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The effect of intraoperative goal-directed fluid therapy in patients under anesthesia for gastrointestinal surgery
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作者 Jun Zhang Xiao-Wen Li Bing-Feng Xie 《World Journal of Gastrointestinal Surgery》 SCIE 2024年第9期2815-2822,共8页
BACKGROUND Intraoperative fluid management is an important aspect of anesthesia mana-gement in gastrointestinal surgery.Intraoperative goal-directed fluid therapy(GDFT)is a method for optimizing a patient's physio... BACKGROUND Intraoperative fluid management is an important aspect of anesthesia mana-gement in gastrointestinal surgery.Intraoperative goal-directed fluid therapy(GDFT)is a method for optimizing a patient's physiological state by monitoring and regulating fluid input in real-time.AIM To evaluate the efficacy of intraoperative GDFT in patients under anesthesia for gastrointestinal surgery.METHODS This study utilized a retrospective comparative study design and included 60 patients who underwent gastrointestinal surgery at a hospital.The experimental group(GDFT group)and the control group,each comprising 30 patients,received intraoperative GDFT and traditional fluid management strategies,respectively.The effect of GDFT was evaluated by comparing postoperative recovery,com-plication rates,hospitalization time,and other indicators between the two patient groups.RESULTS Intraoperative blood loss in the experimental and control groups was 296.64±46.71 mL and 470.05±73.26 mL(P<0.001),and urine volume was 415.13±96.72 mL and 239.15±94.69 mL(P<0.001),respectively.The postoperative recovery time was 5.44±1.1 days for the experimental group compared to 7.59±1.45 days(P<0.001)for the control group.Hospitalization time for the experimental group was 10.87±2.36 days vs 13.65±3 days for the control group(P<0.001).The visual analogue scale scores of the experimental and control groups at 24 h and 48 h INTRODUCTION Gastrointestinal surgery is one of the most common procedures in the field of general surgery[1],involving the stomach,intestines,liver,pancreas,spleen,and other internal abdominal organs[2,3].With advancements in surgical technology and anesthesia methods,the safety and success rates of surgery have significantly improved[4,5].However,intraop-erative fluid management remains a critical challenge[6].Traditional fluid management strategies often rely on experience and basic physiological parameters,which may lead to excessive or insufficient fluid input,thereby affecting postoperative recovery and complication rates.Intraoperative goal-directed fluid therapy(GDFT)is an emerging fluid management strategy that dynamically adjusts fluid input volume by monitoring the patient's hemodynamic parameters in real-time to optimize the patient's physiological state[7,8].GDFT has shown superiority in many surgical fields;however,its application in gastrointestinal surgery requires further research and verification[9,10].The application of intraoperative GDFT in clinical settings has gradually increased in recent years[11,12].Studies have demonstrated that GDFT can optimize tissue perfusion and oxygenation by precisely controlling fluid input and reducing the occurrence of postoperative complications[13,14].For example,in cardiac and major vascular surgeries,GDFT significantly reduced the incidence of postoperative acute kidney injury and cardiovascular events[15,16].Similarly,in abdominal surgery,GDFT effectively reduced postoperative infections and expedited recovery[17].However,studies on the utilization of GDFT in gastrointestinal surgery are relatively limited and they are confounded by contradictory findings[18].Traditional fluid management strategies typically rely on estimating fluid input volume based on the patient's weight,preoperative status,and basic physiological parameters[19].However,this method lacks real-time dynamic adjustment,which may result in either insufficient or excessive fluid input,consequently affecting postoperative recovery.Insufficient fluid input can lead to hypovolemia and inadequate tissue perfusion,whereas excessive fluid input can cause tissue edema and postoperative complications,such as pulmonary edema and heart failure.GDFT involves dynamically adjusting fluid input volume by monitoring the patient's hemodynamic parameters in real-time,such as cardiac output,pulse pressure variability,and central venous pressure.Commonly used monitoring equipment include esophageal Doppler and pulse wave profile analyzers[20].These devices provide real-time hemo-dynamic data to assist anesthesiologists in tailoring fluid therapy to a patient's specific condition.Firstly,the patient's volume responsiveness is assessed by preloading fluid;secondly,fluid input volume is dynamically adjusted based on real-time monitoring data;finally,vasoactive and inotropic drugs are administered in combination to further optimize the patient’s hemodynamic status.Through personalized fluid management,GDFT can more accurately maintain intraop-erative hemodynamic stability and reduce complications[21].Gastrointestinal surgery involves procedures on multiple organs,often requiring prolonged operative times and extensive tissue trauma,which presents challenges for intraop-erative fluid management.Surgical procedures can lead to significant bleeding and fluid loss,requiring prompt and effective fluid replenishment.In addition,the slow recovery of gastrointestinal function after surgery and susceptibility to complications such as intestinal obstruction and delayed gastric emptying elevate the necessity for postoperative fluid management. 展开更多
关键词 Intraoperative goal-directed fluid therapy Gastrointestinal surgery Anesthesia management Postoperative recovery COMPLICATIONS Length of stay
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Seismic isolation design and resilience improvement of railway station considering the influence of near-fault pulse-like ground motions
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作者 Pan Yi Song Jiayu +1 位作者 Chen Qi Liu Yongxin 《Earthquake Engineering and Engineering Vibration》 2025年第1期257-270,共14页
To improve the resilience of railway stations,a typical station was selected as the research object,and an isolation design was introduced.Twenty-four groups of near-fault pulse-like ground motions were selected.The s... To improve the resilience of railway stations,a typical station was selected as the research object,and an isolation design was introduced.Twenty-four groups of near-fault pulse-like ground motions were selected.The seismic resilience of the no-isolation railway stations(NIRS)and the isolation railway stations(IRS)were compared to provide a numerical result of the improvement in resilience.The results show that in the station isolation design,the station's functional requirements and structural characteristics should be considered and the appropriate placement of isolation bearings is under the waiting room.Under the action of a rare earthquake,the repair cost,repair time,rate of harm and death of the IRS were decreased by 8.04 million,18.30 days,6.93×10^(-3)and 1.21×10^(-3),respectively,when compared to the NIRS.The IRS received a seismic resilience grade of three-stars and the NIRS only one-star,indicating that rational isolation design improves the seismic resilience of stations.Thus,for the design of stations close to earthquake faults,it is suggested to utilize appropriate isolation techniques to improve their seismic resilience. 展开更多
关键词 railway station near-fault pulse-like ground motion isolation design seismic resilience resilience improvement
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Goal-directed therapy in intraoperative fluid and hemodynamic management 被引量:7
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作者 Maria Cristina Gutierrez Peter G.Moore Hong Liu 《The Journal of Biomedical Research》 CAS 2013年第5期357-365,共9页
Intraoperative fluid management is pivotal to the outcome and success of surgery, especially in high-risk proce- dures. Empirical formula and invasive static monitoring have been traditionally used to guide intraopera... Intraoperative fluid management is pivotal to the outcome and success of surgery, especially in high-risk proce- dures. Empirical formula and invasive static monitoring have been traditionally used to guide intraoperative fluid management and assess volume status. With the awareness of the potential complications of invasive procedures and the poor reliability of these methods as indicators of volume status, we present a case scenario of a patient who underwent major abdominal surgery as an example to discuss how the use of minimally invasive dynamic monitoring may guide intraoperative fluid therapy. 展开更多
关键词 high-risk surgery HEMODYNAMIC FLUID monitoring goal-directed therapy
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基于Leap Motion手势交互技术的博物馆数字展示应用研究
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作者 倪栋 《印刷与数字媒体技术研究》 CAS 北大核心 2024年第4期37-45,共9页
随着科技的不断发展,博物馆数字展示已成为呈现文物与历史不可或缺的重要手段之一。在数字化潮流的推动下,Leap Motion技术凭借其卓越的手势交互能力引起了广泛的关注与兴趣。本研究旨在探索如何充分利用Leap Motion手势交互技术,设计... 随着科技的不断发展,博物馆数字展示已成为呈现文物与历史不可或缺的重要手段之一。在数字化潮流的推动下,Leap Motion技术凭借其卓越的手势交互能力引起了广泛的关注与兴趣。本研究旨在探索如何充分利用Leap Motion手势交互技术,设计并实现一种全新的博物馆数字展示交互系统,以提升观众的参与度和沉浸式体验。本研究采用实验研究方法,开发并实施了一套基于LeapMotion技术的手势交互系统。通过实验设计、设备选择与安装、手势识别与映射、展示内容的创建与集成、以及用户测试与优化等步骤完成研究。其结果表明,该系统能够准确捕捉观众的手部动作,并将其映射到超大屏幕的交互中,显著提升了展示效果和观众的互动体验。手势识别的误差率控制在5%以内,交互响应速度优秀,达到了预期目标。本研究验证了LeapMotion手势交互技术在博物馆数字展示中的有效性和可行性,提供了一种创新的展示方式,为公众呈现出更为丰富、引人入胜的文化体验,为未来博物馆展示的数字化发展方向提供有益的参考与借鉴,以促进整个行业的创新发展。 展开更多
关键词 博物馆数字展示 Leapmotion 手势交互 体感交互
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基于Leap Motion手势识别的三维交互系统 被引量:1
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作者 项融融 李博 赵桥 《电子设计工程》 2024年第1期44-48,共5页
随着虚拟交互技术的发展,人们迈入了“体验式经济时代”,消费者越来越关注个性体验,因此,基于Leap Motion手势识别设备,设计了一种三维虚拟室内交互系统。该系统以Unity3D作为开发工具,Leap Motion作为硬件平台,结合C#语言进行脚本的编... 随着虚拟交互技术的发展,人们迈入了“体验式经济时代”,消费者越来越关注个性体验,因此,基于Leap Motion手势识别设备,设计了一种三维虚拟室内交互系统。该系统以Unity3D作为开发工具,Leap Motion作为硬件平台,结合C#语言进行脚本的编译,利用3ds Max平台对室内进行场景搭建,通过Unity3D工具将组件整合,设计了七种手势,使用Leap Motion硬件设备对场景中物体进行各种不同的操作。经试验表明,该系统实现了用户与场景中物体的交互能力,可以应用在室内装修和设计等方面,增强人们的体验感与趣味性。 展开更多
关键词 Leap motion 手势识别 UNITY3D 虚拟交互
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Scoliosis in Children: Impact of Goal-Directed Therapies on Intraoperative and Postoperative Outcomes 被引量:3
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作者 Claudine Kumba Lotfi Miladi 《Open Journal of Orthopedics》 2021年第10期315-326,共12页
<b><span style="font-family:Verdana;">Background: </span></b></span><span><span><span style="font-family:""><span style="font-family:Ver... <b><span style="font-family:Verdana;">Background: </span></b></span><span><span><span style="font-family:""><span style="font-family:Verdana;">Scoliosis is among interventions with high postoperative com</span><span><span style="font-family:Verdana;">plication rates due to the characteristics of the surgery, where blood los</span><span style="font-family:Verdana;"></span><span style="font-family:Verdana;">s,</span></span><span style="font-family:Verdana;"> transfusion and fluid requirements can be increased. A monocentric retrospective observational study was undertaken earlier to determine predictors of intraoperative and postoperative outcomes in surgical patients. In this initial cohort, there were patients who underwent scoliosis surgery, and a secondary </span><span style="font-family:Verdana;">analysis to describe outcomes in these patients was realized and presented</span> <span><span style="font-family:Verdana;">here. </span><b><span style="font-family:Verdana;">Objective:</span></b><span style="font-family:Verdana;"> To describe intraoperative and postoperative outcomes in</span></span><span style="font-family:Verdana;"> patients under 18 years old in scoliosis surgery included in the initial study and </span><span style="font-family:Verdana;">to propose improvement </span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">and </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">implementation measures. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> A sec</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">ondary analysis of patients undergoing scoliosis surgery </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">from</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> 1 January 2014 to </span><span style="font-family:Verdana;">17 May 2017 was undertaken in our institution—Necker Enfants Malades</span> <span style="font-family:Verdana;">uni</span><span style="font-family:Verdana;">ver</span><span><span style="font-family:Verdana;">sity hospital. The study was approved by the Ethics Committee. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> There </span></span><span style="font-family:Verdana;">were 116 patients with a mean age of 147.5 ± 40.2 months. Twenty-eight pa</span><span style="font-family:Verdana;">tients </span><span style="font-family:Verdana;">(24.1%) presented intraoperative and/or postoperative complications. The most</span> <span style="font-family:Verdana;">common intraoperative complication was hemorrhagic shock in 3 patients </span><span style="font-family:Verdana;">(2.6%). The most common postoperative organ failure was neuro</span><span style="font-family:Verdana;">logic in seven patients (6%), respiratory in 3 patients (2.6%), car</span><span style="font-family:Verdana;">dio-circulatory in 2 patients (1.7%) and renal failure in </span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">1</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> patient (0.9%). The most common postoperative infection was surgical wound sepsis in 8 patients (6.9%), urinary sepsis in </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">3</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> patients (2.6%), and abdominal sepsis and septicemia in </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">2</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> patients (1.7%). </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">12</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> patients (10.3%) had reoperations. Fif</span><span style="font-family:Verdana;">ty-six patients (48.3%) had </span><span><span style="font-family:Verdana;">intraoperative transfusion. There was no in-hospital mortality. </span><b><span style="font-family:Verdana;">Conclusion:</span></b></span><span style="font-family:Verdana;"> The </span><span style="font-family:Verdana;">portion of patients with intraoperative and or postoperative complications </span><span style="font-family:Verdana;">was 24.1%, integrating goal-directed therapies in this surgical setting could improve postoperative outcomes. 展开更多
关键词 SCOLIOSIS CHILDREN OUTCOME goal-directed Therapies
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Intraoperative Goal-Directed Therapies in Femoral and Pelvic Osteotomies in Children and In-Hospital Postoperative Outcomes 被引量:2
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作者 Claudine Kumba Mathilde Gaume +1 位作者 Arayik Barbarian Zaga Péjin 《Open Journal of Orthopedics》 2021年第11期327-334,共8页
<span style="font-family:Verdana;"> <strong>Background: </strong></span><span><span><span style="font-family:;" "=""><span style=&qu... <span style="font-family:Verdana;"> <strong>Background: </strong></span><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;">Femoral and pelvic osteotomies are potential hemorrhagic interventions where transfusion requirements can be necessary. </span><b><span style="font-family:Verdana;">Objective: </span></b><span style="font-family:Verdana;">We undertook a secondary analysis of patients who underwent femoral and pelvic osteotomy in the initial cohort. The objective of this secondary analysis was to describe intraoperative and postoperative outcomes and to describe intraoperative management in these patients in terms of blood product management and fluid and hemodynamic therapy with the aim of implementing optimization management protocols for postoperative outcome improvement. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> A secondary analysis of patients who underwent femoral and pelvic osteotomy surgery was included in the initial retrospective study. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">There were eighteen patients with a mean age of 104 ± 47.1 months. Four (22.2%) patients had intraoperative and/or postoperative complications. One patient (5.6%) had an intraoperative hemorrhagic shock, two patients (11.1%) had postoperative neurologic failure, and one patient (5.6%) had postoperative wound sepsis. The transfusion rate was 50% in nine patients. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> Femoral and pelvic osteotomies are interventions where blood, transfusion and fluid requirements can be increased;thus, this implies the necessity of a global patient blood management protocol with point-of-care tests and fluid- and hemodynamic-guided protocols with validated tools in children for intraoperative and postoperative outcome optimization.</span></span></span></span> 展开更多
关键词 Femoral Osteotomy Pelvic Osteotomy Patient Blood Management Fluid and Hemodynamic goal-directed Therapy CHILDREN Postoperative Outcome
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Intraoperative Blood Pressure Lability Acts as a Key Mediator in the Impacts of Goal-Directed Fluid Therapy on Postoperative Complications in Patients Undergoing Major Spine Surgery
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作者 Lu Che Jia-Wen Yu +2 位作者 Yue-Lun Zhang Li Xu Yu-Guang Huang 《Chinese Medical Sciences Journal》 CAS CSCD 2023年第4期257-264,共8页
Objective Although goal-directed fluid therapy(GDFT)has been proven to be effective in reducing the incidence of postoperative complications,the underlying mechanisms remain unknown.The aim of this study was to examin... Objective Although goal-directed fluid therapy(GDFT)has been proven to be effective in reducing the incidence of postoperative complications,the underlying mechanisms remain unknown.The aim of this study was to examine the mediating role of intraoperative hemodynamic lability in the association between GDFT and the incidence of postoperative complications.We further tested the role of this mediation effect using mean arterial pressure,a hemodynamic indicator.Methods This secondary analysis used the dataset of a completed nonrandomized controlled study to investigate the effect of GDFT on the incidence of postoperative complications in patients undergoing posterior spine arthrodesis.We used a simple mediation model to test whether there was a mediation effect of average real variability between the association of GDFT and postoperative complications.We conducted mediation analysis using the mediation package in R(version 3.1.2),based on 5,000 bootstrapped samples,adjusting for covariates.Results Among the 300 patients in the study,40%(120/300)developed postoperative complications within 30 days.GDFT was associated with fewer 30-day postoperative complications after adjustment for confounders(odds ratio:0.460,95%CI:0.278,0.761;P=0.003).The total effect of GDFT on postoperative complications was-0.18(95%CI:-0.28,-0.07;P<0.01).The average causal mediation effect was-0.08(95%CI:-0.15,-0.04;P<0.01).The average direct effect was-0.09(95%CI:-0.20,0.03;P=0.17).The proportion mediated was 49.9%(95%CI:18.3%,140.0%).Conclusions The intraoperative blood pressure lability mediates the relationship between GDFT and the incidence of postoperative complications.Future research is needed to clarify whether actively reducing intraoperative blood pressure lability can prevent postoperative complications. 展开更多
关键词 goal-directed fluid therapy mediation analysis postoperative complications hemodynamic stability
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Pulses in ground motions identified through surface partial matching and their impact on seismic rocking consequence 被引量:1
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作者 Tang Yuchuan Wang Jiankang Wu Gang 《Earthquake Engineering and Engineering Vibration》 SCIE EI CSCD 2024年第1期35-50,共16页
In seismology and earthquake engineering,it is fundamental to identify and characterize the pulse-like features in pulse-type ground motions.To capture the pulses that dominate structural responses,this study establis... In seismology and earthquake engineering,it is fundamental to identify and characterize the pulse-like features in pulse-type ground motions.To capture the pulses that dominate structural responses,this study establishes congruence and shift relationships between response spectrum surfaces.A similarity search between spectrum surfaces,supplemented with a similarity search in time series,has been applied to characterize the pulse-like features in pulse-type ground motions.The identified pulses are tested in predicting the rocking consequences of slender rectangular blocks under the original ground motions.Generally,the prediction is promising for the majority of the ground motions where the dominant pulse is correctly identified. 展开更多
关键词 velocity pulse ground motion surface similarity ROCKING OVERTURNING
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Extension of Goal-Directed Behavior Model for Post-Pandemic Korean Travel Intentions to Alternative Local Destinations: Perceived Risk and Knowledge
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作者 Heesup Han Hong Ngoc Nguyen +1 位作者 Hyerin Lee Sanghyeop Lee 《International Journal of Mental Health Promotion》 2023年第4期449-469,共21页
Since the outbreak of COVID-19,tourists have been increasingly concerned over various risks of international travel,while knowledge of the pandemic appears to vary significantly.In addition,as travel restrictions cont... Since the outbreak of COVID-19,tourists have been increasingly concerned over various risks of international travel,while knowledge of the pandemic appears to vary significantly.In addition,as travel restrictions continue to impact adversely on international tourism,tourism efforts should be placed more on the domestic markets.Via structural equation modeling,this study unearthed different risk factors impacting Korean travelers’choices of alternative local destinations in the post-pandemic era.In addition,this study extended the goal-directed behavior framework with the acquisition of perceived risk and knowledge of COVID-19,which was proven to hold a sig-nificantly superior explanatory power of tourists’decisions of local alternatives over foreign countries during the COVID-19 pandemic.Furthermore,desire was found to play an imminent mediating role in the conceptual mod-el,maximizing the impact of perceived risk on travel intentions.Henceforth,this research offers meaningful the-oretical implication as thefirst empirical study to deepen the goal-directed behaviour framework with perceived risk and knowledge in the context of post-COVID-19 era.It also serves as insightful knowledge for Korean tour-ism authorities and practitioners to understand local tourists’decision-making processes and tailor effective recovery strategy for domestic tourism. 展开更多
关键词 Travel intention goal-directed behavior desire perceived risk COVID-19 domestic tourism Korean tourists
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Motion Planning for Autonomous Driving with Real Traffic Data Validation 被引量:1
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作者 Wenbo Chu Kai Yang +1 位作者 Shen Li Xiaolin Tang 《Chinese Journal of Mechanical Engineering》 SCIE EI CAS CSCD 2024年第1期74-86,共13页
Accurate trajectory prediction of surrounding road users is the fundamental input for motion planning,which enables safe autonomous driving on public roads.In this paper,a safe motion planning approach is proposed bas... Accurate trajectory prediction of surrounding road users is the fundamental input for motion planning,which enables safe autonomous driving on public roads.In this paper,a safe motion planning approach is proposed based on the deep learning-based trajectory prediction method.To begin with,a trajectory prediction model is established based on the graph neural network(GNN)that is trained utilizing the INTERACTION dataset.Then,the validated trajectory prediction model is used to predict the future trajectories of surrounding road users,including pedestrians and vehicles.In addition,a GNN prediction model-enabled motion planner is developed based on the model predictive control technique.Furthermore,two driving scenarios are extracted from the INTERACTION dataset to validate and evaluate the effectiveness of the proposed motion planning approach,i.e.,merging and roundabout scenarios.The results demonstrate that the proposed method can lower the risk and improve driving safety compared with the baseline method. 展开更多
关键词 Trajectory prediction Graph neural network motion planning INTERACTION dataset
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Goal-directed fluid therapy in gastrointestinal cancer surgery:A prospective randomized study
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作者 Duygu Akyol Zafer Cukurova +2 位作者 Evrim Kucur Tulubas GüneşÖzlem Yıldız Mehmet Süleyman Sabaz 《Journal of Acute Disease》 2022年第2期52-58,I0001,共8页
Objective:To investigate the effects of perioperative goal-directed fluid therapy(GDFT)on intraoperative fluid balance,postoperative morbidity,and mortality.Methods:This is a prospective randomized study,and 90 patien... Objective:To investigate the effects of perioperative goal-directed fluid therapy(GDFT)on intraoperative fluid balance,postoperative morbidity,and mortality.Methods:This is a prospective randomized study,and 90 patients who underwent elective open gastrointestinal cancer surgery between April 2017 and May 2018 were included.Patients were randomized into 2 groups that received liberal fluid therapy(the LFT group,n=45)and goal-directed fluid therapy(the GDFT group,n=45).Patients’Colorectal Physiologic and Operative Severity Score for the enUmeration of Mortality and Morbidity(CR-POSSUM)physiological score,Charlson Comorbidity Index(CCI),perioperative vasopressor and inotrope use,postoperative AKIN classification,postoperative intensive care unit(ICU)hospitalization,hospital stay,and 30-day mortality were recorded.Results:The volume of crystalloid used perioperatively and the total volume of fluid were significantly lower in the GDFT group compared to the LFT group(P<0.05).CR-POSSUM physiological score and CCI were significantly higher in the GDFT group(P<0.05).Although perioperative vasopressor and inotrope use was significantly higher in the GDFT group(P<0.05),postoperative acute kidney injury development was not affected.Postoperative mortality was determined to be similar in both groups(P>0.05).Conclusion:Although GDFT was demonstrated to be a good alternative method to LFT in open gastrointestinal cancer surgery,and it can prevent perioperative fluid overload,and the postoperative results are comparable in the two groups. 展开更多
关键词 goal-directed fluid therapy Liberal fluid therapy Stroke volume variation Open gastrointestinal cancer surgery
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Simplified Intraoperative Goal-Directed Therapy Using the FloTrac/Vigileo System: An Analysis of Its Usefulness and Safety
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作者 Kenji Ito Miho Ito +2 位作者 Aki Ando Yuki Sakuma Toshiyasu Suzuki 《Open Journal of Anesthesiology》 2017年第1期1-14,共14页
Purpose: We investigated whether the simplified intraoperative Goal-Directed Therapy (GDT) could improve the factors affecting medical costs, and contribute in standardizing intraoperative fluid management. Methods: T... Purpose: We investigated whether the simplified intraoperative Goal-Directed Therapy (GDT) could improve the factors affecting medical costs, and contribute in standardizing intraoperative fluid management. Methods: The enrolled patients underwent esophagectomy, pancreatoduodenectomy, or aortic stent grafting in 2012, and between March 2013 and October 2014. We conducted a comparison study on the effects of GDT, between the before-GDT historical control group (n = 100) and GDT group (n = 100). The hemodynamic indices used for control group patients were conventional: Blood pressure, heart rate, and urine output. For GDT group, additionally, we used stroke volume variation (SVV) and stroke volume index (SVI). The primary outcomes were the length of intensive care unit (ICU) stay and hospital stay (LOS). Regression analysis was used to identify factors affecting LOS. The secondary outcomes were the albumin use, the fluid amount administered, and the variation in the fluid administration rate. Results: The control and GDT groups comprised 96 and 99 patients, respectively. The patient characteristics were similar. The length of ICU stay was significantly shorter (2.1 ± 2.1 days vs. 2.8 ± 1.9 days, P = 0.0009) and LOS was shorter but without statistical significance (24.5 ± 17.7 days vs. 27.7 ± 20.1 days, P = 0.21) in the GDT group than in the control group. The fluid amount administered and the presence/ absence of albumin use were factors affecting LOS. The variation of the fluid administration rate was significantly lower in the GDT group. Conclusion: The simplified GDT may contribute to the improvement of medical economics and standardize the fluid management. 展开更多
关键词 FLOTRAC/VIGILEO Fluid Management goal-directed Therapy PATIENT OUTCOME
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Dynamic Hand Gesture-Based Person Identification Using Leap Motion and Machine Learning Approaches 被引量:1
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作者 Jungpil Shin Md.AlMehedi Hasan +2 位作者 Md.Maniruzzaman Taiki Watanabe Issei Jozume 《Computers, Materials & Continua》 SCIE EI 2024年第4期1205-1222,共18页
Person identification is one of the most vital tasks for network security. People are more concerned about theirsecurity due to traditional passwords becoming weaker or leaking in various attacks. In recent decades, f... Person identification is one of the most vital tasks for network security. People are more concerned about theirsecurity due to traditional passwords becoming weaker or leaking in various attacks. In recent decades, fingerprintsand faces have been widely used for person identification, which has the risk of information leakage as a resultof reproducing fingers or faces by taking a snapshot. Recently, people have focused on creating an identifiablepattern, which will not be reproducible falsely by capturing psychological and behavioral information of a personusing vision and sensor-based techniques. In existing studies, most of the researchers used very complex patternsin this direction, which need special training and attention to remember the patterns and failed to capturethe psychological and behavioral information of a person properly. To overcome these problems, this researchdevised a novel dynamic hand gesture-based person identification system using a Leap Motion sensor. Thisstudy developed two hand gesture-based pattern datasets for performing the experiments, which contained morethan 500 samples, collected from 25 subjects. Various static and dynamic features were extracted from the handgeometry. Randomforest was used to measure feature importance using the Gini Index. Finally, the support vectormachinewas implemented for person identification and evaluate its performance using identification accuracy. Theexperimental results showed that the proposed system produced an identification accuracy of 99.8% for arbitraryhand gesture-based patterns and 99.6% for the same dynamic hand gesture-based patterns. This result indicatedthat the proposed system can be used for person identification in the field of security. 展开更多
关键词 Person identification leap motion hand gesture random forest support vector machine
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Use of Early Goal-Directed Therapy in the Emergency Department before and after the Sepsis Trilogy
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作者 Loren K. Reed Benton R. Hunter Tyler M. Stepsis 《Open Journal of Emergency Medicine》 2016年第2期33-37,共5页
The management of sepsis evolved recently with the publication of three large trials (referred to as the sepsis trilogy) investigating the efficacy of early goal-directed therapy (EGDT). Our goal was to determine if t... The management of sepsis evolved recently with the publication of three large trials (referred to as the sepsis trilogy) investigating the efficacy of early goal-directed therapy (EGDT). Our goal was to determine if the publication of these trials has influenced the use of EGDT when caring for patients with severe sepsis and septic shock in the emergency department (ED). In February 2014, we surveyed a sample of board-certified emergency medicine physicians regarding their use of EGDT in the ED. A follow-up survey was sent after the publication of the sepsis trilogy. Data was analyzed using 95% confidence intervals to determine if there was a change in the use of EGDT following the publication of the above trials. Subgroup analyses were also performed with regard to academic affiliation and emergency department volume. Surveys were sent to 308 and 350 physicians in the pre-and post-publication periods, respectively. Overall, ED use of EGDT did not change with publication of the sepsis trilogy, 48.7% (CI 39.3% - 58.2%) before and 50.5% (CI 40.6% - 60.3%) after. Subgroup analysis revealed that academic-affiliated EDs significantly decreased EGDT use following the sepsis trilogy while nonacademic departments significantly increased EGDT use. Use of EGDT was significantly greater in community departments versus academic departments following the publication of the sepsis trilogy. There was no change overall in the use of EGDT protocols when caring for patients with severe sepsis and septic shock, but subgroup analyses revealed that academic departments decreased their use of EGDT while community departments increased use of EGDT. This may be due to varying rates of uptake of the medical literature between academic and community healthcare systems. 展开更多
关键词 SEPSIS Early goal-directed Therapy Septic Shock EGDT
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Effect of Goal-Directed Fluid Therapy on Lung Function, Cognitive Function and Inflammatory Response in Patients Undergoing Radical Esophageal Cancer Surgery under One-Lung Ventilation
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作者 Jibo Zhao Yuanli Li +4 位作者 Dengyun Xia Xiaojia Sun Yuan Zhang Fulong Li Jinliang Teng 《Journal of Cancer Therapy》 2021年第9期487-496,共10页
<strong>Objective:</strong><span style="font-family:;" "=""><span style="font-family:Verdana;"> To explore the effects of goal-directed fluid therapy (GDFT) o... <strong>Objective:</strong><span style="font-family:;" "=""><span style="font-family:Verdana;"> To explore the effects of goal-directed fluid therapy (GDFT) on lung function, cognitive function and inflammatory response in patients undergoing radical esophageal cancer surgery under one-lung ventilation. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> Sixty-seven patients undergoing radical esophageal cancer surgery were divided into GDFT group</span></span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">(GDFT therapy) and control group</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">(conventional liquid therapy). The changes in patients</span><span style="font-family:Verdana;">’</span><span style="font-family:Verdana;"> pulmonary function,</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">cognitive function and inflammatory response were evaluated. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> Both alveolar-arterial oxygen partial pressure difference</span></span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">[P(A-a)O</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;">] and respiratory index</span></span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">(RI) increased at one-lung ventilation for 30 minutes (T</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;">) and decreased at one-lung ventilation for 60 minutes</span></span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">(T</span><sub><span style="font-family:Verdana;">3</span></sub><span style="font-family:Verdana;">), and after surgery (T</span><sub><span style="font-family:Verdana;">4</span></sub><span style="font-family:Verdana;">) in the two groups, and the GDFT group </span></span><span style="font-family:Verdana;">was</span><span style="font-family:Verdana;"> lower than the control group (P</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;"><</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">0.05);theoxygenation index (OI) of the two groups decreased at T</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;">, T</span><sub><span style="font-family:Verdana;">3</span></sub><span style="font-family:Verdana;">, and T</span><sub><span style="font-family:Verdana;">4</span></sub><span style="font-family:Verdana;"> compared with</span></span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">that at T</span><sub><span style="font-family:Verdana;">1</span></sub><span style="font-family:Verdana;"> (before one-lung ventilation), and the GDFT group was higher than the control group (P</span></span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;"><</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">0.05). At T</span><sub><span style="font-family:Verdana;">4</span></sub><span style="font-family:Verdana;"> and T</span><sub><span style="font-family:Verdana;">5</span></sub><span style="font-family:Verdana;">, the tumor necrosis factor </span><i><span style="font-family:Verdana;">α</span></i><span style="font-family:Verdana;"> (TNF-</span><i><span style="font-family:Verdana;">α</span></i><span style="font-family:Verdana;">), interleukin 6 (IL-6), central nervous system specific protein (S100</span><i><span style="font-family:Verdana;">β</span></i><span style="font-family:Verdana;">), and neuron specific enolase (NSE) in the GDFT group were lower compared to the control group (P</span></span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;"><</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">0.05), while interleukin-10 (IL-10) was higher compared to the control group (P</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;"><</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">0.05);the incidence of perioperative neurocognitive disorder (PND) in the GDFT group was lower than that in the control group (P</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;"><</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">0.05). </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> GDFT can help prevent lung injury during radical esophageal cancer surgery under one-lung ventilation, reduce the body</span></span><span style="font-family:Verdana;">’</span><span style="font-family:Verdana;">s inflammatory response, and reduce the incidence of perioperative cognitive disorder to a certain extent.</span> 展开更多
关键词 goal-directed Fluid Therapy Radical Resection of Esophageal Cancer Lung Function Cognitive Function Inflammatory Response
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基于Leap Motion的仙居花灯手势交互系统的设计与实现
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作者 康凌波 舒后 +4 位作者 宋玮 李欣芮 高梦凡 王汝鑫 黄滋涵 《北京印刷学院学报》 2024年第12期23-28,共6页
手势交互作为一种新的人机交互模式,为传统手工艺的数字化保护提供了新思路,本文以非物质文化遗产仙居针刺无骨花灯为案例,提出了一种基于三维建模技术和手势识别技术的方案,集成Leap Motion设备和Unity 3D开发平台,搭建仙居花灯手势交... 手势交互作为一种新的人机交互模式,为传统手工艺的数字化保护提供了新思路,本文以非物质文化遗产仙居针刺无骨花灯为案例,提出了一种基于三维建模技术和手势识别技术的方案,集成Leap Motion设备和Unity 3D开发平台,搭建仙居花灯手势交互系统,定义了一套虚拟交互手势集,实现基于裸手的场景漫游和交互功能。为了交互体验更加自然流畅,提出了一种改进的动态时间规整(DTW)算法的手势识别方法,并对系统进行实验与评估。实验结果表明,改进的DTW算法具有较高的手势识别准确率,该系统能够有效传播传统文化,提升参观者的互动体验和趣味性,验证了该方案的合理性和有效性。 展开更多
关键词 Leap motion 手势交互 传统手工艺
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基于Leap motion 的大学物理实验虚拟课堂设计
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作者 何小勇 何林 +1 位作者 杨嘉铭 袁玉峰 《高师理科学刊》 2024年第5期93-97,共5页
通过利用手势控制器(Leap Motion)技术,设计并实施一套创新的大学物理虚拟实验课程.通过在Unity3D软件中整合Leap Motion,创建一个大学物理实验测量杨氏模量实验场景,主要是利用C#语言进行开发,通过设计出多个模块,包括主界面设计和基... 通过利用手势控制器(Leap Motion)技术,设计并实施一套创新的大学物理虚拟实验课程.通过在Unity3D软件中整合Leap Motion,创建一个大学物理实验测量杨氏模量实验场景,主要是利用C#语言进行开发,通过设计出多个模块,包括主界面设计和基本实验组件来完成物理实验的设计.在Leap Motion官网上下载关于Unity3D的SDK资源包并且导入Unity3D中,用其建立手部模型,实现Leap Motion控制器与Unity3D的手部交互实验系统的设计.人机交互技术的引入不仅可以丰富大学物理实验的教学手段,而且还能提高学生的学科理解和实际操作能力,同时培养其创新思维和科技素养. 展开更多
关键词 Leap motion UNITY3D 人机交互 虚拟课堂 实验设计
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Safe Motion Planning and Control Framework for Automated Vehicles with Zonotopic TRMPC
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作者 Hao Zheng Yinong Li +1 位作者 Ling Zheng Ehsan Hashemi 《Engineering》 SCIE EI CAS CSCD 2024年第2期146-159,共14页
Model mismatches can cause multi-dimensional uncertainties for the receding horizon control strategies of automated vehicles(AVs).The uncertainties may lead to potentially hazardous behaviors when the AV tracks ideal ... Model mismatches can cause multi-dimensional uncertainties for the receding horizon control strategies of automated vehicles(AVs).The uncertainties may lead to potentially hazardous behaviors when the AV tracks ideal trajectories that are individually optimized by the AV's planning layer.To address this issue,this study proposes a safe motion planning and control(SMPAC)framework for AVs.For the control layer,a dynamic model including multi-dimensional uncertainties is established.A zonotopic tube-based robust model predictive control scheme is proposed to constrain the uncertain system in a bounded minimum robust positive invariant set.A flexible tube with varying cross-sections is constructed to reduce the controller conservatism.For the planning layer,a concept of safety sets,representing the geometric boundaries of the ego vehicle and obstacles under uncertainties,is proposed.The safety sets provide the basis for the subsequent evaluation and ranking of the generated trajectories.An efficient collision avoidance algorithm decides the desired trajectory through the intersection detection of the safety sets between the ego vehicle and obstacles.A numerical simulation and hardware-in-the-loop experiment validate the effectiveness and real-time performance of the SMPAC.The result of two driving scenarios indicates that the SMPAC can guarantee the safety of automated driving under multi-dimensional uncertainties. 展开更多
关键词 Automated vehicles Automated driving motion planning motion control Tube MPC ZONOTOPE
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Positron Emission Tomography Lung Image Respiratory Motion Correcting with Equivariant Transformer
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作者 Jianfeng He Haowei Ye +2 位作者 Jie Ning Hui Zhou Bo She 《Computers, Materials & Continua》 SCIE EI 2024年第5期3355-3372,共18页
In addressing the challenge of motion artifacts in Positron Emission Tomography (PET) lung scans, our studyintroduces the Triple Equivariant Motion Transformer (TEMT), an innovative, unsupervised, deep-learningbasedfr... In addressing the challenge of motion artifacts in Positron Emission Tomography (PET) lung scans, our studyintroduces the Triple Equivariant Motion Transformer (TEMT), an innovative, unsupervised, deep-learningbasedframework for efficient respiratory motion correction in PET imaging. Unlike traditional techniques,which segment PET data into bins throughout a respiratory cycle and often face issues such as inefficiency andoveremphasis on certain artifacts, TEMT employs Convolutional Neural Networks (CNNs) for effective featureextraction and motion decomposition.TEMT’s unique approach involves transforming motion sequences into Liegroup domains to highlight fundamental motion patterns, coupled with employing competitive weighting forprecise target deformation field generation. Our empirical evaluations confirm TEMT’s superior performancein handling diverse PET lung datasets compared to existing image registration networks. Experimental resultsdemonstrate that TEMT achieved Dice indices of 91.40%, 85.41%, 79.78%, and 72.16% on simulated geometricphantom data, lung voxel phantom data, cardiopulmonary voxel phantom data, and clinical data, respectively. Tofacilitate further research and practical application, the TEMT framework, along with its implementation detailsand part of the simulation data, is made publicly accessible at https://github.com/yehaowei/temt. 展开更多
关键词 PET lung scans respiratory motion correction triple equivariant motion transformer lie group motion decomposition
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