Objective:To compare the characteristics of patients between adverse event(AE)group and non-AE group,and to assess the causes,preventability,and severity of AE.Methods:A retrospective triple-phase medical record study...Objective:To compare the characteristics of patients between adverse event(AE)group and non-AE group,and to assess the causes,preventability,and severity of AE.Methods:A retrospective triple-phase medical record study was conducted at a Spanish tertiary hospital.Data was collected over a 6-month period,including all patients with an unplanned intensive care admission.Demographic characteristics,APACHE栻,length of ICU stay,mortality were compare between AE and non-AE group causes,preventability and severity were analyzed in AE cases.Results:597 Patients were included in the study.The overall incidence of AEs was 17.3%(n=103),of which 83.5%were considered preventable.Mortality within the AE group was higher than in the non-AE group(23.3%vs.13.6%),making it 1.7 times more frequent in the AE group(95%CI:1.143-2.071).The primary cause of AE was associated with surgical procedures(43.7%).Of the AEs,18.4%were classified as mild,58.3%as moderate,and 23.3%as severe.Conclusions:The incidence of unplanned intensive care admissions due to AE is high and potentially preventable.This is concerning given the high mortality observed in patients admitted to the intensive care unit because of an AE,although direct causality cannot always be established.The findings emphasize the importance of patient safety and underscore the need for improved quality and management of care resources.They also indicate where efforts should be directed to enhance care risk management.展开更多
Objective To evaluate the utility of computed tomography perfusion(CTP)both at admission and during delayed cerebral ischemia time-window(DCITW)in the detection of delayed cerebral ischemia(DCI)and the change in CTP p...Objective To evaluate the utility of computed tomography perfusion(CTP)both at admission and during delayed cerebral ischemia time-window(DCITW)in the detection of delayed cerebral ischemia(DCI)and the change in CTP parameters from admission to DCITW following aneurysmal subarachnoid hemorrhage.Methods Eighty patients underwent CTP at admission and during DCITW.The mean and extreme values of all CTP parameters at admission and during DCITW were compared between the DCI group and non-DCI group,and comparisons were also made between admission and DCITW within each group.The qualitative color-coded perfusion maps were recorded.Finally,the relationship between CTP parameters and DCI was assessed by receiver operating characteristic(ROC)analyses.Results With the exception of cerebral blood volume(P=0.295,admission;P=0.682,DCITW),there were significant differences in the mean quantitative CTP parameters between DCI and non-DCI patients both at admission and during DCITW.In the DCI group,the extreme parameters were significantly different between admission and DCITW.The DCI group also showed a deteriorative trend in the qualitative color-coded perfusion maps.For the detection of DCI,mean transit time to the center of the impulse response function(Tmax)at admission and mean time to start(TTS)during DCITW had the largest area under curve(AUC),0.698 and 0.789,respectively.Conclusion Whole-brain CTP can predict the occurrence of DCI at admission and diagnose DCI during DCITW.The extreme quantitative parameters and qualitative color-coded perfusion maps can better reflect the perfusion changes of patients with DCI from admission to DCITW.展开更多
BACKGROUND The literature has discussed the relationship between environmental factors and depressive disorders;however,the results are inconsistent in different studies and regions,as are the interaction effects betw...BACKGROUND The literature has discussed the relationship between environmental factors and depressive disorders;however,the results are inconsistent in different studies and regions,as are the interaction effects between environmental factors.We hypo-thesized that meteorological factors and ambient air pollution individually affect and interact to affect depressive disorder morbidity.AIM To investigate the effects of meteorological factors and air pollution on depressive disorders,including their lagged effects and interactions.METHODS The samples were obtained from a class 3 hospital in Harbin,China.Daily hos-pital admission data for depressive disorders from January 1,2015 to December 31,2022 were obtained.Meteorological and air pollution data were also collected during the same period.Generalized additive models with quasi-Poisson regre-ssion were used for time-series modeling to measure the non-linear and delayed effects of environmental factors.We further incorporated each pair of environ-mental factors into a bivariate response surface model to examine the interaction effects on hospital admissions for depressive disorders.RESULTS Data for 2922 d were included in the study,with no missing values.The total number of depressive admissions was 83905.Medium to high correlations existed between environmental factors.Air temperature(AT)and wind speed(WS)significantly affected the number of admissions for depression.An extremely low temperature(-29.0℃)at lag 0 caused a 53%[relative risk(RR)=1.53,95%confidence interval(CI):1.23-1.89]increase in daily hospital admissions relative to the median temperature.Extremely low WSs(0.4 m/s)at lag 7 increased the number of admissions by 58%(RR=1.58,95%CI:1.07-2.31).In contrast,atmospheric pressure and relative humidity had smaller effects.Among the six air pollutants considered in the time-series model,nitrogen dioxide(NO_(2))was the only pollutant that showed significant effects over non-cumulative,cumulative,immediate,and lagged conditions.The cumulative effect of NO_(2) at lag 7 was 0.47%(RR=1.0047,95%CI:1.0024-1.0071).Interaction effects were found between AT and the five air pollutants,atmospheric temperature and the four air pollutants,WS and sulfur dioxide.CONCLUSION Meteorological factors and the air pollutant NO_(2) affect daily hospital admissions for depressive disorders,and interactions exist between meteorological factors and ambient air pollution.展开更多
Network slicing is envisioned as one of the key techniques to meet the extremely diversified service requirements of the Internet of Things(IoT)as it provides an enhanced user experience and elastic resource configura...Network slicing is envisioned as one of the key techniques to meet the extremely diversified service requirements of the Internet of Things(IoT)as it provides an enhanced user experience and elastic resource configuration.In the context of slicing enhanced IoT networks,both the Service Provider(SP)and Infrastructure Provider(InP)face challenges of ensuring efficient slice construction and high profit in dynamic environments.These challenges arise from randomly generated and departed slice requests from end-users,uncertain resource availability,and multidimensional resource allocation.Admission and resource allocation for distinct demands of slice requests are the key issues in addressing these challenges and should be handled effectively in dynamic environments.To this end,we propose an Opportunistic Admission and Resource allocation(OAR)policy to deal with the issues of random slicing requests,uncertain resource availability,and heterogeneous multi-resources.The key idea of OAR is to allow the SP to decide whether to accept slice requests immediately or defer them according to the load and price of resources.To cope with the random slice requests and uncertain resource availability,we formulated this issue as a Markov Decision Process(MDP)to obtain the optimal admission policy,with the aim of maximizing the system reward.Furthermore,the buyer-seller game theory approach was adopted to realize the optimal resource allocation,while motivating each SP and InP to maximize their rewards.Our numerical results show that the proposed OAR policy can make reasonable decisions effectively and steadily,and outperforms the baseline schemes in terms of the system reward.展开更多
Question-Answer systems are now very popular and crucial to support human in automatically responding frequent questions in manyfields.However,these systems depend on learning methods and training data.Therefore,it is ...Question-Answer systems are now very popular and crucial to support human in automatically responding frequent questions in manyfields.However,these systems depend on learning methods and training data.Therefore,it is necessary to prepare such a good dataset,but it is not an easy job.An ontol-ogy-based domain knowledge base is able to help to reason semantic information and make effective answers given user questions.This study proposes a novel chatbot model involving ontology to generate efficient responses automatically.A case study of admissions advising at the International University–VNU HCMC is taken into account in the proposed chatbot.A domain ontology is designed and built based on the domain knowledge of university admissions using Protégé.The Web user interface of the proposed chatbot system is developed as a prototype using NetBeans.It includes a search engine reasoning the ontology and generat-ing answers to users’questions.Two experiments are carried out to test how the system reacts to different questions.Thefirst experiment examines questions made from some templates,and the second one examines normal questions taken from frequent questions.Experimental results have shown that the ontology-based chatbot can release meaningful and long answers.The results are analysed to prove the proposed chatbot is usable and promising.展开更多
Satellite communications has been regarded as an indispensable technology for future mobile networks to provide extremely high data rates,ultra-reliability,and ubiquitous coverage.However,the high dynamics caused by t...Satellite communications has been regarded as an indispensable technology for future mobile networks to provide extremely high data rates,ultra-reliability,and ubiquitous coverage.However,the high dynamics caused by the fast movement of low-earth-orbit(LEO)satellites bring huge challenges in designing and optimizing satellite communication systems.Especially,admission control,deciding which users with diversified service requirements are allowed to access the network with limited resources,is of paramount importance to improve network resource utilization and meet the service quality requirements of users.In this paper,we propose a dynamic channel reservation strategy based on the Actor-Critic algorithm(AC-DCRS)to perform intelligent admission control in satellite networks.By carefully designing the longterm reward function and dynamically adjusting the reserved channel threshold,AC-DCRS reaches a long-run optimal access policy for both new calls and handover calls with different service priorities.Numerical results show that our proposed AC-DCRS outperforms traditional channel reservation strategies in terms of overall access failure probability,the average call success rate,and channel utilization under various dynamic traffic conditions.展开更多
BACKGROUND. The intensive care unit provides critically ill patients with the necessary monitoring, care and supports to optimize their organ/system functions. Parturients are often at risk of sudden deteriorations or...BACKGROUND. The intensive care unit provides critically ill patients with the necessary monitoring, care and supports to optimize their organ/system functions. Parturients are often at risk of sudden deteriorations or exacerbation of chronic illnesses from direct or indirect causes and would often require admissions into the intensive care or high dependency unit. This study is aimed at looking at the trends of maternal admissions in 365 days at the intensive care unit of a tertiary teaching hospital in Southern part of Nigeria, a country that contributes significantly to the global proportion of maternal morbidity and mortality. METHODS. The study adopted a retrospective approach. All critically ill parturients admitted and requiring organ support or close monitoring in the ICU had their files and ICU documents reviewed. The review was held from January-December 2018. RESULTS. Thirty-nine (39) parturients with a mean age (years) of 33 ± 1.3 were admitted, representing 2.9% of annual deliveries. All admissions were postnatal and came predominantly from the unbooked labour ward (51%) and the time lag from maternal deteriorations to presentation to the ICU was 72 ± 10 hours. The main indications for admissions were due to postpartum haemorrhage (33.3%), complications of hypertensive disorders of pregnancy (30.9%) and sepsis (25.6%). Nineteen (48.7%) patients died from obstetric haemorrhage, complications of hypertensive disorders of pregnancy, sepsis and pulmonary embolism. CONCLUSION. The trend of maternal admissions at this specific time frame reflects the burden of maternal critical care in our environment. It highlights the need to holistically tackle the known scourge with improved care.展开更多
Objective:To explore the effects of daily mean temperature(°C),average daily air pressure(hPa),humidity(%),wind speed(m/s),particulate matter(PM)2.5(μg/m3)and PM10(μg/m3)on the admission rate of chronic kidney ...Objective:To explore the effects of daily mean temperature(°C),average daily air pressure(hPa),humidity(%),wind speed(m/s),particulate matter(PM)2.5(μg/m3)and PM10(μg/m3)on the admission rate of chronic kidney disease(CKD)patients admitted to the Second Affiliated Hospital of Harbin Medical University in Harbin and to identify the indexes and lag days that impose the most critical influence.Methods:The R language Distributed Lag Nonlinear Model(DLNM),Excel,and SPSS were used to analyze the disease and meteorological data of Harbin from 01 January 2010 to 31 December 2019 according to the inclusion and exclusion criteria.Results:Meteorological factors and air pollution influence the number of hospitalizations of CKD to vary degrees in cold regions,and differ in persistence or delay.Non-optimal temperature increases the risk of admission of CKD,high temperature increases the risk of obstructive kidney disease,and low temperature increases the risk of other major types of chronic kidney disease.The greater the temperature difference is,the higher its contribution is to the risk.The non-optimal wind speed and non-optimal atmospheric pressure are associated with increased hospital admissions.PM2.5 concentrations above 40μg/m3 have a negative impact on the results.Conclusion:Cold region meteorology and specific environment do have an impact on the number of hospital admissions for chronic kidney disease,and we can apply DLMN to describe the analysis.展开更多
Introduction: Labour admission cardiotocography (CTG) is commonly used non-invasive method of fetal monitoring in Sri Lanka. It may have a potentialto predict perinatal outcome in low-risk term pregnancies. Objectives...Introduction: Labour admission cardiotocography (CTG) is commonly used non-invasive method of fetal monitoring in Sri Lanka. It may have a potentialto predict perinatal outcome in low-risk term pregnancies. Objectives: Objectives of the study were to determine the perinatal outcomes of normal, suspicious and pathological admission CTGs and role of labour admission cardiotocography as a predictive test for perinatal outcome in low-risk term pregnancies in spontaneous labour. Methods: This study was a prospective observational study done involving 445 low risk, term pregnancies in spontaneous labour. Labour admission CTG was performed in each pregnancy and categorized into normal, suspicious and pathological CTG according to criteria depicted by National Institute of Clinical Excellence (NICE) guideline 2007. Apgar score less than 7 at five minutes, resuscitation at birth, admission to neonatal intensive care unit (NICU), seizure within first 24 hours of birth and meconium-stained amniotic fluid were the primary outcome measures to assess fetal asphyxia. Mode of delivery in each category, nuchal cord at birth were also assessed. Results: Majority of participants were in 25-to-29-year age group and were nulliparous. Frequencies of normal, suspicious and pathological CTG were 74.8%, 18% and 7.2% respectively. Pathological CTG was significantly associated with low Apgar score compared to non-pathological CTG group (p 0.005) while other outcome measures were not significant. Rate of operative delivery was 68% in pathological group and 20.8% in non-pathological CTG group. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of labour admission CTG to detect fetal asphyxia were 51.85%, 95.69%, 43.75% and 96.85% respectively. Conclusions: Incidence of pathological labour admission CTG was 7.2%. Apgar score less than 7 at five minutes of birth was significantly associated with pathological CTG group compared to non-pathological CTG (p 0.05). Worsening of CTG from normal to pathological showed increasing rate of operative delivery. Even though sensitivity and positive predictive values of labour admission CTG were low, specificity and negative predictive values were high for detecting low Apgar score. Therefore, labour admission CTG has a value in excluding adverse perinatal outcomes in low-risk term pregnancies in spontaneous labour.展开更多
Objective: To determine the reasons for admission of elderly subjects and the prognosis in general intensive care. Patients and Methods: Observational descriptive and analytical study with prospective collection of da...Objective: To determine the reasons for admission of elderly subjects and the prognosis in general intensive care. Patients and Methods: Observational descriptive and analytical study with prospective collection of data over a period of one year from January 1 to December 31, 2021. Patients aged 65 or over were included. Abstract: During the study period, 223 cases were collected out of 587 patients admitted, giving a prevalence of 37.9%. The average age was 74.127.39 ± years with extremes of 65 and 96 years and a male predominance (58.7%). The comorbidities were dominated by arterial hypertension (71.3%). The patients were: transferred from medical and surgical emergencies (75.8%). The average admission time was 48.8 ± 29.8 hours. One hundred and eight patients had a Glasgow score between 3 and 7. The reasons for admission were dominated by vascular causes (51.6%). Strokes of any type accounted for 43.9% of these reasons for admission. The average time for carrying out the biological assessments and imaging was 41.8 ± 27.3 hours with the extremes of 3 and 89 hours, 37.2% had a complete assessment within 24 hours. The average duration of hospitalization was 7.10 ± 8.87 days with extremes of 1 and 72 days. The mortality rate was 71.7%. Conclusion: This study has made it possible to take stock of the reasons for the admission of elderly subjects to intensive care. It appears that vascular causes are the main reasons for admission with heavy comorbidities which results in high mortality.展开更多
In this paper, a novel admission scheme is proposed which provides high degrees of quality of service (QoS) guarantees for multimedia traffic carried in mobile networks. The proposed scheme combines the admission cont...In this paper, a novel admission scheme is proposed which provides high degrees of quality of service (QoS) guarantees for multimedia traffic carried in mobile networks. The proposed scheme combines the admission control and bandwidth reservation to guarantee QoS requirements. It considers both local information and remote information to determine whether to accept or reject a connection. In order to embody the characteristics of the algorithms proposed in the article, two traditional algorithms of admission control are used for comparison. In the end of the paper the simulation analyses are given and the results show that the proposed algorithm can adjust the bandwidth according to the current status of networks and decrease the probability of connections forcibly dropped. The most important thing is that the algorithm is based on the multimedia communications and can guarantee the QoS of real time connections through decreasing the bandwidth of non real time connections.展开更多
This study mainly uses the move and step analysis to conduct a contrastive genre analysis on the selected 20 Chinese ad-mission brochures(CABs) and 20 American admission brochures(AABs).Differences in moves,move seque...This study mainly uses the move and step analysis to conduct a contrastive genre analysis on the selected 20 Chinese ad-mission brochures(CABs) and 20 American admission brochures(AABs).Differences in moves,move sequences and step arrange-ments have revealed themselves in this comparison.Firstly,Chinese university admission brochures cast more focus on basic infor-mation about the university,the application procedure and admission criteria,while American universities,besides offering such in-formation,also emphasize the promotional function of the admission brochures.They use appealing and creative moves to commer-cially‘sell'advantages of the university to the potential applicants.Secondly,based on Kress & van Leeuwen's visual grammarsymbolic meaning,images and colors in admission brochures are also explored and analyzed as language.For one thing,after count-ing the frequency of the four categories of images,namely portrait,campus scenery,campus life pictures and graphs,it is foundthat,compared with CABs,AABs have a highly more obvious tendency in using images.The images are used as an effective tool toincrease the sense of credibility,identity-recognition,attract reader's attention,and help understanding,making the facts and in-formation more intuitive.For another thing,the main colors used in the brochures are yet another noticeable feature.Especially inAmerican brochures,universities tend to use their‘traditional colors' in the brochure to achieve a sense of consistency.Some Chi-nese brochures also follow this promotional strategy,yet a large percentage of them do not use any recognizable colors other thanthe printed black and white.Based on these differences,suggestions are put forward from perspectives including choice of movesand steps to improve the quality of CABs,hopefully raising their acceptance in the international level.展开更多
BACKGROUND:The influence of surgical delay on mortality and morbidity has been studied extensively among elderly hip fracture patients.However,most studies only focus on the timing of surgery when patients have alread...BACKGROUND:The influence of surgical delay on mortality and morbidity has been studied extensively among elderly hip fracture patients.However,most studies only focus on the timing of surgery when patients have already been hospitalized,without considering pre-admission waiting time.Therefore,the present study aims to explore the infl uence of admission delay on surgical outcomes.METHODS:In this retrospective study,we recorded admission timing and interval from admission to surgery for included patient.Other covariates were also collected to control confounding.The primary outcome was 1-year mortality.The secondary outcomes were 1-month mortality,3-month mortality,ICU admission and postoperative pneumonia.We mainly used multivariate logistic regression to determine the effect of admission timing on postoperative outcomes.An additional survival analysis was also performed to assess the impact of admission delay on survival status in the fi rst year after operation.RESULTS:The proportion of patients hospitalized on day 0,day 1,day 2 after injury was 25.4%,54.7%and 66.3%,respectively.And 12.6%patients visited hospital one week later after injury.Mean time from admission to surgery was 5.2 days(standard deviation 2.8 days).Hospitalization at one week after injury was a risk factor for 1-year mortality(OR 1.762,95%CI 1.026–3.379,P=0.041).CONCLUSION:Admission delay of more than one week is signifi cantly associated with higher 1-year mortality.As a supplement to the current guidelines which emphasizes early surgery after admission,we also advocate early admission once patients get injured.展开更多
Objective To investigate the association between ambient air pollution and hospital emergency admissions in Beijing. Methods In this study, a semi-parametric generalized additive model (GAM) was used to evaluate the...Objective To investigate the association between ambient air pollution and hospital emergency admissions in Beijing. Methods In this study, a semi-parametric generalized additive model (GAM) was used to evaluate the specific influences of air pollutants (PM10, SO2, and NO2) on hospital emergency admissions with different lag structures from 2009 to 2011, the sex and age specific influences of air pollution and the modifying effect of seasons on air pollution to analyze the possible interaction. Results It was found that a 10μg/m3 increase in concentration of PMlo at lag 03 day, SO2 and NO2 at lag 0 day were associated with an increase of 0.88%, 0.76%, and 1.82% respectively in overall emergency admissions. A 10 lag/m3 increase in concentration of PM10, SO2 and NO2 at lag 5 day were associated with an increase of 1.39%, 1.56%, and 1.18% respectively in cardiovascular disease emergency admissions. For lag 02, a 10 μg/m3 increase in concentration of PM10, SO2 and NO2 were associated with 1.72%, 1.34%, and 2.57% increases respectively in respiratory disease emergency admissions. Conclusion This study further confirmed that short-term exposure to ambient air pollution was associated with increased risk of hospital emergency admissions in Beijing.展开更多
Objective The study is to investigate the associations between visibility, major air pollutants and daily counts of hospital admission in Shanghai, China. Methods Daily data on hospital admission, visibility, and air ...Objective The study is to investigate the associations between visibility, major air pollutants and daily counts of hospital admission in Shanghai, China. Methods Daily data on hospital admission, visibility, and air pollution during 2005‐2008 were obtained from the Shanghai Insurance Bureau (SHIB), Shanghai Meteorological Bureau, and Shanghai Environmental Monitoring Center, respectively. The generalized additive model (GAM) with penalized splines was used to examine the associations between daily visibility and hospital admission. Results Among various pollutants, PM 2.5 showed strongest correlation with visibility. Decreased visibility was significantly associated with increased risk of hospital admission in Shanghai. An inter‐quartile range decrease in the 2‐day (L01) moving average of visibility corresponded to 3.66% (95%CI: 1.02%, 6.31%), 4.06% (95%CI: 0.84%, 7.27%), and 4.32% (95%CI: 1.67%, 6.97%) increase of total, cardiovascular, and respiratory hospitalizations, respectively. Conclusion Our analyses provide the first piece of evidence in China, demonstrating that decreased visibility has an effect on hospital admission, and this finding strengthens the rationale for further limiting air pollution levels in Shanghai.展开更多
As device-to-device(D2D) communications usually reuses the resource of cellular networks, call admission control(CAC) and power control are crucial problems. However in most power control schemes, total data rates or ...As device-to-device(D2D) communications usually reuses the resource of cellular networks, call admission control(CAC) and power control are crucial problems. However in most power control schemes, total data rates or throughput are regarded as optimization criterion. In this paper, a combining call admission control(CAC) and power control scheme under guaranteeing QoS of every user equipment(UE) is proposed. First, a simple CAC scheme is introduced. Then based on the CAC scheme, a combining call admission control and power control scheme is proposed. Next, the performance of the proposed scheme is evaluated. Finally, maximum DUE pair number and average transmitting power is calculated. Simulation results show that D2 D communications with the proposed combining call admission control and power control scheme can effectively improve the maximum DUE pair number under the premise of meeting necessary QoS.展开更多
OBJECTIVE:Admission hyperglycemia in acute myocardial infarction (MI) is related with increased in-hospital and long term mortality and major cardiac adverse events。 We aimed to investigate how admission hyperglycemi...OBJECTIVE:Admission hyperglycemia in acute myocardial infarction (MI) is related with increased in-hospital and long term mortality and major cardiac adverse events。 We aimed to investigate how admission hyperglycemia affects the short and long term outcomes in elderly patients >65 years) after primary percutaneous coronary intervention for ST elevation myocardial infarction。 METHODS:We retrospectively analyzed 677 consecutive elderly patients (mean age 72.2 ±5.4)。 Patients were divided into two groups according to admission blood glucose levels。 Group : low glucose group (LLG), glucose < 168 mg/dL; and Group 2: high glucose group (HGG), glucose >168 mg/dL。 RESULTS:In-hospital, long term mortality and in-hospital major adverse cardiac events were higher in the high admission blood glucose group (P <0.001)。 Multivariate regression analysis showed: Killip > 1, post-thrombolysis in MI <3 and admission blood glucose levels were independent predictors of in-hospital adverse cardiac events (P <0.001)。 CONCLUSIONS:Admission hyperglycemia in elderly patients presented with ST elevation myocardial infarction is an independent predictor of in-hospital major adverse cardiac events and is associated with in-hospital and long term mortality。展开更多
Objective To investigate whether admission time was associated with the delay of reperfusion therapy and in-hospital death in patients with ST-elevation myocardial infarction (STEMI). Methods All patients with STEMI...Objective To investigate whether admission time was associated with the delay of reperfusion therapy and in-hospital death in patients with ST-elevation myocardial infarction (STEMI). Methods All patients with STEMI who were admitted to the emergency depart- ment and underwent primary percutaneous coronary intervention at Peking University People's Hospital between April 2012 and March 2015 were included. We examined differences in clinical characteristics, total ischemic time, and in-hospital death between patients admitted during off-hours and those admitted during regular hours. Multivariate logistic regression was used to estimate the relationship between off-hours admission and clinical outcome. Results The sample comprised 184 and 105 patients with STEMI admitted to hospital during off-hours and regular hours, respectively. Total ischemic and onset-to-door times were significantly shorter in patients admitted during off-hours than among those admitted during regular hours (all P 〈 0.05). Door-to-balloon (DTB) time, the rate of DTB time 〈 90 min, and in-hospital death were comparable between groups. Multivariate logistic regression showed that age and creatinine level, but not off-hours admission, were associated independently with increased in-hospital death. Conclusions Off-hours admission did not result in delayed reperfusion therapy or increased in-hospital mortality in patients with STEMI. Further efforts should focus on identifying pivotal factors associated with the pre-hospital and in-hospital delay of reperfusion therapy, and implementing quality improvement initiatives for reperfusion programs.展开更多
Power efficiency and link reliability are of great impor- tance in hierarchical wireless sensor networks (HWSNs), espe- cially at the key level, which consists of sensor nodes located only one hop away from the sink...Power efficiency and link reliability are of great impor- tance in hierarchical wireless sensor networks (HWSNs), espe- cially at the key level, which consists of sensor nodes located only one hop away from the sink node called OHS. The power and admission control problem in HWSNs is comsidered to improve its power efficiency and link reliability. This problem is modeled as a non-cooperative game in which the active OHSs are con- sidered as players. By applying a double-pricing scheme in the definition of OHSs' utility function, a Nash Equilibrium solution with network properties is derived. Besides, a distributed algorithm is also proposed to show the dynamic processes to achieve Nash Equilibrium. Finally, the simulation results demonstrate the effec- tiveness of the proposed algorithm.展开更多
Propose a new degradation call admission control(DCAC)scheme, which can be used in wideband code division multiple access communication system. So-called degradation is that non-real time call has the characteristic...Propose a new degradation call admission control(DCAC)scheme, which can be used in wideband code division multiple access communication system. So-called degradation is that non-real time call has the characteristic of variable bit rate, so decreasing its bit rate can reduce the load of the system, consequently the system can admit new call which should be blocked when the system is close to full load, therefore new call's access probability increases. This paper brings forward design project and does system simulation, simulation proves that DCAC can effectively decrease calls' blocking probability and increase the total number of the on-line users.展开更多
文摘Objective:To compare the characteristics of patients between adverse event(AE)group and non-AE group,and to assess the causes,preventability,and severity of AE.Methods:A retrospective triple-phase medical record study was conducted at a Spanish tertiary hospital.Data was collected over a 6-month period,including all patients with an unplanned intensive care admission.Demographic characteristics,APACHE栻,length of ICU stay,mortality were compare between AE and non-AE group causes,preventability and severity were analyzed in AE cases.Results:597 Patients were included in the study.The overall incidence of AEs was 17.3%(n=103),of which 83.5%were considered preventable.Mortality within the AE group was higher than in the non-AE group(23.3%vs.13.6%),making it 1.7 times more frequent in the AE group(95%CI:1.143-2.071).The primary cause of AE was associated with surgical procedures(43.7%).Of the AEs,18.4%were classified as mild,58.3%as moderate,and 23.3%as severe.Conclusions:The incidence of unplanned intensive care admissions due to AE is high and potentially preventable.This is concerning given the high mortality observed in patients admitted to the intensive care unit because of an AE,although direct causality cannot always be established.The findings emphasize the importance of patient safety and underscore the need for improved quality and management of care resources.They also indicate where efforts should be directed to enhance care risk management.
基金supported by the National Natural Science Foundation of China,Research on Brain Magnetic Resonance Image Segmentation Based on Particle Computation(No.61672386).
文摘Objective To evaluate the utility of computed tomography perfusion(CTP)both at admission and during delayed cerebral ischemia time-window(DCITW)in the detection of delayed cerebral ischemia(DCI)and the change in CTP parameters from admission to DCITW following aneurysmal subarachnoid hemorrhage.Methods Eighty patients underwent CTP at admission and during DCITW.The mean and extreme values of all CTP parameters at admission and during DCITW were compared between the DCI group and non-DCI group,and comparisons were also made between admission and DCITW within each group.The qualitative color-coded perfusion maps were recorded.Finally,the relationship between CTP parameters and DCI was assessed by receiver operating characteristic(ROC)analyses.Results With the exception of cerebral blood volume(P=0.295,admission;P=0.682,DCITW),there were significant differences in the mean quantitative CTP parameters between DCI and non-DCI patients both at admission and during DCITW.In the DCI group,the extreme parameters were significantly different between admission and DCITW.The DCI group also showed a deteriorative trend in the qualitative color-coded perfusion maps.For the detection of DCI,mean transit time to the center of the impulse response function(Tmax)at admission and mean time to start(TTS)during DCITW had the largest area under curve(AUC),0.698 and 0.789,respectively.Conclusion Whole-brain CTP can predict the occurrence of DCI at admission and diagnose DCI during DCITW.The extreme quantitative parameters and qualitative color-coded perfusion maps can better reflect the perfusion changes of patients with DCI from admission to DCITW.
基金This study was reviewed and approved by the Ethics Committee of The First Psychiatric Hospital of Harbin.
文摘BACKGROUND The literature has discussed the relationship between environmental factors and depressive disorders;however,the results are inconsistent in different studies and regions,as are the interaction effects between environmental factors.We hypo-thesized that meteorological factors and ambient air pollution individually affect and interact to affect depressive disorder morbidity.AIM To investigate the effects of meteorological factors and air pollution on depressive disorders,including their lagged effects and interactions.METHODS The samples were obtained from a class 3 hospital in Harbin,China.Daily hos-pital admission data for depressive disorders from January 1,2015 to December 31,2022 were obtained.Meteorological and air pollution data were also collected during the same period.Generalized additive models with quasi-Poisson regre-ssion were used for time-series modeling to measure the non-linear and delayed effects of environmental factors.We further incorporated each pair of environ-mental factors into a bivariate response surface model to examine the interaction effects on hospital admissions for depressive disorders.RESULTS Data for 2922 d were included in the study,with no missing values.The total number of depressive admissions was 83905.Medium to high correlations existed between environmental factors.Air temperature(AT)and wind speed(WS)significantly affected the number of admissions for depression.An extremely low temperature(-29.0℃)at lag 0 caused a 53%[relative risk(RR)=1.53,95%confidence interval(CI):1.23-1.89]increase in daily hospital admissions relative to the median temperature.Extremely low WSs(0.4 m/s)at lag 7 increased the number of admissions by 58%(RR=1.58,95%CI:1.07-2.31).In contrast,atmospheric pressure and relative humidity had smaller effects.Among the six air pollutants considered in the time-series model,nitrogen dioxide(NO_(2))was the only pollutant that showed significant effects over non-cumulative,cumulative,immediate,and lagged conditions.The cumulative effect of NO_(2) at lag 7 was 0.47%(RR=1.0047,95%CI:1.0024-1.0071).Interaction effects were found between AT and the five air pollutants,atmospheric temperature and the four air pollutants,WS and sulfur dioxide.CONCLUSION Meteorological factors and the air pollutant NO_(2) affect daily hospital admissions for depressive disorders,and interactions exist between meteorological factors and ambient air pollution.
基金This work was supported in part by the Chongqing Technological Innovation and Application Development Projects under Grant cstc2019jscx-msxm1322,in part by the Zhejiang Lab under Grant 2021KF0AB03in part by the National Natural Science Foundation of China under Grant 62071091.
文摘Network slicing is envisioned as one of the key techniques to meet the extremely diversified service requirements of the Internet of Things(IoT)as it provides an enhanced user experience and elastic resource configuration.In the context of slicing enhanced IoT networks,both the Service Provider(SP)and Infrastructure Provider(InP)face challenges of ensuring efficient slice construction and high profit in dynamic environments.These challenges arise from randomly generated and departed slice requests from end-users,uncertain resource availability,and multidimensional resource allocation.Admission and resource allocation for distinct demands of slice requests are the key issues in addressing these challenges and should be handled effectively in dynamic environments.To this end,we propose an Opportunistic Admission and Resource allocation(OAR)policy to deal with the issues of random slicing requests,uncertain resource availability,and heterogeneous multi-resources.The key idea of OAR is to allow the SP to decide whether to accept slice requests immediately or defer them according to the load and price of resources.To cope with the random slice requests and uncertain resource availability,we formulated this issue as a Markov Decision Process(MDP)to obtain the optimal admission policy,with the aim of maximizing the system reward.Furthermore,the buyer-seller game theory approach was adopted to realize the optimal resource allocation,while motivating each SP and InP to maximize their rewards.Our numerical results show that the proposed OAR policy can make reasonable decisions effectively and steadily,and outperforms the baseline schemes in terms of the system reward.
基金funded by International University,VNU-HCM under Grant Number T2020-03-IT.
文摘Question-Answer systems are now very popular and crucial to support human in automatically responding frequent questions in manyfields.However,these systems depend on learning methods and training data.Therefore,it is necessary to prepare such a good dataset,but it is not an easy job.An ontol-ogy-based domain knowledge base is able to help to reason semantic information and make effective answers given user questions.This study proposes a novel chatbot model involving ontology to generate efficient responses automatically.A case study of admissions advising at the International University–VNU HCMC is taken into account in the proposed chatbot.A domain ontology is designed and built based on the domain knowledge of university admissions using Protégé.The Web user interface of the proposed chatbot system is developed as a prototype using NetBeans.It includes a search engine reasoning the ontology and generat-ing answers to users’questions.Two experiments are carried out to test how the system reacts to different questions.Thefirst experiment examines questions made from some templates,and the second one examines normal questions taken from frequent questions.Experimental results have shown that the ontology-based chatbot can release meaningful and long answers.The results are analysed to prove the proposed chatbot is usable and promising.
基金supported by the ZTE Industry⁃University⁃Institute Cooperation Funds.
文摘Satellite communications has been regarded as an indispensable technology for future mobile networks to provide extremely high data rates,ultra-reliability,and ubiquitous coverage.However,the high dynamics caused by the fast movement of low-earth-orbit(LEO)satellites bring huge challenges in designing and optimizing satellite communication systems.Especially,admission control,deciding which users with diversified service requirements are allowed to access the network with limited resources,is of paramount importance to improve network resource utilization and meet the service quality requirements of users.In this paper,we propose a dynamic channel reservation strategy based on the Actor-Critic algorithm(AC-DCRS)to perform intelligent admission control in satellite networks.By carefully designing the longterm reward function and dynamically adjusting the reserved channel threshold,AC-DCRS reaches a long-run optimal access policy for both new calls and handover calls with different service priorities.Numerical results show that our proposed AC-DCRS outperforms traditional channel reservation strategies in terms of overall access failure probability,the average call success rate,and channel utilization under various dynamic traffic conditions.
文摘BACKGROUND. The intensive care unit provides critically ill patients with the necessary monitoring, care and supports to optimize their organ/system functions. Parturients are often at risk of sudden deteriorations or exacerbation of chronic illnesses from direct or indirect causes and would often require admissions into the intensive care or high dependency unit. This study is aimed at looking at the trends of maternal admissions in 365 days at the intensive care unit of a tertiary teaching hospital in Southern part of Nigeria, a country that contributes significantly to the global proportion of maternal morbidity and mortality. METHODS. The study adopted a retrospective approach. All critically ill parturients admitted and requiring organ support or close monitoring in the ICU had their files and ICU documents reviewed. The review was held from January-December 2018. RESULTS. Thirty-nine (39) parturients with a mean age (years) of 33 ± 1.3 were admitted, representing 2.9% of annual deliveries. All admissions were postnatal and came predominantly from the unbooked labour ward (51%) and the time lag from maternal deteriorations to presentation to the ICU was 72 ± 10 hours. The main indications for admissions were due to postpartum haemorrhage (33.3%), complications of hypertensive disorders of pregnancy (30.9%) and sepsis (25.6%). Nineteen (48.7%) patients died from obstetric haemorrhage, complications of hypertensive disorders of pregnancy, sepsis and pulmonary embolism. CONCLUSION. The trend of maternal admissions at this specific time frame reflects the burden of maternal critical care in our environment. It highlights the need to holistically tackle the known scourge with improved care.
文摘Objective:To explore the effects of daily mean temperature(°C),average daily air pressure(hPa),humidity(%),wind speed(m/s),particulate matter(PM)2.5(μg/m3)and PM10(μg/m3)on the admission rate of chronic kidney disease(CKD)patients admitted to the Second Affiliated Hospital of Harbin Medical University in Harbin and to identify the indexes and lag days that impose the most critical influence.Methods:The R language Distributed Lag Nonlinear Model(DLNM),Excel,and SPSS were used to analyze the disease and meteorological data of Harbin from 01 January 2010 to 31 December 2019 according to the inclusion and exclusion criteria.Results:Meteorological factors and air pollution influence the number of hospitalizations of CKD to vary degrees in cold regions,and differ in persistence or delay.Non-optimal temperature increases the risk of admission of CKD,high temperature increases the risk of obstructive kidney disease,and low temperature increases the risk of other major types of chronic kidney disease.The greater the temperature difference is,the higher its contribution is to the risk.The non-optimal wind speed and non-optimal atmospheric pressure are associated with increased hospital admissions.PM2.5 concentrations above 40μg/m3 have a negative impact on the results.Conclusion:Cold region meteorology and specific environment do have an impact on the number of hospital admissions for chronic kidney disease,and we can apply DLMN to describe the analysis.
文摘Introduction: Labour admission cardiotocography (CTG) is commonly used non-invasive method of fetal monitoring in Sri Lanka. It may have a potentialto predict perinatal outcome in low-risk term pregnancies. Objectives: Objectives of the study were to determine the perinatal outcomes of normal, suspicious and pathological admission CTGs and role of labour admission cardiotocography as a predictive test for perinatal outcome in low-risk term pregnancies in spontaneous labour. Methods: This study was a prospective observational study done involving 445 low risk, term pregnancies in spontaneous labour. Labour admission CTG was performed in each pregnancy and categorized into normal, suspicious and pathological CTG according to criteria depicted by National Institute of Clinical Excellence (NICE) guideline 2007. Apgar score less than 7 at five minutes, resuscitation at birth, admission to neonatal intensive care unit (NICU), seizure within first 24 hours of birth and meconium-stained amniotic fluid were the primary outcome measures to assess fetal asphyxia. Mode of delivery in each category, nuchal cord at birth were also assessed. Results: Majority of participants were in 25-to-29-year age group and were nulliparous. Frequencies of normal, suspicious and pathological CTG were 74.8%, 18% and 7.2% respectively. Pathological CTG was significantly associated with low Apgar score compared to non-pathological CTG group (p 0.005) while other outcome measures were not significant. Rate of operative delivery was 68% in pathological group and 20.8% in non-pathological CTG group. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of labour admission CTG to detect fetal asphyxia were 51.85%, 95.69%, 43.75% and 96.85% respectively. Conclusions: Incidence of pathological labour admission CTG was 7.2%. Apgar score less than 7 at five minutes of birth was significantly associated with pathological CTG group compared to non-pathological CTG (p 0.05). Worsening of CTG from normal to pathological showed increasing rate of operative delivery. Even though sensitivity and positive predictive values of labour admission CTG were low, specificity and negative predictive values were high for detecting low Apgar score. Therefore, labour admission CTG has a value in excluding adverse perinatal outcomes in low-risk term pregnancies in spontaneous labour.
文摘Objective: To determine the reasons for admission of elderly subjects and the prognosis in general intensive care. Patients and Methods: Observational descriptive and analytical study with prospective collection of data over a period of one year from January 1 to December 31, 2021. Patients aged 65 or over were included. Abstract: During the study period, 223 cases were collected out of 587 patients admitted, giving a prevalence of 37.9%. The average age was 74.127.39 ± years with extremes of 65 and 96 years and a male predominance (58.7%). The comorbidities were dominated by arterial hypertension (71.3%). The patients were: transferred from medical and surgical emergencies (75.8%). The average admission time was 48.8 ± 29.8 hours. One hundred and eight patients had a Glasgow score between 3 and 7. The reasons for admission were dominated by vascular causes (51.6%). Strokes of any type accounted for 43.9% of these reasons for admission. The average time for carrying out the biological assessments and imaging was 41.8 ± 27.3 hours with the extremes of 3 and 89 hours, 37.2% had a complete assessment within 24 hours. The average duration of hospitalization was 7.10 ± 8.87 days with extremes of 1 and 72 days. The mortality rate was 71.7%. Conclusion: This study has made it possible to take stock of the reasons for the admission of elderly subjects to intensive care. It appears that vascular causes are the main reasons for admission with heavy comorbidities which results in high mortality.
文摘In this paper, a novel admission scheme is proposed which provides high degrees of quality of service (QoS) guarantees for multimedia traffic carried in mobile networks. The proposed scheme combines the admission control and bandwidth reservation to guarantee QoS requirements. It considers both local information and remote information to determine whether to accept or reject a connection. In order to embody the characteristics of the algorithms proposed in the article, two traditional algorithms of admission control are used for comparison. In the end of the paper the simulation analyses are given and the results show that the proposed algorithm can adjust the bandwidth according to the current status of networks and decrease the probability of connections forcibly dropped. The most important thing is that the algorithm is based on the multimedia communications and can guarantee the QoS of real time connections through decreasing the bandwidth of non real time connections.
文摘This study mainly uses the move and step analysis to conduct a contrastive genre analysis on the selected 20 Chinese ad-mission brochures(CABs) and 20 American admission brochures(AABs).Differences in moves,move sequences and step arrange-ments have revealed themselves in this comparison.Firstly,Chinese university admission brochures cast more focus on basic infor-mation about the university,the application procedure and admission criteria,while American universities,besides offering such in-formation,also emphasize the promotional function of the admission brochures.They use appealing and creative moves to commer-cially‘sell'advantages of the university to the potential applicants.Secondly,based on Kress & van Leeuwen's visual grammarsymbolic meaning,images and colors in admission brochures are also explored and analyzed as language.For one thing,after count-ing the frequency of the four categories of images,namely portrait,campus scenery,campus life pictures and graphs,it is foundthat,compared with CABs,AABs have a highly more obvious tendency in using images.The images are used as an effective tool toincrease the sense of credibility,identity-recognition,attract reader's attention,and help understanding,making the facts and in-formation more intuitive.For another thing,the main colors used in the brochures are yet another noticeable feature.Especially inAmerican brochures,universities tend to use their‘traditional colors' in the brochure to achieve a sense of consistency.Some Chi-nese brochures also follow this promotional strategy,yet a large percentage of them do not use any recognizable colors other thanthe printed black and white.Based on these differences,suggestions are put forward from perspectives including choice of movesand steps to improve the quality of CABs,hopefully raising their acceptance in the international level.
文摘BACKGROUND:The influence of surgical delay on mortality and morbidity has been studied extensively among elderly hip fracture patients.However,most studies only focus on the timing of surgery when patients have already been hospitalized,without considering pre-admission waiting time.Therefore,the present study aims to explore the infl uence of admission delay on surgical outcomes.METHODS:In this retrospective study,we recorded admission timing and interval from admission to surgery for included patient.Other covariates were also collected to control confounding.The primary outcome was 1-year mortality.The secondary outcomes were 1-month mortality,3-month mortality,ICU admission and postoperative pneumonia.We mainly used multivariate logistic regression to determine the effect of admission timing on postoperative outcomes.An additional survival analysis was also performed to assess the impact of admission delay on survival status in the fi rst year after operation.RESULTS:The proportion of patients hospitalized on day 0,day 1,day 2 after injury was 25.4%,54.7%and 66.3%,respectively.And 12.6%patients visited hospital one week later after injury.Mean time from admission to surgery was 5.2 days(standard deviation 2.8 days).Hospitalization at one week after injury was a risk factor for 1-year mortality(OR 1.762,95%CI 1.026–3.379,P=0.041).CONCLUSION:Admission delay of more than one week is signifi cantly associated with higher 1-year mortality.As a supplement to the current guidelines which emphasizes early surgery after admission,we also advocate early admission once patients get injured.
基金supported by the Gong-Yi Program of China Meteorological Administration(GYHY201106034)the Fundamental Research Funds for the Central Universities(lzuibky-2013-m03)+2 种基金National Natural Science Foundation of China(41075103)National Natural Science Foundation of China(41075102)National Natural Science Foundation of China(41305105)
文摘Objective To investigate the association between ambient air pollution and hospital emergency admissions in Beijing. Methods In this study, a semi-parametric generalized additive model (GAM) was used to evaluate the specific influences of air pollutants (PM10, SO2, and NO2) on hospital emergency admissions with different lag structures from 2009 to 2011, the sex and age specific influences of air pollution and the modifying effect of seasons on air pollution to analyze the possible interaction. Results It was found that a 10μg/m3 increase in concentration of PMlo at lag 03 day, SO2 and NO2 at lag 0 day were associated with an increase of 0.88%, 0.76%, and 1.82% respectively in overall emergency admissions. A 10 lag/m3 increase in concentration of PM10, SO2 and NO2 at lag 5 day were associated with an increase of 1.39%, 1.56%, and 1.18% respectively in cardiovascular disease emergency admissions. For lag 02, a 10 μg/m3 increase in concentration of PM10, SO2 and NO2 were associated with 1.72%, 1.34%, and 2.57% increases respectively in respiratory disease emergency admissions. Conclusion This study further confirmed that short-term exposure to ambient air pollution was associated with increased risk of hospital emergency admissions in Beijing.
基金funded by the National Basic Research Program (973 program) of China (2011CB503802)Gong‐Yi Program of China Ministry of Environmental Protection (200809109)+3 种基金National Natural Science Foundation of China (30800892)Shanghai Pu Jiang Program (09PJ1401700)Program for New Century Excellent Talents in University (NCET‐09‐0314)and National High Technology Research and Development Program of China (863 Program) (2007AA06Z409)
文摘Objective The study is to investigate the associations between visibility, major air pollutants and daily counts of hospital admission in Shanghai, China. Methods Daily data on hospital admission, visibility, and air pollution during 2005‐2008 were obtained from the Shanghai Insurance Bureau (SHIB), Shanghai Meteorological Bureau, and Shanghai Environmental Monitoring Center, respectively. The generalized additive model (GAM) with penalized splines was used to examine the associations between daily visibility and hospital admission. Results Among various pollutants, PM 2.5 showed strongest correlation with visibility. Decreased visibility was significantly associated with increased risk of hospital admission in Shanghai. An inter‐quartile range decrease in the 2‐day (L01) moving average of visibility corresponded to 3.66% (95%CI: 1.02%, 6.31%), 4.06% (95%CI: 0.84%, 7.27%), and 4.32% (95%CI: 1.67%, 6.97%) increase of total, cardiovascular, and respiratory hospitalizations, respectively. Conclusion Our analyses provide the first piece of evidence in China, demonstrating that decreased visibility has an effect on hospital admission, and this finding strengthens the rationale for further limiting air pollution levels in Shanghai.
基金supported in part by the Project of National Natural Science Foundation of China (61301110)Project of Shanghai Key Laboratory of Intelligent Information Processing, China [grant number IIPL-2014-005]+1 种基金the Project funded by the Priority Academic Program Development of Jiangsu Higher Education Institutionsthe Project of Jiangsu Overseas Research & Training Program for University Prominent Young & Middle-Aged Teachers and Presidents
文摘As device-to-device(D2D) communications usually reuses the resource of cellular networks, call admission control(CAC) and power control are crucial problems. However in most power control schemes, total data rates or throughput are regarded as optimization criterion. In this paper, a combining call admission control(CAC) and power control scheme under guaranteeing QoS of every user equipment(UE) is proposed. First, a simple CAC scheme is introduced. Then based on the CAC scheme, a combining call admission control and power control scheme is proposed. Next, the performance of the proposed scheme is evaluated. Finally, maximum DUE pair number and average transmitting power is calculated. Simulation results show that D2 D communications with the proposed combining call admission control and power control scheme can effectively improve the maximum DUE pair number under the premise of meeting necessary QoS.
文摘OBJECTIVE:Admission hyperglycemia in acute myocardial infarction (MI) is related with increased in-hospital and long term mortality and major cardiac adverse events。 We aimed to investigate how admission hyperglycemia affects the short and long term outcomes in elderly patients >65 years) after primary percutaneous coronary intervention for ST elevation myocardial infarction。 METHODS:We retrospectively analyzed 677 consecutive elderly patients (mean age 72.2 ±5.4)。 Patients were divided into two groups according to admission blood glucose levels。 Group : low glucose group (LLG), glucose < 168 mg/dL; and Group 2: high glucose group (HGG), glucose >168 mg/dL。 RESULTS:In-hospital, long term mortality and in-hospital major adverse cardiac events were higher in the high admission blood glucose group (P <0.001)。 Multivariate regression analysis showed: Killip > 1, post-thrombolysis in MI <3 and admission blood glucose levels were independent predictors of in-hospital adverse cardiac events (P <0.001)。 CONCLUSIONS:Admission hyperglycemia in elderly patients presented with ST elevation myocardial infarction is an independent predictor of in-hospital major adverse cardiac events and is associated with in-hospital and long term mortality。
文摘Objective To investigate whether admission time was associated with the delay of reperfusion therapy and in-hospital death in patients with ST-elevation myocardial infarction (STEMI). Methods All patients with STEMI who were admitted to the emergency depart- ment and underwent primary percutaneous coronary intervention at Peking University People's Hospital between April 2012 and March 2015 were included. We examined differences in clinical characteristics, total ischemic time, and in-hospital death between patients admitted during off-hours and those admitted during regular hours. Multivariate logistic regression was used to estimate the relationship between off-hours admission and clinical outcome. Results The sample comprised 184 and 105 patients with STEMI admitted to hospital during off-hours and regular hours, respectively. Total ischemic and onset-to-door times were significantly shorter in patients admitted during off-hours than among those admitted during regular hours (all P 〈 0.05). Door-to-balloon (DTB) time, the rate of DTB time 〈 90 min, and in-hospital death were comparable between groups. Multivariate logistic regression showed that age and creatinine level, but not off-hours admission, were associated independently with increased in-hospital death. Conclusions Off-hours admission did not result in delayed reperfusion therapy or increased in-hospital mortality in patients with STEMI. Further efforts should focus on identifying pivotal factors associated with the pre-hospital and in-hospital delay of reperfusion therapy, and implementing quality improvement initiatives for reperfusion programs.
基金supported by the National Natural Science Foundation of China (7070102571071105)+2 种基金the Program for New Century Excellent Talents in Universities of China (NCET-08-0396)the National Science Fund for Distinguished Young Scholars of China (70925005)the Program for Changjiang Scholars and Innovative Research Team in University (IRT/028)
文摘Power efficiency and link reliability are of great impor- tance in hierarchical wireless sensor networks (HWSNs), espe- cially at the key level, which consists of sensor nodes located only one hop away from the sink node called OHS. The power and admission control problem in HWSNs is comsidered to improve its power efficiency and link reliability. This problem is modeled as a non-cooperative game in which the active OHSs are con- sidered as players. By applying a double-pricing scheme in the definition of OHSs' utility function, a Nash Equilibrium solution with network properties is derived. Besides, a distributed algorithm is also proposed to show the dynamic processes to achieve Nash Equilibrium. Finally, the simulation results demonstrate the effec- tiveness of the proposed algorithm.
文摘Propose a new degradation call admission control(DCAC)scheme, which can be used in wideband code division multiple access communication system. So-called degradation is that non-real time call has the characteristic of variable bit rate, so decreasing its bit rate can reduce the load of the system, consequently the system can admit new call which should be blocked when the system is close to full load, therefore new call's access probability increases. This paper brings forward design project and does system simulation, simulation proves that DCAC can effectively decrease calls' blocking probability and increase the total number of the on-line users.