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This study explored mental workload recognition methods for carrier-based aircraft pilots utilising multiple sensor physiological signal fusion and portable devices. A simulation carrier-based aircraft flight experiment was designed, and subjective mental workload scores and electroencephalogram (EEG) and photoplethysmogram (PPG) signals from six pilot cadets were collected using NASA Task Load Index (NASA-TLX) and portable devices. The subjective scores of the pilots in three flight phases were used to label the data into three mental workload levels. Features from the physiological signals were extracted, and the interrelations between mental workload and physiological indicators were evaluated. Machine learning and deep learning algorithms were used to classify the pilots’ mental workload. The performances of the single-modal method and multimodal fusion methods were investigated. The results showed that the multimodal fusion methods outperformed the single-modal methods, achieving higher accuracy, precision, recall and F1 score. Among all the classifiers, the random forest classifier with feature-level fusion obtained the best results, with an accuracy of 97.69%, precision of 98.08%, recall of 96.98% and F1 score of 97.44%. The findings of this study demonstrate the effectiveness and feasibility of the proposed method, offering insights into mental workload management and the enhancement of flight safety for carrier-based aircraft pilots.
Manned lunar landers must ensure astronaut safety while enhancing payload capacity. Due to traditional landers being weak in high-impact energy absorb and heavy payload capacity, a Starship-type manned lunar lander is proposed in this paper. Firstly, a comprehensive analysis was conducted on the traditional cantilever beam cushioning mechanism for manned lander. Subsequently, a 26-ton manned lander and its landing mechanism were designed, and a rigid-flexible coupling dynamic analysis was performed on the compression process of the primary and auxiliary legs. Secondly, the landing performance of the proposed Starship-type manned lunar lander was compared with the traditional 14-ton manned lander in multiple landing conditions. The results indicate that under normal conditions, the largest acceleration of the proposed 26-ton Starship-type manned lander decreases more than 13.1%. It enables a significant increase in payload capacity while mitigating impact loads under various landing conditions.
Liouville-type theorems for the steady incompressible Navier–Stokes system are investigated for solutions in a three-dimensional (3-D) slab with either no-slip boundary conditions or periodic boundary conditions. When the no-slip boundary conditions are prescribed, we prove that any bounded solution is trivial if it is axisymmetric or $ru^r$ is bounded, and that general 3-D solutions must be Poiseuille flows when the velocity is not big in $L^\infty$ space. When the periodic boundary conditions are imposed on the slab boundaries, we prove that the bounded solutions must be constant vectors if either the swirl or radial velocity is independent of the angular variable, or $ru^r$ decays to zero as $r$ tends to infinity. The proofs are based on the fundamental structure of the equations and energy estimates. The key technique is to establish a Saint-Venant type estimate that characterizes the growth of the Dirichlet integral of non-trivial solutions.
We present the first results from a new backend on the Australian Square Kilometre Array Pathfinder, the Commensal Realtime ASKAP Fast Transient COherent (CRACO) upgrade. CRACO records millisecond time resolution visibility data, and searches for dispersed fast transient signals including fast radio bursts (FRB), pulsars, and ultra-long period objects (ULPO). With the visibility data, CRACO can localise the transient events to arcsecond-level precision after the detection. Here, we describe the CRACO system and report the result from a sky survey carried out by CRACO at 110-ms resolution during its commissioning phase. During the survey, CRACO detected two FRBs (including one discovered solely with CRACO, FRB 20231027A), reported more precise localisations for four pulsars, discovered two new RRATs, and detected one known ULPO, GPM J1839 $-$10, through its sub-pulse structure. We present a sensitivity calibration of CRACO, finding that it achieves the expected sensitivity of 11.6 Jy ms to bursts of 110 ms duration or less. CRACO is currently running at a 13.8 ms time resolution and aims at a 1.7 ms time resolution before the end of 2024. The planned CRACO has an expected sensitivity of 1.5 Jy ms to bursts of 1.7 ms duration or less and can detect $10\times$ more FRBs than the current CRAFT incoherent sum system (i.e. 0.5 $-$2 localised FRBs per day), enabling us to better constrain the models for FRBs and use them as cosmological probes.
Chronic alcoholism can result in severe liver conditions such as fatty liver disease and cirrhosis, potentially leading to life-threatening complications and premature death.
Objectives
This study investigated the age-sex distribution of patients with alcohol addiction and aimed to identify differences in clinic department preferences based on their principal and additional diagnoses in Taiwan, in 2022.
Methods
We conducted a comprehensive analysis of the diagnostic patterns of 334 patients with alcohol addiction from the Taoyuan General Hospital, Ministry of Health and Welfare.
Results
Figure 1 depicts patient demographics, highlighting 297 male and 37 female patients with alcohol-related disorders. Males aged 41-60 years were particularly dominant, as shown in Figure 2. Principal diagnoses, including alcoholic liver disease and acute pancreatitis, are detailed in Table 1. Additional diagnoses, such as chronic pancreatitis and esophageal varices, are presented in Table 2. For departmental preferences, Table 3 reveals the Gastrointestinal (GI) department as the top choice, followed by Kidney, Neurological, and Cardiovascular/Chest.Table 1.
Top 5 Principal Diagnoses of Alcohol Addiction Patients.
ICD-10-CM
Principle diagnosis
Times
Rank
K70
Alcoholic liver disease
43
1
K85
Acute pancreatitis
27
2
F10
Alcohol related disorders
18
3
A41
Other sepsis
14
4
K86
Other chronic pancreatits
11
5
Table 2.
Top 5 Additional Diagnoses of Alcohol Addiction Patients.
ICD-10-CM
Additional diagnosis
Times
Rank
F10
Alcohol related disorders
40
1
K86
Other chronic pancreatits
18
2
I85
Esophageal varices
16
3
K70
Other sepsis
16
E87
Other disorders of fluid, electrolyte and acid-base balance
15
4
R65
Symptoms and signs specifically associated with systemic inflammation and infection
10
5
Table 3.
Top 5 Departments for Alcoholism Patient Presentation.
Department
Times
Rank
Gastrointestinal
162
1
Kidney
39
2
Neurological
25
3
Cardiovascular Chest
15
4
Image:
Image 2:
Conclusions
The study revealed that patients with alcohol addiction often delay seeking psychiatric help instead of presenting for medical care only after liver or gastrointestinal complications occur. This underscores the crucial need for better health education regarding the relationship between alcohol addiction and liver disease. Prompt recognition and early intervention for substance addiction can significantly reduce these risks and improve patient outcomes.
Adolescence is a period marked by highest vulnerability to the onset of depression, with profound implications for adult health. Neuroimaging studies have revealed considerable atrophy in brain structure in these patients with depression. Of particular importance are regions responsible for cognitive control, reward, and self-referential processing. However, the causal structural networks underpinning brain region atrophies in adolescents with depression remain unclear.
Objectives
This study aimed to investigate the temporal course and causal relationships of gray matter atrophy within the brains of adolescents with depression.
Methods
We analyzed T1-weighted structural images using voxel-based morphometry in first-episode adolescent patients with depression (n=80, 22 males; age = 15.57±1.78) and age, gender matched healthy controls (n=82, 25 males; age = 16.11±2.76) to identify the disease stage-specific gray matter abnormalities. Then, with granger causality analysis, we arranged the patients’ illness duration chronologically to construct the causal structural covariance networks that investigated the causal relationships of those atypical structures.
Results
Compared to controls, smaller volumes in ventral medial prefrontal cortex (vmPFC), dorsal anterior cingulate cortex (dACC), middle cingulate cortex (MCC) and insula areas were identified in patients with less than 1 year illness duration, and further progressed to the subgenual ACC, regions of default, frontoparietal networks in longer duration. Causal network results revealed that dACC, vmPFC, MCC and insula were prominent nodes projecting exerted positive causal effects to regions of the default mode and frontoparietal networks. The dACC, vmPFC and insula also had positive projections to the reward network, which included mainly the thalamus, caudate and putamen, while MCC also exerted a positive causal effect on the insula and thalamus.
Conclusions
These findings revealed the progression of structural atrophy in adolescent patients with depression and demonstrated the causal relationships between regions involving cognitive control, reward and self-referential processes.
The COVID-19 pandemic has stressed global healthcare systems, with Taiwan’s National Health Insurance (NHI) playing a crucial role in prevention and treatment. Like other countries, Taiwan grappled with managing the virus alongside regular healthcare services, resulting in notable financial strain on hospitals after COVID-19 pandemic.
Objectives
This study explores the financial implications of the psychiatric department at a medical center in Taiwan, highlighting the changing dynamics of healthcare costs and revenue during this period.
Methods
Data were collected monthly between January 2020 and September 2022, including the number of outpatient visits, inpatient patient-days, medical revenue, medical costs, and gross medical profit. Multivariate linear regression analysis confirmed the assumptions of the model and validated the findings.
Results
Regression analysis revealed a significant correlation between the number of patients and financial indicators (USD1). Medical revenue (Table. 1), grew by 82 USD for each outpatient visit(p<0.001, 95% CI:41–122), and grew by 70 USD for each inpatient-days(p=0.001, 95% CI:31–108). Medical costs (Table. 2), increased by 59 USD for every inpatient-days (p=0.01, 95% CI:15–102). Finally, the gross medical profits (Table. 3) increased by 72 USD for each outpatient visit (p=0.003, 95% CI:27–117).Table 1.
Multiple linear regression analysis of the impact of medical service on medical revenue.
Revenue
Coef.
SE
t
p
[95% Conf. Interval]
Outpatient (Visits)
82
20
4.136
.000
41
122
Inpatient (Patient Days)
70
19
3.664
.001
31
108
Table 2.
Multiple linear regression analysis of the impact of medical service on medical cost.
Cost
Coef.
SE
t
p
[95% Conf. Interval]
Outpatient (Visits)
9
22
0.422
.676
-36
55
Inpatient (Patient Days)
59
21
2.757
.010
15
102
Table 3.
Multiple linear regression analysis of the impact of medical service on medical gross profit.
Gross Profit
Coef.
SE
t
p
[95% Conf. Interval]
Outpatient (Visits)
72
22
3.261
.003
27
117
Inpatient (Patient Days)
11
21
0.501
.620
-33
54
1All values were converted from TWD to USD using the rate as of 2023/08/15.
In summary, outpatient visits significantly augmented revenue and gross profit, whereas inpatient days led to heightened revenue and costs.
Conclusions
During the COVID-19 outbreak, healthcare systems, including those in Taiwan, were tested for unparalleled service challenges. This study found that while outpatient services boosted profits, rising inpatient admissions strained finances, given their higher costs and staffing needs. After the pandemic, psychiatric departments should reconsider resource allocation to balance expenses and revenues. Effective management is crucial for patient outcomes, emphasizing the need for quality care and fiscal control. Future research must focus on fortifying healthcare resilience.
Background: After a transient ischemic attack (TIA) or minor stroke, the long-term risk of subsequent stroke is uncertain. Methods: Electronic databases were searched for observational studies reporting subsequent stroke during a minimum follow-up of 1 year in patients with TIA or minor stroke. Unpublished data on number of stroke events and exact person-time at risk contributed by all patients during discrete time intervals of follow-up were requested from the authors of included studies. This information was used to calculate the incidence of stroke in individual studies, and results across studies were pooled using random-effects meta-analysis. Results: Fifteen independent cohorts involving 129794 patients were included in the analysis. The pooled incidence rate of subsequent stroke per 100 person-years was 6.4 events in the first year and 2.0 events in the second through tenth years, with cumulative incidences of 14% at 5 years and 21% at 10 years. Based on 10 studies with information available on fatal stroke, the pooled case fatality rate of subsequent stroke was 9.5% (95% CI, 5.9 – 13.8). Conclusions: One in five patients is expected to experience a subsequent stroke within 10 years after a TIA or minor stroke, with every tenth patient expected to die from their subsequent stroke.
Background: Liquid biopsy represents a major development in cancer research, with significant translational potential. Similarly, the integration of multiple molecular platforms has yielded novel insights into disease biology and heterogeneity. We hypothesise that applying contemporary multi-omic approaches to liquid biopsies will improve the power of current models. Methods: We have compiled a cohort of 51 patients with glioblastoma, brain metastasis, and primary CNS lymphoma who underwent CSF sampling as part of clinical care. Cell free methylated DNA and shotgun proteomic profiling was obtained from the CSF of each patient and used to build tumour-specific classifiers. Integrated classifiers were compared with single platform classifiers using multiple approaches. Results: In this study, we show that the DNA methylation and protein profiles of cerebrospinal fluid can be combined to fully discriminate lymphomas from their major diagnostic counterparts with perfect AUCs of 1 (95% confidence interval 1-1) and 100% specificity. Each integrated lymphoma classifier significantly outperforms single-platform classifiers, suggesting synergistic biology is obtained using multiple molecular platforms. Conclusions: We present the most specific and accurate CNS lymphoma classifier to date by integrating the methylome and proteome of CSF. This has important implications for the future of cancer diagnostics and generates immediate utility for patients with CNS lymphoma.
The purpose of this study was to explore the electroencephalogram (EEG) features sensitive to situation awareness (SA) and then classify SA levels. Forty-eight participants were recruited to complete an SA standard test based on the multi-attribute task battery (MATB) II, and the corresponding EEG data and situation awareness global assessment technology (SAGAT) scores were recorded. The population with the top 25% of SAGAT scores was selected as the high-SA level (HSL) group, and the bottom 25% was the low-SA level (LSL) group. The results showed that (1) for the relative power of $\beta$1 (16–20Hz), $\beta$2 (20–24Hz) and $\beta$3 (24–30Hz), repeated measures analysis of variance (ANOVA) in three brain regions (Central Central-Parietal, and Parietal) × three brain lateralities (left, midline, and right) × two SA groups (HSL and LSL) showed a significant main effect for SA groups; post hoc comparisons revealed that compared with LSL, the above features of HSL were higher. (2) for most ratio features associated with $\beta$1 ∼ $\beta$3, ANOVA also revealed a main effect for SA groups. (3) EEG features sensitive to SA were selected to classify SA levels with small-sample data based on the general supervised machine learning classifiers. Five-fold cross-validation results showed that among the models with easy interpretability, logistic regression (LR) and decision tree (DT) presented the highest accuracy (both 92%), while among the models with hard interpretability, the accuracy of random forest (RF) was 88.8%, followed by an artificial neural network (ANN) of 84%. The above results suggested that (1) the relative power of $\beta$1 ∼ $\beta$3 and their associated ratios were sensitive to changes in SA levels; (2) the general supervised machine learning models all exhibited good accuracy (greater than 75%); and (3) furthermore, LR and DT are recommended by combining the interpretability and accuracy of the models.
The locus coeruleus (LC) innervates the cerebrovasculature and plays a crucial role in optimal regulation of cerebral blood flow. However, no human studies to date have examined links between these systems with widely available neuroimaging methods. We quantified associations between LC structural integrity and regional cortical perfusion and probed whether varying levels of plasma Alzheimer’s disease (AD) biomarkers (Aß42/40 ratio and ptau181) moderated these relationships.
Participants and Methods:
64 dementia-free community-dwelling older adults (ages 55-87) recruited across two studies underwent structural and functional neuroimaging on the same MRI scanner. 3D-pCASL MRI measured regional cerebral blood flow in limbic and frontal cortical regions, while T1-FSE MRI quantified rostral LC-MRI contrast, a well-established proxy measure of LC structural integrity. A subset of participants underwent fasting blood draw to measure plasma AD biomarker concentrations (Aß42/40 ratio and ptau181). Multiple linear regression models examined associations between perfusion and LC integrity, with rostral LC-MRI contrast as predictor, regional CBF as outcome, and age and study as covariates. Moderation analyses included additional terms for plasma AD biomarker concentration and plasma x LC interaction.
Results:
Greater rostral LC-MRI contrast was linked to lower regional perfusion in limbic regions, such as the amygdala (ß = -0.25, p = 0.049) and entorhinal cortex (ß = -0.20, p = 0.042), but was linked to higher regional perfusion in frontal cortical regions, such as the lateral (ß = 0.28, p = 0.003) and medial (ß = 0.24, p = 0.05) orbitofrontal (OFC) cortices. Plasma amyloid levels moderated the relationship between rostral LC and amygdala CBF (Aß42/40 ratio x rostral LC interaction term ß = -0.31, p = 0.021), such that as plasma Aß42/40 ratio decreased (i.e., greater pathology), the strength of the negative relationship between rostral LC integrity and amygdala perfusion decreased. Plasma ptau181levels moderated the relationship between rostral LC and entorhinal CBF (ptau181 x rostral LC interaction term ß = 0.64, p = 0.001), such that as ptau181 increased (i.e., greater pathology), the strength of the negative relationship between rostral LC integrity and entorhinal perfusion decreased. For frontal cortical regions, ptau181 levels moderated the relationship between rostral LC and lateral OFC perfusion (ptau181 x rostral LC interaction term ß = -0.54, p = .004), as well as between rostral LC and medial OFC perfusion (ptau181 x rostral LC interaction term ß = -0.53, p = .005), such that as ptau181 increased (i.e., greater pathology), the strength of the positive relationship between rostral LC integrity and frontal perfusion decreased.
Conclusions:
LC integrity is linked to regional cortical perfusion in non-demented older adults, and these relationships are moderated by plasma AD biomarker concentrations. Variable directionality of the associations between the LC and frontal versus limbic perfusion, as well as the differential moderating effects of plasma AD biomarkers, may signify a compensatory mechanism and a shifting pattern of hyperemia in the presence of aggregating AD pathology. Linking LC integrity and cerebrovascular regulation may represent an important understudied pathway of dementia risk and may help to bridge competing theories of dementia progression in preclinical AD studies.
According to CEOWORLD Magazine‘s 2019 “Health Care Indicators” rating of 89 countries in the world, Taiwan ranks first in the world. The coverage of the National Health Insurance covers all necessary medical treatment, including outpatient, hospitalization, and prescription drugs etc. The psychiatrist was wondering which item with the highest service cost–performance (CP) ratio of the psychiatrist performance in a general hospital and used proportion of PPF as performance indicator. He used allocation to distribute the hours across job activities.
Objectives
The purpose of this study is to investigate items allocation proportion for outpatient and inpatient ward in a specific month, examining the distribution of performance and figure out an appropriate model to optimal medical service.
Methods
Demographic data were collected through PPF projects included 15 outpatient items and 19 inpatient ward items from the third-month of the psychiatrist’s employment in the general hospital, as shown in Table 1. Items related to physiological examination has been excluded. The performance is calculated by combining outpatient and inpatient wards.
Results
Demographic data analysis found that proportion of inpatient ward PPF (67.01%) was significantly greater than proportion of outpatient PPF (32.99%) (Figure 1). The inpatient ward performance was 2 times the outpatient performance. This result showed that most performance came from inpatient ward. Among all items of the proportion of PPF unit, the highest two for inpatient ward items were general hospital bed inpatient consultation (32.58%) and special treatment for psychiatric inpatients (14.35%), and for outpatient, the highest was psychiatric outpatient consultation - more than two (11.31%) (Table 1).
Image:
Image 2:
Conclusions
National Health Insurance is an important system to assist in epidemic prevention during the COVID-19 period. The most PPF of psychiatrist service in a general hospital came from the service of inpatient ward items, including the general hospital bed inpatient consultation with the highest CP ratio. These findings may suggest that the inpatient service could offer psychiatrists fair PPF, and the hospital environment could be favorable for recruitment.
TDuring COVID-19 pandemic, it was noticed that it was students who were mostly affected by the changes that aroused because of the pandemic. The interesting part is whether students’ well-being could be associated with their fields of study as well as coping strategies.
Objectives
In this study, we aimed to assess 1) the mental health of students from nine countries with a particular focus on depression, anxiety, and stress levels and their fields of study, 2) the major coping strategies of students after one year of the COVID-19 pandemic.
Methods
We conducted an anonymous online cross-sectional survey on 12th April – 1st June 2021 that was distributed among the students from Poland, Mexico, Egypt, India, Pakistan, China, Vietnam, Philippines, and Bangladesh. To measure the emotional distress, we used the Depression, Anxiety, and Stress Scale-21 (DASS-21), and to identify the major coping strategies of students - the Brief-COPE.
Results
We gathered 7219 responses from students studying five major studies: medical studies (N=2821), social sciences (N=1471), technical sciences (N=891), artistic/humanistic studies (N=1094), sciences (N=942). The greatest intensity of depression (M=18.29±13.83; moderate intensity), anxiety (M=13.13±11.37; moderate intensity ), and stress (M=17.86±12.94; mild intensity) was observed among sciences students. Medical students presented the lowest intensity of all three components - depression (M=13.31±12.45; mild intensity), anxiety (M=10.37±10.57; moderate intensity), and stress (M=13.65±11.94; mild intensity). Students of all fields primarily used acceptance and self-distraction as their coping mechanisms, while the least commonly used were self-blame, denial, and substance use. The group of coping mechanisms the most frequently used was ‘emotional focus’. Medical students statistically less often used avoidant coping strategies compared to other fields of study. Substance use was only one coping mechanism that did not statistically differ between students of different fields of study. Behavioral disengagement presented the highest correlation with depression (r=0.54), anxiety (r=0.48), and stress (r=0.47) while religion presented the lowest positive correlation with depression (r=0.07), anxiety (r=0.14), and stress (r=0.11).
Conclusions
1) The greatest intensity of depression, anxiety, and stress was observed among sciences students, while the lowest intensity of those components was found among students studying medicine.
2) Not using avoidant coping strategies might be associated with lower intensity of all DASS components among students.
3) Behavioral disengagement might be strongly associated with greater intensity of depression, anxiety, and stress among students.
4) There was no coping mechanism that provided the alleviation of emotional distress in all the fields of studies of students.
Major Depressive Disorder (MDD) is one of the most common mental illnesses worldwide and is strongly associated with suicidality. Commonly used treatments for MDD with suicidality include crisis intervention, oral antidepressants (although risk of suicidal behavior is high among non-responders and during the first 10-14 days of the treatment) benzodiazepines and lithium. Although several interventions addressing suicidality exist, only few studies have characterized in detail patients with MDD and suicidality, including treatment, clinical course and outcomes. Patient Characteristics, Validity of Clinical Diagnoses and Outcomes Associated with Suicidality in Inpatients with Symptoms of Depression (OASIS-D)-study is an investigator-initiated trial funded by Janssen-Cilag GmbH.
Objectives
For population 1 out of 3 OASIS-D populations, to assess the sub-population of patients with suicidality and its correlates in hospitalized individuals with MDD.
Methods
The ongoing OASIS-D study consecutively examines hospitalized patients at 8 German psychiatric university hospitals treated as part of routine clinical care. A sub-group of patients with persistent suicidality after >48 hours post-hospitalization are assessed in detail and a sub-group of those are followed for 6 months to assess course and treatment of suicidality associated with MDD. The present analysis focuses on a preplanned interim analysis of the overall hospitalized population with MDD.
Results
Of 2,049 inpatients (age=42.5±15.9 years, females=53.2%), 68.0% had severe MDD without psychosis and 21.2% had moderately severe MDD, with 16.7% having treatment-resistant MDD. Most inpatients referred themselves (49.4%), followed by referrals by outpatient care providers (14.6%), inpatient care providers (9.0%), family/friends (8.5%), and ambulance (6.8%). Of these admissions, 43.1% represented a psychiatric emergency, with suicidality being the reason in 35.9%. Altogether, 72.4% had at least current passive suicidal ideation (SI, lifetime=87.2%), including passive SI (25.1%), active SI without plan (15.5%), active SI with plan (14.2%), and active SI with plan+intent (14.1%), while 11.5% had attempted suicide ≤2 weeks before admission (lifetime=28.7%). Drug-induced mental and behavioral disorders (19.6%) were the most frequent comorbid disorders, followed by personality disorders (8.2%). Upon admission, 64.5% were receiving psychiatric medications, including antidepressants (46.7%), second-generation antipsychotics (23.0%), anxiolytics (11.4%) antiepileptics (6.0%), and lithium (2.8%). Altogether, 9.8% reported nonadherence to medications within 6 months of admission.
Conclusions
In adults admitted for MDD, suicidality was common, representing a psychiatric emergency in 35.9% of patients. Usual-care treatments and outcomes of suicidality in hospitalized adults with MDD require further study.
In Taiwan, National Health Insurance has been implemented for 27 years and continues to receive international recognition. People pay part of the quota at the time of medical treatment, and the rest of the medical expenses will be paid by the national health insurance. In this study, the researcher, a psychiatrist in the general hospital, investigated the correlation between service and revenue. He has started to work in this hospital since November 1st, 2021, without any other psychiatrist peers.
Objectives
This study used proportion of PPF as performance indicator and aimed to observe the changes of PPF unit from November 1st, 2021, to January 31st, 2022, examining the trend of PPF growth. The purpose is to figure out an appropriate model to optimize medical services and performance outcomes.
Methods
Demographic data were collected through PPF projects, consisting of 17 inpatient ward items and 14 outpatient items from November 1st, 2021, to January 31st, 2022, and items with no performance or related to physiological examination has been excluded. In addition, items with a ratio of greater than 1.5% are presented in the bar graphs, as shown in Figure 2 and 3. The performance proportion of inpatient ward and outpatient were calculated separately.
Results
Demographic data found PPF rises significantly over time (Figure 1). The 2nd month PPF unit (27.09%) was 2.5 times the 1st month PPF unit (10.70%), and the 3rd month PPF unit (62.21%) was 2.2 times the 2nd month PPF unit (27.085%). The highest proportion of PPF items were general hospital bed inpatient consultation fee for inpatient ward item (Figure 2) and psychiatric outpatient consultation fee for outpatient item (Figure 3). Furthermore, only the proportion of psychiatric outpatient consultation – more than two consecutive transfers increased continuously and the proportion of psychiatric outpatient consultation – adjusted by the hospital decreased, the other items has not changed significantly.
Image:
Image 2:
Image 3:
Conclusions
In the first three months of the psychiatrist employment, the performance showed an increasing trend. These findings may suggest that the psychiatrist could be competent in a general hospital with patients’ confidence. In addition, under an optimal model of PPF and medical service, psychiatrists would more like to work in the general hospital, to serve acute psychiatric patients in need.
We use New York City (NYC) taxi data to identify trips between mutual fund offices and local firm headquarters. NYC funds overweight the stocks of local firms they visit via taxi, and firm visits are associated with superior investment performance. Firm visits are elevated prior to earnings announcements, and mutual fund trades that are associated with firm taxi visits predict earnings surprises. The results are generally stronger when fund and firm executives share educational connections. Additional tests support the conclusion that funds’ local bias and investment performance are driven by portfolio managers’ efforts and ability to actively gather material information.
The target backsheath field acceleration mechanism is one of the main mechanisms of laser-driven proton acceleration (LDPA) and strongly depends on the comprehensive performance of the ultrashort ultra-intense lasers used as the driving sources. The successful use of the SG-II Peta-watt (SG-II PW) laser facility for LDPA and its applications in radiographic diagnoses have been manifested by the good performance of the SG-II PW facility. Recently, the SG-II PW laser facility has undergone extensive maintenance and a comprehensive technical upgrade in terms of the seed source, laser contrast and terminal focus. LDPA experiments were performed using the maintained SG-II PW laser beam, and the highest cutoff energy of the proton beam was obviously increased. Accordingly, a double-film target structure was used, and the maximum cutoff energy of the proton beam was up to 70 MeV. These results demonstrate that the comprehensive performance of the SG-II PW laser facility was improved significantly.
Background: Veno-venous extracorporeal membrane oxygenation (VV-ECMO) is an invasive intervention for patients with respiratory failure associated with COVID-19. This meta-analysis aims to determine the incidence of neurovascular complications in COVID-19 patients requiring VV-ECMO. Methods: Systematic literature search of MEDLINE, Embase, PsycINFO, and Cochrane databases was performed to identify studies that reported neurovascular complications of adult COVID-19 patients on VV-ECMO for respiratory failure. Case series and reports were excluded. Studies with 95% or more of its patients on VV-ECMO were pooled for meta-analysis. Results: Eighteen studies (n=1968) were included for meta-analyses. In COVID-19 patients requiring VV-ECMO, the incidences of intracranial hemorrhage and ischemic stroke were 11% [95% CI, 8–15%] and 2% [95% CI, 1–3%], respectively. Intraparenchymal and subarachnoid hemorrhages accounted for 73% and 8% of all intracranial hemorrhages, respectively. The risk ratio of mortality in COVID-19 patients with neurovascular complications on VV-ECMO compared to patients without neurovascular complications was 2.24 [95% CI, 1.46–3.46]. Conclusions: COVID-19 patients requiring VV-ECMO have a higher incidence of intracranial hemorrhage compared to historical data in non-COVID-19 patients (11% vs. 8%), while the incidence of ischemic stroke is similar (2%) in both cohorts. COVID-19 patients with neurovascular complications on VV-ECMO are at an increased risk of death.
Background: Meningiomas are the most common intracranial tumor, graded from 1 (benign) to 3 (malignant). The aim of this study was to identify clinical features associated with overall survival (OS), progression-free survival (PFS) and functional status for malignant meningiomas. Methods: Demographic, clinical and histopathological data from grade 3 intracranial meningioma cases were identified in the clinical databases from seven sites in North America and Europe from 1991-2022. Summary statistics and Kaplan-Meier OS and PFS curves were generated. Results: We identified 108 patients, with a median age 65 years (IQR: 52, 72) and 53.7% were female. Median OS was 109 months (95% CIs: 88, 227), and 5-year OS rate was 65% (95% CIs: 56, 76). Median PFS was 38 months (95% CIs: 24, 56) and 5-year PFS rate was 37% (95% CIs: 28, 49). OS and PFS were significantly lower in patients aged ≥65 years. Median preoperative KPS score was 80 (IQR: 70, 90), postoperatively KPS was 90 (IQR: 70, 98) and 1-year follow-up KPS was 70 (IQR: 50, 80). Conclusions: This study provides robust survival, recurrence and functional data for grade 3 meningiomas in North America and Europe over a 30-year period.
This study aimed to compare the pre- and post-operative vestibular and equilibrium functions of patients with cholesteatoma-induced labyrinthine fistulas who underwent different management methods.
Methods
Data from 49 patients with cholesteatoma-induced labyrinthine fistulas who underwent one of three surgical procedures were retrospectively analysed. The three management options were fistula repair, obliteration and canal occlusion.
Results
Patients underwent fistula repair (n = 8), canal occlusion (n = 18) or obliteration procedures (n = 23). Patients in the fistula repair and canal occlusion groups suffered from post-operative vertigo and imbalance, which persisted for longer than in those in the obliteration group. Despite receiving different management strategies, all patients achieved complete recovery of equilibrium functions through persistent efforts in rehabilitation exercises.
Conclusion
Complete removal of the cholesteatoma matrix overlying the fistula is reliable for preventing iatrogenic hearing deterioration due to unremitting labyrinthitis. Thus, among the three fistula treatments, obliteration is the optimal method for preserving post-operative vestibular functions.