Venous Doppler flow patterns,venous congestion,heart disease and renal dysfunction:A complex liaison

The World Journal of Cardiology published an article written by Kuwahara et al that we take the pleasure to comment on.We focused our attention on venous congestion.In intensive care settings,it is now widely accepted that venous congestion is an important clinical feature worthy of investigation.Evaluating venous Doppler profile abnormalities at multiple sites could suggest adequate treatment and monitor its efficacy.Renal dysfunction could trigger or worsen fluid overload in heart disease,and cardio-renal syndrome is a well-characterized spectrum of disorders describing the complex interactions between heart and kidney diseases.Fluid overload and venous congestion,including renal venous hypertension,are major determinants of acute and chronic renal dysfunction arising in heart disease.Organ congestion from venous hypertension could be involved in the development of organ injury in several clinical situations,such as critical diseases,congestive heart failure,and chronic kidney disease.Ultrasonography and abnormal Doppler flow patterns diagnose clinically significant systemic venous congestion.Cardiologists and nephrologists might use this valuable,noninvasive,bedside diagnostic tool to establish fluid status and guide clinical choices.

Portal vein pulsatility:An important sonographic tool assessment of systemic congestion for critical ill patients

In this editorial we comment on the article by Kuwahara et al,published in the recent issue of the World Journal of Cardiology.In this interesting paper,the authors showed a correlation between portal vein pulsatility ratio,examined by bedside ultrasonography,and prognosis of hospitalized patients with acute heart failure.Systemic congestion is being notoriously underdetected in the acutely ill population with conventional methods like clinical examination,biomarkers,central venous pressure estimation and X-rays.However,congestion should be a key therapeutic target due to its deleterious effects to end organ function and subsequently patient prognosis.Doppler flow assessment of the abdominal veins is gaining popularity worldwide,as a valuable tool in estimating comprehensively congestion and giving a further insight into hemodynamics and patient management.

An Adaptive Congestion Control Optimization Strategy in SDN-Based Data Centers

The traffic within data centers exhibits bursts and unpredictable patterns.This rapid growth in network traffic has two consequences:it surpasses the inherent capacity of the network’s link bandwidth and creates an imbalanced network load.Consequently,persistent overload situations eventually result in network congestion.The Software Defined Network(SDN)technology is employed in data centers as a network architecture to enhance performance.This paper introduces an adaptive congestion control strategy,named DA-DCTCP,for SDN-based Data Centers.It incorporates Explicit Congestion Notification(ECN)and Round-Trip Time(RTT)to establish congestion awareness and an ECN marking model.To mitigate incorrect congestion caused by abrupt flows,an appropriate ECN marking is selected based on the queue length and its growth slope,and the congestion window(CWND)is adjusted by calculating RTT.Simultaneously,the marking threshold for queue length is continuously adapted using the current queue length of the switch as a parameter to accommodate changes in data centers.The evaluation conducted through Mininet simulations demonstrates that DA-DCTCP yields advantages in terms of throughput,flow completion time(FCT),latency,and resistance against packet loss.These benefits contribute to reducing data center congestion,enhancing the stability of data transmission,and improving throughput.

DetSpace:Distributed Congestion Free Routing for Global Deterministic Network in Mega-Constellations

Emerging long-range industrial IoT applications(e.g.,remote patient monitoring)have increasingly higher requirements for global deterministic delay.Although many existing methods have built deterministic networks in small-scale networks through centralized computing and resource reservation,they cannot be applied on a global scale.The emerging mega-constellations enable new opportunities for realizing deterministic delay globally.As one constellation(e.g.,Starlink)might be managed by a single operator(e.g.,SpaceX),packets can be routed within deterministic number of hops.Moreover,the path diversity brought by the highly symmetrical network structure in mega-constellations can help to construct a congestion free network by routing.This paper leverages these unique characteristics of mega-constellations to avoid the traditional network congestion caused by multiple inputs and single output,and to determine the routing hops,and thus realizing a global deterministic network(DETSPACE).The model based on the 2D Markov chain theoretically verifies the correctness of DETSPACE.The effectiveness of DETSPACE in different traffic load con-ditions is also verified by extensive simulations.

Ultrasound unveiling:Decoding venous congestion in heart failure for precision management of fluid status

This editorial discusses the manuscript by Di Maria et al,published in the recent issue of the World Journal of Cardiology.We here focus on the still elusive pathophysiological mechanisms underlying cardio-renal syndrome(CRS),despite its high prevalence and the substantial worsening of both kidney function and heart failure.While the measure of right atrial pressure through right cardiac catheterization remains the most accurate albeit invasive and costly procedure,integrating bedside ultrasound into diagnostic protocols may substantially enhance the staging of venous congestion and guide therapeutic decisions.In particular,with the assessment of Doppler patterns across multiple venous districts,the Venous Excess Ultrasound(VExUS)score improves the management of fluid overload and provides insight into the underlying factors contributing to cardio-renal interactions.Integrating specific echocardiographic parameters,particularly those concerning the right heart,may thus improve the VExUS score sensitivity,offering perspective into the nuanced comprehension of cardio-renal dynamics.A multidisciplinary approach that consistently incorporates the use of ultrasound is emerging as a promising advance in the understanding and management of CRS.

Congestion Control Algorithms for the Internet-A Secondary Publication

In the last five years,there has been a V-shaped recovery in the number of papers on congestion control algorithms on the Internet.In this paper,congestion problems on the Internet are discussed,such as congestion collapse and bufferbloat from the perspective of the necessity of congestion control algorithms.The typical congestion control algorithms are introduced,and the research areas and methods of congestion control algorithms are described.Recent research trends and future prospects of congestion control algorithms are also presented.

An Effective Optimization Algorithm for Ant Colony Vehicular Congestion Management

Adaptability and dynamicity are special properties of social insects derived from the decentralized behavior of the insects. Authors have come up with designs for software solution that can regulate traffic congestion in a network transportation environment. The effectiveness of various researches on traffic management has been verified through appropriate metrics. Most of the traffic management systems are centered on using sensors, visual monitoring and neural networks to check for available parking space with the aim of informing drivers beforehand to prevent traffic congestion. There has been limited research on solving ongoing traffic congestion in congestion prone areas like car park with any of the common methods mentioned. This study focus however is on a motor park, as a highly congested area when it comes to traffic. The car park has two entrance gate and three exit gates which is divided into three Isle of parking lot where cars can park. An ant colony optimization algorithm (ACO) was developed as an effective management system for controlling navigation and vehicular traffic congestion problems when cars exit a motor park. The ACO based on the nature and movement of the natural ants, simulates the movement of cars out of the car park through their nearest choice exit. A car park simulation was also used for the mathematical computation of the pheromone. The system was implemented using SIMD because of its dual parallelization ability. The result showed about 95% increase on the number of vehicles that left the motor park in one second. A clear indication that pheromones are large determinants of the shortest route to take as cars followed the closest exit to them. Future researchers may consider monitoring a centralized tally system for cars coming into the park through a censored gate being.

Research of Fly over as a Solution to Congestion of Intersection Junction(Case Study:Jalan Jatingaleh Semarang)

In the next few years traffic will happen most of the time.This was triggered by the growing rate of vehicles against the road capacity which is not balance.All the time the congestion in the city of Semarang has been occurred at peak hours.Congestion also occurred in between Teuku Umar and Setia Budi road Jatingaleh because of a plot intersection(Kesatrian intersection,PLN intersection and Jatingaleh intersection)with the Toll Road.Jatingaleh is located in the southern city of Semarang which is a central meeting point between the upper and lower Semarang where the vehicle flows in through a combination of local current and regional traffic,and the flow of vehicles coming in and out from highway.The main cause of the problems that occurred in the area of Jatingaleh is due to the numbers of vehicles movement that occurs at the intersections.With the above issues,it is necessary to analyse the existing conditions and look into some solutions.Before carrying out an analysis a field surveys at peak hours for example morning(06:00 to 08:00 am)and for the afternoon(04:00 to 06:00 pm)should be conducted,then the number of vehicles is counted manually with“short-breakcounting”according to types of vehicles.From the analysis we found that the degree of saturation(DS)is 1.61 between Teuku Umar and Setia Budi road during the morning peak hours and 1.56 during the afternoon peak hours.This means that the capacity of the existing road is no longer able to accommodate the traffic flow.One of the solutions for the congestion that occurs at the intersection of Jatingaleh is to apply the efficiency of the intersection that is not in a plot with a Fly over,Underpass and the combination of Fly Over-Underpass.Base on the flow reduction calculation with 3 comparative modeling it shows that the Fly Over is the most technically efficient to be applied in this research.

基于SIR模型的城市路网拥堵传播分析

研究城市道路交通拥堵传播规律对缓解交通拥堵问题有着积极作用,为此建立了基于SIR的城市道路交通拥堵传播模型,用以分析城市道路交通拥堵传播过程。首先,基于城市实际路网构建路网对偶拓扑网络,并依据SIR建立交通拥堵传播模型。其次,结合道路网络的复杂网络特征和道路自身的相关属性,引入随机森林算法计算相关权重,确定拥堵模型中的传播速率等关键参数。最后,以南京市秦淮区某区域路网为例,构建有69个节点,163条连线的城市路网对偶拓扑网络进行仿真实验。结果表明:道路节点度和道路饱和度是影响道路拥堵传播的关键因素,道路节点度的影响相对较小,传播范围增长在5%以内,恢复时间影响在10%左右;道路饱和度的影响相对较大,随着道路饱和度的增长,传播范围增长最大可至40%,恢复时间影响在20%左右。

A Fast and Efficient Global Router for Congestion Optimization

An efficient parallel global router using random optimization that is independent of net ordering is proposed.Parallel approaches are described and strategies guaranteeing the routing quality are discussed.The wire length model is implemented on multiprocessor,which enables the algorithm to approach feasibility of large scale problems.Timing driven model on multiprocessor and wire length model on distributed processors are also presented.The parallel algorithm greatly reduces the run time of routing.The experimental results show good speedups with no degradation of the routing quality.

An environment-friendly control method for congestion flow ahead of expressway toll stations

To alleviate the resulting increase in energy consumption and emissions and other issues caused by the traffic congestion ahead of the expressway toll station, a novel traffic flowcontrol method is put forward based on the environment-friendly conception. The technical thinking of inducing the slowly moving traffic into a batch pass is determined based on the conclusion of the research, traffic flowtheory and traffic sensing detection technology. The model of stop times is established and the parameters of the system are optimized in accordance with the principle of minimizing the fuel consumption. The optimal location selection of traffic control lights and Detector 2 for queue of different lengths at toll stations are calculated based on the model. Finally, the effect of the congestion flowcontrol system is verified via the Paramics simulation system. The result shows that the control system is capable of reducing90% of fuel consumption for vehicles going through toll stations.

Analyses of unified congestion measures for interrupted traffic flow on urban roads

To study the congestion of interrupted flow on urban roads, a comprehensive evaluation method is proposed. First, based on the results of correlation analysis between different parameters of interrupted flow, the traffic parameters of interrupted traffic flow are divided into two categories： the basic parameters and the operation parameters. Polynomial regression is used to formulize the nonlinear relationships between the basic parameters and the operation parameters. Then, the congestion model incorporating both operational and volume characteristics of traffic flow is proposed. The inputs of the model are the basic parameters, while the output is a dimensionless index value between 0 and 1. Finally, the proposed methods are compared with existing evaluation measures of congestion. Results show that the proposed indices can capture the variation of both the basic parameters and the operation parameters, which is more balanced compared with the existing evaluation measures.

The comprehensive measure model for urban traffic congestion based on value function

According to the distribution characteristics of traffic congestion in time and space, a measure index system of urban traffic congestion is set up based on the spatial and temporal distribution. Based on the analysis of the main characteristics of traffic congestion and the generation process of traffic congestion, the measure model for urban traffic congestion is constructed by the value function. Moreover, based on the measure values of traffic congestion in urban road networks with defined different levels, a method to prevent and control traffic congestion is designed. The application results confirm that the proposed method is feasible in comprehensive measures for urban traffic congestion and they are consistent with the results of other methods. The measuring results can therefore reflect the actual situation. The comprehensive measure model is scientific and the process is simple, and it has wide application prospects and practical value.

Analysis and Taxonomy of Congestion Control Mechanisms for Internet Reliable Multicast

The research of congestion control for Internet reliable multicast is one of the most active fields in reliable multicast protocol research. Many reliable multicast congestion control mechanisms have been put forward. In this paper we present principal problems of congestion control for Internet reliable multicast, analyze solutions and difficulties of solving these problems, and then give a classification of some reliable multicast congestion control mechanisms. Lastly the future work is proposed.

New Incremental Placement Algorithm Based on Integer Programming for Reducing Congestion

A new incremental placement algorithm C-ECOP for standard cell layout is presented to reduce routing congestion.It first estimates the routing congestion through a new routing model.Then,it formulates an integer linear programming (ILP) problem to determine cell flow direction and to avoid the conflictions between adjacent congestion areas.Experimental results show that the algorithm can considerably reduce routing congestion and preserve the performance of the initial placement with high speed.

Time varying congestion pricing for multi-class and multi-mode transportation system with asymmetric cost functions

This paper considers the problem of time varying congestion pricing to determine optimal time-varying tolls at peak periods for a queuing network with the interactions between buses and private cars.Through the combined applications of the space-time expanded network（STEN） and the conventional network equilibrium modeling techniques,a multi-class,multi-mode and multi-criteria traffic network equilibrium model is developed.Travelers of different classes have distinctive value of times（VOTs）,and travelers from the same class perceive their travel disutility or generalized costs on a route according to different weights of travel time and travel costs.Moreover,the symmetric cost function model is extended to deal with the interactions between buses and private cars.It is found that there exists a uniform（anonymous） link toll pattern which can drive a multi-class,multi-mode and multi-criteria user equilibrium flow pattern to a system optimum when the system＇s objective function is measured in terms of money.It is also found that the marginal cost pricing models with a symmetric travel cost function do not reflect the interactions between traffic flows of different road sections,and the obtained congestion pricing toll is smaller than the real value.

加减黄连温胆汤治疗痰湿壅盛型代谢综合征的临床疗效观察

目的:观察加减黄连温胆汤治疗痰湿壅盛型代谢综合征患者的临床疗效。方法:选取2021年9月-2022年9月于黑龙江中医药大学附属第一医院心内科就诊的痰湿壅盛型代谢综合征(MS)患者68例,采用随机数字表法将其随机分为对照组和治疗组,每组34例,对照组给予常规西药治疗,并辅以健康教育,治疗组在对照组治疗方案基础上,加用加减黄连温胆汤,两组治疗周期均为6周。比较两组患者治疗前后中医证候疗效、血压(舒张压、收缩压)、腹围、血糖指标[胰岛素抵抗指数(HOMA-IR)、空腹胰岛素(FINS)、空腹血糖(FPG)]、体质量指数(BMI)、血脂指标[高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)、甘油三酯(TG)]。结果:治疗6周后,两组患者腹围、舒张压、收缩压、HOMA-IR、FINS、FPG、LDL-C、TC、TG、BMI均明显降低(P<0.05),同时治疗组显著低于对照组(P<0.05);两组患者HDL-C较治疗前明显增高(P<0.05),同时治疗组显著高于对照组(P<0.05)。治疗组和对照组的中医证候疗效总有效率分别是94.1%(32/34)和79.4%(27/34),治疗组总有效率显著高于对照组(P<0.05)。结论:加减黄连温胆汤可有效改善痰湿壅盛型MS的症状,并降低患者腹围、血压、BMI、血脂指标、血糖指标。

城市交通拥堵预测研究:以西安市为例

随着经济的发展和生活水平的提升,出行旅游逐渐成为流行的休闲方式,尤其在国庆等假日期间。然而,集中的出行需求引起的城市交通拥堵问题,不仅影响出行效率和体验,也加大了城市运行压力。该研究以西安市为例,深入分析假日期间的交通拥堵模式和特征,提出了一种基于深度学习拥堵预测模型ConstFormer。该模型融合了图卷积网络(graph convolutional network)和Transformer架构,利用图卷积网络探索空间邻接关系,以及Transformer的自注意力机制来挖掘长时空依赖关系,从而有效预测未来的交通状况。对比实验表明,ConstFormer模型对比基线模型均取得了最佳的性能,能够为人们规避高峰期和合理安排出行提供帮助。

Full-Chip Scalable Routing Framework Considering Congestion and Performance

This paper presents a novel full-chip scalable routing framework that simultaneously considers the routing congestion and the circuit performance. In order to bridge the gap, the presented framework calls the detailed router immediately after a global route is extracted. With the interleaving mode of global routing immediately followed by detailed routing, accurate routing resource and congestion information can be obtained, which provides valuable guidance for the following global routing process. The framework features the fast pattern and framed shortest path global router,a maze-based congestion-driven detailed router, and better interaction between the two routers. In the framework, timing critical nets can be assigned higher priority for performance concern, and different net ordering techniques can be adopted for different routing objectives. The framework is tested on a set of commonly used benchmark circuits and compared with a previous multilevel routing framework. Experimental results show that the presented framework obtains significantly better routing solutions than the previous one considering circuit performance, routing completion rate, and runtime.

基于MIMIC数据库分析体温对ICU充血性心力衰竭患者预后的预测价值

目的探讨充血性心力衰竭(CHF)患者入ICU后首次体温与住院死亡率的相关性,以期为临床体温管理提供借鉴。方法采用回顾性队列研究的方法,提取MIMIC-IV数据库中的CHF患者,应用logistic回归、广义加性模型、logistic曲线拟合等评估入ICU后首次体温与住院死亡率之间的关系。结果共纳入15983例CHF患者,平均年龄(72.9±13.4)岁,其中男性占54.6%;CHF患者入ICU期间死亡率为12.4%。Logistic回归分析显示,CHF患者入ICU后首次体温与住院死亡风险独立相关(OR=0.67,95%CI 0.62~0.74,P<0.001);曲线拟合结果显示CHF患者入ICU后首次体温与住院死亡风险呈U形曲线关系,体温拐点是36.7℃。分段Cox回归模型显示,当入ICU后首次体温小于36.7℃时,体温与住院死亡风险呈显著负相关(OR=0.698,95%CI 0.497~0.981,P=0.0385)。相反,当入ICU后首次体温大于36.7℃时,体温与住院死亡风险显著正相关(OR=1.541,95%CI 1.378~2.398,P=0.0437)。结论CHF患者入ICU后首次体温与住院期间死亡风险之间的关系是非线性的,呈U形曲线。较高和较低的入ICU后首次体温均与住院死亡率升高有关。