AIM:To determine whether bispectral index (BIS) monitoring is useful for propofol administration for deep sedation during endoscopic retrograde cholangiopancreatography (ERCP). METHODS:Fifty-nine consecutive patients ...AIM:To determine whether bispectral index (BIS) monitoring is useful for propofol administration for deep sedation during endoscopic retrograde cholangiopancreatography (ERCP). METHODS:Fifty-nine consecutive patients with a variety of reasons for ERCP who underwent the procedure at least twice between 1 July 2010 and 30 November 2010. This was a randomized cross-over study, in which each patient underwent ERCP twice, once with BIS monitoring and once with control monitoring. Whether BIS monitoring was done during the first or second ERCP procedure was random. Patients were intermittently administered a mixed regimen including midazolam, pethidine, and propofol by trained nurses. The nurse used a routine practice to monitor sedation using the Modified Observer's Assessment of Alertness/Sedation (MOAA/S) scale or the BIS monitoring. The total amount of midazolam and propofol used and serious side effects were compared between the BIS and control groups. RESULTS:The mean total propofol dose administered was 53.1 ± 32.2 mg in the BIS group and 54.9 ± 30.8 mg in the control group (P = 0.673). The individual propofol dose received per minute during the ERCP procedure was 2.90 ± 1.83 mg/min in the BIS group and 3.44 ± 2.04 mg in the control group (P = 0.103). The median value of the MOAA/S score during the maintenance phase of sedation was comparable for the two groups. The mean BIS values throughout the procedure (from insertion to removal of the endoscope) were 76.5 ± 8.7 for all 59 patients in using the BIS monitor. No significant differences in the frequency of < 80% oxygen saturation, hypotension (< 80 mmHg), or bradycardia (< 50 beats/min) were observed between the two study groups. Four cases of poor cooperation occurred, in which the procedure should be stopped to add the propofol dose. After adding the propofol, the procedure could be conducted successfully (one case in the BIS group, three cases in the control group). The endoscopist rated patient sedation as excellent for all patients in both groups. All patients in both groups rated their level of satisfaction as high (no discomfort). During the post-procedural follow-up in the recovery area, no cases of clinically significant hypoxic episodes were recorded in either group. No other postoperative side effects related to sedation were observed in either group. CONCLUSION:BIS monitoring trend to slighlty reduce the mean propofol dose. Nurse-administered propofol sedation under the supervision of a gastroenterologist may be considered an alternative under anesthesiologist.展开更多
Road condition is an important variable to measure in order to decrease road and vehicle operating/maintenance costs, but also to increase ride comfort and traffic safety. By using the built-in vibration sensor in sma...Road condition is an important variable to measure in order to decrease road and vehicle operating/maintenance costs, but also to increase ride comfort and traffic safety. By using the built-in vibration sensor in smart phones, it is possible to collect road roughness data which can be an indicator of road condition up to a level of Class 2 or 3 in a simple and cost efficient way. Since data collection therefore is possible to be done more frequently, one can better monitor roughness changes over time. The continuous data collection can also give early warnings of changes and damage, enable new ways to work in the operational road maintenance management, and can serve as a guide for more accurate surveys for strategic asset management and pavement planning. Collected measurement data are wirelessly transferred by the operator when needed via a web service to an internet mapping server with spatial filtering functions. The measured data can be aggregated in preferred sections, as well as exported to other GlS （geographical information systems） or road management systems. Our conclusion is that measuring roads with smart phones can provide an efficient, scalable, and cost-effective way for road organizations to deliver road condition data.展开更多
In this paper,we analyzed the One Foundations relief and reconstruction activities after the Yaan earthquake.The analysis shows that the participation of NGOs in disaster relief activities has undergone different stag...In this paper,we analyzed the One Foundations relief and reconstruction activities after the Yaan earthquake.The analysis shows that the participation of NGOs in disaster relief activities has undergone different stages.In the Jiujiang earthquake,NGOs participation was in the rudimentary stage.In the Wenchuan earthquake,they became one of the active participants.In the Yaan earthquake,they played an active role through a cooperation mechanism.That means NGOs have had the capability of resource mobilization and cooperation with them will improve disaster management capacities,especially in the national significant seismic monitoring and protection regions.展开更多
文摘AIM:To determine whether bispectral index (BIS) monitoring is useful for propofol administration for deep sedation during endoscopic retrograde cholangiopancreatography (ERCP). METHODS:Fifty-nine consecutive patients with a variety of reasons for ERCP who underwent the procedure at least twice between 1 July 2010 and 30 November 2010. This was a randomized cross-over study, in which each patient underwent ERCP twice, once with BIS monitoring and once with control monitoring. Whether BIS monitoring was done during the first or second ERCP procedure was random. Patients were intermittently administered a mixed regimen including midazolam, pethidine, and propofol by trained nurses. The nurse used a routine practice to monitor sedation using the Modified Observer's Assessment of Alertness/Sedation (MOAA/S) scale or the BIS monitoring. The total amount of midazolam and propofol used and serious side effects were compared between the BIS and control groups. RESULTS:The mean total propofol dose administered was 53.1 ± 32.2 mg in the BIS group and 54.9 ± 30.8 mg in the control group (P = 0.673). The individual propofol dose received per minute during the ERCP procedure was 2.90 ± 1.83 mg/min in the BIS group and 3.44 ± 2.04 mg in the control group (P = 0.103). The median value of the MOAA/S score during the maintenance phase of sedation was comparable for the two groups. The mean BIS values throughout the procedure (from insertion to removal of the endoscope) were 76.5 ± 8.7 for all 59 patients in using the BIS monitor. No significant differences in the frequency of < 80% oxygen saturation, hypotension (< 80 mmHg), or bradycardia (< 50 beats/min) were observed between the two study groups. Four cases of poor cooperation occurred, in which the procedure should be stopped to add the propofol dose. After adding the propofol, the procedure could be conducted successfully (one case in the BIS group, three cases in the control group). The endoscopist rated patient sedation as excellent for all patients in both groups. All patients in both groups rated their level of satisfaction as high (no discomfort). During the post-procedural follow-up in the recovery area, no cases of clinically significant hypoxic episodes were recorded in either group. No other postoperative side effects related to sedation were observed in either group. CONCLUSION:BIS monitoring trend to slighlty reduce the mean propofol dose. Nurse-administered propofol sedation under the supervision of a gastroenterologist may be considered an alternative under anesthesiologist.
文摘Road condition is an important variable to measure in order to decrease road and vehicle operating/maintenance costs, but also to increase ride comfort and traffic safety. By using the built-in vibration sensor in smart phones, it is possible to collect road roughness data which can be an indicator of road condition up to a level of Class 2 or 3 in a simple and cost efficient way. Since data collection therefore is possible to be done more frequently, one can better monitor roughness changes over time. The continuous data collection can also give early warnings of changes and damage, enable new ways to work in the operational road maintenance management, and can serve as a guide for more accurate surveys for strategic asset management and pavement planning. Collected measurement data are wirelessly transferred by the operator when needed via a web service to an internet mapping server with spatial filtering functions. The measured data can be aggregated in preferred sections, as well as exported to other GlS （geographical information systems） or road management systems. Our conclusion is that measuring roads with smart phones can provide an efficient, scalable, and cost-effective way for road organizations to deliver road condition data.
基金sponsored by the National Social Science Fund of China "Research on the Status,Efficiencies and the Policy on the National Significant Seismic Monitoring and Protection Regions"(11&ZD054)Policy Research Projects of China Earthquake Administration in 2014 "The Role of NGOs in Earthquake Relief and the Meaning to Policy"
文摘In this paper,we analyzed the One Foundations relief and reconstruction activities after the Yaan earthquake.The analysis shows that the participation of NGOs in disaster relief activities has undergone different stages.In the Jiujiang earthquake,NGOs participation was in the rudimentary stage.In the Wenchuan earthquake,they became one of the active participants.In the Yaan earthquake,they played an active role through a cooperation mechanism.That means NGOs have had the capability of resource mobilization and cooperation with them will improve disaster management capacities,especially in the national significant seismic monitoring and protection regions.
