The Anatomy of Teleneurosurgery in China

With its huge population and vast territory, China faces a great challenge in providing modern advanced health care services to all parts of the country. The advances of information communication technologies (ICTs) and the advent of internet have revolutionised the means in the delivery of healthcare via telemedicine to remote and underserved populations, which to a certain extent has been very well exploited in China, especially where 70% peasants residing in the rural areas. This paper reviews the latest development in telemedicine infrastructure in China with the focus on the development of teleneurosurgery, drawing from the results gained from a 3-year networking project between Europe and China on telemedicine (TIME, 2005–2007) funded by European Commission under Asia ICT programme, with an aim to shape up envisages of future medical care in China. Comparison with its counterparts in Europe is also addressed

Source Delay in Mobile Ad Hoc Networks

Source delay, the time a packet experiences in its source node, serves as a fundamental quantity for delay performance analysis in networks. However, the source delay performance in highly dynamic mobile ad hoc networks (MANETs) is still largely unknown by now. This paper studies the source delay in MANETs based on a general packet dispatching scheme with dispatch limit $f$ (PD-$f$ for short), where a same packet will be dispatched out up to $f$ times by its source node such that packet dispatching process can be flexibly controlled through a proper setting of $f$. We first apply the Quasi-Birth-and-Death (QBD) theory to develop a theoretical framework to capture the complex packet dispatching process in PD-$f$ MANETs. With the help of the theoretical framework, we then derive the cumulative distribution function as well as mean and variance of the source delay in such networks. Finally, extensive simulation and theoretical results are provided to validate our source delay analysis and illustrate how source delay in MANETs are related to network parameters.Comment: 11page

Extended warfarin treatment versus rivaroxaban treatment for first episode of symptomatic unprovoked pulmonary embolism: A prospective cohort study

Purpose: To compare the benefits and risks of extra 6 months of warfarin therapy with those of rivaroxaban treatment in patients with initial unprovoked pulmonary embolism (PE) episode who completed 3- or 6-month of therapy on heparin/vitamin K antagonist standard regime.Methods: This prospective observational study included 212 patients with follow-up from July 2013 to July 2018. The primary endpoint was symptomatic recurrent venous thromboembolism (VT), composite of non-fatal symptomatic PE or deep vein thrombosis or fatal VT, and major bleeding (non-fatal/fatal) up to 6 months. Secondary endpoints were death not related to PE or major bleeding.Results: During the 6-month therapy period, the primary endpoint was seen in 3 out of 106 patients (2.83 %) in warfarin category, and in  rivaroxaban category, for a hazard ratio (HR) of 1.22 [95 % confidence interval (CI) = 0.09 - 11.18; p = 0.813]. With warfarin therapy, 2 patients (1.89 %) had recurrent VT, while 3 patients (2.83 %) had VT with rivaroxaban. Major bleeding was observed in 2 patients (1.89 %) on warfarin, and in one patient (0.94 %) on rivaroxaban. During the entire 18-month period, the primary endpoint was seen in 15 patients (14.15 %) treated with warfarin, and in 18 patients (16.98 %) treated with rivaroxaban (HR 0.84; 95 % CI = 0.47 - 1.84; p = 0.431). Major bleeding was observed in 5 patients (4.72 %) under warfarin (one fatal), relative to 3 patients (2.83 %) under rivaroxaban (R 1.67; 95 % CI = 0.62 - 5.95; p = 0.09).Conclusion: Rivaroxaban showed higher efficacy than warfarin in recurrent VT prevention, with lower risk of major bleeding. However, the extended therapeutic benefit was not maintained post-therapy. Keywords: Pulmonary embolism, Rivaroxaban, Warfarin, Heparin, Vitamin K, Hazard rati