Comparison of the innovative endoscopic oropharyngeal airway and the conventional mouthpiece in elderly outpatients undergoing esophagogastroduodenoscopy under sedation: a prospective and randomized study

Background Undesirable outcomes may appear for elderly patients undergoing esophagogastroduodenoscopy (EGD) under sedation, such as hypoxia and hypotension. The aim of our study was to investigate the ability of the innovative endoscopic oropharyngeal airway to reduce the frequency of hypoxia during EGD under sedation in elderly patients. Methods In this trial, aged patients undergoing EGD were randomized into airway group and mouthpiece group. The primary outcome was the incidence of the minimum pulse oxygen saturation < 90% and minimum pulse oxygen saturation. In addition, sedation dose, recovery time, emergency management and adverse reactions were recorded. Results 360 patients completed the study (180 in each groups). The minimum pulse oxygen saturation during EGD was significantly higher in airway group (97.66 ± 2.96%) than in mouthpiece group (95.52 ± 3.84%, P < 0.001). The incidence of pulse oxygen saturation of 85–89% of airway group (5.0%, 9/180) was lower than mouthpiece group (10.6%, 19/180, P = 0.049). The endoscopy entry time in airway group was 3 (2, 4) seconds and in mouthpiece group was 5 (4, 6) (P < 0.001). Propofol total dose and awakening time were significantly lower in the airway group than in the mouthpiece group (P = 0.020 and P = 0.012, respectively). Furthermore, the incidence rate of hypotension was significantly higher in mouthpiece group (12.2%) than in airway group (5.0%) (P = 0.015). By comparison with the mouthpiece group, the satisfaction of endoscopists was higher in airway group (P = 0.012). Conclusion Elderly patients undergoing EGD, Endoscopy Protector was associated with a significantly lower incidence of hypoxia, shortened endoscopy entry time and more stable hemodynamics. Trial registration: ChiCTR, ChiCTR2000031998, 17/04/2020. http://www.chictr.org.cn/index.aspx

Quantifying bias from dependent left truncation in survival analyses of real world data

In real world data (RWD) studies, observed datasets are often subject to left truncation, which can bias estimates of survival parameters. Standard methods can only suitably account for left truncation when survival and entry time are independent. Therefore, in the dependent left truncation setting, it is important to quantify the magnitude and direction of estimator bias to determine whether an analysis provides valid results. We conduct simulation studies of common RWD analytic settings in order to determine when standard analysis provides reliable estimates, and to identify factors that contribute most to estimator bias. We also outline a procedure for conducting a simulation-based sensitivity analysis for an arbitrary dataset subject to dependent left truncation. Our simulation results show that when comparing a truncated real-world arm to a non-truncated arm, we observe the estimated hazard ratio biased upwards, providing conservative inference. The most important data-generating parameter contributing to bias is the proportion of left truncated patients, given any level of dependence between survival and entry time. For specific datasets and analyses that may differ from our example, we recommend applying our sensitivity analysis approach to determine how results would change given varying proportions of truncation.

Application Value of Transvaginal Ultrasound on Early Screening for Ectopic Pregnancy

Objective: To explore the effect and value of transvaginal ultrasound in screening early ectopic pregnancy. Methods: A total of 146 patients with ectopic pregnancy in our hospital were selected. The patients' entry time was from May 2018 to December 2020. 146 patients were divided into two groups. The control group was screened by abdominal ultrasound with 73 cases, and the experimental group was screened by vaginal ultrasound with 73 cases. The uterine adnexal mass, pelvic effusion, peritoneal effusion and diagnostic accuracy were detected. Results: The positive number of abdominal ultrasound was significantly higher than that of vaginal ultrasound; In the detection process of abdominal ultrasound, 54 cases of ectopic pregnancy, 19 cases of non-ectopic pregnancy, the detection rate was 73.97%, 26 cases of ectopic pregnancy, 47 cases of non-ectopic pregnancy, the detection rate was 32.62%. Conclusion: The accuracy of transvaginal ultrasound is relatively high, and the accuracy of ectopic pregnancy examined by transvaginal ultrasound is higher, which is more friendly to patients, less traumatic and high operability. It can provide more accurate reports for patients and relieve the psychological pressure of patients, which is worthy of application in actual screening.

Strategic Communication and Neuromarketing in the Fisheries Sector: Generating Ideas From the Territory

Background: Globalization and technological progress has changed the relationships among fisheries, society and markets. The industrial primacy has led, among others, to the marginalization of fishermen and the deletion of local culture. It followed a loss of the conventional link between territory and traditions, with a change in consumer behavior.Aim: The purpose of this study is to investigate the way through which the communication of territoriality of fish products influences the consumers' quality perception, their willingness to pay and the exploration of packaging, in the Italian context.Method: In order to obtain quantitative and qualitative data on visual paths (the series of fixations and saccades) and areas of interest (AOI) of the analyzed packaging, gaze data were recorded. AOI permits to define regions of a visual stimulus and to link eye-movement measures to parts of the used stimulus. This study used AOI in order to measure Spent Time (the amount of time that consumers have spent looking at a particular AOI) and Entry Time (the time passed from the moment of the first fixation in a particular AOI) on brands and on products.Results: The results of the drivers identified crucial points for the future communication of fish products and the promotion of the territory. In particular, the analysis lays the foundations for a reorganization of the approach to the creation of product packaging, through greater attention to detail and the intrinsic values that this can express.Conclusion: The use of neuromarketing techniques has proved to be valid in identifying what is the main information that is processed for the evaluation of the product also considering the role played by emotions.

Study on the COVID-19 infection status, prevention and control strategies among people entering Shenzhen

Background The novel coronavirus disease 2019 (COVID-19) confirmed cases overseas have continued to rise in the last months, and many people overseas have chosen to return to China. This increases the risk of a large number of imported cases which may cause a relapse of the COVID-19 outbreak. In order to prevent imported infection, the Shenzhen government has implemented a closed-loop management strategy using nucleic acid testing (NAT) for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and requiring 14 days of medical observation for individuals with an overseas tour history (Hong Kong, Macao, Taiwan province and other countries). Our study aims to describe the status of COVID-19 infection among people entering Shenzhen, and to evaluate the effect of the closed-loop management strategy. Methods We undertook a descriptive study and risk analysis by the entry time, time of reporting, and local confirmed cases in countries of origin. The NAT were completed in Shenzhen Center for Disease Control and Prevention (CDC), ten district-level CDCs, and fever clinics. Results A total of 86,844 people from overseas entered Shenzhen from January 1 to April 18, 2020; there were 39 imported COVID cases and 293 close contacts. The infection rate of people entering was 4.49‰ [95% Confidence interval (CI): 3.26‰–6.05‰]. Fourteen imported cases (35.9%) came from the UK, and nine (23.08%) came from the USA. People entering from the USA since March 9 or from the UK since March 13 are the high-risk population. As of July 17, there have been no new confirmed cases in Shenzhen for 153 days, and the numbers of confirmed case, close contacts, and asymptomatic cases are 0. Conclusions The closed-loop management has been effective in preventing imported infection and controlling domestic relapse. The distribution of entry time and report time for imported cases overseas was similar. This shows that it is important to implement closed-loop management at the port of entry.

Eliminate the Queuing Time in the New Suez Canal: Predicting Adjustment on Ships’ Arrival Time under Optimal Non-Queuing Toll Scheme

In 2016, the construction of the New Suez Canal was completed, enabling most large-size vessels to pass through and causing more ships to queue into the canal. As the queueing problem at the entrance of the canal was anticipated to be serious, an optimal non-queueing toll scheme was previously established to eliminate the queueing phenomenon at the anchorage of the canal. However, no information about each ship’s arrival time adjustment under the optimal non-queueing toll scheme is available from the previous literature. To solve this problem, we derive a series of mathematical formulae for each ship’s arrival time, length of queuing time and entry time before, and after, implementing the optimal non-queueing toll scheme. The arrival time adjustments, which enable ships to enter the canal without queueing, could then be obtained. These results enable the Suez Canal authorities to draw up the ship’s arrival timetable under the optimal non-queueing toll scheme, so that the captain could follow to enter the canal. The above information that we provide would be conducive to the management decision for the canal authorities to implement such a toll scheme. Once a tolled ship could enter the canal at the scheduled time without queueing, the ship owner could accurately control the sailing schedule, and the use of the ship could be more efficient.

Strategic Alliances in the Electromobility Sector

Since the late 2000s, the transition from a fossil fuel-based system to the fully renewable system has begun. This period, known as an “Era of Ferment”, is characterized by high technical and economic uncertainty and it’s leading the automotive industry towards a paradigm shift: developing new car technologies, creating charging infrastructure needs and shaking up the supply chain structure. In light of ecosystem theory and the importance of alliances in the quest to develop an electric vehicle market, this paper analyses the electromobility ecosystem, tracking its lifecycle and investigating vertical and horizontal alliances between the main actors over time, including original equipment manufacturers, traditional suppliers, battery suppliers, and charging infrastructure providers. We analyzed an original longitudinal dataset composed of 281 alliances in the electric passenger vehicles market, initiated between 2000 and 2015. Through the study of the network of alliances, we describe the Electric Vehicle ecosystem’s evolution, examining the entry time of incumbents, suppliers and complementors, the role of actors in the ecosystem and their previous industry sector, the key knowledge they possess and technological areas in which they operate, and the nations involved. Key network measures also provide insights into power and connectedness of different actors, highlighting a creative accumulation strategy of the incumbents.

Basin and petroleum system modeling in conjunction zone of the Alexander and Srednevasyugan anticlines and Ust-Tym depression, southeastern part of the West Siberian hydrocarbon province (Russia)

The paper is aimed at the basin and petroleum system modeling in the conjunction zone of the Alexander and Srednevasyugan anticlines and Ust-Tym depression during the Mesozoic-Cenozoic time. The exploration area is located in the southeastern part of the West Siberian hydrocarbon province. The present research primarily identifies the oil-window-entry time, maturity, generation points, generation power, and remaining potential of the Togur and Bazhenov source rocks. The Togur oil-window-entry time is 139.5 Ma. The Bazhenov oil-window-entry time is 99 Ma. Liquid hydrocarbons are extensively generated by the source rocks at the present time, since the Togur and Bazhenov Formations are found to be in the oil window. The significant amount of generated hydrocarbons is lost in migration processes. The source rock generation power and remaining potential are 1.1 and 1.5 billion tons of hydrocarbons, respectively.

PSV-24 Use of the entry time and exit velocity as tools for the assessment of water buffalo temperament

The use of the entry time, chute score, and exit velocity as tools for the assessment water buffaloes (WB) temperament were used. Seventy-five non-castrated WB (390±32 days of age; 310±61.27 kg of initial body weight) of 3 genetic groups (GG:Jafarabadi, Mediterranean, and Murrah; n = 25 for each GG) were used. The WB arrived at research center (-28d) and were submitted to 28 days of adaptation period to the feedlot facilities, diet, and handling. On day 0, the temperament variables were collected, namely: entry time into squeeze chute (by chronometer); chute score (5-point scale:1=calm animals; 5=very reactive animals); and, exit velocity (by infrared sensors). Subsequently, blood samples were collected from the jugular vein and analyzed for serum levels of cortisol using radioimmunoassay technique; and, rectal temperature was recorded. The individual temperament score (TSc) was calculated averaging entry time score (5-point scale:1=greater time spent, and 5=less time spent), chute score, and exit velocity score (5-point scale:1=lower speed; 5=higher speed). Data were subjected to a stepwise discriminant analysis (SDA) using the STEPDISC procedure in SAS. The value of P &lt; 0.01 was stipulated to consider and include the variable in the model. The respective data of the selected variables were submitted to multivariate analysis of variance using the GLM procedure in SAS. The GG were added to the model to test the possible effect. Correlation analysis was performed using CORR procedure in SAS. The SDA used three steps and selected only the entry time and exit velocity scores (Table 1). Positive correlations were verified between the TSc and cortisol (r=0.37; P = 0.02), and TSc and rectal temperature (r=0.36; P &lt; 0.01). In conclusion, the entry time and exit velocity may be tools for the assessment of water buffalo temperament and their use should be tested in animals of different categories. Supported by FAPESP (#2018/25939-1; #2014/05473-7).

FPGA Routing Architecture Estimation Models and Methods

The problem of analyzing and evaluating the structure of FPGA routing resources at early stages of the design flow presents great interest for researchers. Until now, an approach, consisting in passing the full design flow (logic synthesis, placement, routing) on a set of the test circuits with subsequent estimation of various parameters for each FPGA architecture being analyzed, had been dominant. Despite the high accuracy, this approach has a long runtime and requires lots of computing resources, as well as CAD tuned to the analyzed FPGA architecture. Modern FPGA contain more than a million logical gates, therefore, the application of such approach is inefficient. Today, more attention is paid to the development of various models, which allows to evaluate the structure of the routing resources at early stages without using the benchmark circuits. In this work an overview of the existing models and methods for analyzing the structure of FPGA routing resources has been presented. A comparison of the methods and models has been performed, the estimation of their efficiency and possibility of application for designing domestic FPGA has been made. It has been found that the most optimal approach for analyzing of arbitrary structures of the routing resources FPGA is the development and application of mixed methods. This will allow to obtain the accurate models as well as to significantly reduce the development and market entry time.