RESUMEN
A smooth and secure spatial path planning algorithm that integrates the improved ant colony optimization with the corrective connected spatial search strategy is proposed, aiming at heavy heading switching pressure of autonomous underwater vehicles sailing in complex marine environment. On the one hand, to overcome the low-dimensional search domain and inaccurate spatial communication information in traditional spatial path planning, the spatial connectivity adjacency domain search strategy is designed based on grid environment model. On the other hand, to alleviate heading switching pressure due to large path steering angles and redundant path turning points, the heuristic functions and pheromone update criterion based on ant colony optimization are introduced to improve the solution quality of smooth paths. The simulation results show that the space search strategy can improve the success probability of safe path planning without reducing the scope of explorable free space. Additionally, the simulations demonstrate that the improved ant colony optimization using the spatial search strategy can guarantee the shortest path with lowest tortuous degree and fewest turning times in the same grid environment.
RESUMEN
WHAT IS KNOWN AND OBJECTIVE: To investigate the general characteristics, economic burden, causative drugs and medical errors associated with litigation involving severe cutaneous adverse drug reactions (SCADRs) in China, with the aims of improving rational medication use and reducing the extent of damage from SCADRs. METHODS: This study analysed 150 lawsuit judgements involving SCADRs from 2005 to 2019, collected from China Judgments Online. RESULTS AND DISCUSSION: In total, 50% of lawsuits stemmed from SCADRs occurring in general hospitals. The average time elapsed from the date of occurrence of the SCADRs to the end of litigation procedures was 1055 days. Of the patients involved, 51% were female and more than two thirds (69%) were under 60 years old. The most common outcome of SCADRs was death (39%), followed by disabilities (30%). The average responsibility of the medical provider was 48 ± 29%. The average amount of compensation was $43 424. Of the cases studied, 51% of SCADRs were Stevens-Johnson syndrome or toxic epidermal necrolysis, which together accounted for 75% of cases with known clinical subtype. The overall average economic burden of SCADRs was $99 178, of which indirect costs made up the largest proportion (more than 60%). The most common causative drug groups were antimicrobial drugs (49%), Chinese patent medicine and Chinese herbal medicine (17%), and antipyretic analgesics (16%). Finally, 61% of medical errors were found to stem from violation of duty of care, 20% from violation of informed consent and 18% from violations related to the medical record writing and management system. WHAT IS NEW AND CONCLUSION: Severe cutaneous adverse drug reactions not only severely affect patient survival and quality of life, but also impose a heavy economic burden in terms of health care and societal costs. Medical providers should be better educated on strategies to reduce risk to patients and establish mechanisms of risk sharing and management.
