Background Systemic non-steroidal anti-inflammatory drugs have been evaluated for their possible preemptive analgesic effects.The efficacy of flurbiprofen axetil for preemptive analgesia in patients undergoing radical...Background Systemic non-steroidal anti-inflammatory drugs have been evaluated for their possible preemptive analgesic effects.The efficacy of flurbiprofen axetil for preemptive analgesia in patients undergoing radical resection of esophageal carcinoma via the left thoracic approach needs further investigation.The aim of this study was to research the preemptive analgesic effects of flurbiprofen axetil in thoracic surgery,and the influence of preoperative administration on postoperative respiratory function.Methods This randomized,double-blind,controlled trial enrolled 60 patients undergoing radical resection of esophageal carcinoma via the left thoracic approach.Anesthesia management was standardized.Each patient was randomly assigned to receive either 100 mg flurbiprofen axetil intravenously 15 minutes before incision （PA group） or intravenous normal saline as a control （C group）.Postoperative analgesia was with sufentanil delivered by patient-controlled analgesia pump.Postoperative sufentanil consumption,visual analog scale pain scores,plasma levels of interleukin-8,and oxygenation index were measured.Results Compared with the preoperative baseline,postoperative patients in the PA group had no obvious increase in pain scores （P 〉0.05）,but patients in the C group had significantly increased pain scores （P〈0.05）.Pain scores in the C group were significantly higher at 24 hours postoperatively than preoperatively.Intergroup comparisons showed lower visual analog scale scores at 2-24 hours postoperatively in the PA group than the C group （P 〈0.05）.Sufentanil consumption and plasma interleukin-8 levels at 2 and 12 hours postoperatively were significantly lower in the PA group than the C group （P 〈0.05）.The oxygenation index at 2 and 12 hours postoperatively was significantly higher in the PA group than the C group （P〈0.05）.Conclusions Intravenous flurbiprofen axetil appears to have a preemptive analgesic effect in patients undergoing radical resection of esophageal carcinoma via 展开更多
More than five decades after it was originally conceptualized as rescue therapy for patients with intractable variceal bleeding,the transjugular intrahepatic portosystemic shunt(TIPS)procedure continues to remain a fo...More than five decades after it was originally conceptualized as rescue therapy for patients with intractable variceal bleeding,the transjugular intrahepatic portosystemic shunt(TIPS)procedure continues to remain a focus of intense clinical and biomedical research.By the impressive reduction in portal pressure achieved by this intervention,coupled with its minimally invasive nature,TIPS has gained increasing acceptance in the treatment of complications of portal hypertension.The early years of TIPS were plagued by poor long-term patency of the stents and increased incidence of hepatic encephalopathy.Moreover,the diversion of portal flow after placement of TIPS often resulted in derangement of hepatic functions,which was occasionally severe.While the incidence of shunt dysfunction has markedly reduced with the advent of covered stents,hepatic encephalopathy and instances of early liver failure continue to remain a significant issue after TIPS.It has emerged over the years that careful selection of patients and diligent post-procedural care is of paramount importance to optimize the outcome after TIPS.The past twenty years have seen multiple studies redefining the role of TIPS in the management of variceal bleeding and refractory ascites while exploring its application in other complications of cirrhosis like hepatic hydrothorax,portal hypertensive gastropathy,ectopic varices,hepatorenal and hepatopulmonary syndromes,non-tumoral portal vein thrombosis and chylous ascites.It has also been utilized to good effect before extrahepatic abdominal surgery to reduce perioperative morbidity and mortality.The current article aims to review the updated literature on the status of TIPS in the management of patients with liver cirrhosis.展开更多
随着 Internet和芯片技术的迅猛发展 ,嵌入式操作系统的研究成为当前热点。通过分析 L inux作为嵌入式操作系统的优点和缺点 ,从进程调度策略和中断管理技术方面详细分析了 L inux操作系统内核实时性能不足的原因 ,最后提出了两种提高 L...随着 Internet和芯片技术的迅猛发展 ,嵌入式操作系统的研究成为当前热点。通过分析 L inux作为嵌入式操作系统的优点和缺点 ,从进程调度策略和中断管理技术方面详细分析了 L inux操作系统内核实时性能不足的原因 ,最后提出了两种提高 L inux实时性的解决方案 :修正 L inux内核 ,在 L inux内核的限定范围内尽可能扩充实时性 ;在 L inux内核之外 ,另备实时处理模块 。展开更多
Pancreatic cancer is the 4<sup>th</sup> leading cause of cancer-related death in Western countries. Considering the low incidence of pancreatic cancer, population-based screening is not feasible. However, ...Pancreatic cancer is the 4<sup>th</sup> leading cause of cancer-related death in Western countries. Considering the low incidence of pancreatic cancer, population-based screening is not feasible. However, the existence of a group of individuals with an increased risk to develop pancreatic cancer has been well established. In particular, individuals suffering from a somatic or genetic condition associated with an increased relative risk of more than 5- to 10-fold seem to be suitable for enrollment in a surveillance program for prevention or early detection of pancreatic cancer. The aim of such a program is to reduce pancreatic cancer mortality through early or preemptive surgery. Considering the risk associated with pancreatic surgery, the concept of preemptive surgery cannot consist of a prophylactic removal of the pancreas in high-risk healthy individuals, but must instead aim at treating precancerous lesions such as intraductal papillary mucinous neoplasms or pancreatic intraepithelial neoplasms, or early cancer. Currently, results from clinical trials do not convincingly demonstrate the efficacy of this approach in terms of identification of precancerous lesions, nor do they define the outcome of the surgical treatment of these lesions. For this reason, surveillance programs for individuals at risk of pancreatic cancer are thus far generally limited to the setting of a clinical trial. However, the acquisition of a deeper understanding of this complex area, together with the increasing request for screening and treatment by individuals at risk, will usher pancreatologists into a new era of preemptive pancreatic surgery. Along with the growing demand to treat individuals with precancerous lesions, the need for low-risk investigation, low-morbidity operation and a minimally invasive approach becomes increasingly pressing. All of these considerations are reasons for preemptive pancreatic surgery programs to be undertaken in specialized centers only.展开更多
In this paper, we consider the following semi-online List Model problem with known total size. We are given a sequence of independent jobs with positive sizes, which must be assigned to be processed on machines. No ma...In this paper, we consider the following semi-online List Model problem with known total size. We are given a sequence of independent jobs with positive sizes, which must be assigned to be processed on machines. No machines are initially provided, and when a job is revealed the algorithm has the option to purchase new machines. By normalizing all job sizes and machine cost, we assume that the cost of purchasing one machine is 1. We further know the total size of all jobs in advance. The objective is to minimize the sum of the makespan and the number of machines to be purchased. Both non-preemptive and preemptive versions are considered. For the non-preemptive version, we present a new lower bound 6/5 which improves the known lower bound 1.161. For the preemptive version, we present an optimal semi-online algorithm with a competitive ratio of 1 in the case that the total size is not greater than 4, and an algorithm with a competitive ratio of 5/4 otherwise, while a lower bound 1.0957 is also presented for general case.展开更多
AIM: To analyze differences in patients' clinical course, we compared two regimes of either preemptive therapy or prophylaxis after liver transplantation.METHODS: This retrospective study was reviewed and approved...AIM: To analyze differences in patients' clinical course, we compared two regimes of either preemptive therapy or prophylaxis after liver transplantation.METHODS: This retrospective study was reviewed and approved by the institutional review board of the University of Leipzig. Cytomegalovirus(CMV) prophylaxis with valganciclovir hydrochloride for liver transplant recipients was replaced by a preemptive strategy in October 2009. We retrospectively compared liver transplant recipients 2 years before and after October 2009. During the first period, all patients received valganciclovir daily. During the second period all patients included in the analysis were treated following a preemptive strategy. Outcomes included one year survival and therapeutic intervention due to CMV viremia or infection.RESULTS: Between 2007 and 2010 n = 226 patients underwent liver transplantation in our center. n = 55 patients were D^+/R^- high risk recipients and were excluded from further analysis. A further 43 patients had to be excluded since CMV prophylaxis/preemptive strategy was not followed although there was no clinical reason for the deviation. Of the remaining 128 patients whose data were analyzed, 60 receivedprophylaxis and 68 were treated following a preemptive strategy. The difference in overall mortality was not significant, nor was it significant for one-year mortality where it was 10%(95%CI: 8%-28%, P = 0.31) higher for the preemptive group. No significant differences in blood count abnormalities or the incidence of sepsis and infections were observed other than CMV. In total, 19 patients(14.7%) received ganciclovir due to CMV viremia and/or infections. Patients who were treated according to the preemptive algorithm had a significantly higher rate risk of therapeutic intervention with ganciclovir [n = 16(23.5%) vs n = 3(4.9%), P = 0.003)].CONCLUSION: These data suggest that CMV prophylaxis is superior to a preemptive strategy in patients undergoing liver transplantation.展开更多
The pain following gynecological laparoscopic surgery is less intense than that following open surgery; however, patients often experience visceral pain after the former surgery. The aim of this study was to determine...The pain following gynecological laparoscopic surgery is less intense than that following open surgery; however, patients often experience visceral pain after the former surgery. The aim of this study was to determine the effects of preemptive ketamine on visceral pain in patients undergoing gynecological laparoscopic surgery. Ninety patients undergoing gynecological laparoscopic surgery were randomly assigned to one of three groups. Group 1 received placebo. Group 2 was intravenously injected with preincisional saline and local infiltration with 20 m L ropivacaine（4 mg/m L） at the end of surgery. Group 3 was intravenously injected with preincisional ketamine（0.3 mg/kg） and local infiltration with 20 m L ropivacaine（4 mg/m L） at the end of surgery. A standard anesthetic was used for all patients, and meperidine was used for postoperative analgesia. The visual analogue scale（VAS） scores for incisional and visceral pain at 2, 6, 12, and 24 h, cumulative analgesic consumption and time until first analgesic medication request, and adverse effects were recorded postoperatively. The VAS scores of visceral pain in group 3 were significantly lower than those in group 2 and group 1 at 2 h and 6 h postoperatively（P〈0.05 and P〈0.01, respectively）. At 2 h and 6 h, the VAS scores of incisional pain did not differ significantly between groups 2 and 3, but they were significantly lower than those in group 1（P〈0.01）. Groups 1 and 2 did not show any differences in visceral pain scores at 2 h and 6 h postoperatively. Moreover, the three groups showed no statistically significant differences in visceral and incisional pain scores at 12 h and 24 h postoperatively. The consumption of analgesics was significantly greater in group 1 than in groups 2 and 3, and the time to first request for analgesics was significantly longer in groups 2 and 3 than in group 1, with no statistically significant difference between groups 2 and 3. However, the three groups showed no significant difference in the incidence of s展开更多
Background and Objective: Post-operative nausea and vomiting (PONV) is a common adverse effect of the anesthesia in laparoscopic surgery. Ondansetron has been used for prevention and treatment of the PONV. The purpose...Background and Objective: Post-operative nausea and vomiting (PONV) is a common adverse effect of the anesthesia in laparoscopic surgery. Ondansetron has been used for prevention and treatment of the PONV. The purpose of the present study was to compare the effects of preemptive and preventive intravenous ondansetron on PONV in patients undergoing diagnostic gynecologic laparoscopy. Materials & Methods: In a randomized double-blind clinical trial, 80 women candidate of diagnostic laparoscopy, were enrolled to study in two preemptive or preventive groups (n = 40). Ondansetron 4 mg IV was administered 5 min before anesthesia induction or 5 min before extubation in preemptive or preventive groups, respectively. The frequency and severity of the PONV were compared at post-anesthetic care unit (PACU), 3th, 6th and 24th postoperatively in two groups. Also the first time of need for the antiemetic drug was studied. Results: Demographic data were similar but duration of anesthesia was shorter in preventive group. The PONV rate was similar in two groups [(37.5% and 32.5% in preemptive and preventive groups, respectively (P = 0.815)]. In preemptive group it was more intense at PACU and 24 hours after surgery (P-value <0.05) and rate of vomiting was high (11 vs. 3, P-value 0.037). The first request for antiemetic drug was earlier and the antiemetic consumption dose (P-value <0.05), recovery and hospital stay times were high in preemptive group (P-value = 0.001). Conclusion: Preventive ondansetron is more effective than preemptive form, in reducing the severity of PONV but not rate of the PONV in diagnostic gynecologic laparoscopy.展开更多
Medical Internet of Things(IoT)devices are becoming more and more common in healthcare.This has created a huge need for advanced predictive health modeling strategies that can make good use of the growing amount of mu...Medical Internet of Things(IoT)devices are becoming more and more common in healthcare.This has created a huge need for advanced predictive health modeling strategies that can make good use of the growing amount of multimodal data to find potential health risks early and help individuals in a personalized way.Existing methods,while useful,have limitations in predictive accuracy,delay,personalization,and user interpretability,requiring a more comprehensive and efficient approach to harness modern medical IoT devices.MAIPFE is a multimodal approach integrating pre-emptive analysis,personalized feature selection,and explainable AI for real-time health monitoring and disease detection.By using AI for early disease detection,personalized health recommendations,and transparency,healthcare will be transformed.The Multimodal Approach Integrating Pre-emptive Analysis,Personalized Feature Selection,and Explainable AI(MAIPFE)framework,which combines Firefly Optimizer,Recurrent Neural Network(RNN),Fuzzy C Means(FCM),and Explainable AI,improves disease detection precision over existing methods.Comprehensive metrics show the model’s superiority in real-time health analysis.The proposed framework outperformed existing models by 8.3%in disease detection classification precision,8.5%in accuracy,5.5%in recall,2.9%in specificity,4.5%in AUC(Area Under the Curve),and 4.9%in delay reduction.Disease prediction precision increased by 4.5%,accuracy by 3.9%,recall by 2.5%,specificity by 3.5%,AUC by 1.9%,and delay levels decreased by 9.4%.MAIPFE can revolutionize healthcare with preemptive analysis,personalized health insights,and actionable recommendations.The research shows that this innovative approach improves patient outcomes and healthcare efficiency in the real world.展开更多
A single-server queueing system with preemptive access is considered.Each customer has one attempt to enter the system at its working interval[0,T].As soon as the customer request enters the system,the server immediat...A single-server queueing system with preemptive access is considered.Each customer has one attempt to enter the system at its working interval[0,T].As soon as the customer request enters the system,the server immediately starts the service.But when the next request arrives in the system,the previous one leaves the system even he has not finished his service yet.We study a non-cooperative game in which the customers wish to maximize their probability of obtaining service within a certain period of time.We characterize the Nash equilibrium and the price of anarchy,which is defined as the ratio between the optimal and equilibrium social utility.Two models are considered.In the first model the number of players is fixed,while in the second it is random and obeys the Poisson distribution.We demonstrate that there exists a unique symmetric equilibrium for both models.Finally,we calculate the price of anarchy for both models and show that the price of anarchy is not monotone with respect to the number of customers.展开更多
基金This study was supported by the National Natural Science Foundation of China （No.30872433）.
文摘Background Systemic non-steroidal anti-inflammatory drugs have been evaluated for their possible preemptive analgesic effects.The efficacy of flurbiprofen axetil for preemptive analgesia in patients undergoing radical resection of esophageal carcinoma via the left thoracic approach needs further investigation.The aim of this study was to research the preemptive analgesic effects of flurbiprofen axetil in thoracic surgery,and the influence of preoperative administration on postoperative respiratory function.Methods This randomized,double-blind,controlled trial enrolled 60 patients undergoing radical resection of esophageal carcinoma via the left thoracic approach.Anesthesia management was standardized.Each patient was randomly assigned to receive either 100 mg flurbiprofen axetil intravenously 15 minutes before incision （PA group） or intravenous normal saline as a control （C group）.Postoperative analgesia was with sufentanil delivered by patient-controlled analgesia pump.Postoperative sufentanil consumption,visual analog scale pain scores,plasma levels of interleukin-8,and oxygenation index were measured.Results Compared with the preoperative baseline,postoperative patients in the PA group had no obvious increase in pain scores （P 〉0.05）,but patients in the C group had significantly increased pain scores （P〈0.05）.Pain scores in the C group were significantly higher at 24 hours postoperatively than preoperatively.Intergroup comparisons showed lower visual analog scale scores at 2-24 hours postoperatively in the PA group than the C group （P 〈0.05）.Sufentanil consumption and plasma interleukin-8 levels at 2 and 12 hours postoperatively were significantly lower in the PA group than the C group （P 〈0.05）.The oxygenation index at 2 and 12 hours postoperatively was significantly higher in the PA group than the C group （P〈0.05）.Conclusions Intravenous flurbiprofen axetil appears to have a preemptive analgesic effect in patients undergoing radical resection of esophageal carcinoma via
文摘More than five decades after it was originally conceptualized as rescue therapy for patients with intractable variceal bleeding,the transjugular intrahepatic portosystemic shunt(TIPS)procedure continues to remain a focus of intense clinical and biomedical research.By the impressive reduction in portal pressure achieved by this intervention,coupled with its minimally invasive nature,TIPS has gained increasing acceptance in the treatment of complications of portal hypertension.The early years of TIPS were plagued by poor long-term patency of the stents and increased incidence of hepatic encephalopathy.Moreover,the diversion of portal flow after placement of TIPS often resulted in derangement of hepatic functions,which was occasionally severe.While the incidence of shunt dysfunction has markedly reduced with the advent of covered stents,hepatic encephalopathy and instances of early liver failure continue to remain a significant issue after TIPS.It has emerged over the years that careful selection of patients and diligent post-procedural care is of paramount importance to optimize the outcome after TIPS.The past twenty years have seen multiple studies redefining the role of TIPS in the management of variceal bleeding and refractory ascites while exploring its application in other complications of cirrhosis like hepatic hydrothorax,portal hypertensive gastropathy,ectopic varices,hepatorenal and hepatopulmonary syndromes,non-tumoral portal vein thrombosis and chylous ascites.It has also been utilized to good effect before extrahepatic abdominal surgery to reduce perioperative morbidity and mortality.The current article aims to review the updated literature on the status of TIPS in the management of patients with liver cirrhosis.
文摘随着 Internet和芯片技术的迅猛发展 ,嵌入式操作系统的研究成为当前热点。通过分析 L inux作为嵌入式操作系统的优点和缺点 ,从进程调度策略和中断管理技术方面详细分析了 L inux操作系统内核实时性能不足的原因 ,最后提出了两种提高 L inux实时性的解决方案 :修正 L inux内核 ,在 L inux内核的限定范围内尽可能扩充实时性 ;在 L inux内核之外 ,另备实时处理模块 。
文摘Pancreatic cancer is the 4<sup>th</sup> leading cause of cancer-related death in Western countries. Considering the low incidence of pancreatic cancer, population-based screening is not feasible. However, the existence of a group of individuals with an increased risk to develop pancreatic cancer has been well established. In particular, individuals suffering from a somatic or genetic condition associated with an increased relative risk of more than 5- to 10-fold seem to be suitable for enrollment in a surveillance program for prevention or early detection of pancreatic cancer. The aim of such a program is to reduce pancreatic cancer mortality through early or preemptive surgery. Considering the risk associated with pancreatic surgery, the concept of preemptive surgery cannot consist of a prophylactic removal of the pancreas in high-risk healthy individuals, but must instead aim at treating precancerous lesions such as intraductal papillary mucinous neoplasms or pancreatic intraepithelial neoplasms, or early cancer. Currently, results from clinical trials do not convincingly demonstrate the efficacy of this approach in terms of identification of precancerous lesions, nor do they define the outcome of the surgical treatment of these lesions. For this reason, surveillance programs for individuals at risk of pancreatic cancer are thus far generally limited to the setting of a clinical trial. However, the acquisition of a deeper understanding of this complex area, together with the increasing request for screening and treatment by individuals at risk, will usher pancreatologists into a new era of preemptive pancreatic surgery. Along with the growing demand to treat individuals with precancerous lesions, the need for low-risk investigation, low-morbidity operation and a minimally invasive approach becomes increasingly pressing. All of these considerations are reasons for preemptive pancreatic surgery programs to be undertaken in specialized centers only.
基金Research supported by the Natural Science Foundation of Zhejiang Province （Grant No. Y605316）, and Natural Science Foundation of Education Department of Zhejiang Province （Grant No. 20060578）.
文摘In this paper, we consider the following semi-online List Model problem with known total size. We are given a sequence of independent jobs with positive sizes, which must be assigned to be processed on machines. No machines are initially provided, and when a job is revealed the algorithm has the option to purchase new machines. By normalizing all job sizes and machine cost, we assume that the cost of purchasing one machine is 1. We further know the total size of all jobs in advance. The objective is to minimize the sum of the makespan and the number of machines to be purchased. Both non-preemptive and preemptive versions are considered. For the non-preemptive version, we present a new lower bound 6/5 which improves the known lower bound 1.161. For the preemptive version, we present an optimal semi-online algorithm with a competitive ratio of 1 in the case that the total size is not greater than 4, and an algorithm with a competitive ratio of 5/4 otherwise, while a lower bound 1.0957 is also presented for general case.
文摘AIM: To analyze differences in patients' clinical course, we compared two regimes of either preemptive therapy or prophylaxis after liver transplantation.METHODS: This retrospective study was reviewed and approved by the institutional review board of the University of Leipzig. Cytomegalovirus(CMV) prophylaxis with valganciclovir hydrochloride for liver transplant recipients was replaced by a preemptive strategy in October 2009. We retrospectively compared liver transplant recipients 2 years before and after October 2009. During the first period, all patients received valganciclovir daily. During the second period all patients included in the analysis were treated following a preemptive strategy. Outcomes included one year survival and therapeutic intervention due to CMV viremia or infection.RESULTS: Between 2007 and 2010 n = 226 patients underwent liver transplantation in our center. n = 55 patients were D^+/R^- high risk recipients and were excluded from further analysis. A further 43 patients had to be excluded since CMV prophylaxis/preemptive strategy was not followed although there was no clinical reason for the deviation. Of the remaining 128 patients whose data were analyzed, 60 receivedprophylaxis and 68 were treated following a preemptive strategy. The difference in overall mortality was not significant, nor was it significant for one-year mortality where it was 10%(95%CI: 8%-28%, P = 0.31) higher for the preemptive group. No significant differences in blood count abnormalities or the incidence of sepsis and infections were observed other than CMV. In total, 19 patients(14.7%) received ganciclovir due to CMV viremia and/or infections. Patients who were treated according to the preemptive algorithm had a significantly higher rate risk of therapeutic intervention with ganciclovir [n = 16(23.5%) vs n = 3(4.9%), P = 0.003)].CONCLUSION: These data suggest that CMV prophylaxis is superior to a preemptive strategy in patients undergoing liver transplantation.
基金supported by the Key Technologies R&D program of Henan Province,China(No.201503178)
文摘The pain following gynecological laparoscopic surgery is less intense than that following open surgery; however, patients often experience visceral pain after the former surgery. The aim of this study was to determine the effects of preemptive ketamine on visceral pain in patients undergoing gynecological laparoscopic surgery. Ninety patients undergoing gynecological laparoscopic surgery were randomly assigned to one of three groups. Group 1 received placebo. Group 2 was intravenously injected with preincisional saline and local infiltration with 20 m L ropivacaine（4 mg/m L） at the end of surgery. Group 3 was intravenously injected with preincisional ketamine（0.3 mg/kg） and local infiltration with 20 m L ropivacaine（4 mg/m L） at the end of surgery. A standard anesthetic was used for all patients, and meperidine was used for postoperative analgesia. The visual analogue scale（VAS） scores for incisional and visceral pain at 2, 6, 12, and 24 h, cumulative analgesic consumption and time until first analgesic medication request, and adverse effects were recorded postoperatively. The VAS scores of visceral pain in group 3 were significantly lower than those in group 2 and group 1 at 2 h and 6 h postoperatively（P〈0.05 and P〈0.01, respectively）. At 2 h and 6 h, the VAS scores of incisional pain did not differ significantly between groups 2 and 3, but they were significantly lower than those in group 1（P〈0.01）. Groups 1 and 2 did not show any differences in visceral pain scores at 2 h and 6 h postoperatively. Moreover, the three groups showed no statistically significant differences in visceral and incisional pain scores at 12 h and 24 h postoperatively. The consumption of analgesics was significantly greater in group 1 than in groups 2 and 3, and the time to first request for analgesics was significantly longer in groups 2 and 3 than in group 1, with no statistically significant difference between groups 2 and 3. However, the three groups showed no significant difference in the incidence of s
文摘Background and Objective: Post-operative nausea and vomiting (PONV) is a common adverse effect of the anesthesia in laparoscopic surgery. Ondansetron has been used for prevention and treatment of the PONV. The purpose of the present study was to compare the effects of preemptive and preventive intravenous ondansetron on PONV in patients undergoing diagnostic gynecologic laparoscopy. Materials & Methods: In a randomized double-blind clinical trial, 80 women candidate of diagnostic laparoscopy, were enrolled to study in two preemptive or preventive groups (n = 40). Ondansetron 4 mg IV was administered 5 min before anesthesia induction or 5 min before extubation in preemptive or preventive groups, respectively. The frequency and severity of the PONV were compared at post-anesthetic care unit (PACU), 3th, 6th and 24th postoperatively in two groups. Also the first time of need for the antiemetic drug was studied. Results: Demographic data were similar but duration of anesthesia was shorter in preventive group. The PONV rate was similar in two groups [(37.5% and 32.5% in preemptive and preventive groups, respectively (P = 0.815)]. In preemptive group it was more intense at PACU and 24 hours after surgery (P-value <0.05) and rate of vomiting was high (11 vs. 3, P-value 0.037). The first request for antiemetic drug was earlier and the antiemetic consumption dose (P-value <0.05), recovery and hospital stay times were high in preemptive group (P-value = 0.001). Conclusion: Preventive ondansetron is more effective than preemptive form, in reducing the severity of PONV but not rate of the PONV in diagnostic gynecologic laparoscopy.
文摘Medical Internet of Things(IoT)devices are becoming more and more common in healthcare.This has created a huge need for advanced predictive health modeling strategies that can make good use of the growing amount of multimodal data to find potential health risks early and help individuals in a personalized way.Existing methods,while useful,have limitations in predictive accuracy,delay,personalization,and user interpretability,requiring a more comprehensive and efficient approach to harness modern medical IoT devices.MAIPFE is a multimodal approach integrating pre-emptive analysis,personalized feature selection,and explainable AI for real-time health monitoring and disease detection.By using AI for early disease detection,personalized health recommendations,and transparency,healthcare will be transformed.The Multimodal Approach Integrating Pre-emptive Analysis,Personalized Feature Selection,and Explainable AI(MAIPFE)framework,which combines Firefly Optimizer,Recurrent Neural Network(RNN),Fuzzy C Means(FCM),and Explainable AI,improves disease detection precision over existing methods.Comprehensive metrics show the model’s superiority in real-time health analysis.The proposed framework outperformed existing models by 8.3%in disease detection classification precision,8.5%in accuracy,5.5%in recall,2.9%in specificity,4.5%in AUC(Area Under the Curve),and 4.9%in delay reduction.Disease prediction precision increased by 4.5%,accuracy by 3.9%,recall by 2.5%,specificity by 3.5%,AUC by 1.9%,and delay levels decreased by 9.4%.MAIPFE can revolutionize healthcare with preemptive analysis,personalized health insights,and actionable recommendations.The research shows that this innovative approach improves patient outcomes and healthcare efficiency in the real world.
基金supported by the Russian Science Foundation(No.22-11-20015,https://rscf.ru/project/22-11-20015/)jointly with support of the authorities of the Republic of Karelia with funding from the Venture Investment Foundation of the Republic of Karelia.Also the research was supported by the National Natural Science Foundation of China(No.72171126).
文摘A single-server queueing system with preemptive access is considered.Each customer has one attempt to enter the system at its working interval[0,T].As soon as the customer request enters the system,the server immediately starts the service.But when the next request arrives in the system,the previous one leaves the system even he has not finished his service yet.We study a non-cooperative game in which the customers wish to maximize their probability of obtaining service within a certain period of time.We characterize the Nash equilibrium and the price of anarchy,which is defined as the ratio between the optimal and equilibrium social utility.Two models are considered.In the first model the number of players is fixed,while in the second it is random and obeys the Poisson distribution.We demonstrate that there exists a unique symmetric equilibrium for both models.Finally,we calculate the price of anarchy for both models and show that the price of anarchy is not monotone with respect to the number of customers.
