Journal articles: 'Arrival discharge'

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Wu, Luo, Jia, Sun, Sheng, and Jiang. "RSSI-Power-Based Direction of Arrival Estimation of Partial Discharges in Substations." Energies 12, no. 18 (September 6, 2019): 3450. http://dx.doi.org/10.3390/en12183450.

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The localization of partial discharges in air-insulated substations using ultra-high frequency technology is widely studied for power equipment early warning purposes. Ultra-high frequency partial discharge localization systems are usually based on the time-difference of electromagnetic wave signals. However, the large size of test equipment and the need for a high sampling rate and time synchronization accuracy limit their practical application. To address this challenge, this paper proposes a power-based partial discharge direction of arrival method using a received signal strength indicator from an ultra-high frequency wireless sensor array. Furthermore, the Gaussian mixture model is used for noise suppression, and the Gaussian process classifier is used for line of sight received signal strength indicator data identification. Laboratory tests are performed and the results show the average error of direction of arrival is less than 5°. The results verify the effectiveness of the proposed partial discharge localization system.

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Dahl, Jonas, Johan Dannewitz, Lars Karlsson, Erik Petersson, Anna Löf, and Bjarne Ragnarsson. "The timing of spawning migration: implications of environmental variation, life history, and sex." Canadian Journal of Zoology 82, no. 12 (December 1, 2004): 1864–70. http://dx.doi.org/10.1139/z04-184.

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During 1960–2002, the arrival times of all spawning male and female Atlantic salmon (Salmo salar L., 1758) and brown trout (Salmo trutta L., 1758) entering Dalälven River were recorded. To study the role of environmental variation in spawning migration timing, we used long-term temperature (river and sea) and river discharge data. For salmon, the spawning migration peak was strongly correlated with mean monthly sea and river temperatures during spring: salmon arrived earlier when temperatures were higher and later when temperatures were lower. River discharge explained little of the variation in migration timing. Female salmon migration showed a stronger correlation with temperature than male salmon migration, and female salmon arrived ≈18 days earlier than males. Trout showed a larger variation in their spawning migration, but river and sea temperatures and river discharge explained little of the variation. Trout females arrived ≈7 days earlier than males. The sea and river temperatures were highly correlated during the spawning migration, indicating that large climate processes determine the temperature regimes in the Baltic Sea and its tributaries. Time of arrival at the river was not correlated with ovulation date; a female salmon or brown trout arriving late could ovulate almost immediately, whereas a female arriving early could wait to ovulate.

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Bereka, V. O., and I. P. Kondratenko. "MATCHING OF COMPATIBLE WORK OF SHORT HIGH-VOLTAGE PULSES OF TENSION GENERATOR AND WATER TREATMENT CHAMBER BY DINT OF PULSE BARRIER DISCHARGE." Praci Institutu elektrodinamiki Nacionalanoi akademii nauk Ukraini 2021, no. 60 (December 10, 2021): 21–27. http://dx.doi.org/10.15407/publishing2021.60.021.

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A technique for calculating the parameters of a magnetic switch as an element of a generator of short high-voltage pulses of tension to coordinate its compatible work with a water treatment chamber by dint of pulse barrier discharge is shown. The expediency and efficiency of using such a switch as an element that, by shunting, the discharge chamber, discharges the barrier to the arrival of the next voltage pulse has been confirmed. It is proved that with the accepted geometrical dimensions of the discharge chamber and the amplitude of the pulse voltage, provided that the magnetic switch is present that it is possible to increase the practical use of electricity by ~ 40% due to that which was accumulated in the dielectric barrier in one discharge. Ref.10, fig. 5.

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Fosnocht, D. E., and E. R. Swanson. "398: Arrival and Discharge Pain Intensity in the Emergency Department." Annals of Emergency Medicine 52, no. 4 (October 2008): S163—S164. http://dx.doi.org/10.1016/j.annemergmed.2008.06.425.

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Choi, Mun-Gyu, and Hanju Cha. "Partial Discharge Position Tracking Method using a GIS Partial Discharge Signal and Arrival Time Difference." Transactions of The Korean Institute of Electrical Engineers 62, no. 9 (September 1, 2013): 1297–301. http://dx.doi.org/10.5370/kiee.2013.62.9.1297.

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Ren, Li, Tingbo Jia, Anqing Sun, Nan Zheng, Fan Wu, and Lingen Luo. "Partial Discharge Angle of Arrival Estimation Using UHF Wireless Sensor Array." IOP Conference Series: Materials Science and Engineering 486 (July 10, 2019): 012031. http://dx.doi.org/10.1088/1757-899x/486/1/012031.

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Pasternack, Jordan B., Matthew L. Ciminero, Michael Silver, Joseph Chang, Piyush Gupta, and Kevin K. Kang. "Does Care at a Trauma Center Affect Geriatric Hip Fracture Patients?" Geriatric Orthopaedic Surgery & Rehabilitation 11 (January 1, 2020): 215145932091186. http://dx.doi.org/10.1177/2151459320911865.

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Introduction: With respect to care setting, there are mixed results in the literature with respect to the role of trauma centers in management of isolated geriatric hip fractures. During a transition from a Level 3 to a Level 1 trauma center, significant protocol changes were implemented that sought to standardize and improve the care of hip fracture patients. The objective of this study was to determine the effects of this transition on the management, efficiency, morbidity, mortality, and discharge of geriatric hip fracture patients. Methods: A retrospective chart review of geriatric hip fractures treated operatively was conducted. Two cohorts were compared: hip fractures in the year prior to (2015) and year following (2017) Level 1 Trauma designation. Primary outcome measures were length of stay (LOS), transfusion rate, complication rate, and mortality rate. Secondary outcome measures were time from emergency department (ED) arrival to medical optimization, time from medical optimization to surgery, time from ED arrival to surgery, and discharge destination. Results: There were no differences in LOS, transfusion rate, or complication rate between the two cohorts. There was a nonsignificant trend toward lower in-hospital mortality after the transition (2.24% vs 0.83%). There were no differences in time from ED arrival to medical optimization, time from medical optimization to surgery, time from ED arrival to surgery, and percentage of patients discharged home between the cohorts. Discussion: Management of operative geriatric hip fractures at our institution has remained consistent following transition to a Level 1 trauma center. There was a trend toward lower mortality after transition, but this difference was not statistically significant. We attribute the variety of findings in the literature with respect to trauma center management of hip fractures to individualized institutional trauma protocols as well as the diverse patient populations these centers serve.

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Elías-Maxil, J. A., Jan Peter van der Hoek, Jan Hofman, and Luuk Rietveld. "A bottom-up approach to estimate dry weather flow in minor sewer networks." Water Science and Technology 69, no. 5 (January 17, 2014): 1059–66. http://dx.doi.org/10.2166/wst.2014.010.

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In order to evaluate the feasibility of installing decentralised installations for wastewater reuse in cities, information about flows at specific spots of a sewer is needed. However, measuring intermittent flows in partially filled conduits is a technical task which is sometimes difficult to accomplish. This paper describes a method to model intermittent discharges in small sewers by linking a stochastic model for wastewater discharge to a hydraulic model to predict the attenuation of the discharges and its impact on the arrival time to a defined spot. The method was validated in a case study. The model estimated adequately the wastewater discharges on working days.

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Yan, Jiangzehui, Luping Xu, Weihao Tie, and Dan Jiang. "Experiment on Direction of Arrival Estimation of Atmospheric Spark Discharge Plasma Using Combined Time-Domain Antenna." International Journal of Antennas and Propagation 2020 (September 27, 2020): 1–11. http://dx.doi.org/10.1155/2020/5247253.

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Apart from interfering in the communication system of an aircraft, electromagnetic pulses (EMPs) radiated from spark discharge plasma, which is generated during high-speed flight, can also be utilized in passive detection. In order to validate this idea, an experiment on direction of arrival (DOA) estimation of a spark discharge plasma target using its radiated EMPs is carried out in this paper. A combined time-domain antenna is designed based on the model of spark discharge process and is used to receive the radiated EMPs during the experiment. According to the experimental results, the DOA estimation system with combined antenna is able to obtain the direction information of a spark discharge plasma. Results also show that the estimation performance of elevation angle is better when the actual elevation angle of the discharge plasma target is higher, while the estimation performance of azimuth is opposite. The azimuth angle of a target has very little influence on the DOA estimation. Moreover, the estimation error can be reduced effectively by increasing the aperture size of receiving array. The previously mentioned results provide an approach to locate the discharge plasma source using radiated EMPs with passive detection techniques.

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Ekhaguere, Osayame Austine, Rosena Olubanke Oluwafemi, Angela Oyo-Ita, Burke Mamlin, Paul Bondich, Eneida A. Mendonca, and Angela L. Rollins. "Determinants of Long Immunization Clinic Wait Times in a Sub-Saharan African Country." Global Pediatric Health 8 (January 2021): 2333794X2110282. http://dx.doi.org/10.1177/2333794x211028211.

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The wait time clients spend during immunization clinic visits in low- and middle-income countries is a not well-understood reported barrier to vaccine completion. We used a prospective, observational design to document the total time from client arrival-to-discharge and all sequential provider-client activities in 1 urban, semi-urban, and rural immunization clinic in Nigeria. We also conducted caregiver and provider focus group discussions to identify perceived determinants of long clinic wait times. Our findings show that the time from arrival-to-discharge varied significantly by the clinic and ranged between 57 and 235 minutes, as did arrival-to-all providers-client activities. Focus group data attributed workflow delays to clinic staff waiting for a critical mass of clients to arrive for their immunization appointment before starting the essential health education talk or opening specific vaccine vials. Additionally, respondents indicated that complex documentation processes caused system delays. Research on clinic workflow transformation and simplification of immunization documentation is needed.

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Mehmood, Amber, Nukhba Zia, Olive Kobusingye, Rukia H. Namaganda, Hussein Ssenyonjo, Joel Kiryabwire, and Adnan A. Hyder. "Determinants of emergency department disposition of patients with traumatic brain injury in Uganda: results from a registry." Trauma Surgery & Acute Care Open 3, no. 1 (December 2018): e000253. http://dx.doi.org/10.1136/tsaco-2018-000253.

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BackgroundTraumatic brain injuries (TBIs) are a common cause of emergency department (ED) visits and hospital admissions in Kampala, Uganda. The objective of this study was to assess determinants of ED discharge disposition based on patient demographic and injury characteristics. Four ED outcomes were considered: discharge home, hospital admission, death, and others.MethodsThis prospective study was conducted at Mulago National Referral Hospital, Kampala, Uganda, from May 2016 to July 2017. Patients of all age groups presenting with TBI were included. Patient demographics, external causes of injury, TBI characteristics, and disposition from EDs were noted. Injury severity was estimated using the Glasgow Coma Scale (GCS), Kampala Trauma Score (KTS), and the Revised Trauma Score (RTS). A multinomial logistic regression model was used to estimate conditional ORs of hospital admission, death, and other dispositions compared with the reference category “discharged home”.ResultsA total of 3944 patients were included in the study with a male versus female ratio of 5.5:1 and a mean age of 28.5 years (SD=14.2). Patients had closed head injuries in 62.9% of cases. The leading causes of TBIs were road traffic crashes (58.8%) and intentional injuries (28.7%). There was no significant difference between the four discharge categories with respect to age, sex, mode of arrival, cause of TBI, place of injury, type of head injury, transport time, and RTS (p>0.05). There were statistically significant differences between the four discharge categories for a number of serious injuries, GCS on arrival, change in GCS, and KTS. In a multinomial logistic regression model, change in GCS, area of residence, number of serious injuries, and KTS were significant predictors of ED disposition.DiscussionThis study provides evidence that ED disposition of patients with TBI is differentially affected by injury characteristics and is largely dependent on injury severity and change in GCS during ED stay.Level of evidenceLevel II.

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Sunil Kumar P, Dhanwantari Naidu, Padmanabhan P, and Paul T Joyes. "Modified dosage evaluation of continued release of DiDomenico sodium tablets by means of hydrophilic polymer blends." International Journal of Research in Pharmaceutical Sciences 11, SPL4 (December 20, 2020): 315–22. http://dx.doi.org/10.26452/ijrps.v11ispl4.3797.

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That term altered - discharge measurement manifestation is used to portray results that change the timing and rate for the arrival of the drug substance. A modified release measurement type will be characterized "as a particular case to which the pill arrival aspects for a period course or area need aid picked on finish restorative alternately comfort destinations not advertised by routine measurement structures, for example, solutions, ointments, alternately immediately dissolving dosages manifestations. xanthan gum, a polysaccharide, crude cashew gum, Diclofenac sodium powder, hydroxypropyl methylcellulose, microcrystalline cellulose, talc and magnesium stearate. Wet granulation, procedure of wet granulation in 6-Step. Every last one of batches of tablets passed that consistency and weight test and pill substance test the batches of tablets be that as clump 3 passed those pulverizing quality test every last one of batches and tablets yet batches 4 furthermore 10 passed the friability test. Tablets holding main xanthan gum similarly as arrival modifier attained the most astounding pulverizing quality friability proportion (CSFR) for the individuals clinched alongside clump 10 hosting those most reduced. Furthermore, the individuals for clump 3 required the most reduced swelling list. Those investigations need demonstrated that cashew furthermore xanthan gums utilized alone can't proficiently control medication regardless of discharge. Batches 7 and 8 holding xanthan gum also HPMC were capable on the result in supported medication regardless of discharge comparable to Voltaren retard.

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Ji, Wei, Qing Xie, Cheng Qiang Wang, Shan Shan Hou, and Fang Cheng Lv. "Partial Discharge DOA Estimation Based on Ultrasonic Array Sensor and Genetic MUSIC." Advanced Materials Research 614-615 (December 2012): 1142–46. http://dx.doi.org/10.4028/www.scientific.net/amr.614-615.1142.

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The partial discharge direction of arrival (DOA) estimation based on ultrasonic array sensor is the basic of partial discharge’s accurate positioning. The precision and searching success rate of traditional MUSIC direction finding algorithm is low. So this paper presented a new method based on ultrasonic array sensor and genetic MUSIC algorithm in partial discharge DOA estimation. The genetic MUSIC algorithm constructed fitness function by spatial spectrum estimation formula, searched the spectral peak of azimuth based on the idea of genetic iterative searching in order to obtain the global optimal solution. This paper carried out a large number of simulation experiments through the establishment of signal model and array model, then used three indicators of searching precision, searching success rate and searching time as the basis, to compare the direction finding results of classical MUSIC and genetic MUSIC. The results show that the optimization precision and searching success rate based on the genetic MUSIC algorithm is improved greatly, can obtain higher accuracy of partial discharge DOA angle.

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Tsuchitani, C. "The inhibition of cat lateral superior olive unit excitatory responses to binaural tone bursts. I. The transient chopper response." Journal of Neurophysiology 59, no. 1 (January 1, 1988): 164–83. http://dx.doi.org/10.1152/jn.1988.59.1.164.

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1. The temporal properties of lateral superior olivary (LSO) unit discharges to binaural tone bursts were studied to determine the general time course and statistical properties of these discharges and to provide a basis for extending a point process model of LSO unit monaural discharges to describe their binaural discharges. Single-unit activity was recorded extracellularly from the LSO of the anesthetized cat. The initial transient and the gross temporal features of LSO unit discharges to binaural simultaneous tone bursts are examined in this paper. 2. The poststimulus time (PST) histograms generated by LSO unit discharges to monaural and binaural tone bursts illustrated that the ipsilaterally elicited tone-burst discharges were most strongly inhibited during the initial segment of the binaural response and that the degree of inhibition decreased (i.e., discharge rate increased) as the poststimulus onset time increased. Hence, the contralateral inhibitory effect “adapts” in a manner similar to the ipsilaterally elicited discharges. 3. When the interaural level difference was decreased, the degree of discharge inhibition increased: the period of maximal inhibition spread to shorter and longer poststimulus onset times as the contralateral latency decreased and as the contralateral response magnitude increased. The latency of the inhibitory effect could decrease sufficiently to result in the suppression of the first spike of the ipsilateral discharge. Also, when the binaural stimulus was of sufficient intensity, an increase in spike output, the OFF discharge, was often observed during the last 1-10 ms of the response. 4. It was concluded that the initial and general time course of the binaural response could serve as cues of binaural stimulus level, interaural level differences, and interaural time-of-arrival differences of high-frequency stimuli. The binaural response could be discriminated from a monaural response of similar discharge rate as the former either occurred with shorter latency or, when the first spike was suppressed, with much longer and/or more variable latency than the latter. The gross temporal differences between the monaural and binaural responses could be accounted for in terms of differences in certain gross temporal features (e.g., latency and adaptation) of the ipsilateral and contralateral responses. 5. The effect of stimulating the contralateral ear was not limited to the inhibition of discharges. The timing of a discharge to an ipsilateral stimulus could be perturbed (lengthened) by a contralateral stimulus at levels below that which suppressed the discharge.(ABSTRACT TRUNCATED AT 400 WORDS)

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Chen, Zilong. "Review of direction of arrival estimation algorithms for partial discharge localisation in transformers." IET Science, Measurement & Technology 13, no. 4 (June 1, 2019): 529–35. http://dx.doi.org/10.1049/iet-smt.2018.5297.

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Pope, Ian, Sharif Ismail, Benjamin Bloom, Gwyneth Jansen, Helen Burn, David McCoy, and Tim Harris. "Short-stay admissions at an inner city hospital: a cross-sectional analysis." Emergency Medicine Journal 35, no. 4 (January 5, 2018): 238–46. http://dx.doi.org/10.1136/emermed-2016-205803.

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ObjectiveTo investigate factors predictive of short hospital admissions and appropriate placement to inpatient versus clinical decision units (CDUs).MethodThis is a retrospective analysis of attendance and discharge data from an inner-city ED in England for December 2013. The primary outcome was admission for less than 48 hours either to an inpatient unit or CDU. Variables included: age, gender, ethnicity, deprivation score, arrival date and time, arrival method, admission outcome and discharge diagnosis. Analysis was performed by cross-tabulation followed by binary logistic regression in three models using the outcome measures above and seeking to identify factors associated with short-stay admission.ResultsThere were 2119 (24%) admissions during the study period and 458 were admitted for less than 24 hours. Those who were admitted in the middle of the week or with ambulatory care sensitive conditions (ACSCs) were significantly more likely to experience short-stays. Older patients and those who arrived by ambulance were significantly more likely to have a longer hospital stay. There was no association of length of inpatient stay with being admitted in the last 10 min of a 4 hours ED stay.ConclusionOnly a few factors were independently predictive of short stays. Patients with ACSCs were more likely to have short stays, regardless of whether they were admitted to CDU or an inpatient ward. This may be a group of patients that could be targeted for dedicated outpatient management pathways or CDU if they need admission.

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Hatami, Rezvan, Graeme Inglis, Stephen E. Lane, Abraham Growcott, Daniel Kluza, Catherine Lubarsky, Charlotte Jones-Todd, Kimberley Seaward, and Andrew P. Robinson. "Modelling the likelihood of entry of marine non-indigenous species from internationally arriving vessels to maritime ports: a case study using New Zealand data." NeoBiota 72 (April 18, 2022): 183–203. http://dx.doi.org/10.3897/neobiota.72.77266.

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The establishment of marine non-indigenous species (NIS) in new locations can degrade environmental, socio-cultural, and economic values. Vessels arriving from international waters are the main pathway for the entry of marine NIS, via exposure due to ballast water discharge (hereafter, ballast discharge) and biofouling. We developed a systematic statistical likelihood-based methodology to investigate port-level marine NIS propagule pressure from ballast discharge and biofouling exposure using a combination of techniques, namely k-Nearest-Neighbour and random forest algorithms. Vessel characteristics and travel patterns were assessed as candidate predictors. For the ballast discharge analysis, the predictors used for model building were vessel type, dead weight tonnage, and the port of first arrival; the predictors used for the biofouling analysis were days since last antifouling paint, mean vessel speed, dead weight tonnage, and hull niche area. Propagule pressure for both pathways was calculated at a voyage, port and annual level, which were used to establish the relative entry score for each port. The model was applied to a case study for New Zealand. Biosecurity New Zealand has commissioned targeted marine surveillance at selected ports since 2002 to enable early detection of newly arrived marine NIS (Marine High-Risk Site Surveillance, MHRSS). The reported methodology was used to compare contemporary entry likelihoods between New Zealand ports. The results suggested that Tauranga now receives the highest volume of discharged ballast water and has the second most biofouling exposure compared to all other New Zealand ports. Auckland was predicted to receive the highest biofouling mass and was ranked tenth for ballast discharge exposure. Lyttelton, Napier, and New Plymouth also had a high relative ranking for these two pathways. The outputs from this study will inform the refinement of the MHRSS programme, facilitating continued early detection and cost-effective management to support New Zealand’s wider marine biosecurity system. More generally, this paper develops an approach for using statistical models to estimate relative likelihoods of entry of marine NIS.

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Romano, Jose G., Hannah Gardener, Eric E. Smith, Iszet Campo-Bustillo, Yosef Khan, Sofie Tai, Nikesha Riley, et al. "Frequency and Prognostic Significance of Clinical Fluctuations Before Hospital Arrival in Stroke." Stroke 53, no. 2 (February 2022): 482–87. http://dx.doi.org/10.1161/strokeaha.121.034124.

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Background and Purpose: Clinical fluctuations in ischemic stroke symptoms are common, but fluctuations before hospital arrival have not been previously characterized. Methods: A standardized qualitative assessment of fluctuations before hospital arrival was obtained in an observational study that enrolled patients with mild ischemic stroke symptoms (National Institutes of Health Stroke Scale [NIHSS] score of 0–5) present on arrival to hospital within 4.5 hours of onset, in a subset of 100 hospitals participating in the Get With The Guidelines–Stroke quality improvement program. The number of fluctuations, direction, and the overall improvement or worsening was recorded based on reports from the patient, family, or paramedics. Baseline NIHSS on arrival and at 72 hours (or discharge if before) and final diagnosis and stroke subtype were collected. Outcomes at 90 days included the modified Rankin Scale, Barthel Index, Stroke Impact Scale 16, and European Quality of Life. Prehospital fluctuations were examined in relation to hospital NIHSS change (admission to 72 hours or discharge) and 90-day outcomes. Results: Among 1588 participants, prehospital fluctuations, consisting of improvement, worsening, or both were observed in 35.5%: 25.1% improved once, 5.3% worsened once, and 5.1% had more than 1 fluctuation. Those who improved were less likely and those who worsened were more likely to receive alteplase. Those who improved before hospital arrival had lower change in the hospital NIHSS than those who did not fluctuate. Better adjusted 90-day outcomes were noted in those with prehospital improvement compared to those without any fluctuations. Conclusions: Fluctuations in neurological symptoms and signs are common in the prehospital setting. Prehospital improvement was associated with better 90-day outcomes, controlling for admission NIHSS and alteplase treatment. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT 02072681.

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Mohamed, Israa, Ibrahim El-Henawy, and Ramadan Zean El-Din. "An early discharge approach for managing hospital capacity." International Journal of Modeling, Simulation, and Scientific Computing 08, no. 01 (January 10, 2017): 1750006. http://dx.doi.org/10.1142/s1793962317500064.

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The Kidney and Oncology Departments at Zagazig University Hospital are suffering from increased demand and limited capacity. Arrival patients who find all beds occupied are simply turned away, i.e., no waiting is allowed. This paper investigates the impact of an early discharge approach that can be applied to patients that have been scheduled to discharge within 5 h. A discrete event simulation (DES) model is built using empirical distributions based on real data. The model has been validated against real data and the results have shown that the proposed early discharge approach can reduce the number of turned away patients by 10% in the Kidney Department, equivalent to 182 patients annually and by 11% in the Oncology Department, equivalent to 150 patients annually.

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Hu, Jinxi, Wenhong Liu, Haotian Zhang, Hang Liu, Keni Xu, and Mianmian Wang. "Arrival Time Difference Estimation of Ultrasonic Signals from Partial Discharge in Electric Power Equipments." Journal of Electrical and Electronic Engineering 7, no. 5 (2019): 113. http://dx.doi.org/10.11648/j.jeee.20190705.13.

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Fang, Fang Clara, and Lily Elefteriadou. "Modeling and simulation of vehicle projection arrival-discharge process in adaptive traffic signal controls." Journal of Advanced Transportation 44, no. 3 (July 2010): 176–92. http://dx.doi.org/10.1002/atr.133.

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Suzuki, Yu-ichi, Masatake Kawada, Zen-ichiro Kawasaki, Kenji Matsu-ura, and Makoto Kawasaki. "Location of Partial Discharge by Superimposed Positioning Optimization on the Time Delay of Arrival." IEEJ Transactions on Power and Energy 118, no. 2 (1998): 157–63. http://dx.doi.org/10.1541/ieejpes1990.118.2_157.

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Lyon, Richard. "Temperature post out-of-hospital cardiac arrest: the TOPCAT study." Emergency Medicine Journal 27, Suppl 1 (September 2010): A6.1—A6. http://dx.doi.org/10.1136/emj.2010.103150.15.

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IntroductionOut-of-hospital cardiac arrest (OHCA) is a significant cause of death and severe neurological disability. The only postreturn of spontaneous circulation (ROSC) therapy shown to increase survival is mild therapeutic hypothermia (MTH). The relationship between body temperature post OHCA and outcome is still poorly defined.MethodsProspective observational study of all OHCA patients admitted to a single centre for a 14-month period. Oesophageal temperature was measured in the Emergency Department and Intensive Care Unit (ICU). Select patients had prehospital temperature monitoring.Results164 OHCA patients were included in the study. 105 (64.0%) were pronounced dead in the Emergency Department. 59 (36.0%) were admitted to ICU for cooling; 40 (24.4%) died in ICU and 19 (11.6%) survived to hospital discharge. Patients who achieved ROSC and had oesophageal temperature measured prehospital (n=29) had a mean prehospital temperature of 33.9°C (95% CI 33.2 to 34.5). All patients arriving in the ED post OHCA had a relatively low oesophageal temperature (34.3°C, 95% CI 34.1 to 34.6). Patients surviving to hospital discharge were warmer on admission to ICU than patients who died in hospital (35.7°C vs 34.3°C, p<0.05). Patients surviving to hospital discharge also took longer to reach target MTH temperature than non-survivors (2 h 48 min vs 1 h 32 min, p<0.05). There was no difference in mean arterial blood pressure on arrival in the ED between survivors and non-survivors.ConclusionsFollowing OHCA all patients have oesophageal temperatures below normal in the prehospital phase and on arrival in the Emergency Department. This questions the need for prehospital cooling post-OHCA patients. Patients who achieve ROSC following OHCA and survive to hospital discharge are warmer on arrival in ICU and take longer to reach target MTH temperatures compared to patients who die in hospital. The mechanisms of action underlying oesophageal temperature and survival from OHCA remain unclear and further research is warranted to clarify this relationship.

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Hatton, Gabrielle E., John A. Harvin, Charles E. Wade, and Lillian S. Kao. "Importance of duration of acute kidney injury after severe trauma: a cohort study." Trauma Surgery & Acute Care Open 6, no. 1 (May 2021): e000689. http://dx.doi.org/10.1136/tsaco-2021-000689.

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BackgroundAcute kidney injury (AKI) is common after severe trauma. AKI incidence and AKI stage have previously been shown to be associated with poor outcomes after trauma. However, AKI duration may also be important for outcomes after trauma, given that it is associated with long-term morbidity and mortality in general intensive care unit (ICU) and hospitalized patients. We hypothesized that duration of AKI is independently associated with poor outcomes after trauma.MethodsA cohort study was conducted at a single, level 1 trauma center. Patients admitted to the ICU between 2009 and 2018 were included. Data were extracted from the trauma registry and electronic medical records. AKI within 7 days from presentation was defined according to the Kidney Disease Improving Global Outcomes guidelines. Multivariable analyses were performed to assess the association between AKI incidence, AKI stage, and AKI duration with outcomes including prolonged ICU and hospital length of stay, discharge to home, and mortality.ResultsOf 7049 patients included, 72% were male, the median age was 41 years (IQR 27–58), and 10% died. The AKI incidence was 45%, with 69% of these patients presenting with AKI on arrival. The majority (73%) of patients who suffered AKI recovered within 2 days. After adjustment in separate models, AKI incidence, AKI stage and AKI duration were each associated with prolonged hospitalization, an unfavorable discharge disposition, and mortality. AKI stage and duration were not used in the same model due to collinearity.ConclusionsPost-traumatic AKI was common on arrival and frequently short lasting. Duration correlated with highest AKI stage, and both were separately associated with prolonged hospitalization, discharge destination other than home, and mortality on adjusted analyses. Given the high incidence of AKI on arrival, stage or duration may be better targets for future interventions and quality improvement initiatives to improve outcomes after post-traumatic AKI.Level of evidenceIII. Prognostic.

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Galal, Omar, Fuad Abbag, Fadel Fadley, Andrew Redington, Peter Szurman, and Saud Oufi. "Transcatheter closure of the patent arterial duct as a day-case procedure." Cardiology in the Young 5, no. 1 (January 1995): 48–50. http://dx.doi.org/10.1017/s1047951100011458.

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AbstractWe have now achieved transcatheter occlusion of the patent arterial duct as a day-case procedure in 26 patients. In all but two, who were judged not to be appropriate for the device, implantation was successful. Most of the patients arrived in the hospital at 8:00 a.m. and had to wait for a mean time of 154 minutes until they were taken for cardiac catheterization. The procedure, performed under sedation in 25 patients and under general anesthesia in two, took a mean of 91 minutes. The children were then monitored for two hours in the recovery room. The interval From the time of arrival in the Unit until waking was a mean of 196 minutes. Then, from the time of waking, a mean of 123 minutes elapsed prior to discharge. Admission of the patient was necessary in three instances (11.1%). Two patients vomited and remained too drowsy for safe discharge. A third patient had either occlusion or thrombosis of the femoral artery and received an infusion of heparin which necessitated admission overnight. All three patients were discharged the following morning. Patients from outside Riyadh stayed overnight in Riyadh before they went home. One patient complained of non-cardiac chest pains a few hours after discharge and was subsequently sent home. Total occlusion, as judged by mean follow-up of 13 months (5–26 months) using color flow Doppler was achieved in 19 of the 24 patients (79!) in whom devices were inserted. All patients are well and there are no complaints concerning the procedure done on a day-case basis. We conclude that the day-case protocol for transcatheter occlusion of the patent arterial duct is a safe and cost-effective option for selected patients.

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Dammerman, Kari J., Molly A. H. Webb, and Kim T. Scribner. "Riverine characteristics and adult demography influence female lake sturgeon (Acipenser fulvescens) spawning behavior, reproductive success, and ovarian quality." Canadian Journal of Fisheries and Aquatic Sciences 76, no. 7 (July 2019): 1147–60. http://dx.doi.org/10.1139/cjfas-2018-0141.

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Abiotic conditions and demographic factors can influence the timing of spawning. Behavioral plasticity allows females to select spawning conditions that are conducive to offspring development; however, reproductive costs associated with delaying spawning are not well understood. In this study, factors influencing timing of female spawning, residence time (RT), and reproductive success (RS) during two seasons were determined, and plasma testosterone concentrations were used to quantify atretic rates in a wild, lake sturgeon (Acipenser fulvescens) population. For the 123 females monitored, RT ranged from 1 to 23 days and was influenced by arrival date, temperature, discharge, and male number, with the latter having the largest influence. RS varied due to arrival date, temperature, discharge, male number, male length, and operational sex ratio. Two females had testosterone levels indicative of atresia and RS estimates lower than yearly means; however, most females had normal ovaries, suggesting little reproductive costs of plasticity in spawning ground residency time. Results demonstrate the multitude of factors influencing female reproductive behavior and RS, highlighting the importance of abiotic and demographic conditions to recruitment in wild populations.

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Bedoya-Sommerkamp, Marcelo, Victor Hugo Chau-Rodríguez, Jesús Medina-Ranilla, Alejandro Escalaya-Advíncula, Ray Ticse-Aguirre, Walter De La Cruz-Ramírez, and Jorge G. Burneo. "Convulsive Status Epilepticus in a Cohort of Patients from a Peruvian Academic Hospital." Journal of Epilepsy Research 11, no. 1 (June 30, 2021): 83–92. http://dx.doi.org/10.14581/jer.21011.

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Background and Purpose: Status epilepticus is a neurologic emergency whose epidemiology, etiology and management are scarcely known in developing countries. Our objective was to describe the demographic and clinical features as well as the management of generalized convulsive status epilepticus (GCSE) in adult patients admitted to the emergency department of an academic hospital in Peru, between March 2019 and March 2020.Methods: Observational study of a prospective cohort in which patients were assessed by the emergency and neurology department on the first day of hospitalization, at discharge and at 30 days post-discharge in a follow-up visit. Relevant demographics and clinical data were collected. After being encoded and sorted, univariate statistical analysis was carried out.Results: Of the sample of 59 patients, 62.7% were males, 57.6% were unemployed, 89.8% did not finish high school, and 55.9% had intermittent GCSE with no seizure at arrival. The total calculated median times were: 60 minutes from GCSE onset to hospital arrival, 110 minutes from GCSE onset to 1st line therapy, and 7 minutes from hospital arrival to 1st line therapy. The most frequently used antiepileptic drugs were one dose of benzodiazepine (41.7%), phenytoin (76.9%), and additional doses of benzodiazepines (60%) for 1st, 2nd, and 3rd line therapies, respectively. The most frequent etiologies were antiepileptic drug suspension (27.1%), undetermined (25.4%) and acute stroke (11.8%). 62.71% had 0-2 modified Rankin score at discharge.Conclusions: In this cohort of patients, GCSE was mainly intermittent. Management times differed from the guidelines’ recommendations.

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Ong, Marcus Eng Hock, Ying Hao, Susan Yap, Pin Pin Pek, Terrance Siang Jin Chua, Faith Suan Peng Ng, and Swee Han Lim. "Validation of the new Vancouver Chest Pain Rule in Asian chest pain patients presenting at the emergency department." CJEM 19, no. 1 (July 27, 2016): 18–25. http://dx.doi.org/10.1017/cem.2016.336.

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AbstractObjectivesThe new Vancouver Chest Pain (VCP) Rule recommends early discharge for chest pain patients who are at low risk of developing acute coronary syndrome (ACS), and thus can be discharged within 2 hours of arrival at the emergency department (ED). This study aimed to assess the performance of the new VCP Rule for Asian patients presenting with chest pain at the ED.MethodsThis prospective cohort study involved patients attended to at the ED of a large urban centre. Patients of at least 25 years old, presenting with stable chest pain and a non-diagnostic ECG, and with no history of active coronary artery disease were included in the study. The main outcome measures were cardiac events, angioplasty, or coronary artery bypass within 30 days of enrolment.ResultsThe study included 1690 patients from 27 August 2000 to 1 May 2002, with 661 patients fulfilling the VCP criteria. Of those for early discharge, 24 had cardiac events and 13 had angioplasty or bypass at 30 days, compared to 91 and 41, respectively, for those unsuitable for discharge. This gave the rule a sensitivity of 78.1% for cardiac events, including angioplasty and bypass. Specificity was 41.0%, and negative predictive value (NPV) was 94.4%.ConclusionWe found the new VCP Rule to have moderate sensitivity and poor specificity for adverse cardiac events in our population. With an NPV of less than 100%, this means that a small proportion of patients sent home with early discharge would still have adverse cardiac events.

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Pulkkinen, Henni, Panu Orell, Jaakko Erkinaro, and Samu Mäntyniemi. "Bayesian arrival model for Atlantic salmon smolt counts powered by environmental covariates and expert knowledge." Canadian Journal of Fisheries and Aquatic Sciences 77, no. 3 (March 2020): 462–74. http://dx.doi.org/10.1139/cjfas-2018-0352.

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Annual run size and timing of Atlantic salmon (Salmo salar) smolt migration was estimated using Bayesian model framework and data from 6 years of a video monitoring survey. The model has a modular structure. It separates subprocesses of departing, traveling, and observing, of which the first two together define the arrival distribution. The subprocesses utilize biological background and expert knowledge about the migratory behavior of smolts and about the probability to observe them from the video footage under varying environmental conditions. Daily mean temperature and discharge were used as environmental covariates. The model framework does not require assuming a simple distributional shape for the arrival dynamics and thus also allows for multimodal arrival distributions. Results indicate that 20%–43% of smolts passed the Utsjoki monitoring site unobserved during the years of study. Predictive studies were made to estimate daily run size in cases with missing counts either at the beginning or in the middle of the run, indicating good predictive performance.

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Zhu, Ming-Xiao, Yan-Bo Wang, Ding-Ge Chang, Guan-Jun Zhang, Xin Tong, and Ling Ruan. "Quantitative comparison of partial discharge localization algorithms using time difference of arrival measurement in substation." International Journal of Electrical Power & Energy Systems 104 (January 2019): 10–20. http://dx.doi.org/10.1016/j.ijepes.2018.06.036.

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Tantisattayakul, Thanapol, Katsumi Masugata, Iwao Kitamura, and Ken Kontani. "Broadband VHF sources locating system using arrival-time differences for mapping of lightning discharge process." Journal of Atmospheric and Solar-Terrestrial Physics 67, no. 11 (July 2005): 1031–39. http://dx.doi.org/10.1016/j.jastp.2005.04.002.

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Halfi, Eran, Vishal Deshpande, Joel P. L. Johnson, David Katoshevski, Ian Reid, Yael Storz-Peretz, and Jonathan B. Laronne. "Characterization of bedload discharge in bores and very unsteady flows in an ephemeral channel." E3S Web of Conferences 40 (2018): 02036. http://dx.doi.org/10.1051/e3sconf/20184002036.

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Bedload flux under steady flow conditions is calculated by a multitude of available methods and equations. Yet, very little is known about the effect of very unsteady flows, such as flash floods and specifically bores, on bedload flux. The unpredictable nature of the floods together with many logistic difficulties and safety issues in monitoring explain this gap in knowledge. Global climate change may increase flood event occurrence, making their understanding even more crucial. The methodology of our study is based on automatically monitoring bedload flux (Reid slot samplers). Automation allowed high frequency monitoring of hydraulic parameters and bedload flux. Added novelty includes pipe and plate microphones for capturing acoustic signals of bedload sediments and 3-D velocimetry for characterizing turbulence. Alerting sensors and cellular data transmission enabled onsite presence upon bore arrival. Calibration between the acoustic indirect sensors and the direct slot samplers allows determination of bedload flux at a frequency of 1 Hz. Analyses of flood events indicate an increase in turbulent kinetic energy, instantaneous vertical velocities, shear stress and bedload flux during the rising limb within the first two minutes after bore arrival. This has implications for the likely destabilization of the channel bed and for bedload transport after passage of the bore and during subsequent, less unsteady flows.

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Gan, Bin-Rui, Xing-Guo Yang, Hai-Mei Liao, and Jia-Wen Zhou. "Flood Routing Process and High Dam Interception of Natural Discharge from the 2018 Baige Landslide-Dammed Lake." Water 12, no. 2 (February 23, 2020): 605. http://dx.doi.org/10.3390/w12020605.

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The outburst flood of the Baige landslide dam caused tremendous damage to infrastructure, unfinished hydraulic buildings, roads, and bridges that were built or under construction along the Jinsha River. Can downstream hydraulic buildings, such as high dams with flood control and discharge function, accommodate outburst floods or generate more serious losses due to wave overtopping? In this study, the unsteady flow of a one-dimensional hydraulic calculation was used to simulate natural flood discharge. Assuming a high dam (Yebatan arch dam) is constructed downstream, the flood processes were carried out in two forms of high dam interception (complete interception, comprehensive flood control of blocking and draining). Moreover, three-dimensional visualization of the inundation area was performed. Simulation results indicate that the Yebatan Hydropower Station can completely eliminate the outburst flood risk even under the most dangerous situations. This station can reduce the flood peak and delay the peak flood arrival time. Specifically, the flood peak decreased more obviously when it was closer to the upstream area, and the flood peak arrival time was more delayed when the flood spread further downstream. In addition, the downstream water depth was reduced by approximately 10 m, and the inundation area was reduced to half of the natural discharge. This phenomenon shows that hydraulic buildings such as high dams can reduce the inundation area of downstream farmlands and extend the evacuation time for downstream residents during the flood process, thus reducing the loss of life and property.

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Foster, D. S., C. Paterson, and G. Fairfield. "Evaluation of Immediate Discharge Documents — Room for Improvement?" Scottish Medical Journal 47, no. 4 (August 2002): 77–79. http://dx.doi.org/10.1177/003693300204700402.

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Background: The Immediate Discharge Document is a tool used to communicate patient discharge information between hospitals and general practitioners. The standard of information provided may be variable, and sometimes delayed in arriving at the GP practice. Typed communication from the hospital can also be slow. This can result in difficulty managing patients in the community following their discharge. Our aim was to assess the quantity of information provided on Immediate Discharge Documents, and to assess the time scale taken for GPs to receive written communications from hospitals regarding patient discharges. An audit was initiated using a tool devised from Scottish Intercollegiate Guidelines Network Publication no 5 and involving four general practices within City of Perth, Scotland. Data was collected over a 28-day period in June/July 2001, by examining Immediate Discharge Documents relevant to each practice population received during this period, and by noting the time of arrival of a final typed summary. Data was analysed by Tayside Audit Resource for Primary Care. A total of 244 Documents were audited. Most significant results include basic administrative detail lacking in up to 30%. Of total documents, 13% failed to record a main condition or diagnosis; 93% recorded drug information, but only in 28% were follow up plans clear; 60% were received within five days of discharge, whilst final typed summaries were received from the hospitals within four weeks only in 51%. Conclusion: These results show there to be room for improvement with regard communication of patient discharge information, in regard to both the content of information provided and the time it takes to arrive. We require to raise awareness of this problem amongst hospital colleagues involving clinical governance and audit staff, with the objective to improve the quality and timescale of information transfer. Where this piece fits It is known that effective information transfer between health professionals is vital to optimise patient care. This work gives further impetus to improve the current standard of communication, and confirms a significant time delay that it takes information to reach GPs from the hospital setting.

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Charles, Ra, F. Lateef, and V. Anantharaman. "Strengthening Links in the “Chain of Survival”: A Singapore Perspective." Hong Kong Journal of Emergency Medicine 9, no. 3 (July 2002): 121–25. http://dx.doi.org/10.1177/102490790200900301.

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Introduction The concept of the chain of survival is widely accepted. The four links viz. early access, early cardiopulmonary resuscitation (CPR), early defibrillation and early Advanced Cardiac Life Support (ACLS) are related to survival after pre-hospital cardiac arrest. Owing to the dismal survival-to-discharge figures locally, we conducted this study to identify any weaknesses in the chain, looking in particular at bystander CPR rates and times to Basic Cardiac Life Support (BCLS) and ACLS. Methods and materials A retrospective cohort study was conducted in the Emergency Department of an urban tertiary 1500-bed hospital. Over a 12-month period, all cases of non-trauma out-of-hospital cardiac arrest were evaluated. Results A total of 142 cases of non-trauma out-of-hospital cardiac arrest were identified; the majority being Chinese (103/142, 72.5%) and male (71.8%) with a mean age of 64.3±7.8 years (range 23–89 yrs). Most patients (111/142, 78.2%) did not receive any form of life support until arrival of the ambulance crew. Mean time from collapse to arrival of the ambulance crew and initiation of BCLS and defibrillation was 9.2±3.5 minutes. Mean time from collapse to arrival in the Emergency Department (and thus ACLS) was 16.8±7.1 minutes. Three patients (2.11%) survived to discharge. Conclusion There is a need to (i) facilitate layperson training in bystander CPR, and (ii) enhance paramedic training to include ACLS, in order to improve the current dismal survival outcomes from out-of-hospital cardiac arrest in Singapore.

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Wang, Zhanzhong, Liying Zhao, Ningbo Cao, Yue Lu, and Mingtao Chen. "A Modified Total Crossing Time Model of Bidirectional Pedestrians at Signalized Crosswalks." Discrete Dynamics in Nature and Society 2017 (2017): 1–12. http://dx.doi.org/10.1155/2017/2190724.

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Since crosswalk width and pedestrian green time directly affect the safety of signalized crosswalks, modeling an exact total crossing time model to estimate those two variables is imperative. The total crossing time needed by a group of pedestrians to cross a signalized crosswalk contains the discharge time and the crossing time. The discharge time depends primarily on the maximum queue length, which is determined by pedestrian arrival rate, red interval, waiting position distribution, and the crosswalk width. Crossing time increases when interactions between bidirectional pedestrian flows become more serious. Thus, quantifying the impacts of the start-up process on the discharge time and the effects of the interactions on the crossing time is a prerequisite for optimizing the design of signalized crosswalks. This paper establishes a modified total crossing time model consisting of modified pedestrian discharge and crossing time. Discharge time is modeled by applying traffic wave theory, and crossing time is modeled based on drag force theory. The proposed models provide guidance for the design of crosswalk width and pedestrian green intervals.

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Shaker, Yomna Omran. "Detection of partial discharge acoustic emission in power transformer." International Journal of Electrical and Computer Engineering (IJECE) 9, no. 6 (December 1, 2019): 4573. http://dx.doi.org/10.11591/ijece.v9i6.pp4573-4579.

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<span>Partial discharge is one the most important factor that leads to deteroration and failure of the power transformer transformer. Acoustic emission detection is effective method to evaluate the health index of the power transformer. Using acoustic emission (AE) sensors for partial discharge (PD) measurement is considered as one of the most promising techniques to detect and localize PD activities inside the transformer tank. On the other hand, AE waves suffer from high attenuation and reflections while traveling from the PD source to the AE sensor. The modeling of the AE wave can help to understand the behavior of the AE PD signal during its travel. In this paper, the AE PD signal is assumed to be composed of different frequencies. This work aims to investigate the influence of the frequency value on the attenuation and arrival time of the acoustic wave.</span>

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Carlton, Edward Watts, Jenny Ingram, Hazel Taylor, Joel Glynn, Rebecca Kandiyali, Sarah Campbell, Lucy Beasant, et al. "Limit of detection of troponin discharge strategy versus usual care: randomised controlled trial." Heart 106, no. 20 (May 5, 2020): 1586–94. http://dx.doi.org/10.1136/heartjnl-2020-316692.

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IntroductionThe clinical effectiveness of a ‘rule-out’ acute coronary syndrome (ACS) strategy for emergency department patients with chest pain, incorporating a single undetectable high-sensitivity cardiac troponin (hs-cTn) taken at presentation, together with a non-ischaemic ECG, remains unknown.MethodsA randomised controlled trial, across eight hospitals in the UK, aimed to establish the clinical effectiveness of an undetectable hs-cTn and ECG (limit of detection and ECG discharge (LoDED)) discharge strategy. Eligible adult patients presented with chest pain; the treating clinician intended to perform investigations to rule out an ACS; the initial ECG was non-ischaemic; and peak symptoms occurred <6 hours previously. Participants were randomised 1:1 to either the LoDED strategy or the usual rule-out strategy. The primary outcome was discharge from the hospital within 4 hours of arrival, without a major adverse cardiac event (MACE) within 30 days.ResultsBetween June 2018 and March 2019, 632 patients were randomised; 3 were later withdrawn. Of 629 patients (age 53.8 (SD 16.1) years, 41% women), 7% had a MACE within 30 days. For the LoDED strategy, 141 of 309 (46%) patients were discharged within 4 hours, without MACE within 30 days, and for usual care, 114 of 311 (37%); pooled adjusted OR 1.58 (95% CI 0.84 to 2.98). No patient with an initial undetectable hs-cTn had a MACE within 30 days.ConclusionThe LoDED strategy facilitates safe early discharge in >40% of patients with chest pain. Clinical effectiveness is variable when compared with existing rule-out strategies and influenced by wider system factors.Trial registration numberISRCTN86184521.

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Khan, Umar F., Pavlos I. Lazaridis, Hamd Mohamed, Ricardo Albarracín, Zaharias D. Zaharis, Robert C. Atkinson, Christos Tachtatzis, and Ian A. Glover. "An Efficient Algorithm for Partial Discharge Localization in High-Voltage Systems Using Received Signal Strength." Sensors 18, no. 11 (November 16, 2018): 4000. http://dx.doi.org/10.3390/s18114000.

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The term partial discharge (PD) refers to a partial bridging of insulating material between electrodes that sustain an electric field in high-voltage (HV) systems. Long-term PD activity can lead to catastrophic failures of HV systems resulting in economic, energy and even human life losses. Such failures and losses can be avoided by continuously monitoring PD activity. Existing techniques used for PD localization including time of arrival (TOA) and time difference of arrival (TDOA), are complicated and expensive because they require time synchronization. In this paper, a novel received signal strength (RSS) based localization algorithm is proposed. The reason that RSS is favoured in this research is that it does not require clock synchronization and it only requires the energy of the received signal rather than the PD pulse itself. A comparison was made between RSS based algorithms including a proposed algorithm, the ratio and search and the least squares algorithm to locate a PD source for nine different positions. The performance of the algorithms was evaluated by using two field scenarios based on seven and eight receiving nodes, respectively. The mean localization error calculated for two-field-trial scenarios show, respectively, 1.80 m and 1.76 m for the proposed algorithm for all nine positions, which is the lowest of the three algorithms.

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Wang, Qiying, Arina Udom, Yanxin Wang, Paulina Kusnierz-Was, Megan Castro, Matthew Butler, and Sotirios Posporelis. "#3106 Limb weakness in the emergency department: a focus on unexplained aetiology presentations." Journal of Neurology, Neurosurgery & Psychiatry 92, no. 8 (July 16, 2021): A16.2—A17. http://dx.doi.org/10.1136/jnnp-2021-bnpa.37.

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BackgroundFunctional neurological disorder (FND) is a common and potentially disabling neuropsychiatric condition. While its presentation can be extremely diverse, from aphonia to seizure activity, one of the most common symptoms is weakness of one or more limbs. Despite functional weakness being one of the most common presentations seen in neurological practice, little is known about its prevalence in an Emergency Department (ED) setting. Hereby, we aim to describe the demographic and clinical characteristics of patients attending the ED with limb weakness of an unknown and potentially functional aetiology.MethodsWe carried out a retrospective electronic records review of all ED attendances with limb weakness as the presenting complaint, at Kings College Hospital. Patients admitted to the hospital were followed up until the point of discharge. The following clinical and demographic data were analyzed: age, gender, mode of arrival, psychiatric history and clinical diagnosis on discharge. Results: During the 15-month study period, 1340 patients presented with leg weakness at the ED, nearly half of these (47.54%) arrived by ambulance. 4.55% had unexplained weakness with no definite diagnosis on discharge. A significant proportion (62.31%) were admitted for further investigations; 6.35% of these were diagnosed with FND, while a further 25 patients (2.99%) were discharged with suspected FND. Patients with an FND diagnosis had a median age of 45 years; 62.96% were females, and they were significantly younger than male patients with FND (P=0.003). Less than half (44%) of the FND patients had one or more psychiatric diagnoses.DiscussionA diagnosis of functional leg weakness was given to 3.95% (53/1340) of patients presenting with leg weakness in the ED. It is striking that none of these patients were given a diagnosis of FND in the ED, but only after admission to a ward. 6.4% (86/1340) were discharged from the hospital with an unclear diagnosis, 14% of which a functional overlay was suspected. Main limitations of the study: it is retrospective and single-centre.ConclusionThis study highlights difficulties and obstacles in recognising and diagnosing functional presentations of limb weakness in the ED. There is a clear need for optimisation of the classification and coding system of the Emergency Department. Increased awareness and education around FND has the potential to raise diagnostic confidence and significantly improve patient experience and care.

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IBRAHIM, NUR. "Pendeteksian Lokasi Sumber Noise (Partial Discharge) secara Tiga Dimensi menggunakan Antenna Array." ELKOMIKA: Jurnal Teknik Energi Elektrik, Teknik Telekomunikasi, & Teknik Elektronika 3, no. 2 (July 1, 2015): 106. http://dx.doi.org/10.26760/elkomika.v3i2.106.

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ABSTRAKPada penelitian ini akan dilakukan simulasi teknik pendeteksian lokasi sumber noise berupa partial discharge (PD) pada peralatan tegangan tinggi, dengan menggunakan susunan antena yang terdiri dari empat buah antena monopole sebagai sensor untuk mendeteksi gelombang elektromagnetik (EM) yang dipancarkan dari partial discharge (PD). Algoritma yang digunakan mengacu kepada time difference of arrival (TDOA) dari sinyal yang diterima antar antena (dengan menjadikan salah satu antena sebagai antena referensi). Metode yang digunakan untuk menentukan TDOA adalah metode Akaike Information Criterion, metode Energy Criterion, metode Gabor Centroid, metode threshold detection, metode peak detection, dan metode cross-correlation. Sistem pendeteksian lokasi sumber noise ini menggunakan konfigurasi susunan antena membentuk Y. Jarak antar antena diatur sejauh 2 meter dan 4 meter. Berdasarkan hasil pengamatan dan analisis, konfigurasi susunan antena membentuk Y memiliki tingkat akurasi 97.67%. Metode yang paling akurat untuk menentukan TDOA adalah metode cross-correlation.Kata kunci: PD, TDOA, susunan antena.ABSTRACTThis paper presents a simulation of locating noise source (Partial Discharge) on high-voltage apparatuses, by using antenna array that consisted of four monopole antennas as sensor to record the electromagnetic waves (EM) emitted from Partial Discharge (PD). The detection algorithm is based on the time difference of arrival (TDOA) of the signals received between antennas (by using one of four antennas as reference antenna). The methods to determine TDOAs are Akaike Information Criterion method, Energy Criterion method, Gabor Centroid method, threshold detection method, peak detection method, and/or cross-correlation method. These system use Y-shaped array configuration. The adjusted distance between antennas are 2 meter and 4 meter. From the observation and analysis results, Y-shaped array antenna configuration has accuracy 97.76%. The best method to get TDOA is the cross-correlation method.Keywords: PD, TDOA, antenna array.

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Davis, M., A. Schappert, B. Chau, A. Leung, and K. Van Aarsen. "P043: Outcomes associated with prehospital refractory ventricular fibrillation." CJEM 19, S1 (May 2017): S92. http://dx.doi.org/10.1017/cem.2017.245.

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Introduction: When ventricular fibrillation (VF) cannot be terminated with conventional external defibrillation, it is classified as refractory VF (RVF). There is a paucity of information regarding prehospital or patient factors that may be associated with RVF. The objectives of this study were to determine factors that may be associated with RVF, the initial ED rhythm for patients with prehospital RVF, and the incidence of survival in patients who had RVF and were transported to hospital. Methods: Ambulance Call Records (ACRs) of patients with out of hospital cardiac arrest between Mar. 1 2012 and Apr. 1 2016 were reviewed. Cases of RVF (≥5 consecutive shocks delivered) were determined by manual review of the ACR. ED and hospital records were analyzed to determine outcomes of patients who were in RVF and transported to hospital. Descriptive statistics were calculated and all variables were tested for an association with initial ED rhythm, survival to admission, and survival to discharge. Results: Eighty-five cases of RVF were identified. A history of coronary artery disease (47.10%) and hypertension (50.60%) were the most common comorbidities in patients transported to the ED with RVF. Upon arrival to the ED, 24 (28.2%) remained in RVF, 38 (44.7%) had a non-shockable rhythm, and 23 (27.1%) had return of spontaneous circulation. Thirty-four (40%) survived to admission, while only 18 (21.2%) survived to discharge. Pre-existing comorbidities, time to first shock, time on scene, and transport time were not statistically associated with initial ED rhythm, survival to admission or discharge. Patient age was statistically associated with improved rhythm on ED arrival (p=0.013) and survival to discharge (58.24 yrs vs 67.40 yrs, Δ9.17, 95% CI 1.82 to 16.52, p=0.015). Conclusion: The majority of patients with prehospital RVF have a rhythm deterioration by the time care is transferred to the ED. Of these patients with a rhythm deterioration, few survive to hospital discharge. Younger patients are more likely to remain in RVF and survive to discharge. Further research is required to determine prehospital treatment strategies for RVF, as well as patient populations that may benefit from those treatments.

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Jakobsen, R., K. Høgh Jensen, and K. L. Brettmann. "Tracer Test in Fractured Chalk." Hydrology Research 24, no. 4 (August 1, 1993): 263–74. http://dx.doi.org/10.2166/nh.1993.0007.

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A two-well tracer test was conducted in eastern Denmark, in which a short duration pulse of lithium chloride was injected into a recharge well and made to flow through a fractured chalk aquifer to a discharge well. The wells were 25 m apart, and the concentration of lithium arriving at the discharge well was monitored at five vertical intervals in the well for a 21-day period. The observed breakthrough curves show a sharp breakthrough front, with an arrival time that is consistent with advective transport through the fractures in the chalk. The breakthrough curves also exhibit a long tail in the falling limb, suggesting the influence of a secondary transport mechanism of diffusion into the porous matrix.

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Cody, Patrick, Sean Lauderdale, David E. Hogan, and Robert R. Frantz. "Comparison of Two Protocols for Pulseless Cardiopulmonary Arrest: Vasopressin Combined with Epinephrine Versus Epinephrine Alone." Prehospital and Disaster Medicine 25, no. 5 (October 2010): 420–23. http://dx.doi.org/10.1017/s1049023x00008499.

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AbstractIntroduction:Survival from pulseless cardiac arrest typically is dismal. Some suggest that adding vasopressin to epinephrine as a cardiovascular stimulant can improve outcomes.Problem:This study compares survival outcomes using epinephrine verses vasopressin and epinephrine in persons with pulseless cardiac arrest.Methods:This is a retrospective, cohort evaluation of two resuscitative protocols (P1-epinephrine or P2-vasopressin with epinephrine) in a tiered response, community emergency medical service (EMS) with an approximately 100,000 catchment area. Cases are defined as 18 years or older determined to be in pulseless cardiac arrest. Outcomes were survival to emergency department arrival, to 24 hours, and to hospital discharge. Data were entered into Microsoft Office Excel® and processed using Analyze-it® for continuous and categorical data and Epi-Info® for odds ratios with confidence intervals.Results:There were 204 cases (60.3% males and 39.7% females) who met the inclusion criteria. Thirteen cases received electrical therapy only, and were dropped from analysis, leaving 191 (93.6%) who were included in the study; P1 to 85 (44.5%) and P2 to 106 (55.5%). Younger age was associated with improved survival to discharge home in both protocols, p = 0.003 (95% CI = 0.004–0.010). No difference in survival was noted at the levels of emergency department arrival OR 1.42 (95% CI = 0.73, 2.76) p = 0.26; 24 hour survival OR 0.54 (95% CI = 0.22–1.30) p = 0.133, or discharge home OR = 1.81 (95% CI = 0.49–6.88) p = 0.319.Conclusions:This study in a community EMS did not demonstrate improved survival with the addition of vasopressin to epinephrine for pulseless cardiac arrest.

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Wagenaars, P., P. A. A. F. Wouters, P. C. J. M. Van Der Wielen, and E. F. Steennis. "Accurate estimation of the time-of-arrival of partial discharge pulses in cable systems in service." IEEE Transactions on Dielectrics and Electrical Insulation 15, no. 4 (August 2008): 1190–99. http://dx.doi.org/10.1109/tdei.2008.4591242.

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Zhou, Nan, Lingen Luo, Gehao Sheng, and Xiuchen Jiang. "Direction of arrival estimation method for multiple UHF partial discharge sources based on virtual array extension." IEEE Transactions on Dielectrics and Electrical Insulation 25, no. 4 (August 2018): 1526–34. http://dx.doi.org/10.1109/tdei.2018.007093.

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Hu, Jinxi, Wenhong Liu, Haotian Zhang, and Zhonghua Liu. "Estimation of arrival time difference of partial discharge ultrasonic signals based on nonlinear transformation and covariant." Journal of Physics: Conference Series 1684 (November 2020): 012121. http://dx.doi.org/10.1088/1742-6596/1684/1/012121.

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Gülnihar, Kaan, Serap Cekli, Cengiz Polat Uzunoğlu, and Mukden Uğur. "Location estimation of partial discharge-based electromagnetic source using multilateration with time difference of arrival method." Electrical Engineering 100, no. 2 (May 13, 2017): 839–47. http://dx.doi.org/10.1007/s00202-017-0556-9.

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Shpadi, Yuriy Reingoldovich, Alexandr Sergeevich Inchin, Anatoliy Yurievich Lozbin, Galymzhan Ayazbayev, Maxim Yurievich Shpadi, and Ludmila Ismailovna Mailibayeva. "About Resolvability of the Problem of Lightning Coordinates Finding by the Time of Lightning Discharge Arrival." Journal of Geoscience and Environment Protection 09, no. 03 (2021): 209–21. http://dx.doi.org/10.4236/gep.2021.93013.

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Greenberg, Robert S., Lynne G. Maxwell, Marianna Zahurak, and Myron Yaster. "Preanesthetic Medication of Children with Midazolam Using the Biojector Jet Injector." Anesthesiology 83, no. 2 (August 1, 1995): 264–69. http://dx.doi.org/10.1097/00000542-199508000-00005.

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Abstract:

Background A rapid, dependable, and economical technique to atraumatically sedate children before anesthesia that does not prolong postanesthesia care unit time remains elusive. The Biojector jet injection system uses carbon dioxide rather than a needle to deliver an intramuscular injection. The dose-response relationship when midazolam is administered was studied using this jet injector. Methods Forty children (2.3 +/- 1.3 yr old) undergoing elective myringotomy and tube placement were randomly assigned to receive 0.05, 0.1, 0.15, 0.2, or 0.3 mg.kg-1 midazolam injected intramuscularly using the Biojector disposable syringe (0.006-inch orifice). Assessment of each child before, during, and 10 min after injection, on application of the anesthesia face mask, and every 15 min for 1 h after arrival to the postanesthesia care unit was made by an observer blinded to drug dosage. Results Face mask tolerance using doses > or = 0.1 mg.kg-1 midazolam was acceptable and statistically different from 0.05 mg/kg. Crying on injection tended to increase with increasing dose. All children were awake and arousable, meeting discharge criteria, after 30 min from arrival in the postanesthesia care unit. Conclusions Midazolam (0.1-0.15 mg.kg-1) administered using jet injection effectively and rapidly produces sedation, in a manner acceptable to parents, without delaying postanesthesia care unit discharge.

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Journal articles on the topic 'Arrival discharge'

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