An accurate and reproducible method for the evaluation of postoperative morbidity is essential for a valid assessment of the outcomes of surgery. However, there is still no consensus on reporting of ...complications. The Clavien-Dindo classification (CDC) of complications is a validated system which reports only the most severe complication. The Comprehensive Complication Index (CCI) is a novel scale designed to capture the overall burden of complications. The aim of our study is to validate and compare the CDC and the CCI in the setting of high-risk surgical patients in whom multiple complications are common.
A prospective, observational study analyzed 206 high-risk adult patients undergoing major abdominal surgery. Each postoperative complication was recorded until discharge or readmission within 30 days. The severity of complications was graded with the CDC, and the CCI was calculated subsequently. Correlations of the CDC and the CCI with hospitalization indicators and functional activity on discharge were assessed and compared.
A total of 424 complications occurred in 125 (60.7%) patients. The median CCI for the cohort was 20.9 (0-44.9). CD grade II was the most frequent among patients with complications (62/125; 49.6%). The CCI and the CDC have shown a strong correlation (r = 0.969, P < 0.01). Both scales strongly correlated with the parameters of hospitalization, but the CCI showed a stronger correlation to the intensive care unit length of stay (LOS; 0.670 versus 0.628, P < 0.001), postoperative LOS (0.652 versus 0.630, P = 0.041), and prolonged intensive care unit LOS (0.604 versus 0.555, P < 0.001). The median CCI and the highest CD grade were significantly different respective to the functional activity on discharge (P < 0.001).
The CDC and the CCI are the effective methods for reporting of complications after major abdominal surgery. The CCI is a more accurate scale for use in high-risk patients and correlates better with the postoperative LOS.
Since the inception of the traffic flow theory, numerous traffic flow models have been formulated by scholars in an effort to more accurately delineate the relationships between various traffic flow ...parameters. However, only a limited number of studies have explored the distinctions between fundamental traffic diagrams, which characterize continuous and interrupted traffic flow conditions. Addressing this research lacuna, we compared twelve “speed–density” and “flow–density” models fitted to empirical data collected under continuous and interrupted traffic flow conditions on a selected regional road in Croatia. The empirical data used to develop these models were extracted from video footage captured by an unmanned aerial vehicle on two representative road segments during characteristic peak and off-peak hours on workdays. Our analysis reveals that, depending on the selected traffic flow model and prevailing traffic flow conditions, the practical capacity of the observed regional road is estimated to be in the range from 799 to 2333 veh/h/lane. It was also discovered that the considered models reach practical capacity at a significantly different density under continuous and interrupted traffic stream conditions, i.e., between 37 and 129 veh/km/lane. The conducted t-tests underscore the need to employ distinct “speed–density” and “flow–density” regression functions for modeling continuous and interrupted traffic stream conditions.
Personnel selection plays a decisive role in human resource management since it determines the input quality of personnel. One approach, fuzzy decision-making methods, has become popular in decision ...making for personnel selection, considering those methods provide a wide range of tools for dealing with uncertainty. Choquet integral is an aggregation operator, frequently used to unite interrelated information. Choquet integral, with respect to fuzzy, allows consideration of the phenomenon of dependence between criteria. In this paper, personnel selection was performed using the Choquet integral, based on a fuzzy measure. The problem of the evaluation of employees is performed with respect to the personal characteristics of the employees, task performance, employee–employee relationship approaches, and effectiveness of communication.
This article addresses the possibility of improving the traditional bus passenger demand forecasting models by leveraging additional data from relevant big data systems and proposes a conceptual ...framework for developing big data-based forecasting models. Based on the data extracted from available big data systems, the authors have developed a conceptual procedural framework for determining the significance of statistical indicators that can potentially be used as predictor variables for forecasting future passenger demand. At the first stage of the proposed framework, the statistical significance of partial linear correlations between observed statistical indicators and bus ridership demand are determined. All statistical indicators identified as potentially significant are further tested for multicollinearity, homoscedasticity, autocorrelation and multivariate normality to determine the suitability of their inclusion in the final equation of the prediction model. The final formulation of the predictive model was developed using stepwise regression. The R programming language was used to implement the proposed procedural framework to develop a model suitable for predicting passenger demand on the Prizren-Zagreb international bus route. Two predictor variables identified as the most statistically significant are the population of Kosovo and the annual number of Kosovo citizens crossing the Croatian border by bus.
In the last few years, spintronics has attracted the full attention of the scientific community for the synergy it provides to conventional complimentary metal-oxide-semiconductor (CMOS) devices ...(nonvolatility, infinite endurance, radiation immunity, increased density, and so on). Many hybrid (magnetic/CMOS) cells have been proposed which can store and process data in both electrical and magnetic ways. Such cells are mainly based on magnetic tunnel junctions (MTJs) and are suitable for use in magnetic random access memories (MRAMs) and reprogrammable computing (magnetic FPGAs, nonvolatile registers, processor cache memories, and so on). In this paper, we report the results of exhaustive energy-performance analysis of the set of hybrid cells recently published in the literature. We explore their limits in metrics of the required silicon area, robustness, read/write speed, and consumed energy. Two different mechanisms for writing non-volatile data stored in MTJs are applied to each hybrid cell: thermally assisted switching (TAS) and spin-transfer torque (STT). All the results were obtained through simulations in Cadence Spectre 7.2. For the CMOS part, we used 45 nm predictive transistor models whereas the MTJ part was simulated using the 120 nm × 120 nm TAS Spintec model and the 100 nm × 50 nm STT Spinlib model. The results presented here are a valuable resource for future designers of hybrid devices if they need to select an appropriate hybrid cell for a target application.
Most countries of the European Union ensure certain obligations (criteria) which universal service providers must meet to ensure the realization of the universal service. These criteria vary from ...country to country, giving their own choice of an optimal model for the density of the postal network. Such postal network of the operator providing universal postal service must be organized so that post offices are accessible at the optimal distance from the user. This paper presents two different approaches. The first one is based on the population criteria determined in the previous study. The second one is new, a general method created to determine the minimum number of postal unit applications of Set Covering Location Problem. The authors apply both methods on real data collected from the Serbian municipalities and finally, compare the obtained results.
In the Republic of Serbia, commercial postal services are provided by 49 postal operators. Universal postal service is provided only by the Post of Serbia. Collaboration between the Post of Serbia ...and private operators is exclusively in the area of commercial services and based on bilateral agreements. At the end of 2014, the National Regulatory Authority (NRA) adopted an Ordinance on the methods and conditions of access to the postal network of the Public Postal Operator (PPO). As the market is liberalized, postal operators are given the opportunity to provide the universal service function, with the exception of reserved services, without owning a network. In conjunction with the NRA and the postal operators, and with input from experts, we analyze current market conditions and the demand for access to Serbia's postal network, and evaluate the PPO from the stand point of expected and experienced postal service quality of access to postal network. The obtained results will be useful in developing the postal network.
•The purpose of this work is to contribute to the development of the postal services market.•The main issue in this work is the ability of the public postal operator to address the users’ needs to access the postal network.•The aim is evaluate of the public postal operator from the standpoint of the expected and delivered service quality of access to the postal network.
Background: The objective of our study was to determine the serum concentrations of protein S100B and neuron specific enolase (NSE) as well as their ability and accuracy in the prediction of early ...neurological outcome after a traumatic brain injury. Methods: A total of 130 polytraumatized patients with the associated traumatic brain injuries were included in this prospective cohort study. Serum protein S100B and NSE levels were measured at 6, 24, 48 and 72 hours after the injury. Early neurological outcome was scored by Glasgow Outcome Scale (GOS) on day 14 after the brain injury. Results: The protein S100B concentrations were maximal at 6 hours after the injury, which was followed by an abrupt fall, and subsequently slower release in the following two days with continual and significantly increased values (p<0.0001) in patients with poor outcome. Secondary increase in protein S100B at 72 hours was recorded in patients with lethal outcome (GOS 1). Dynamics of NSE changes was characterized by a secondary increase in concentrations at 72 hours after the injury in patients with poor outcome. Conclusion: Both markers have good predictive ability for poor neurological outcome, although NSE provides better discriminative potential at 72 hours after the brain injury, while protein S100B has better discriminative potential for mortality prediction.
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