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Hypoalbuminemia and Albumin Replacement during Extracorporeal Membrane Oxygenation in Patients with Cardiogenic Shock

  • Jae Beom Jeon;Cho Hee Lee;Yongwhan Lim;Min-Chul Kim;Hwa Jin Cho;Do Wan Kim;Kyo Seon Lee;In Seok Jeong
    • Journal of Chest Surgery
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    • v.56 no.4
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    • pp.244-251
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    • 2023
  • Background: Extracorporeal membrane oxygenation (ECMO) has been widely used in patients with cardiorespiratory failure. The serum albumin level is an important prognostic marker in critically ill patients. We evaluated the efficacy of using pre-ECMO serum albumin levels to predict 30-day mortality in patients with cardiogenic shock (CS) who underwent venoarterial (VA) ECMO. Methods: We reviewed the medical records of 114 adult patients who underwent VA-ECMO between March 2021 and September 2022. The patients were divided into survivors and non-survivors. Clinical data before and during ECMO were compared. Results: Patients' mean age was 67.8±13.6 years, and 36 (31.6%) were female. The proportion of survival to discharge was 48.6% (n=56). Cox regression analysis showed that the pre-ECMO albumin level independently predicted 30-day mortality (hazard ratio, 0.25; 95% confidence interval [CI], 0.11-0.59; p=0.002). The area under the receiver operating characteristic curve of albumin levels (pre-ECMO) was 0.73 (standard error [SE], 0.05; 95% CI, 0.63-0.81; p<0.001; cut-off value=3.4 g/dL). Kaplan-Meier survival analysis showed that the cumulative 30-day mortality was significantly higher in patients with a pre-ECMO albumin level ≤3.4 g/dL than in those with a level >3.4 g/dL (68.9% vs. 23.8%, p<0.001). As the adjusted amount of albumin infused increased, the possibility of 30-day mortality also increased (coefficient=0.140; SE, 0.037; p<0.001). Conclusion: Hypoalbuminemia during ECMO was associated with higher mortality, even with higher amounts of albumin replacement, in patients with CS who underwent VA-ECMO. Further studies are needed to predict the timing of albumin replacement during ECMO.

Quantity-based Early Cost Estimation Model for Road Construction Projects (대표물량 기반의 도로공사 설계단계의 개략공사비 예측모델)

  • Kim, Du Yon;Kim, Byungil;Yeo, Donghoon;Han, Seung Heon
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.29 no.3D
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    • pp.373-379
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    • 2009
  • Cost estimation in the early phase enables government to plan public budgeting more efficiently by providing information about construction cost. However, cost estimation in the early phase is difficult to predict because only a little information can be utilized. The cost estimation method now being used by the government is calculated by length of the road multiplied by unit cost per length and shows high error rate because it cannot reflect the unique characteristics of each project. As the project is being proceeded, level of available information also changed. So, reflecting available information of a project is important. This paper divided early phase into two parts : planning phase and early design phase, and developed cost estimation model considering level of available information of each phase. Total 143 cases are utilized to find influencing variables and develop cost estimation model and model validation is done by adopting required accuracy level. This cost estimation model reflecting level of available information can be applied to public budgeting, feasibility test, and comparison between routes.

관성센서 출력 측정을 위한 AF 변환기 교정기법

  • Kim, Jeong-Yong;Cho, Hyun-Chul;Roh, Woong-Rae;Choi, Hyung-Don;Cho, Gwang-Rae
    • Aerospace Engineering and Technology
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    • v.4 no.2
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    • pp.117-125
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    • 2005
  • Generally, the inertial navigation and guidance unit uses AF(Analog-to-Frequency) converters which convert analog signals into frequency signals to enhance a measurement accuracy of gyroscope and accelerometer outputs. The confidence level of AF converter is guaranteed by a prudential decision of calibration procedure and a performance of periodic calibration test. In this paper, we focus on the synchronous charge balance type AF converter which has a separate positive or negative current input and its calibration method is described. The calibration tests are classified into the scale factor error calibration and the bias calibration. These tests are automatically performed by the calibration program.

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Enhancing Location Estimation and Reducing Computation using Adaptive Zone Based K-NNSS Algorithm

  • Song, Sung-Hak;Lee, Chang-Hoon;Park, Ju-Hyun;Koo, Kyo-Jun;Kim, Jong-Kook;Park, Jong-Sun
    • KSII Transactions on Internet and Information Systems (TIIS)
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    • v.3 no.1
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    • pp.119-133
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    • 2009
  • The purpose of this research is to accurately estimate the location of a device using the received signal strength indicator (RSSI) of IEEE 802.11 WLAN for location tracking in indoor environments. For the location estimation method, we adopted the calibration model. By applying the Adaptive Zone Based K-NNSS (AZ-NNSS) algorithm, which considers the velocity of devices, this paper presents a 9% improvement of accuracy compared to the existing K-NNSS-based research, with 37% of the K-NNSS computation load. The accuracy is further enhanced by using a Kalman filter; the improvement was about 24%. This research also shows the level of accuracy that can be achieved by replacing a subset of the calibration data with values computed by a numerical equation, and suggests a reasonable number of calibration points. In addition, we use both the mean error distance (MED) and hit ratio to evaluate the accuracy of location estimation, while avoiding a biased comparison.

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Uncertainty Observer using the Radial Basis Function Networks for Induction Motor Control

  • Huh, Sung-Hoe;Lee, Kyo-Beum;Ick Choy;Park, Gwi-Tae;Yoo, Ji-Yoon
    • Journal of Power Electronics
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    • v.4 no.1
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    • pp.1-11
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    • 2004
  • A stable adaptive sensorless speed controller for three-level inverter fed induction motor direct torque control (DTC) system using the radial-basis function network (RBFN) is presented in this paper. Torque ripple in the DTC system for high power induction motor could be drastically reduced with the foregoing researches of switching voltage selection and torque ripple reduction algorithms. However, speed control performance is still influenced by the inherent uncertainty of the system such as parametric uncertainty, external load disturbances and unmodeled dynamics, and its exact mathematical model is much difficult to be obtained due to their strong nonlinearity. In this paper, the inherent uncertainty is approximated on-line by the RBFN, and an additional robust control term is introduced to compensate for the reconstruction error of the RBFN instead of the rich number of rules and additional updated parameters. Control law for stabilizing the system and adaptive laws for updating both of weights in the RBFN and a bounding constant are established so that the whole closed-loop system is stable in the sense of Lyapunov, and the stability proof of the whole control system is presented. Computer simulations as well as experimental results are presented to show the validity and effectiveness of the proposed system.

Design and Implementation of 64 QAM(155Mbps) Demodulator for Transmitting Digital Microwave Radio (Digital Microwave Radio 신호전송을 위한 64QAM(155Mbps) 복조기 설계 및 구현)

  • 방효창;안준배;이대영;조성준;김원후
    • The Journal of Korean Institute of Communications and Information Sciences
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    • v.19 no.11
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    • pp.2081-2093
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    • 1994
  • In this study, we design and implement 64 QAM demodulator which has 155 Mbps, first level of CCITT G707 SDH(Synchronous Digital Hierachy) for STM 1 signal transmission. Carrier recovery which effects the demodulator performance uses decision feedback carrier using 8 bits A/D converter. Also, PSF(Pulse Shaping Filter) is 7 order elliptic filter. Carrier recovery circuit is designed and implemented digital type which use high 3 bits of 8 bits conversion data as data and the order low bits as error data and hybrid type which use VCO and analog integrator. Therefore we obtain stable performance recovery.

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A Novel Two-Stage Approach in Rectifying BioHash's Problem under Stolen Token Scenario

  • Lim, Meng-Hui;Jeong, Min-Yi;Teoh, Andrew Beng Jin
    • Journal of information and communication convergence engineering
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    • v.8 no.2
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    • pp.173-179
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    • 2010
  • Over recent years, much research attention has been devoted to a two-factor authentication mechanism which integrates both tokenized pseudorandom numbers with user specific biometric features for biometric verification, known as Biohash. The main advantage of Biohash over sole biometrics is that Biohash is able to achieve a zero equal error rate and provide a clean separation of the genuine and imposter populations, thereby allowing elimination of false accept rates without imperiling the false reject rates. Nonetheless, when the token of a user is compromised, the recognition performance of a biometric system drops drastically. As such, a few solutions have been proposed to improve the degraded performance but such improvements appear to be insignificant. In this paper, we investigate and pinpoint the basis of such deterioration. Subsequently, we propose a two-level approach by utilizing strong inner products and fuzzy logic weighting strategies accordingly to increase the original performance of Biohash under this scenario.

Precise attitude determination strategy for spacecraft based on information fusion of attitude sensors: Gyros/GPS/Star-sensor

  • Mao, Xinyuan;Du, Xiaojing;Fang, Hui
    • International Journal of Aeronautical and Space Sciences
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    • v.14 no.1
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    • pp.91-98
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    • 2013
  • The rigorous requirements of modern spacecraft missions necessitate a precise attitude determination strategy. This paper mainly researches that, based on three space-borne attitude sensors: 3-axis rate gyros, 3-antenna GPS receiver and star-sensor. To obtain global attitude estimation after an information fusion process, a feedback-involved Federated Kalman Filter (FKF), consisting of two subsystem Kalman filters (Gyros/GPS and Gyros/Star-sensor), is established. In these filters, the state equation is implemented according to the spacecraft's kinematic attitude model, while the residual error models of GPS and star-sensor observed attitude are utilized, to establish two observation equations, respectively. Taking the sensors' different update rates into account, these two subsystem filters are conducted under a variable step size state prediction method. To improve the fault tolerant capacity of the attitude determination system, this paper designs malfunction warning factors, based on the principle of ${\chi}^2$ residual verification. Mathematical simulation indicates that the information fusion strategy overwhelms the disadvantages of each sensor, acquiring global attitude estimation with precision at a 2-arcsecs level. Although a subsystem encounters malfunction, FKF still reaches precise and stable accuracy. In this process, malfunction warning factors advice malfunctions correctly and effectively.

Study on mechanical behaviors of cable-supported ribbed beam composite slab structure during construction phase

  • Qiao, W.T.;An, Q.;Wang, D.;Zhao, M.S.
    • Steel and Composite Structures
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    • v.21 no.1
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    • pp.177-194
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    • 2016
  • The cable-supported ribbed beam composite slab structure (CBS) is a new type of pre-stressed hybrid structure. The standard construction method of CBS including five steps and two key phases are proposed in this paper. The theoretical analysis and experimental research on a 1:5 scaled model were carried out. First, the tensioning construction method based on deformation control was applied to pre-stress the cables. The research results indicate that the actual tensile force applied to the cable is slightly larger than the theoretical value, and the error is about 6.8%. Subsequently, three support dismantling schemes are discussed. Scheme one indicates that each span of CBS has certain level of mechanical independence such that the construction of a span is not significantly affected by the adjacent spans. It is shown that dismantling from the middle to the ends is an optimal support dismantling method. The experimental research also indicates that by using this method, the CBS behaves identically with the numerical analysis results during the construction and service.

Gaussian Interpolation GPSAM Method to Overcome Fast Fading in High Speed Mobile Environments (고속 모바일 환경에서 fast 페이딩 극복을 위한 가우시안 보간 GPSAM 기법)

  • Kim, Jeong-Su
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.7
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    • pp.3482-3486
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    • 2013
  • In the case of the Pilot Symbol Assisted Modulation (PSAM) method predicting and compensating amplitude and phases caused on fading channels, there can be severe performance deterioration by Doppler spread on fast fading channels. In this paper, the fading compensation method suggested so as to improve occurring problems as well as analyze them. Doppler spread is the major cause of the bit error rate(BER) performance deterioration. Compared to the existing PSAM method, the more performance deterioration occurs, the larger Doppler spread appears but performance shows well its less $10^{-2}BER$ performance than the existing PSAM method in the suggested method whereas the existing PSAM method has about $10^{-1}BER$ its considerable performance deterioration that caused by Doppler spread within a symbol cycle with the level of delay wave interference.