Estimation of the Direct Cost of Management of Venous Thromboembolism in Three Reference Hospitals in the City of Yaoundé: A Retrospective Study over a Three-Year Period

Background: Venous thromboembolism (VTE) is a major public health problem due to its increasing frequency, mortality and management cost. This cost may require major financial efforts from patients, especially in developing countries like ours where less than 7% of the population has health insurance. This study aimed to estimate the direct cost of managing VTE in three reference hospitals in Yaoundé. Methods: This was a cross-sectional retrospective study over a three-year period (from January 1st 2018 to December 31 2020) carried out in the Cardiology departments of the Central and General Hospitals, and the Emergency Centre of the city of Yaoundé. All patients managed during the study period for deep vein thrombosis and pulmonary embolism confirmed by venous ultrasound coupled with Doppler and computed tomography pulmonary angiography respectively were included. For each patient, we collected sociodemographic and clinical data as well as data on the cost of consultation, hospital stay, workups and medications. These data were analysed using SPSS version 23.0. Results: A total of 92 patient’s records were analysed. The median age was 60 years [48 - 68] with a sex ratio of 0.53. The median direct cost of management of venous thromboembolism was 766,375 CFAF [536,455 - 1,029,745] or $1415 USD. Management of pulmonary embolism associated with deep vein thrombosis was more costly than isolated pulmonary embolism or deep vein thrombosis. Factors influencing the direct cost of management of venous thromboembolism were: hospital structure (p = 0.015), health insurance (p 0.001), type of pulmonary embolism (p = 0.021), and length of hospital stay (p = 0.001). Conclusion: Management of VTE is a major financial burden for our patients and this burden is influenced by the hospital structure, health insurance, type of pulmonary embolism and length of hospital stay.

AGV Scheduling Optimization of Automated Port Based on Disruption Management

The recent rapid development of China’s foreign trade has led to the significant increase in waterway transportation and automated container ports. Automated terminals can significantly improve the loading and unloading efficiency of container terminals. These terminals can also increase the port’s transportation volume while ensuring the quality of cargo loading and unloading, which has become an inevitable trend in the future development of ports. However, the continuous growth of the port’s transportation volume has increased the horizontal transportation pressure on the automated terminal, and the problems of route conflicts and road locks faced by automated guided vehicles (AGV) have become increasingly prominent. Accordingly, this work takes Xiamen Yuanhai automated container terminal as an example. This work focuses on analyzing the interference problem of path conflict in its horizontal transportation AGV scheduling. Results show that path conflict, the most prominent interference factor, will cause AGV scheduling to be unable to execute the original plan. Consequently, the disruption management was used to establish a disturbance recovery model, and the Dijkstra algorithm for combining with time windows is adopted to plan a conflict-free path. Based on the comparison with the rescheduling method, the research obtains that the deviation of the transportation path and the deviation degree of the transportation path under the disruption management method are much lower than those of the rescheduling method. The transportation path deviation degree of the disruption management method is only 5.56%. Meanwhile, the deviation degree of the transportation path under the rescheduling method is 44.44%.

Optimization Management of Industrial Organizations Based on Performance Indicators

This paper proposes an intelligent management system (IMS) to help managers in their delicate and tedious task of exploiting the plethora of data (indicators) contained in management dashboards. This system is based on intelligent agents, ontologies and data mining. It is implemented by PASSI (Process for Agent Societies Specification and Implementation) methods for agent design and implementation, the Methodology for Knowledge Modeling and Hot-Winters for data prediction. Intelligent agents not only track indicators but also store the knowledge of managers within the company. Ontologies are used to manage the representation and presentation aspects of knowledge. Data mining makes it possible to: make the most of all available data;model the industrial process of data selection, exploration and modeling;and transform behaviors into predictive indicators. An instance of the IMS named SYGISS, currently in operation within a large brewery organization, allows us to observe very interesting results: the extraction of indicators is done in less than 5 minutes whereas manual extraction used to take 14 days;the generation of dashboards is instantaneous whereas it used to take 12 hours;the interpretation of indicators is instantaneous whereas it used to take a day;forecasts are possible and are done in less than 5 minutes whereas they did not exist with the old management. These important contributions help to optimize the management of this organization.

Optimizing Resource Management for IoT Devices in Constrained Environments

Embedded computing device implementation on the Internet of Things (IoT) requires careful assessment of their intrinsic resource limitations. These constraints are not limited to memory and processing capabilities but extend to the network interfaces, particularly due to the low-power radio standards that these devices typically employ. The IPv6 protocol is shown to be a strong option for guaranteeing interoperability in the IoT, mostly because of its large address space, the range of current IP-based protocols, and its intrinsic versatility. Considering these benefits, we investigate if current IP-based network management protocols can be implemented on devices with limited resources. We investigate the resource needs in particular for implementing Network Configuration Protocol (NETCONF) and Simple Network Management Protocol (SNMP) on an 8-bit AVR-based device. Our investigation reveals the specific memory and processing demands of these protocols, providing valuable insights into their practicality and efficiency in constrained IoT environments. This study underscores the potential and challenges of leveraging IPv6-based network management protocols to enhance the functionality and interoperability of IoT devices while operating within stringent resource limitations.

Research on the Optimization of Enterprise Financial Management under the Financial Sharing Model

With the advancement of globalization and information technology,the financial sharing mode has gradually emerged as a crucial means for enterprises to optimize their financial management.Particularly within the context of economic globalization,informatization,and digital transformation,enterprises find themselves navigating a rapidly evolving market environment by intensifying competition.To enhance efficiency and competitiveness,many enterprises have embraced the financial sharing model to streamline financial management processes,curtail costs,and bolster the execution of corporate strategies.This article aims to dissect the definition and essence of the financial sharing model and its significance in the realm of enterprise financial management.Drawing upon this analysis and aligning with the needs of enterprise financial management,the article proposes ideas for optimizing management practices,aspiring to foster reform and innovation in enterprise financial management while enhancing its level of financial management and ability to respond to financial risks.This contribution seeks to provide valuable insights for practitioners in the field.

Optimizing pain management in elderly patients post-knee surgery:A novel collaborative strategy

Total knee replacement,a common surgery among the elderly primarily necessitated by osteoarthritis,replaces the damaged knee joint with an artificial one.Given the aging population and the increasing prevalence of such surgeries,the article highlights the critical need for effective postoperative care strategies.This editorial provides an overview of rehabilitation care for pain in elderly knee replacement patients,emphasizing the importance of a multimodal approach to postoperative recovery.Furthermore,the article advocates for a patient-centered,comprehensive rehabilitation regimen that enhances recovery and quality of life in elderly patients undergoing knee replacement surgery.

Management of lateral pelvic lymph nodes in rectal cancer:Is it time to reach an Agreement?

In this editorial,we proceed to comment on the article by Chua et al,addressing the management of metastatic lateral pelvic lymph nodes(mLLN)in stage II/III rectal cancer patients below the peritoneal reflection.The treatment of this nodal area sparks significant controversy due to the strategic differences followed by Eastern and Western physicians,albeit with a higher degree of convergence in recent years.The dissection of lateral pelvic lymph nodes without neoadjuvant therapy is a standard practice in Eastern countries.In contrast,in the West,preference leans towards opting for neoadjuvant therapy with chemoradiotherapy or radiotherapy,that would cover the treatment of this area without the need to add the dissection of these nodes to the total mesorectal excision.In the presence of high-risk nodal characteristics for mLLN related to radiological imaging and lack of response to neoadjuvant therapy,the risk of lateral local recurrence increases,suggesting the appropriate selection of strategies to reduce the risk of recurrence in each patient profile.Despite the heterogeneous and retrospective nature of studies addressing this area,an international consensus is necessary to approach this clinical scenario uniformly.

Research on Enterprise Legal Service Strategy Based on Compliance Management Optimization

With the background of enterprise compliance management,this paper discusses how to improve the level of enterprise legal service and reduce enterprise legal risks by optimizing the compliance management system.It aims to analyze the current situation and existing problems of enterprise legal services through the analysis of the importance of compliance management.Furthermore,it delves into the case of enterprise legal service strategy based on compliance management optimization to verify the effectiveness and feasibility of enterprise legal service strategy.

Optimization Analysis of Human Resource Management Strategies of Nantong University,a Local Comprehensive University in China

This study analyzes the current situation and challenges of Nantong University amid the rapid development of higher education,addressing aspects such as faculty structure,administrative management efficiency,and promotion mechanisms.Through questionnaire surveys and field research,coupled with SWOT analysis and various theoretical methods,a comprehensive analysis was conducted on Nantong University’s internal and external environment.The study proposes an improved comprehensive development strategy and implementation measures,which include updating management concepts,strengthening professional training,optimizing employment conditions,and improving salary systems.Ultimately,this study provides practical strategies for human resource management and the transformational development of Nantong University and other local comprehensive universities.

Research on the Optimization Paths for Outstanding Agricultural Economics and Management Talents under the Background of Curriculum Ideology and Politics

The article aims to discuss how to cultivate outstanding agricultural economics and management talents to meet the needs of agricultural and rural economic development in the new era,within the context of ideological and political education.Through literature review and field research,a series of innovative talent training optimization paths are proposed,and specific suggestions are made for policymakers and educational practitioners.

Predictors and optimal management of tumor necrosis factor antagonist nonresponse in inflammatory bowel disease:A literature review

Tumor necrosis factor-α(TNF-α)antagonists,the first biologics approved for treating patients with inflammatory bowel disease(IBD),are effective for the induction and maintenance of remission and significantly improving prognosis.However,up to one-third of treated patients show primary nonresponse(PNR)to anti-TNF-αtherapies,and 23%-50%of IBD patients experience loss of response(LOR)to these biologics during subsequent treatment.There is still no recognized predictor for evaluating the efficacy of anti-TNF drugs.This review summarizes the existing predictors of PNR and LOR to anti-TNF in IBD patients.Most predictors remain controversial,and only previous surgical history,disease manifestations,drug concentrations,antidrug antibodies,serum albumin,some biologic markers,and some genetic markers may be potentially predictive.In addition,we also discuss the next steps of treatment for patients with PNR or LOR to TNF antagonists.Therapeutic drug monitoring plays an important role in treatment selection.Dose escalation,combination therapy,switching to a different anti-TNF drug,or switching to a biologic with a different mechanism of action can be selected based on the concentration of the drug and/or antidrug antibodies.

Research on Performance Optimization of Liquid Cooling and Composite Phase Change Material Coupling Cooling Thermal Management System for Vehicle Power Battery

The serpentine tube liquid cooling and composite PCM coupled cooling thermal management system is designed for 18650 cylindrical power batteries,with the maximum temperature and temperature difference of the power pack within the optimal temperature operating range as the target.The initial analysis of the battery pack at a 5C discharge rate,the influence of the single cell to cooling tube distance,the number of cooling tubes,inlet coolant temperature,the coolant flow rate,and other factors on the heat dissipation performance of the battery pack,initially determined a reasonable value for each design parameter.A control strategy is used to regulate the inlet flow rate and coolant temperature of the liquid cooling system in order to make full use of the latent heat of the composite PCM and reduce the pump’s energy consumption.The simulation results show that the maximum battery pack temperature of 309.8 K and the temperature difference of 4.6 K between individual cells with the control strategy are in the optimal temperature operating range of the power battery,and the utilization rate of the composite PCM is up to 90%.

Distributionally robust optimization based chance-constrained energy management for hybrid energy powered cellular networks

Energy harvesting has been recognized as a promising technique with which to effectively reduce carbon emis-sions and electricity expenses of base stations.However,renewable energy is inherently stochastic and inter-mittent,imposing formidable challenges on reliably satisfying users'time-varying wireless traffic demands.In addition,the probability distribution of the renewable energy or users’wireless traffic demand is not always fully known in practice.In this paper,we minimize the total energy cost of a hybrid-energy-powered cellular network by jointly optimizing the energy sharing among base stations,the battery charging and discharging rates,and the energy purchased from the grid under the constraint of a limited battery size at each base station.In solving the formulated non-convex chance-constrained stochastic optimization problem,a new ambiguity set is built to characterize the uncertainties in the renewable energy and wireless traffic demands according to interval sets of the mean and covariance.Using this ambiguity set,the original optimization problem is transformed into a more tractable second-order cone programming problem by exploiting the distributionally robust optimization approach.Furthermore,a low-complexity distributionally robust chance-constrained energy management algo-rithm,which requires only interval sets of the mean and covariance of stochastic parameters,is proposed.The results of extensive simulation are presented to demonstrate that the proposed algorithm outperforms existing methods in terms of the computational complexity,energy cost,and reliability.

TIM-1-Fc融合蛋白对哮喘小鼠Th1/Th2和Th17/Treg免疫失衡的调节

目的制备T细胞免疫球蛋白和黏蛋白结构域1(T cell immunoglobulin domain and mucin domain protein-1,TIM-1)-Fc融合蛋白并探讨TIM-1-Fc融合蛋白对卵白蛋白(ovabumin,OVA)诱导的哮喘小鼠的干预作用及潜在作用机制。方法通过基因工程技术获得TIM-1-Fc融合蛋白。采用腹腔注射OVA氢氧化铝溶液致敏建立过敏性哮喘小鼠模型,随机分为对照组、哮喘组和TIM-1-Fc干预组。每次干预前20 min,使用40μL卵白蛋白生理盐水溶液(OVA-NS)滴鼻,TIM-1-Fc融合蛋白干预包括TIM-1-Fc滴鼻组(每只小鼠每次给予1μg/40μL TIM-1-Fc滴鼻)和TIM-1-Fc注射组(每只小鼠每次给予6μg/200μL TIM-1-Fc腹腔注射),每天1次,连续7 d,对照组用生理盐水替代。采用苏木精-伊红(HE)染色观察肺组织病理变化;采用流式细胞术检测小鼠外周血中辅助性T细胞2(type 2 T helper cells,Th2)、辅助性T细胞17(type 17 T helper cells,Th17)和调节性T细胞(Treg)比例及相关细胞因子水平。结果成功构建TIM-1-Fc融合蛋白,成功构建OVA诱导的过敏性哮喘小鼠模型。与哮喘组相比,TIM-1-Fc融合蛋白干预后显著减轻了哮喘小鼠气道炎性损伤和肺组织损伤;TIM-1-Fc融合蛋白干预能显著降低外周血中TIM-1^(+)CD4^(+)T细胞和TIM-1^(+)Th17细胞比例,使TIM-1^(+)Treg细胞增多,显著降低Th2、Th17细胞比例,提高Treg细胞比例,调节哮喘中Th1/Th2和Th17/Treg免疫失衡。结论TIM-1-Fc融合蛋白改善OVA诱导的过敏性哮喘小鼠气道炎症和肺组织损伤,其作用机制可能与TIM-1-Fc融合蛋白对Th1/Th2和Th17/Treg的免疫调节有关。

Traffic Incident Management Performance Measures: Ranking Agencies on Roadway Clearance Time

This study develops a procedure to rank agencies based on their incident responses using roadway clearance times for crashes. This analysis is not intended to grade agencies but to assist in identifying agencies requiring more training or resources for incident management. Previous NCHRP reports discussed usage of different factors including incident severity, roadway characteristics, number of lanes involved and time of incident separately for estimating the performance. However, it does not tell us how to incorporate all the factors at the same time. Thus, this study aims to account for multiple factors to ensure fair comparisons. This study used 149,174 crashes from Iowa that occurred from 2018 to 2021. A Tobit regression model was used to find the effect of different variables on roadway clearance time. Variables that cannot be controlled directly by agencies such as crash severity, roadway type, weather conditions, lighting conditions, etc., were included in the analysis as it helps to reduce bias in the ranking procedure. Then clearance time of each crash is normalized into a base condition using the regression coefficients. The normalization makes the process more efficient as the effect of uncontrollable factors has already been mitigated. Finally, the agencies were ranked by their average normalized roadway clearance time. This ranking process allows agencies to track their performance of previous crashes, can be used in identifying low performing agencies that could use additional resources and training, and can be used to identify high performing agencies to recognize for their efforts and performance.

Patient satisfaction and follow-up adherence to glaucoma case management clinic in China

AIM:To assess glaucoma patient satisfaction and follow-up adherence in case management and identify associated predictors to improve healthcare quality and patient outcomes.METHODS:In this cross-sectional study,a total of 119 patients completed a Patient Satisfaction Questionnaire-18 and a sociodemographic questionnaire.Clinical data was obtained from the case management system.Follow-up adherence was defined as completing each follow-up within±30d of the scheduled time set by ophthalmologists during the study period.RESULTS:Average satisfaction scored 78.65±7,with an average of 4.39±0.58 across the seven dimensions.Age negatively correlated with satisfaction(P=0.008),whilst patients with follow-up duration of 2 or more years reported higher satisfaction(P=0.045).Multivariate logistics regression analysis revealed that longer follow-up durations were associated with lower follow-up adherence(OR=0.97,95%CI,0.95-1.00,P=0.044).Additionally,patients with suspected glaucoma(OR=2.72,95%CI,1.03-7.20,P=0.044)and those with an annual income over 100000 Chinese yuan demonstrated higher adherence(OR=5.57,95%CI,1.00-30.89,P=0.049).CONCLUSION:The case management model proves effective for glaucoma patients,with positive adherence rates.The implementation of this model can be optimized in the future based on the identified factors and extended to glaucoma patients in more hospitals.

Physics-based battery SOC estimation methods:Recent advances and future perspectives

The reliable prediction of state of charge(SOC)is one of the vital functions of advanced battery management system(BMS),which has great significance towards safe operation of electric vehicles.By far,the empirical model-based and data-driven-based SOC estimation methods of lithium-ion batteries have been comprehensively discussed and reviewed in various literatures.However,few reviews involving SOC estimation focused on electrochemical mechanism,which gives physical explanations to SOC and becomes most attractive candidate for advanced BMS.For this reason,this paper comprehensively surveys on physics-based SOC algorithms applied in advanced BMS.First,the research progresses of physical SOC estimation methods for lithium-ion batteries are thoroughly discussed and corresponding evaluation criteria are carefully elaborated.Second,future perspectives of the current researches on physics-based battery SOC estimation are presented.The insights stated in this paper are expected to catalyze the development and application of the physics-based advanced BMS algorithms.

党参炔苷调节TIM3/Gal9信号通路对子宫内膜癌细胞增殖、凋亡和免疫逃逸的影响

目的研究党参炔苷调节T细胞免疫球蛋白及黏蛋白结构域分子3(TIM3)/半乳糖凝集素9(Gal9)信号通路对子宫内膜癌细胞增殖、凋亡和免疫逃逸的影响。方法以CCK-8法检测0、15、30、60、90、120、150mg/L的党参炔苷处理后的子宫内膜癌细胞HEC-1-A存活率,筛选出其最佳作用浓度。将体外培养的HEC-1-A细胞随机分为对照组、党参炔苷组、TIM3敲低组、空载组、党参炔苷+TIM3过表达组,分组处理后以实时荧光定量PCR和免疫印迹检测各组细胞TIM3/Gal9通路表达;以免疫荧光染色和CCK-8法检测各组细胞增殖;以流式细胞术检测各组细胞凋亡;以免疫荧光染色检测各组细胞凋亡相关蛋白表达,比较Bax/Bcl-2。将人外周血淋巴细胞与各组细胞以不同比例共培养后以CCK-8法检测其对各组细胞的杀伤率。结果与对照组比较,党参炔苷组、TIM3敲低组细胞TIM3、Gal9 mRNA及蛋白表达、Ki67阳性率、存活率降低(P<0.05),凋亡率、Bax/Bcl-2、杀伤率升高(P<0.05);空载组细胞各指标无明显变化(P>0.05)。与党参炔苷组比较,党参炔苷+TIM3过表达组细胞TIM3、Gal9 mRNA及蛋白表达、Ki67阳性率、存活率升高(P<0.05),凋亡率、Bax/Bcl-2、杀伤率降低(P<0.05)。结论党参炔苷可通过下调TIM3/Gal9信号通路表达来抑制子宫内膜癌细胞增殖并促进其凋亡,还可减弱其免疫逃逸,进而增强免疫细胞对其的杀伤力。

Personal Thermal Management by Radiative Cooling and Heating

Maintaining thermal comfort within the human body is crucial for optimal health and overall well-being.By merely broadening the setpoint of indoor temperatures,we could significantly slash energy usage in building heating,ventilation,and air-conditioning systems.In recent years,there has been a surge in advancements in personal thermal management(PTM),aiming to regulate heat and moisture transfer within our immediate surroundings,clothing,and skin.The advent of PTM is driven by the rapid development in nano/micro-materials and energy science and engineering.An emerging research area in PTM is personal radiative thermal management(PRTM),which demonstrates immense potential with its high radiative heat transfer efficiency and ease of regulation.However,it is less taken into account in traditional textiles,and there currently lies a gap in our knowledge and understanding of PRTM.In this review,we aim to present a thorough analysis of advanced textile materials and technologies for PRTM.Specifically,we will introduce and discuss the underlying radiation heat transfer mechanisms,fabrication methods of textiles,and various indoor/outdoor applications in light of their different regulation functionalities,including radiative cooling,radiative heating,and dual-mode thermoregulation.Furthermore,we will shine a light on the current hurdles,propose potential strategies,and delve into future technology trends for PRTM with an emphasis on functionalities and applications.

Overview of the immunological mechanisms in hepatitis B virus reactivation:Implications for disease progression and management strategies

Hepatitis B virus(HBV)reactivation is a clinically significant challenge in disease management.This review explores the immunological mechanisms underlying HBV reactivation,emphasizing disease progression and management.It delves into host immune responses and reactivation’s delicate balance,spanning innate and adaptive immunity.Viral factors’disruption of this balance,as are interac-tions between viral antigens,immune cells,cytokine networks,and immune checkpoint pathways,are examined.Notably,the roles of T cells,natural killer cells,and antigen-presenting cells are discussed,highlighting their influence on disease progression.HBV reactivation’s impact on disease severity,hepatic flares,liver fibrosis progression,and hepatocellular carcinoma is detailed.Management strategies,including anti-viral and immunomodulatory approaches,are critically analyzed.The role of prophylactic anti-viral therapy during immunosuppressive treatments is explored alongside novel immunotherapeutic interventions to restore immune control and prevent reactivation.In conclusion,this compre-hensive review furnishes a holistic view of the immunological mechanisms that propel HBV reactivation.With a dedicated focus on understanding its implic-ations for disease progression and the prospects of efficient management stra-tegies,this article contributes significantly to the knowledge base.The more profound insights into the intricate interactions between viral elements and the immune system will inform evidence-based approaches,ultimately enhancing disease management and elevating patient outcomes.The dynamic landscape of management strategies is critically scrutinized,spanning anti-viral and immunomodulatory approaches.The role of prophylactic anti-viral therapy in preventing reactivation during immunosuppressive treatments and the potential of innovative immunotherapeutic interventions to restore immune control and proactively deter reactivation.