiting times and length of stay (LOS) of trauma patients in emergency departments in Botswa...Background: Mortality and morbidity due to trauma are a significant public health challenge. There is paucity of data on the waiting times and length of stay (LOS) of trauma patients in emergency departments in Botswana. The aim of this study was to determine the Emergency Department (ED) waiting times and LOS of trauma patients at Princess Marina Hospital in Gaborone, Botswana. Methods: This was a retrospective medical records review of waiting times (time from triage to review by ED medical officer) and LOS (time from triage to disposition from the emergency department). The waiting times for the different assigned acuities were assessed against the South African Triage System (SATS) standards. All trauma patients seen from 19/11/2018 to 18/12/2018 were included in the study. Prolonged length of stay was defined as duration > 6 hours. Categorical data was summarized with frequencies while numeric data was summarized with medians and interquartile ranges. Results: A total of 187 trauma patients’ files were analyzed. Of these, 72 (38.5%) were females. The median waiting time was 3.8 hours and the maximum was 19.2 hours. The median length of stay (LOS) was 8.8 hours with a maximum of 37.2 hours. Only 53 (28.3%) of the participants had a LOS of less than 6 hours. None of the emergent patients were seen immediately. Only 5 (4.0%) of the very urgent patients were seen within the target of 10 minutes. Finally, only 10 (20.4%) of urgent patients were seen within the target time of 1 hour. Conclusion: The waiting times and length of stay in Princess Marina Hospital were mostly above the recommended standards. Urgent interventions are needed to reduce waiting times and length of stay for trauma patients. More studies are needed to explore the sources of delay and investigate possible solutions to this public health challenge.展开更多
World Health Organization(WHO)predicted 1.4 million people infected Health Associated Infection(HAIs).One of the risk factors caused is behavior of nosocomial infection control on patient watcher.The purpose is to kno...World Health Organization(WHO)predicted 1.4 million people infected Health Associated Infection(HAIs).One of the risk factors caused is behavior of nosocomial infection control on patient watcher.The purpose is to know relation behavior of nosocomial infection control on patient watcher patient in Semarang hospital and the number of participants was 61 people.Research method was observation with cross sectional approach.Sampling technique was purposive sampling.Data analysis used univariate and bivariate analysis with Pearson correlation test and chi-square test.Result showed a half of them,mean age of the participants was 45.56.Minimum-maximum values were 20-62 with standard deviation 11.114,gender in the research,most of them was female(83.6%),last education was junior high school(34,4%),most of them worked as maids(45.9%).Category of behavior of nosocomial infection control:less(44.3%),moderate(34.4%),and good(21.3%).There is a meaningful relation between behavior of nosocomial infection control behavior with age(p=0.000),education(p=0.000),and occupation(p=0.000).There is no meaningful relation between behavior of nosocomial infection control with gender(p=0.186).Conclusion:there is a meaningful relation between behavior of nosocomial infection control on patient watcher with age,education,and job,while gender does not have a meaningful relation with behavior of nosocomial infection control.Based on this research,it is recommended to be done as intervention which is able to increase behavior of nosocomial infection control on patient watcher by improving nursing service.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
Suppose that C is a finite collection of patterns. Observe a Markov chain until one of the patterns in C occurs as a run. This time is denoted by τ. In this paper, we aim to give an easy way to calculate the mean wai...Suppose that C is a finite collection of patterns. Observe a Markov chain until one of the patterns in C occurs as a run. This time is denoted by τ. In this paper, we aim to give an easy way to calculate the mean waiting time E(τ) and the stopping probabilities P(τ = τA)with A ∈ C, where τA is the waiting time until the pattern A appears as a run.展开更多
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.
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.
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 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.
基金This work was suPPorted by the Natiotal Out-standing YOuth Sdence FOundstion (79725tX)2) the suPporting program of the Nat
文摘This paper considers an M/G/1 queue with Poisson rate lambda > 0 and service time distribution G(t) which is supposed to have finite mean 1/mu. The following questions are first studied: (a) The closed bounds of the probability that waiting time is more than a fixed value; (b)The total busy time of the server, which including the distribution, probability that are more than a fixed value during a given time interval (0, t], and the expected value. Some new and important results are obtained by theories of the classes of life distributions and renewal process.
文摘Aim: To investigate the waiting times in the emergency department of both private and public hospitals. Methods: The study employs theoretical, qualitative, and quantitative approaches to come up with conclusions that are reliable. A total of 473 participants who had a direct interaction with the emergency department were asked to provide data on the waiting time, the kind of hospital they went to, the symptoms they had, and their gender for evaluation purposes. Common symptoms identified to the patients visiting the emergency department are related to head and neck, chest, abdominal pains, genitals, limbs, and back. It was found that more patients visited public hospitals over private hospitals. Additionally, more patients had symptoms related to abdominal than any other of the common symptoms and more males than females participated in the research. Data recording is done in tables using MS Excel and data presented through analysis using bar graphs for comparative purposes. Conclusion: Based on the results of the research, it was concluded that the efficiency of the emergency department is below the recommended standards. Finally, the recommendations made from the research findings included an audit of the emergency departments, increasing the staff in the department, and more research should be conducted throughout the country to come up with a more reliable record that is more inclusive.
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.
文摘<b><span style="font-family:Verdana;">Introduction: </span></b><span style="font-family:;" "=""><span style="font-family:Verdana;">Emergency medicine is a critical component of quality public health service. In fact length of stay and waiting times in the Emergency department are key indicators of quality. The aim of this study was to determine </span><span style="font-family:Verdana;">waiting times and determinants of prolonged length of stay (LOS) in the</span><span style="font-family:Verdana;"> Princess Marina Hospital Emergency Department. </span><b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:Verdana;">This was a retrospective observational study. It was done at Princess Marina, a referral hospital </span><span style="font-family:Verdana;">in Gaborone, Botswana. Triage forms of patients who presented between</span><span style="font-family:Verdana;"> 19/11/</span></span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">2018 and 18/12/2018 were reviewed. Data from patient files was used to determine time duration from triage to being reviewed by a doctor, time duration from review by emergency doctor to patients’ disposition and the time </span><span style="font-family:Verdana;">duration from patient’s triage to disposition (length of stay). Prolonged</span><span style="font-family:Verdana;"> length </span><span><span style="font-family:Verdana;">of stay was defined as duration > 6 hours. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">A total of 1052 files</span></span><span style="font-family:Verdana;"> repre</span></span><span style="font-family:Verdana;">- </span><span style="font-family:Verdana;">senting patients seen over a 1-month period were reviewed. 72.5% of the patients had a prolonged length of stay. The median emergency doctor waiting time was 4.5 hours (IQR 1.6 - 8.3 hours) and the maximum was 27.1 hours. The median length of stay in the emergency department was 9.6 hours (IQR 5.8 - 14.6 hours</span><span style="font-family:Verdana;">)</span><span style="font-family:;" "=""><span style="font-family:Verdana;"> and the maximum was 45.9 hours. Patient’s age (AOR 1.01), mental status (AOR 0.61), admission to internal medicine service (AOR 5.12) </span><span style="font-family:Verdana;">and pediatrics admissions (AOR 0.11) were significant predictors of pro</span><span style="font-family:Verdana;">longed </span><span><span style="font-family:Verdana;">length of stay in the emergency department. </span><b><span style="font-family:Verdana;">Conclusion</span></b><span style="font-family:Verdana;">: Princess Marina</span></span><span style="font-family:Verdana;"> Hospital emergency department waiting times and length of stay are long. Age, </span></span><span style="font-family:Verdana;">normal </span><span style="font-family:;" "=""><span style="font-family:Verdana;">mental status and internal medicine admission were independent predictors of prolonged stay (>6 hours). Admission to the pediatrics service was associated with shorter length of stay. There is a need for interven</span><span style="font-family:Verdana;">tions to address the long waiting times and length of stay. Interventions</span><span style="font-family:Verdana;"> should particularly focus on the identified predictors.</span></span>
文摘We study waiting time problems for first-order Markov dependent trials via conditional probability generating functions. Our models involve α frequency cells and β run cells with prescribed quotas and an additional γ slack cells without quotas. For any given and , in our Model I we determine the waiting time until at least frequency cells and at least run cells reach their quotas. For any given τ ≤ α + β, in our Model II we determine the waiting time until τ cells reach their quotas. Computer algorithms are developed to calculate the distributions, expectations and standard deviations of the waiting time random variables of the two models. Numerical results demonstrate the efficiency of the algorithms.
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.
基金Sponsored by the National Natural Science Foundation of China(Grant No.70631002)Youth Science &Technology Foundation of Xi’an University of Architecture &Technology(Grant No.0608)
文摘To maximize the number of vehicles passing by the stop-line in a cycle and improve the operation efficiency of intersection in China, the settlement of left-turn lane waiting-zone is becoming prevailing. Based on conflicting-point method, the internal mechanism of left-turn flow after stopping line was analyzed through taking postposition left-turn lane waiting-zone intersection for instance. The relationship between the first left-turn vehicle and the last vehicle of previous phase passing the conflicting point was expounded. According to the time of successive arriving of two vehicle flows at conflicting-point, the reasonable layout for waiting area of left-turn vehicles was researched when the clearance index was less than O. The results suggest that the appropriate layout for waiting area of left-turning vehicles can improve the operation efficiency of intersections.
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Background: Mortality and morbidity due to trauma are a significant public health challenge. There is paucity of data on the waiting times and length of stay (LOS) of trauma patients in emergency departments in Botswana. The aim of this study was to determine the Emergency Department (ED) waiting times and LOS of trauma patients at Princess Marina Hospital in Gaborone, Botswana. Methods: This was a retrospective medical records review of waiting times (time from triage to review by ED medical officer) and LOS (time from triage to disposition from the emergency department). The waiting times for the different assigned acuities were assessed against the South African Triage System (SATS) standards. All trauma patients seen from 19/11/2018 to 18/12/2018 were included in the study. Prolonged length of stay was defined as duration > 6 hours. Categorical data was summarized with frequencies while numeric data was summarized with medians and interquartile ranges. Results: A total of 187 trauma patients’ files were analyzed. Of these, 72 (38.5%) were females. The median waiting time was 3.8 hours and the maximum was 19.2 hours. The median length of stay (LOS) was 8.8 hours with a maximum of 37.2 hours. Only 53 (28.3%) of the participants had a LOS of less than 6 hours. None of the emergent patients were seen immediately. Only 5 (4.0%) of the very urgent patients were seen within the target of 10 minutes. Finally, only 10 (20.4%) of urgent patients were seen within the target time of 1 hour. Conclusion: The waiting times and length of stay in Princess Marina Hospital were mostly above the recommended standards. Urgent interventions are needed to reduce waiting times and length of stay for trauma patients. More studies are needed to explore the sources of delay and investigate possible solutions to this public health challenge.
文摘World Health Organization(WHO)predicted 1.4 million people infected Health Associated Infection(HAIs).One of the risk factors caused is behavior of nosocomial infection control on patient watcher.The purpose is to know relation behavior of nosocomial infection control on patient watcher patient in Semarang hospital and the number of participants was 61 people.Research method was observation with cross sectional approach.Sampling technique was purposive sampling.Data analysis used univariate and bivariate analysis with Pearson correlation test and chi-square test.Result showed a half of them,mean age of the participants was 45.56.Minimum-maximum values were 20-62 with standard deviation 11.114,gender in the research,most of them was female(83.6%),last education was junior high school(34,4%),most of them worked as maids(45.9%).Category of behavior of nosocomial infection control:less(44.3%),moderate(34.4%),and good(21.3%).There is a meaningful relation between behavior of nosocomial infection control behavior with age(p=0.000),education(p=0.000),and occupation(p=0.000).There is no meaningful relation between behavior of nosocomial infection control with gender(p=0.186).Conclusion:there is a meaningful relation between behavior of nosocomial infection control on patient watcher with age,education,and job,while gender does not have a meaningful relation with behavior of nosocomial infection control.Based on this research,it is recommended to be done as intervention which is able to increase behavior of nosocomial infection control on patient watcher by improving nursing service.
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.
基金Supported by the National Natural Science Foundation of China(11771286,11371317)the Zhejiang Provincial Natural Science Foundation of China(LQ18A010007)
文摘Suppose that C is a finite collection of patterns. Observe a Markov chain until one of the patterns in C occurs as a run. This time is denoted by τ. In this paper, we aim to give an easy way to calculate the mean waiting time E(τ) and the stopping probabilities P(τ = τA)with A ∈ C, where τA is the waiting time until the pattern A appears as a run.