2 research outputs found
Routing Diverse Crowds in Emergency with Dynamic Grouping
Evacuee routing algorithms in emergency typically adopt one single criterion
to compute desired paths and ignore the specific requirements of users caused
by different physical strength, mobility and level of resistance to hazard. In
this paper, we present a quality of service (QoS) driven multi-path routing
algorithm to provide diverse paths for different categories of evacuees. This
algorithm borrows the concept of Cognitive Packet Network (CPN), which is a
flexible protocol that can rapidly solve optimal solution for any user-defined
goal function. Spatial information regarding the location and spread of hazards
is taken into consideration to avoid that evacuees be directed towards
hazardous zones. Furthermore, since previous emergency navigation algorithms
are normally insensitive to sudden changes in the hazard environment such as
abrupt congestion or injury of civilians, evacuees are dynamically assigned to
several groups to adapt their course of action with regard to their on-going
physical condition and environments. Simulation results indicate that the
proposed algorithm which is sensitive to the needs of evacuees produces better
results than the use of a single metric. Simulations also show that the use of
dynamic grouping to adjust the evacuees' category and routing algorithms with
regard for their on-going health conditions and mobility, can achieve higher
survival rates.Comment: Contains 6 pages, 5 pages. Accepted by PerNEM' 201
Empagliflozin in Patients with Chronic Kidney Disease
Background The effects of empagliflozin in patients with chronic kidney disease who are at risk for disease progression are not well understood. The EMPA-KIDNEY trial was designed to assess the effects of treatment with empagliflozin in a broad range of such patients. Methods We enrolled patients with chronic kidney disease who had an estimated glomerular filtration rate (eGFR) of at least 20 but less than 45 ml per minute per 1.73 m(2) of body-surface area, or who had an eGFR of at least 45 but less than 90 ml per minute per 1.73 m(2) with a urinary albumin-to-creatinine ratio (with albumin measured in milligrams and creatinine measured in grams) of at least 200. Patients were randomly assigned to receive empagliflozin (10 mg once daily) or matching placebo. The primary outcome was a composite of progression of kidney disease (defined as end-stage kidney disease, a sustained decrease in eGFR to < 10 ml per minute per 1.73 m(2), a sustained decrease in eGFR of & GE;40% from baseline, or death from renal causes) or death from cardiovascular causes. Results A total of 6609 patients underwent randomization. During a median of 2.0 years of follow-up, progression of kidney disease or death from cardiovascular causes occurred in 432 of 3304 patients (13.1%) in the empagliflozin group and in 558 of 3305 patients (16.9%) in the placebo group (hazard ratio, 0.72; 95% confidence interval [CI], 0.64 to 0.82; P < 0.001). Results were consistent among patients with or without diabetes and across subgroups defined according to eGFR ranges. The rate of hospitalization from any cause was lower in the empagliflozin group than in the placebo group (hazard ratio, 0.86; 95% CI, 0.78 to 0.95; P=0.003), but there were no significant between-group differences with respect to the composite outcome of hospitalization for heart failure or death from cardiovascular causes (which occurred in 4.0% in the empagliflozin group and 4.6% in the placebo group) or death from any cause (in 4.5% and 5.1%, respectively). The rates of serious adverse events were similar in the two groups. Conclusions Among a wide range of patients with chronic kidney disease who were at risk for disease progression, empagliflozin therapy led to a lower risk of progression of kidney disease or death from cardiovascular causes than placebo