system delay
Recently Published Documents

Nowadays, with the rapid development of intelligent technology, it is urgent to effectively prevent infectious diseases and ensure people's privacy. The present work constructs the intelligent prevention system of infectious diseases based on edge computing by using the edge computing algorithm, and further deploys and optimizes the privacy information security defense strategy of users in the system, controls the cost, constructs the optimal conditions of the system security defense, and finally analyzes the performance of the model. The results show that the system delay decreases with the increase of power in the downlink. In the analysis of the security performance of personal privacy information, it is found that six different nodes can maintain the optimal strategy when the cost is minimized in the finite time domain and infinite time domain. In comparison with other classical algorithms in the communication field, when the intelligent prevention system of infectious diseases constructed adopts the best defense strategy, it can effectively reduce the consumption of computing resources of edge network equipment, and the prediction accuracy is obviously better than that of other algorithms, reaching 83%. Hence, the results demonstrate that the model constructed can ensure the safety performance and forecast accuracy, and achieve the best defense strategy at low cost, which provides experimental reference for the prevention and detection of infectious diseases in the later period.

Managing interference in the multi-radio networks is critical challenge; problem becomes even more serious in 2.4 GHz band due to minimal availability of orthogonal channels. This work attempts to propose a channel assignment scheme for interference zones of 2.4 GHz backhaul of Wireless Mesh Networks (WMN). The static nodes of Infrastructure based Backhaul employing directional antennas to connect static nodes, orthogonal channel zones introducing Interference are formatted with the selection of single tire direct hop and two tier directional hopes. The effort maintain the orthogonality of channels on system thus reduce the co-channel interference between inter flow and intra flow links. Group of non-overlapping channels of selected band are obtained by a mathematical procedure, interference is modeled by directed graph and Channel assignment is carried out with the help of greedy algorithms. Experimental analysis of the technical proposal is done by simulation through OPNET 14. Our framework can act as an imperative way to enhance the network performance resulting a leading improvement in system throughput and reduction in system delay

Background Understanding health delivery service from a patient´s perspective, including factors influencing healthcare seeking behaviour, is crucial when treating diseases, particularly infectious ones, like tuberculosis. This study aims to trace and contextualise the trajectories patients pursued towards diagnosis and treatment, while discussing key factors associated with treatment delays. Tuberculosis patients’ pathways may serve as indicator of the difficulties the more vulnerable sections of society experience in obtaining adequate care. Methods We conducted 27 semi-structured interviews with tuberculosis patients attending a treatment centre in a suburban area of Lisbon. We invited nationals and migrant patients in active treatment to participate by sharing their illness experiences since the onset of symptoms until the present. The Health Belief Model was used as a reference framework to consolidate the qualitative findings. Results By inductive analysis of all interviews, we categorised participants’ healthcare seeking behaviour into 4 main types, related to the time participants took to actively search for healthcare (patient delay) and time the health system spent to diagnose and initiate treatment (health system delay). Each type of healthcare seeking behaviour identified (inhibited, timely, prolonged, and absent) expressed a mindset influencing the way participants sought healthcare. The emergency room was the main entry point where diagnostic care cascade was initiated. Primary Health Care was underused by participants. Conclusions The findings support that healthcare seeking behaviour is not homogeneous and influences diagnostic delays. If diagnostic delays are to be reduced, the identification of behavioural patterns should be considered when designing measures to improve health services’ delivery. Healthcare professionals should be sensitised and perform continuous capacity development training to deal with patients´ needs. Inhibited and prolonged healthcare seeking behaviour contributes significantly to diagnostic delays. These behaviours should be detected and reverted. Timely responses, from patients and the healthcare system, should be promoted.

Wendelstein 7-X (W7-X) is the leading experiment on the path of demonstrating that stellarators are a feasible concept for a future power plant. One of its major goals is to prove quasi-steady-state operation in a reactor-relevant parameter regime. The surveillance and protection of the water-cooled plasma-facing components (PFCs) against overheating is fundamental to guarantee a safe steady-state high-heat-flux operation. The system has to detect thermal events in real-time and timely interrupt operation if it detects a critical event. The fast reaction times required to prevent damage to the device make it imperative to automate fully the image analysis algorithms. During the past operational phases, W7-X was equipped with inertially cooled test divertor units and the system still required manual supervision. With the experience gained, we have designed a new real-time PFC protection system based on image processing techniques. It uses a precise registration of the entire field of view against the CAD model to determine the temperature limits and thermal properties of the different PFCs. Instead of reacting when the temperature limits are breached in certain regions of interest, the system predicts when an overload will occur based on a heat flux estimation, triggering the interlock system in advance to compensate for the system delay. To conclude, we present our research roadmap towards a feedback control system of thermal loads to prevent unnecessary plasma interruptions in long high-performance plasmas.

Introduction: China continues to rank among one of the countries with the highest number of tuberculosis (TB) cases globally. Migrants are a particularly at-risk subgroup for TB and pose a challenge for case management in contemporary China. The early diagnosis and treatment of patients with TB are pivotal for effective TB control. This study investigates the delay in the TB diagnosis of migrants as compared with residents, to provide an evidence base for improved case detection and the better management of migrant patients with TB.Materials and Methods: The data was collected from the Tuberculosis Information Management System (TBIMS) (2015–2019) in an eastern county of China. The total diagnostic delay, consisting of patient delay and health system delay, is defined as the interval between the onset of TB symptoms and the confirmation of TB diagnosis in the designated TB hospital. The comparison of the delay in the TB diagnosis between migrants and residents was conducted using a Mann-Whitney U-test and chi-square test. The difference in the delay curves between these two groups was examined using a log-rank test.Results: Of 2,487 patients with TB, 539 (22%) were migrants. The migrants tended to be younger, presented with less severe conditions, received an initial diagnosis at prefectural and above-level hospitals. Compared with the local patients with TB, the migrant patients with TB had a longer median total diagnostic delay (30 vs. 9, P = 0.000) and a higher proportion of patients with this delay >28 days (52 vs. 13%, P = 0.000). Similarly, the migrant patients with TB also had a longer median patient delay (13 vs. 9, P = 0.000) and a higher proportion of patients with this delay >14 days (47 vs. 30%, P = 0.000), longer median health system delay (9 vs. 0, P = 0.000), and a higher proportion of patients with this delay >14 days (42 vs. 0.5%, P = 0.000) than the local patients with TB. The survival curves of delay showed that the longer the time interval was, the more likely the migrant patients with TB were to be diagnosed (P < 0.05).Conclusions: Diagnosis is significantly delayed among migrant patients with TB. Our study highlights the importance of early screening and diagnosis for TB especially among migrants, to improve access and ensure better management for all patients with TB.

Introduction: Patients with out-of-hospital cardiac arrest (OHCA) are increasingly transported to tertiary cardiac arrest centers, when the arrest is presumed to be of cardiac origin. For some patients, centralization has led to longer transport distances to advanced care resulting in prolonged prehospital system delays, which may affect outcome. Hypothesis: Longer transport distance to center for patients with OHCA reduces 30-day survival. Methods: Central Denmark Region covers rural and urban areas of 13 000 square kilometers and has a population of approximately 1.3 million inhabitants. Aarhus University Hospital functions as the tertiary cardiac care hospital with access to 24/7 cardiac catherization service and extracorporeal cardiopulmonary resuscitation. Distance to center varies greatly among citizens in the region; with longest distance exceeding 170 km. This observational retrospective study included all patients with OHCA referred to Aarhus University Hospital from 2015 to 2018. Kaplan-Meier curves were conducted to evaluate association between distance and mortality. The odds of 30-day mortality were generated using logistic regression. Results: A total of 807 patients with OHCA were referred to center. Distance to center was < 25km (22%), 25 to 50km (40%), 50 to 100km (20%) and > 100km (18%), respectively. The median prehospital system delay from collapse to arrival at center was 70 minutes [IQR, 55-90 minutes]. Logistic regression did not demonstrate an association between 30-day mortality and increasing distance to center (distance < 25 km as reference, 25 to 50km: OR 0.83, 95% CI [0.58-1.20], 50 to 100km: OR 0.96, 95% CI [0.62-1.47] and >100km: OR 1.20, 95% CI [0.77-1.88]). Conclusions: In OHCA patients with long transport distances to a tertiary cardiac center, survival was similar in patients with short distance to center. Centralization of post cardiac care is feasible in the setting of long transport distances.

Abstract Objective Coronavirus disease 2019 (COVID-19) pandemic may have indirect consequences in ST-segment elevation myocardial infarction (STEMI) outcomes due to difficulties in healthcare access, but also due to reperfusion delays. The objective of this study was to evaluate the performance indicators in STEMI during the early phase of the lockdown following the COVID-19 pandemic. Methods The “patient delay” and the “system delay” were evaluated in 312 patients with suspected STEMI, in the period of the first State of Emergency in Portugal, through a survey called “Moment COVID” implemented within 18th March to 2 May 2020, in 18 national centers of Interventional Cardiology where PPCI is carried out 24/7. These patients were compared with a historical cohort of 267 patients from the 5th year after integration of SFL Initiative in Portugal (Moment 2015) in which the same survey was applied. Patients with late presentation of STEMI (&gt;12 hours of symptoms onset) were excluded from this analysis. Results In “Moment COVID” there was a trend towards a longer “patient delay” (incremental median 20 min; p=0.059) and a significant longer system-delay (incremental median 17 min; p=0.033) compared to the historical cohort of “Moment 2015”. Consequently, times to revascularization tended to be longer (incremental median 26 min; p=0.074). Indeed, in “Moment COVID” patients were less compliant with the times recommended by the European guidelines: door-to-balloon time &lt;60 min was achieved in 47.6% of patients compared to 57.0% (p=0.052) in “Moment 2015” and system-delay &lt;90 min in 13.9% compared to 21.8% (p=0.033). Conclusion These results from a multicentric national analysis demonstrated a trend to longer time from symptom onset to request healthcare system assistance and a significantly longer time from first medical contact to revascularization among patients with STEMI during COVID-19 pandemic. This delay for treatment could negatively impact the STEMI prognosis at the long-term. FUNDunding Acknowledgement Type of funding sources: None.

Abstract Background Previous studies showed prolonged patient and system delay in female patients with acute coronary syndromes (ACS) which is thought to be a major driver of discrepancies in their cardiovascular (CV) outcomes. Indeed, timely management is particularly important in patients with ST-segment elevation myocardial infarction (STEMI), as increased total ischemic time augments infarct size and relates to poor CV survival. However, contemporary evidence on sex-specific differences in ACS management and discrepancies in outcomes is limited and controversial. Purpose We sought to systematically investigate whether a sex-gap in symptom-to-door (STD), door-to-balloon (DTB)/door-to-PCI (DTP) time exists in a prospective ACS cohort and if such differences translate into different rates of major adverse cardiovascular events (MACE) at one year. Methods From 2009 to 2019, 4'930 ACS patients with a main diagnosis of NSTEMI (43.3%), STEMI (53.3%) or unstable angina (3.4%) were enrolled in the multicentre, prospective SPUM-ACS study of which 4'671 completed follow-up at one year. STD, DTB and DTP time was analyzed. The primary endpoint, a composite measure of all-cause death, nonfatal myocardial infarction, nonfatal stroke and ischemia-driven revascularization, was adjudicated by an independent clinical endpoint committee. Kaplan-Meier and multivariate-adjusted Cox proportional hazard regression models were used for time-to-event analyses. Results A total of 1'019 (20.7%) women and 3'911 (79.3%) men with a main diagnosis of ACS were included in the study. At presentation, women were older (69.6±12.0 vs. 62.2±12.1 years, P&lt;0.001), more likely to have impaired renal function (median, 81.2 vs. 89.2 ml/min/1.73m2, P&lt;0.001) and a history of hypertension (63.9% vs. 54.3%, P&lt;0.001). STD time was significantly higher in female STEMI (median, 3.2 vs. 2.5 hours, P&lt;0.001) and NSTEMI patients (median, 7.0 vs. 5.0 hours, P=0.015). Importantly, DTB time did not differ between sexes in STEMI patients (1.0 vs. 1.0 hour, P=0.430). Similarly, DTP time of female NSTEMI patients was comparable to males (4.3 vs. 4.4 hours, P=0.855). In the entire cohort, female ACS patients did not show a higher occurrence of the primary endpoint at one year (crude HR 0.86, 95% CI 0.72–1.04; adjusted HR 0.83, 95% CI, 0.66–1.05). In a multivariate-adjusted subgroup analysis, neither female STEMI (adjusted HR 0.82, 95% CI 0.59–1.15) nor NSTEMI patients (adjusted HR 0.87, 95% CI 0.61–1.24) showed higher hazards for the primary endpoint compared to male patients. Conclusions Women with a main diagnosis of STEMI show considerably higher prehospital delay, thus prolonged total ischemic time which is mainly driven by increased STD time. Intriguingly, this does not translate into higher rates of MACE compared to men at one year. Women with ACS may particularly benefit from measures aimed at reducing prehospital delay, as this may further improve long-term prognosis after the acute event. FUNDunding Acknowledgement Type of funding sources: Other. Main funding source(s): Swiss National Science Foundation - SNFFoundation for Cardiovascular Research - Zurich Heart House