BACKGROUND Patients who undergo orthopedic procedures are often given excess opioid medication.Understanding the relationship between pain and opioid consumption following total hip arthroplasty(THA)is key to creating...BACKGROUND Patients who undergo orthopedic procedures are often given excess opioid medication.Understanding the relationship between pain and opioid consumption following total hip arthroplasty(THA)is key to creating safe and effective opioid prescribing guidelines.AIM To evaluate the association between the quantity of opioid consumption in relation to pain scores both pre-and postoperatively in patients undergoing primary THA.METHODS We retrospectively reviewed patients who underwent primary THA from November 2018-May 2019 and answered both the visual analog scale(VAS)pain and opioid medication questionnaires pre-and postoperatively.Both surveys were delivered daily for 7-days before surgery through the first 30 postoperative days.Survey results were divided into preoperative,postoperative days 1-7,postoperative days 8-14,and postoperative days 15-30 for analysis.Mean opioid pill consumption and VAS pain scores in each time period were determined and compared to patients’preoperative status using hierarchical Poisson and linear regressions,respectively.RESULTS There were 105 patients included.Mean VAS pain scores were the highest preoperatively 7.41±1.72.However,VAS pain scores significantly declined in each successive postoperative category compared to preoperative scores:postoperative day 1-7(5.07±1.79;P<0.001),postoperative day 8-14(3.60±1.64;P<0.001),and postoperative day 15-30(3.15±1.63;P<0.001).Mean opioid pill consumption preoperatively was 0.68±1.29 pills.Compared to preoperative opioid consumption,opioid use was significantly greater between postoperative days 1-7(1.51±1.58;P=0.001)and postoperative days 8-14(1.00±1.27;P=0.043).Opioid consumption declined below preoperative levels between postoperative days 15-30(0.35±0.72;P=0.160)which correlates with a VAS pain score of 3.15.CONCLUSION All patients experienced significant benefit and pain relief from having undergone THA.Average postoperative opioid consumption decreased below preoperative consumption between postoperative days 15-30,which was associated with a VAS pain score of 3.15.These results can be used to appropriately guide opioid prescribing practices and set patient expectations regarding pain management following THA.展开更多
Introduction: The Liebowitz Social Anxiety Scale (LSAS), used to assess the severity of social anxiety disorder (SAD), requires considerable effort and time to complete. The aims of this study were: 1) to investigate ...Introduction: The Liebowitz Social Anxiety Scale (LSAS), used to assess the severity of social anxiety disorder (SAD), requires considerable effort and time to complete. The aims of this study were: 1) to investigate whether a visual analogue scale (VAS) could be linear with the LSAS and substitute for the LSAS, 2) to relate such a VAS instrument to patient demographics. Methods: Fifty SAD patients were assessed using the LSAS and VAS instruments completed by both patients and doctors at the same session. We then drew distributions and calculated the Spearman’s ρ and κ coefficient values (divided at the median for each scale) between patient and doctor assessments. Next, each pair among the scores for the LSAS, the patient VAS and the doctor VAS was compared using Wilcoxon rank sum tests according to patient life profile data. Results: Scatter plots of pairs of scores were obtained. Spearman’s ρ was 0.661 between the LSAS and the patient VAS, 0.461 between the LSAS and the doctor VAS, and 0.494 between VAS scores of patients and doctors. The κ coefficients were 0.501 between the LSAS and patient VAS, 0.251 between the LSAS and doctor VAS, and 0.425 between patient VAS and doctor VAS (for all six, p < 0.001). The Wilcoxon rank sum tests indicated a significant difference between the groups with/ without “employment” (LSAS, patient/doctor VAS), with/without “graduation from junior college/university” (doctor VAS) (p < 0.05) and with/without marital history (the age of first consultation) (p < 0.01). Conclusions: A patient VAS may substitute for the LSAS and offer the versatility necessary to capture patient states and life profiles.展开更多
Caffeine is a commonly ingested psychoactive substance which affects alertness and cognition. A clinical study was conducted to determine the effect of orally ingested caffeine on visual analogue scale (VAS) responses...Caffeine is a commonly ingested psychoactive substance which affects alertness and cognition. A clinical study was conducted to determine the effect of orally ingested caffeine on visual analogue scale (VAS) responses in healthy, moderate caffeine-consuming volunteers through the use of population pharmacokinetic-pharmacodynamic (PK-PD) modeling. Twelve subjects were recruited for a three-period cross-over study which utilized caffeine containing beverages. Each visit included 8-hour blood plasma and VAS response collection for PK and PD assessment respectively. The VAS used in the study, also called the caffeine analog scale, has been previously validated for caffeine. Population PK-PD modeling was conducted with NONMEM 7.2. Simultaneous and sequential modeling of PK-PD was attempted. Final model selection was based on parameter estimate precision, diagnostic plots, and visual predictive check (VPC) plots. Results showed that a one-compartment open model with first-order absorption and elimination best described the pharmacokinetics of caffeine. Sequential PK-PD modeling was successful and an effect compartment model with linear slope and baseline parameter best described caffeine pharmacodynamics. Diagnostic plots showed no major bias and VPC plots showed agreement between observations and predictions. The model was able to link VAS responses to caffeine concentration in healthy volunteers and may be useful in clinical trial simulations and design.展开更多
Recently,analog visual transmission has attracted considerable attention owing to its graceful performance degradation for various wireless channels.In this study,we propose a novel analog visual communications system...Recently,analog visual transmission has attracted considerable attention owing to its graceful performance degradation for various wireless channels.In this study,we propose a novel analog visual communications system,named DVCast,in which an image denoising algorithm is used to fully utilize spatial correlation;moreover,the variable block size Discrete Cosine Transform(DCT)is used to preserve more correlation information in an image.Obviously,there is a tradeoff between system performance and computing complexity.Therefore,to improve the real-time performance of the proposed system,implementation of Block Matching with 3D filtering(BM3D)and DCT by Graphics Processing Units(GPUs)is introduced.According to DCT block size,i.e.,88,1616,and 3232,the schemes DVCast8,DVCast16,and DVCast32,respectively,are designed and implemented.Simulations show that DVCast with larger block size achieves better gain and visual quality than reference schemes.Moreover,it requires less computing time.DVCast32 outperforms conventional digital schemes by approximately 3.51 dB and achieves a 1.12 dB gain over state-of-the-art reference schemes.Furthermore,the analysis shows that DVCast can reduce overhead by at least 75%.展开更多
Reaction dynamics in gases at operating temperatures at the atomic level are the basis of heterogeneous gas-solid catalyst reactions and are crucial to the catalyst function.Supported noble metal nanocatalysts such as...Reaction dynamics in gases at operating temperatures at the atomic level are the basis of heterogeneous gas-solid catalyst reactions and are crucial to the catalyst function.Supported noble metal nanocatalysts such as platinum are of interest in fuel cells and as diesel oxidation catalysts for pollution control,and practical ruthenium nanocatalysts are explored for ammonia synthesis.Graphite and graphitic carbons are of interest as supports for the nanocatalysts.Despite considerable literature on the catalytic processes on graphite and graphitic supports,reaction dynamics of the nanocatalysts on the supports in different reactive gas environments and operating temperatures at the single atom level are not well understood.Here we present real time in-situ observations and analyses of reaction dynamics of Pt in oxidation,and practical Ru nanocatalysts in ammonia synthesis,on graphite and related supports under controlled reaction environments using a novel in-situ environmental(scanning) transmission electron microscope with single atom resolution.By recording snapshots of the reaction dynamics,the behaviour of the catalysts is imaged.The images reveal single metal atoms,clusters of a few atoms on the graphitic supports and the support function.These all play key roles in the mobility,sintering and growth of the catalysts.The experimental findings provide new structural insights into atomic scale reaction dynamics,morphology and stability of the nanocatalysts.展开更多
BACKGROUND Transarterial chemoembolization(TACE)combined with microwave ablation(MWA)is an effective treatment strategy for patients with advanced gastric cancer and liver metastasis.However,it may cause severe postop...BACKGROUND Transarterial chemoembolization(TACE)combined with microwave ablation(MWA)is an effective treatment strategy for patients with advanced gastric cancer and liver metastasis.However,it may cause severe postoperative pain and inflammatory responses.The paravertebral block(PVB)is a regional anesthetic technique that provides analgesia to the thoracic and abdominal regions.AIM To evaluate the effect of PVB on postoperative analgesia and inflammatory response in patients undergoing TACE combined with MWA for advanced gastric cancer and liver metastasis.METHODS Sixty patients were randomly divided into PVB and control groups.The PVB group received ultrasound-guided PVB with 0.375%ropivacaine preoperatively,whereas the control group received intravenous analgesia with sufentanil.The primary outcome was the visual analog scale(VAS)score for pain at 6 h,12 h,24 h,and 48 h after the procedure.Secondary outcomes were the dose of sufentanil used,incidence of adverse events,and levels of inflammatory markers(white blood cell count,neutrophil percentage,C-reactive protein,and procalcitonin)before and after the procedure.RESULTS The PVB group had significantly lower VAS scores at 6 h,12 h,24 h,and 48 h after the procedure compared with the control group(P<0.05).The PVB group also had a significantly lower consumption of sufentanil and a lower incidence of nausea,vomiting,and respiratory depression than did the control group(P<0.05).Compared with the control group,the PVB group had significantly lower levels of inflammatory markers 24 h and 48 h after the procedure(P<0.05).CONCLUSION PVB can effectively reduce postoperative pain and inflammatory responses and improve postoperative comfort and recovery in patients with advanced gastric cancer and liver metastasis treated with TACE combined with MWA.展开更多
文摘BACKGROUND Patients who undergo orthopedic procedures are often given excess opioid medication.Understanding the relationship between pain and opioid consumption following total hip arthroplasty(THA)is key to creating safe and effective opioid prescribing guidelines.AIM To evaluate the association between the quantity of opioid consumption in relation to pain scores both pre-and postoperatively in patients undergoing primary THA.METHODS We retrospectively reviewed patients who underwent primary THA from November 2018-May 2019 and answered both the visual analog scale(VAS)pain and opioid medication questionnaires pre-and postoperatively.Both surveys were delivered daily for 7-days before surgery through the first 30 postoperative days.Survey results were divided into preoperative,postoperative days 1-7,postoperative days 8-14,and postoperative days 15-30 for analysis.Mean opioid pill consumption and VAS pain scores in each time period were determined and compared to patients’preoperative status using hierarchical Poisson and linear regressions,respectively.RESULTS There were 105 patients included.Mean VAS pain scores were the highest preoperatively 7.41±1.72.However,VAS pain scores significantly declined in each successive postoperative category compared to preoperative scores:postoperative day 1-7(5.07±1.79;P<0.001),postoperative day 8-14(3.60±1.64;P<0.001),and postoperative day 15-30(3.15±1.63;P<0.001).Mean opioid pill consumption preoperatively was 0.68±1.29 pills.Compared to preoperative opioid consumption,opioid use was significantly greater between postoperative days 1-7(1.51±1.58;P=0.001)and postoperative days 8-14(1.00±1.27;P=0.043).Opioid consumption declined below preoperative levels between postoperative days 15-30(0.35±0.72;P=0.160)which correlates with a VAS pain score of 3.15.CONCLUSION All patients experienced significant benefit and pain relief from having undergone THA.Average postoperative opioid consumption decreased below preoperative consumption between postoperative days 15-30,which was associated with a VAS pain score of 3.15.These results can be used to appropriately guide opioid prescribing practices and set patient expectations regarding pain management following THA.
文摘Introduction: The Liebowitz Social Anxiety Scale (LSAS), used to assess the severity of social anxiety disorder (SAD), requires considerable effort and time to complete. The aims of this study were: 1) to investigate whether a visual analogue scale (VAS) could be linear with the LSAS and substitute for the LSAS, 2) to relate such a VAS instrument to patient demographics. Methods: Fifty SAD patients were assessed using the LSAS and VAS instruments completed by both patients and doctors at the same session. We then drew distributions and calculated the Spearman’s ρ and κ coefficient values (divided at the median for each scale) between patient and doctor assessments. Next, each pair among the scores for the LSAS, the patient VAS and the doctor VAS was compared using Wilcoxon rank sum tests according to patient life profile data. Results: Scatter plots of pairs of scores were obtained. Spearman’s ρ was 0.661 between the LSAS and the patient VAS, 0.461 between the LSAS and the doctor VAS, and 0.494 between VAS scores of patients and doctors. The κ coefficients were 0.501 between the LSAS and patient VAS, 0.251 between the LSAS and doctor VAS, and 0.425 between patient VAS and doctor VAS (for all six, p < 0.001). The Wilcoxon rank sum tests indicated a significant difference between the groups with/ without “employment” (LSAS, patient/doctor VAS), with/without “graduation from junior college/university” (doctor VAS) (p < 0.05) and with/without marital history (the age of first consultation) (p < 0.01). Conclusions: A patient VAS may substitute for the LSAS and offer the versatility necessary to capture patient states and life profiles.
文摘Caffeine is a commonly ingested psychoactive substance which affects alertness and cognition. A clinical study was conducted to determine the effect of orally ingested caffeine on visual analogue scale (VAS) responses in healthy, moderate caffeine-consuming volunteers through the use of population pharmacokinetic-pharmacodynamic (PK-PD) modeling. Twelve subjects were recruited for a three-period cross-over study which utilized caffeine containing beverages. Each visit included 8-hour blood plasma and VAS response collection for PK and PD assessment respectively. The VAS used in the study, also called the caffeine analog scale, has been previously validated for caffeine. Population PK-PD modeling was conducted with NONMEM 7.2. Simultaneous and sequential modeling of PK-PD was attempted. Final model selection was based on parameter estimate precision, diagnostic plots, and visual predictive check (VPC) plots. Results showed that a one-compartment open model with first-order absorption and elimination best described the pharmacokinetics of caffeine. Sequential PK-PD modeling was successful and an effect compartment model with linear slope and baseline parameter best described caffeine pharmacodynamics. Diagnostic plots showed no major bias and VPC plots showed agreement between observations and predictions. The model was able to link VAS responses to caffeine concentration in healthy volunteers and may be useful in clinical trial simulations and design.
基金the National Nature Science Foundation of China(Nos.61601128,61762053)the Science and Technology Plan Funding of Jiangxi Province of China(No.20151BBE50076)+1 种基金the Research Foundations of Education Bureau of Jiangxi Province(Nos.GJJ151001,GJJ150984)the Open Project Funding of Key Laboratory of Jiangxi Province for Numerical Simulation and Emulation Techniques,China.
文摘Recently,analog visual transmission has attracted considerable attention owing to its graceful performance degradation for various wireless channels.In this study,we propose a novel analog visual communications system,named DVCast,in which an image denoising algorithm is used to fully utilize spatial correlation;moreover,the variable block size Discrete Cosine Transform(DCT)is used to preserve more correlation information in an image.Obviously,there is a tradeoff between system performance and computing complexity.Therefore,to improve the real-time performance of the proposed system,implementation of Block Matching with 3D filtering(BM3D)and DCT by Graphics Processing Units(GPUs)is introduced.According to DCT block size,i.e.,88,1616,and 3232,the schemes DVCast8,DVCast16,and DVCast32,respectively,are designed and implemented.Simulations show that DVCast with larger block size achieves better gain and visual quality than reference schemes.Moreover,it requires less computing time.DVCast32 outperforms conventional digital schemes by approximately 3.51 dB and achieves a 1.12 dB gain over state-of-the-art reference schemes.Furthermore,the analysis shows that DVCast can reduce overhead by at least 75%.
基金the Engineering and Physical Science Research Council(EPSRC),U.K.for the award of a research grant EP/J0118058/1 and postdoctoral research assistantships(PDRAs) to M.R.W.and R.W.M.from the grant。
文摘Reaction dynamics in gases at operating temperatures at the atomic level are the basis of heterogeneous gas-solid catalyst reactions and are crucial to the catalyst function.Supported noble metal nanocatalysts such as platinum are of interest in fuel cells and as diesel oxidation catalysts for pollution control,and practical ruthenium nanocatalysts are explored for ammonia synthesis.Graphite and graphitic carbons are of interest as supports for the nanocatalysts.Despite considerable literature on the catalytic processes on graphite and graphitic supports,reaction dynamics of the nanocatalysts on the supports in different reactive gas environments and operating temperatures at the single atom level are not well understood.Here we present real time in-situ observations and analyses of reaction dynamics of Pt in oxidation,and practical Ru nanocatalysts in ammonia synthesis,on graphite and related supports under controlled reaction environments using a novel in-situ environmental(scanning) transmission electron microscope with single atom resolution.By recording snapshots of the reaction dynamics,the behaviour of the catalysts is imaged.The images reveal single metal atoms,clusters of a few atoms on the graphitic supports and the support function.These all play key roles in the mobility,sintering and growth of the catalysts.The experimental findings provide new structural insights into atomic scale reaction dynamics,morphology and stability of the nanocatalysts.
文摘BACKGROUND Transarterial chemoembolization(TACE)combined with microwave ablation(MWA)is an effective treatment strategy for patients with advanced gastric cancer and liver metastasis.However,it may cause severe postoperative pain and inflammatory responses.The paravertebral block(PVB)is a regional anesthetic technique that provides analgesia to the thoracic and abdominal regions.AIM To evaluate the effect of PVB on postoperative analgesia and inflammatory response in patients undergoing TACE combined with MWA for advanced gastric cancer and liver metastasis.METHODS Sixty patients were randomly divided into PVB and control groups.The PVB group received ultrasound-guided PVB with 0.375%ropivacaine preoperatively,whereas the control group received intravenous analgesia with sufentanil.The primary outcome was the visual analog scale(VAS)score for pain at 6 h,12 h,24 h,and 48 h after the procedure.Secondary outcomes were the dose of sufentanil used,incidence of adverse events,and levels of inflammatory markers(white blood cell count,neutrophil percentage,C-reactive protein,and procalcitonin)before and after the procedure.RESULTS The PVB group had significantly lower VAS scores at 6 h,12 h,24 h,and 48 h after the procedure compared with the control group(P<0.05).The PVB group also had a significantly lower consumption of sufentanil and a lower incidence of nausea,vomiting,and respiratory depression than did the control group(P<0.05).Compared with the control group,the PVB group had significantly lower levels of inflammatory markers 24 h and 48 h after the procedure(P<0.05).CONCLUSION PVB can effectively reduce postoperative pain and inflammatory responses and improve postoperative comfort and recovery in patients with advanced gastric cancer and liver metastasis treated with TACE combined with MWA.
文摘识别非驾驶行为是提高驾驶安全性的重要手段之一。目前基于骨架序列和图像的融合识别方法具有计算量大和特征融合困难的问题。针对上述问题,本文提出一种基于多尺度骨架图和局部视觉上下文融合的驾驶员行为识别模型(skeleton-image based behavior recognition network,SIBBR-Net)。SIBBR-Net通过基于多尺度图的图卷积网络和基于局部视觉及注意力机制的卷积神经网络,充分提取运动和外观特征,较好地平衡了模型表征能力和计算量间的关系。基于手部运动的特征双向引导学习策略、自适应特征融合模块和静态特征空间上的辅助损失,使运动和外观特征间互相引导更新并实现自适应融合。最终在Drive&Act数据集进行算法测试,SIBBR-Net在动态标签和静态标签条件下的平均正确率分别为61.78%和80.42%,每秒浮点运算次数为25.92G,较最优方法降低了76.96%。
文摘目的 观察头穴丛刺长留针法治疗偏头痛的临床疗效。方法 将88例偏头痛患者随机分为观察组(44例,脱落2例)和对照组(44例,脱落3例)。观察组采用常规针刺联合头穴丛刺长留针法治疗,对照组采用常规针刺方法治疗。比较两组临床疗效,观察两组治疗前后的视觉模拟量表(visual analog scale, VAS)评分、偏头痛特异性生活质量问卷(migraine-specific quality of life questionnaire, MSQ)、血清5-羟色胺(5-hydroxytryptamine, 5-HT)浓度。结果 观察组总有效率为92.9%,高于对照组的78.0%,差异有统计学意义(P>0.05)。两组治疗后VAS评分较治疗前降低(P<0.05),两组随访时VAS评分较治疗前和治疗后降低(P<0.05);观察组治疗后及随访时,VAS评分均低于对照组(P<0.05)。两组治疗后MSQ评分较治疗前升高(P<0.05),两组随访时MSQ评分较治疗前和治疗后升高(P<0.05);观察组治疗后及随访时,MSQ评分均高于对照组(P<0.05)。两组治疗后血清5-HT浓度均升高,且观察组高于对照组,差异有统计学意义(P<0.05)。结论 在常规针刺基础上,头穴丛刺长留针法治疗偏头痛临床疗效优于常规针刺方法,且在减轻偏头痛患者疼痛程度,改善其生活质量及提高5-HT浓度方面优于常规针刺方法。
