Sacral neuromodulation is an effective, minimally invasive treatment for refractory lower urinary tract dysfunction. However, regular postoperative programming is crucial for the maintenance of the ...curative effects of electronic sacral stimulator devices. The outbreak of coronavirus disease 2019 (COVID-19) limited the ability of practitioners to perform traditional face-to-face programming of these stimulators. Therefore, this study aimed to evaluate the application of remote programming technology for sacral neuromodulation during the COVID-19 pandemic in China.
We retrospectively collected data including baseline and programming information of all patients with lower urinary tract dysfunction who underwent sacral neuromodulation remote programming in China after the outbreak of COVID-19 (i.e., December 2019). The patients also completed a self-designed telephone questionnaire on the subject.
A total of 51 patients from 16 centers were included. They underwent 180 total remote programming visits, and 118, 2, 25, and 54 voltage, current, pulse width, and frequency adjustments, respectively, were performed. Additionally, remote switching on and off was performed 8 times; impedance test, 54 times; and stimulation contact replacement, 25 times. The demand for remote programming was the highest during the first 6 months of sacral neuromodulation (average, 2.39 times per person). In total, 36 out of the 51 patients completed the questionnaire survey. Of these, all indicated that they chose remote programming to minimize unnecessary travel because they had been affected by COVID-19. The questionnaire also showed that remote programming could reduce the number of patient visits to the hospital, save time, reduce financial costs, and would be easy for patients to master. All surveyed patients indicated that they were satisfied with remote programming and were willing to recommend it to other patients.
Remote programming for sacral neuromodulation is feasible, effective, safe, and highly recommended by patients with refractory lower urinary tract dysfunction. Remote programming technology has great development and application potential in the post-pandemic era.
Higher bandwidth and spatial reuse through densification of wireless cells are necessary to meet the increase of wireless traffic demand in the next decade. Millimeter wave network can fulfill both ...of these criteria with the availability of abundant bandwidth and higher spatial reuse through directional beamforming. However, millimeter wave network suffers from coverage hole in urban environment due to blockage because of high path loss for millimeter wave signals. Wireless backhaul allows densification of mobile networks without incurring additional fiber deployment cost. Millimeter wave band based Integrated access and backhaul (IAB) is expected to provide a low cost coverage enhancement and capacity improvement solution. This paper focuses on the system performance of IAB node deployment in terms of coverage and user throughput by field experiment using millimeter wave band. The trial results prove that coverage ratio is significant improved with deploying IAB node. Meanwhile, dynamic resource allocation, including dynamic time division multiplexing (TDM) and dynamic TDM with flexible space division multiplexing (SDM) between access and backhaul link, brings obvious user throughput gain due to better resource utilization and providing more access transmission opportunities for User Equipment (UE) in backhaul slot.
There is a lack of large-scale epidemiological data on the clinical practice of enteral nutrition (EN) feeding in China. This study aimed to provide such data on Chinese hospitals and to investigate ...factors associated with EN delivery.
This cross-sectional study was launched in 118 intensive care units (ICUs) of 116 mainland hospitals and conducted on April 26, 2017. At 00:00 on April 26, all patients in these ICUs were included. Demographic and clinical variables of patients on April 25 were obtained. The dates of hospitalization, ICU admission and nutrition initiation were reviewed. The outcome status 28 days after the day of investigation was obtained.
A total of 1953 patients were included for analysis, including 1483 survivors and 312 nonsurvivors. The median study day was day 7 (IQR 2-19 days) after ICU entry. The proportions of subjects starting EN within 24, 48 and 72 h after ICU entry was 24.8% (84/352), 32.7% (150/459) and 40.0% (200/541), respectively. The proportion of subjects receiving > 80% estimated energy target within 24, 48, 72 h and 7 days after ICU entry was 10.5% (37/352), 10.9% (50/459), 11.8% (64/541) and 17.8% (162/910), respectively. Using acute gastrointestinal injury (AGI) 1 as the reference in a Cox model, patients with AGI 2-3 were associated with reduced likelihood of EN initiation (HR 0.46, 95% CI 0.353-0.599; p < 0.001). AGI 4 was significantly associated with lower hazard of EN administration (HR 0.056; 95% CI 0.008-0.398; p = 0.004). In a linear regression model, greater Sequential Organ Failure Assessment scores (coefficient - 0.002, 95% CI - 0.008 to - 0.001; p = 0.024) and male gender (coefficient - 0.144, 95% CI - 0.203 to - 0.085; p < 0.001) were found to be associated with lower EN proportion. As compared with AGI 1, AGI 2-3 was associated with lower EN proportion (coefficient - 0.206, 95% CI - 0.273 to - 0.139; p < 0.001).
The study showed that EN delivery was suboptimal in Chinese ICUs. More attention should be paid to EN use in the early days after ICU admission.
Higher bandwidth and spatial reuse through densification of wireless cells are necessary to meet the increase of wireless traffic demand in the next decade. Millimeter wave network can fulfill both ...of these criteria with the availability of abundant bandwidth and higher spatial reuse through directional beamforming. Millimeter wave band based integrated access and backhaul (IAB), is expected to provide a low cost coverage enhancement and capacity improvement solution. This paper focuses on the system performance of IAB node deployment in terms of coverage and user throughput by field experiment using millimeter wave band. The trial results prove that coverage ratio is significant improved with the introduced IAB node. Meanwhile, dynamic resource allocation, dynamic time division multiplexing (TDM) and dynamic TDM with flexible space division multiplexing (SDM) between access and backhaul link, brings obvious user throughput gain due to better resource utilization and providing more access transmission opportunities for UE in backhaul slot according to the scheduling decision at IAB node.
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