Assessing risk factors and predicting sepsis mortality using logistic and survival methods

Identifying sepsis patients with high risk of death is crucial for making treatment decisions and has a public health significance. Sepsis mortality can be predicted by including clinical features and biomarkers in a predictive model. Hypotheses: (1) Clinical features combined with biomarkers would significantly enhance prediction power over clinical features alone; (2) time-trends of measurements contribute to prediction; (3) Cox proportional hazards model is more informative than logistic model. Sepsis patients with complete data were identified from the Protocol-based Care in Early Septic Shock (ProCESS) trial. The trial obtained measurements at baseline (0 hours), 6 hours, and 24 hours of hospital admission, as well as patients’ within-60-day-of-admission death time. To evaluate biomarkers, logistic regressions with biomarkers and clinical features were compared to logistic regressions with clinical features only. To assess trends, at each time point, trends variables were evaluated in logistic regressions. To compare statistical models, landmark mortality within 3-day, 7-day, 14-day, and 60-day of admission were modeled using logistic regressions; a Cox model was developed to predict mortality over the same period. Areas under the Receiver Operating Characteristic curve (AUC) with bootstrap confidence intervals (CI) were used to evaluate model performance. There were 528 patients included in baseline cohort (60-day mortality: 25%, mean age: 60 years, mean baseline lactate: 2.41 mmol/L), 534 patients in 6 hours cohort (24%, 60, 2.35), and 432 patients in 24 hours cohort (21%, 60, 2.26). At baseline, the AUC increased significantly from 0.766 [95% CI] = [0.710, 0.826] to 0.812 [0.749, 0.868] when biomarkers were added. In all models, trends were nonsignificant. For logistic models, 3-day model has AUC 0.888 [0.836, 0.939]; 7-day model has AUC 0.827 [0.776, 0.879]; 14-day model has AUC 0.858 [0.820, 0.895]; and 60-day model has AUC 0.795 [0.716, 0.835]. For the Cox model, the time-dependent AUC ranges between (0.859, 0.884). Biomarkers provided incremental discrimination ability over clinical features alone to predict 60-day mortality at baseline. Trends of time-dependent variables did not increase predictive power. Logistic models and Cox models have similar predictive power in predicting short-term mortality but a Cox model is better in predicting long-term mortality

Research on Product Conceptual Design Based on Integrated of TRIZ and HOQ

Abstract. The conceptual design determines the success of the final product quality and competition of market. The determination of design parameters and the effective method to resolve parameters contradiction are the key to success. In this paper, the concept of HOQ products designed to determine the parameters, then using the TRIZ contradiction matrix and inventive principles of design parameters to solve the problem of contradictions. Facts have proved that the effective method is to obtain the product concept design parameters and to resolve contradictions line parameters

Wireless powered communication networks using peer harvesting

For an energy-constrained wireless network, energy harvesting (EH) is a promising technology to prolong the network life. Whether traditional near-field wireless power transfer (WPT) using inductive and resonant coupling or far-field WPT via radiated electromagnetic waves, both of them draw considerable research interests these years [1], [2]. In particular, the far-field WPT is meaningful for wireless powered communication (WPC) networks. A fundamental tradeoff was first studied for simultaneous wireless information and power transfer (SWIPT) in [3], [4]. These results aroused the interest of researchers. Subsequently, wireless communication with EH technology was presented in [5], [6]

Secured green communication scheme for interference alignment based networks

In this paper, a new security and green communication scheme is proposed to the Interference-Alignment (IA) based networks. To achieve a secured communication, full-duplex receivers are utilized to transmit artificial noise (AN). Both the signals and the ANs are used to harvest energy to realize green communication. For these reasons, the feasible conditions of this scheme are analyzed first. Secondly, the average transmission rate, the secrecy performance and the harvested energy are investigated. Thirdly, an optimization scheme of simultaneous wireless information and power transfer (SWIPT) is given to optimize the information transmission and the energy harvesting efficiency. Meanwhile, an improved IA iteration algorithm is designed to eliminate both the AN and the interference. Furthermore, relay cooperation is considered and its system performance is analyzed. The simulations show that the target average transmission rate is not affected by AN, while the secrecy performance can be greatly improved. The energy harvesting efficiency is also better than the traditional schemes. As expected, the average transmission rate further is improved with the relay cooperation

The agreement of low lean mass with obesity using different definitions and its correlation with hyperuricemia

BackgroundThe agreement on the identification of sarcopenic obesity remains elusive, and its association with hyperuricemia remains unestablished. This study sought to evaluate the agreement of low lean mass (LLM) with obesity and its correlation with hyperuricemia.MethodsA total of 25,252 study participants, comprising 4,597 individuals with hyperuricemia, were obtained from the National Health and Nutrition Examination Survey spanning the years 1999–2006 and 2011–2018. LLM with obesity was characterized by the coexistence of LLM, determined by the ratio of appendicular lean mass to body mass index (BMI), and three categories of obesity including BMI, body fat percentage (BF%), and waist circumference (WC). We employed Cohen’s kappa to evaluate the agreement among the different diagnostic criteria and implemented survey multiple logistic regression and stratified analyses to explicate the connection between LLM with obesity and the risk of hyperuricemia.ResultsWhen defining obesity using BF%, BMI, and WC, the prevalence of LLM with obesity varied from 6.6 to 10.1%, with moderate-to-strong agreement. In the fully adjusted model, individuals with LLM or any of the three types of obesity exhibited notably elevated odds of developing hyperuricemia. Likewise, participants with LLM and obesity had 2.70 (LLM + BMI), 2.44 (LLM + BF%), and 3.12 (LLM + WC) times the risk of hyperuricemia, respectively, compared with healthy individuals. The association between LLM with obesity and hyperuricemia remained stable and significant across different age and sex subgroups.ConclusionWhen employing the three definitions of obesity, the incidence of LLM with obesity was not high, and the diagnostic agreement was relatively good. The participants with LLM and obesity exhibited an increased risk of hyperuricemia

Evolution of the combined effect of different irrigation solutions and activation techniques on the removal of smear layer and dentin microhardness in oval-shaped root canal: An in-vitro study

The aim of this in vitro study was to evaluate the effect of three final irrigants, namely QMix, MTAD and EDTA, combined with three irrigation techniques, namely conventional needle irrigation (CNI), passive ultrasonic irrigation (PUI) and photon-induced photoacoustic streaming (PIPS), on smear layer removal, dentin mineral content and microhardness in oval-shaped canals.    130 decoronated premolars with single, oval root canals were equally divided into1 blank control group and 12 treatment groups (n=10) according to the final irrigation protocols. Roots in treatment groups were instrumented with ProTaper Gold to size F4 and subjected to final irrigation. Smear layer removal was assessed by using a four-level scoring system under an environmental scanning electron microscope. Energy dispersive X-ray spectroscopy was performed to measure the dentin mineral content. Dentin microhardness was measured by Knoop microhardness testing. Statistical analysis of the data was performed by using Kruskal-Wallis test, followed by Dunn’s post hoc test with Bonferroni correction. PUI- and PIPS-activated QMix and EDTA removed smear layer more effectively than MTAD groups (p<0.05). Regarding the dentin mineral content and microhardness, QMix groups yielded the least calcium (Ca), phosphorus (P)  and Ca/P ratio, followed by EDTA groups and MTAD groups (p<0.05). QMix groups produced significantly lower dentin microhardness values and higher hardness reduction percentages than MTAD groups (p<0.05).  Within the limitations of the present study, it was concluded that QMix and EDTA were superior to MTAD in smear layer removal, especially when activated by PUI and PIPS, but these agents produced more pronounced effect on dentin mineral content and microhardness than MTAD