Risky air contaminants including PM10 can accumulate inside underground confined loading docks because of the enclosed nature and limited contacts of loading docks with ambient air. Exposure to PM10 can increase morbidity and mortality rates. Hence, this study aimed to investigate and model PM10 concentrations in an underground loading dock located at Kuala Lumpur city center, Malaysia. For this purpose, a real-time air quality monitoring instrument was used for measuring PM10 concentrations for 20 consecutive weeks starting from November 8, 2014. After that, the Statistical Package for Social Sciences (SPSS) software was used to analyze measured PM10 concentrations through series of statistical analyses, whereas MATLAB R2013a was employed for developing prediction models of future PM10 concentrations. Moreover, PM10 temporal variation was examined using time series plots. The results showed that short-term PM10 concentrations did not exceed the Malaysian indoor allowable limit of 150 μg/m3. Despite that, PM10 had 8 % probability of exceedance of WHO standard concentration of 50 μg/m3. This indicates that the occupants will be under the risk of prolonged exposure to PM10 even at low concentrations. The results confirmed a strong correlation between PM10 concentrations and diesel-powered vehicles flow. Contrarily, the flow of gasoline-powered vehicles was poorly correlated. Finally, future daily-averaged PM10 concentrations were predicted for the three weekdays that followed the measurement period using single exponential smoothing. The obtained accuracy was at 70 % of measured PM10 concentrations. Future hourly-averaged PM10 concentrations were estimated using single linear regression with an accuracy of 53 %. 相似文献
Recent progress in machine learning (ML), together with advanced computational power, have provided new research opportunities in cardiovascular modeling. While classifying patient outcomes and medical image segmentation with ML have already shown significant promising results, ML for the prediction of biomechanics such as blood flow or tissue dynamics is in its infancy. This perspective article discusses some of the challenges in using ML for replacing well-established physics-based models in cardiovascular biomechanics. Specifically, we discuss the large landscape of input features in 3D patient-specific modeling as well as the high-dimensional output space of field variables that vary in space and time. We argue that the end purpose of such ML models needs to be clearly defined and the tradeoff between the loss in accuracy and the gained speedup carefully interpreted in the context of translational modeling. We also discuss several exciting venues where ML could be strategically used to augment traditional physics-based modeling in cardiovascular biomechanics. In these applications, ML is not replacing physics-based modeling, but providing opportunities to solve ill-defined problems, improve measurement data quality, enable a solution to computationally expensive problems, and interpret complex spatiotemporal data by extracting hidden patterns. In summary, we suggest a strategic integration of ML in cardiovascular biomechanics modeling where the ML model is not the end goal but rather a tool to facilitate enhanced modeling.
ABSTRACT: BACKGROUND: A commitment to Electronic Health Record (EHR) systems now constitutes a core part of many governments' healthcare reform strategies. The resulting politically-initiated largescale or national EHR endeavors are challenging because of their ambitious agendas of change, the scale of resources needed to make them work, the (relatively) short timescales set, and the large number of stakeholders involved, all of whom pursue somewhat different interests. These initiatives need to be evaluated to establish if they improve care and represent value for money. METHODS: Critical reflections on these complexities in the light of experience of undertaking the first national, longitudinal, and sociotechnical evaluation of the implementation and adoption of England's National Health Service's Care Records Service (NHS CRS). Results/discussion We advance two key arguments. First, national programs for EHR implementations are likely to take place in the shifting sands of evolving sociopolitical and sociotechnical and contexts, which are likely to shape them in significant ways. This poses challenges to conventional evaluation approaches which draw on a model of baseline operations intervention changed operations (outcome). Second, evaluation of such programs must account for this changing context by adapting to it. This requires careful and creative choice of ontological, epistemological and methodological assumptions. SUMMARY: New and significant challenges are faced in evaluating national EHR implementation endeavors. Based on experiences from this national evaluation of the implementation and adoption of the NHS CRS in England, we argue for an approach to these evaluations which moves away from seeing EHR systems as Information and Communication Technologies (ICT) projects requiring an essentially outcome-centred assessment towards a more interpretive approach that reflects the situated and evolving nature of EHR seen within multiple specific settings and reflecting a constantly changing milieu of policies, strategies and software, with constant interactions across such boundaries. 相似文献
Journal of Interventional Cardiac Electrophysiology - Diabetes mellitus (DM) is known to affect the pharmacokinetics of drugs. In this study, we evaluated the effect of DM on the liver content of... 相似文献
Few studies were performed to compare ultrasound guided brachial plexus block with procedural sedation for reduction of shoulder dislocations in the Emergency Department (ED). This study was done to provide further evidence regarding this comparison.
Methods
This was a randomized clinical trial performed on patients presenting with anterior shoulder dislocations to the emergency department of an academic level 2 trauma center. Exclusion criteria were any contraindications to the drugs used, any patient which may not be potentially assigned into both groups because of an underlying medical condition, presence of neurovascular compromise related to the dislocation, presence of concomitant fractures, and patient refusal to participate in the study. Patients were randomly assigned into the Procedural Sedation and Analgesia (PSA) group with propofol and fentanyl or ultrasound guided Inter-Scalene Brachial Plexus Block (ISBPB) with lidocaine and epinephrine.
Results
A total of 60 patients (30 in each group) were included in the study. The emergency room length of stay was significantly lower in the ISBPB group, with mean (SD) values of 108.6 (42.1) vs. 80.2 (25.2) minutes (p = 0.005). However, pain scores in the PSA group during reduction showed advantage over ISBPB [0.38 vs. 3.43 (p < 0.001)]. Moreover, patient satisfaction was higher with PSA (p < 0.001).
Conclusion
Using ISBPB for reduction of anterior shoulder dislocations takes less time to discharge and may make it more feasible in conditions mandating faster discharge of the patient. However, since pain scores may be lower using PSA, this method may be preferred by many physicians in some other situations. 相似文献
MethodsForty subjects with ALS were randomly assigned to two groups, which received either subcutaneous G-CSF (5 µg/kg/q12h) or placebo for 5 days. The subjects were then followed up for 3 months using the ALS Functional Rating Scale-Revised (ALSFRS-R), manual muscle testing, ALS Assessment Questionnaire-40, and nerve conduction studies. CD34+/CD133+ cell count and monocyte chemoattractant protein-1 (MCP-1) levels were evaluated at baseline.ResultsThe rate of disease progression did not differ significantly between the two groups. The reduction in ALSFRS-R scores was greater in female subjects in the G-CSF group than in their counterparts in the placebo group. There was a trend toward a positive correlation between baseline CSF MCP-1 levels and the change in ALSFRS-R scores in both groups (Spearman''s ρ=0.370, p=0.070).ConclusionsWith the protocol implemented in this study, G-CSF is not a promising option for the treatment of ALS. Furthermore, it may accelerate disease progression in females. 相似文献
Temperature sensitive injectable hydrogels have been used as drug/protein carriers for a variety of pharmaceutical applications. Oligo(ethylene glycol) methacrylate (OEGMA) monomers with varying ethylene oxide chain lengths have been used for the synthesis of in situ forming hydrogel. In this study, a new series of thermally induced gelling hydrogel nanoparticles (PMOA hydrogel nanoparticles) was developed by copolymerization with di(ethylene glycol) methyl ether methacrylate (MEO2MA), poly(ethylene glycol) methyl ether methacrylate (300 g mol−1, OEGMA300), and acrylic acid (AAc). The effects of acrylic acid content on the physical, chemical, and biological properties of the nanoparticle-based hydrogels were investigated. Due to its high electrostatic properties, addition of AAc increases LCST as well as gelation temperature. Further, using Cy5-labelled bovine serum albumin and erythropoietin (Epo) as model drugs, studies have shown that the thermogelling hydrogels have the ability to tune the release rate of these proteins in vitro. Finally, the ability of Epo releasing hydrogels to recruit prostate cancer cells was assessed in vivo. Overall, our results support that this new series of thermally induced gelling systems can be used as protein control releasing vehicles and cancer cell traps.At body temperature, thermosensitive nanoparticles release erythropoietin to lure metastatic cancer cells.相似文献
Drug-resistant epilepsy seems like a different disease compared with easy to control epilepsy, and new strategies are needed to help these patients. Vagus nerve stimulation (VNS) therapy is the most frequently used neurostimulation modality for patients with drug-resistant epilepsy who are not eligible for seizure surgery. In this study, we aimed to evaluate the efficacy and adverse effects of VNS in patients with drug-resistant epilepsy in an open-label, prospective, long-term study in Iran. We selected 48 patients with partial-onset drug-resistant epilepsy. Implantations were performed in the neurosurgery department of Loghman Hospital, Tehran, Iran. Follow-up visits were done on monthly bases for 5 years. Forty-four patients completed the study. Mean age of patients was 24.4 years. Mean years of epilepsy history was 14 years. The mean number of anti-epileptic drugs did not significantly change over five years (p = 0.15). There was no exacerbation of epilepsy; however, one patient discontinued his therapy due to unsatisfactory results. Five patient had more than 50 %, and 26 patients (59 %) had 25–49 % reduction in the frequency of monthly seizures persistently. Overall mean frequency of monthly seizures decreased by 57.8, 59.6, 65, 65.9, and 67 %, in 1st, 2nd, 3rd, 4th, and 5th years of follow-up, respectively. Most common side effects were as follows: hoarseness (25 %) and throat discomfort (10 %). We found VNS as a safe and effective therapy for drug-resistant epilepsy, with an approximate long-term decrease in mean seizure frequency of 57.8–67 %. Thus, VNS is recommended for suitable patients in developing countries. 相似文献