Early Mobilization on Patients with Mechanical Ventilation in the ICU

Patients in intensive care unit (ICU) usually experienced being immobile and restrained, and these can induce muscle weakness, cognitive impairments, psychological difficulties, difficult weaning, and increased length of stay (LOS) in hospital. However, early mobilization has multiple benefits including improved ventilation, perfusion, muscle strength, and functional capacity

A Forecasting Approach Combining Self-Organizing Map with Support Vector Regression for Reservoir Inflow during Typhoon Periods

This study describes the development of a reservoir inflow forecasting model for typhoon events to improve short lead-time flood forecasting performance. To strengthen the forecasting ability of the original support vector machines (SVMs) model, the self-organizing map (SOM) is adopted to group inputs into different clusters in advance of the proposed SOM-SVM model. Two different input methods are proposed for the SVM-based forecasting method, namely, SOM-SVM1 and SOM-SVM2. The methods are applied to an actual reservoir watershed to determine the 1 to 3 h ahead inflow forecasts. For 1, 2, and 3 h ahead forecasts, improvements in mean coefficient of efficiency (MCE) due to the clusters obtained from SOM-SVM1 are 21.5%, 18.5%, and 23.0%, respectively. Furthermore, improvement in MCE for SOM-SVM2 is 20.9%, 21.2%, and 35.4%, respectively. Another SOM-SVM2 model increases the SOM-SVM1 model for 1, 2, and 3 h ahead forecasts obtained improvement increases of 0.33%, 2.25%, and 10.08%, respectively. These results show that the performance of the proposed model can provide improved forecasts of hourly inflow, especially in the proposed SOM-SVM2 model. In conclusion, the proposed model, which considers limit and higher related inputs instead of all inputs, can generate better forecasts in different clusters than are generated from the SOM process. The SOM-SVM2 model is recommended as an alternative to the original SVR (Support Vector Regression) model because of its accuracy and robustness

Gravity Waves from Quantum Stress Tensor Fluctuations in Inflation

We consider the effects of the quantum stress tensor fluctuations of a conformal field in generating gravity waves in inflationary models. We find a non-scale invariant, non-Gaussian contribution which depends upon the total expansion factor between an initial time and the end of inflation. This spectrum of gravity wave perturbations is an illustration of a negative power spectrum, which is possible in quantum field theory. We discuss possible choices for the initial conditions. If the initial time is taken to be sufficiently early, the fluctuating gravity waves are potentially observable both in the CMB radiation and in gravity wave detectors, and could offer a probe of transplanckian physics. The fact that they have not yet been observed might be used to constrain the duration and energy scale of inflation.Comment: 17 -pages, no figure

Cost and Benefit Analysis of Line Arresters for a 69kV Transmission System in Taiwan

This paper presents a systematical evaluation experience on the performance and economic studies of line arresters for a 69 kV transmission system in Taiwan. The transient over-voltage phenomenon in high voltage transmission lines under lightning by using the Electro-Magnetic Transients Program (EMTP) package is well modeled and analyzed. The modeling for the simulated system including lightning, transmission line, transmission tower and line arrester are all considered to have more practical results. The cost and benefit evaluation for line arresters installation  is then conducted to provide a reasonable suggestion for lightning protection.  The performance of line arresters is evaluated by considering different installation schemes and lightning currents. Finally, a Taiwan’s experience is illustrated from both of the cost and benefit points of view

Urolithiasis Is a Risk Factor for Uroseptic Shock and Acute Kidney Injury in Patients With Urinary Tract Infection.

Urinary tract infection (UTI) is a common complication in patients with urolithiasis. This study aimed to compare clinical manifestations and treatment outcomes among UTI patients with or without urolithiasis. It also focused on identifying relationships among urolithiasis, uroseptic shock, and acute kidney injury (AKI). This retrospective study enrolled hospitalized UTI patients who underwent imaging in an acute care setting from January 2006 to March 2015. Of 662 participants enrolled, 113 (17.1%) had urolithiasis, 107 (16.2%) developed uroseptic shock, and 184 (27.8%) developed AKI. A multivariate logistic regression analysis showed that in UTI patients, urolithiasis is associated with an increased risk of uroseptic shock (OR 1.80, 95% CI: 1.08-3.02, P = 0.025), AKI (OR 1.95, 95% CI: 1.22-3.12, P = 0.005), and bacteremia (OR 1.68, 95% CI: 1.08-2.64, P = 0.022). Urolithiasis is common in UTI patients and is associated with an increased risk of uroseptic shock and AKI

Static behaviour of two-tiered Dou-Gong system reinforced by super-elastic alloy

Dou-Gong system in Asian timber structures play an important role in resisting seismic action. Traditional carpentry in Asia uses timber pegs to connect components which enables relative movement between components, and hence provide friction to dissipate energy in an earthquake. This method however has some short falls such as inadequate stiffness to resist large lateral force and therefore the structures tend to exhibit permanent deformation after the earthquakes. This study proposes a new technique by using super-elastic alloy bars to replace the conventional wooden peg connections to enhance the seismic performance of the structures. Static push-over experiments were conducted on full scaled two-tiered Dou-Gong systems and the high-strength steel and conventional wood pegs as benchmarks. The ultimate stiffness of Dou-Gong system has shown increase by using both high-strength steel and super-elastic alloy bars, but only super-elastic alloy can provide a consistent high damping ratio. This technique also involves pre-strain the super-elastic alloy and the outcomes of this series of experiments have shown that pre-strain in the super-elastic alloy can significantly increase the damping ratio in the structure and hence more energy is dissipated. The results of this paper can be used in the projects of timber structures with Dou-Gong system