standard algorithm
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Abstract Background: To develop a set of R scripts that could efficiently and accurately identify the home page information of medical records and perform China Healthcare Security Diagnosis Related Groups (CHS-DRG) simulating grouping.Methods: Based on the CHS-DRG grouping rules, we abstracted the DRG grouping process into a standard algorithm and compiled the R script Z-DRG. The DRG simulating groupings by Z-DRG were compared with the DRG results from the regional CHS-DRG integrated service platform to evaluate the accuracy.Results: The Z-DRG includes one function module (zdrgfun. Rc), one operation module (zdrgpro. R) and one database form (zdrgcodes.RData). The function module set 7 algorithm steps and 8 custom functions. The functions were set for multiple diagnoses, multiple operations, joint diagnosis and operation. Only (17.85±0.11) milliseconds were taken for CHS-DRG simulating grouping of one case. Compared with the regional CHS-DRG results, the accuracy rate was 99.10%. The difference in the number of other diagnoses is the main reason that affected the accuracy.Conclusions: Z-DRG is easy to operate. The CHS-DRG simulating groupings were efficient and accurate. The simulation results could be effectively applied for medical institutions to carry out CHS-DRG grouping prediction and improve the implementation effect of CHS-DRG payment work.

Abstract Today, Red-Black trees are becoming a popular data structure typically used to implement dictionaries, associative arrays, symbol tables within some compilers (C++, Java …) and many other systems. In this paper, we present an improvement of the delete algorithm of this kind of binary search tree. The proposed algorithm is very promising since it colors differently the tree while reducing color changes by a factor of about 29%. Moreover, the maintenance operations re-establishing Red-Black tree balance properties are reduced by a factor of about 11%. As a consequence, the proposed algorithm saves about 4% on running time when insert and delete operations are used together while conserving search performance of the standard algorithm.

Purpose of the study. To analyze retrospectively our own experience of using intramural dexamethasone injections during endoscopic bougienage of recurrent or very tight (refractory) benign cicatricial strictures of the esophagus and esophageal anastomoses.Materials and methods. From 2013 to March 2021, this method was applied in 43 patients (26 — men, 17 — women) with peptic (11), cicatricial (8), burn (6) esophageal strictures and strictures of anastomoses (18) prone to restenosis. Dexamethasone was injected into the constricted area with a needle passed through the endoscope biopsy channel as an addition to supportive bougienage.Results. After dexamethasone injections, 41 (95.3%) of 43 patients achieved a satisfactory lumen diameter, at which the symptoms of dysphagia disappeared for a long time without relapse. In most patients, the lumen in the stricture zone stabilized at a diameter of 8–18 mm (average 13 mm). With strictures of the esophagus, it was possible to achieve a diameter of 8–14 mm (average 11 mm), and with strictures of the anastomoses — 10–18 mm (average 14 mm).Conclusion. With the tendency of stricture to restenosis, the standard algorithm for endoscopic bougienage, developed in the endoscopy department of the “Petrovsky National Research Center of Surgery”, was supplemented with intramural injections of dexamethasone. This combined endoscopic treatment made it possible to increase the diameter of the bougie and the intervals between bougienage due to the stabilization of the scar frame and to complete the endoscopic treatment with a satisfactory result in 95.3% of patients.

One of the aspirations of today’s standard algorithm for clinical decision making is to avoid physician paternalism. This chapter argues that this aspiration is in tension with what often actually happens at the bedside. The chapter suggests further that what actually happens may be preferable to the rigorous exclusion of paternalism. The current algorithm for bedside decision making has had the effect of limiting the scope for the exercise of the physician’s practical wisdom. Although the physician’s exercise of practical wisdom can verge on paternalism, it can also help patient and physician jointly arrive at the best decision, all things considered. Such an exercise of practical wisdom is what many patients expect and what excellent clinical practice requires. The chapter explores the tension between these competing claims on physician conduct in the care of patients.

Intravenous ports serve as vascular access and are indispensable in cancer treatment. Most studies are not based on a systematic and standardized approach. Hence, the aim of this study was to demonstrate long-term results of port implantation following a standard algorithm. A total of 2950 patients who underwent intravenous port implantation between March 2012 and December 2018 were included. Data of patients managed following a standard algorithm were analyzed for safety and long-term outcomes. The cephalic vein was the predominant choice of entry vessel. In female patients, wire assistance without use of puncture sheath was less likely and echo-guided puncture via internal jugular vein (IJV) with use of puncture sheath was more likely to be performed, compared to male patients (p < 0.0001). The procedure-related complication rate was 0.07%, and no pneumothorax, hematoma, catheter kinking, catheter fracture, or pocket erosion was reported. Catheter implantations by echo-guided puncture via IJV notably declined from 4.67% to 0.99% (p = 0.027). Mean operative time gradually declined from 37.88 min in 2012 to 23.20 min in 2018. The proposed standard algorithm for port implantation reduced the need for IJV echo-guided approach and eliminated procedure-related catastrophic complications. In addition, it shortened operative time and demonstrated good functional results.

The internet of things (IoT) is a multiple devices, which connects with the internet for communication, in order to obtain the updated from the cloud. The fog can act as a controller and it is located between the IoT devices and cloud. The major attacks like de-synchronization, and disclosure has arises in the devices, this has been prevented. The major contribution in this work is key generation and authentication, for key generation the “advanced encryption standard algorithm” is developed, in which the new and old keys are generated. The encryption is done under the source side, and decryption is done under the device side. The fog security is maintained through “device tag, and bit wise XOR rotational algorithm”. The security, and the computational complexity is defined in this work and it is given in table format. The implementations are carried out in the MATLAB R2016 a. The proposed algorithm is compared with the existing protocols like LMAP, M2AP, EMAP, SASI, and RAPP, from the comparison the proposed methodology makes the better knowledge about the security and prevents from various attacks.