Occurrence Of Shock Research Articles

Competitive athletes with implantable cardioverter–defibrillators—How to program? Data from the Implantable Cardioverter–Defibrillator Sports Registry

Athletes with an implantable cardioverter-defibrillator (ICD) may require unique optimal device-based tachycardia programming. The purpose of this study was to assess the association of tachycardia programming characteristics of ICDs with occurrence of shocks, transient loss-of-consciousness, and death among athletes. A subanalysis of a prospective, observational, international registry of 440 athletes with ICDs followed for a median of 44 months was performed. Programming characteristics were divided into groups for rate cutoff (very high, high, or low) and detection (long-detection interval [>nominal] or nominal). Endpoints included total, appropriate, and inappropriate shocks, transient loss-of-consciousness, and mortality. In this cohort, 62% were programmed with high-rate cutoff and 30% with long detection. No athlete died of an arrhythmia (related or unrelated) to ICD shocks. Three patients had sustained ventricular tachycardia below programmed detection rate, presenting as palpations and/or dizziness. ICD shocks were received by 98 athletes (64 appropriate, 32 inappropriate); 2 patients received both. Programming a high-rate cutoff was associated with decreased risk of total (P = .01) and inappropriate (P = .04) shocks overall and during competition or practice. Programming long-detection intervals was associated with fewer total shocks. Single- vs dual-chamber devices and the number of zones were unrelated to risk of shock. Transient loss-of-consciousness, associated with 27 appropriate shocks, was not related to programming characteristics. High-rate cutoff and long-detection duration programming of ICDs in athletes at risk for sudden death can reduce total and inappropriate ICD shocks without affecting survival or the incidence of transient loss-of-consciousness.

Solar wind and interplanetary shock parameters near Saturn's orbit (∼10 AU)

In this work, in-situ 1-h averaged plasma and magnetic field spacecraft data are used to characterize solar wind conditions near Saturn's orbit. Further, high resolution solar wind interplanetary data are used to identify and to calculate interplanetary shock parameters. When only plasma or magnetic field data are available, identified discontinuities were classified as possible shocks. Solar wind parameters at 10 AU decrease as expected from the inner heliosphere averages. For instance, solar wind dynamic pressure is ∼2% and ∼40% of its value at 1 and 5 AU, respectively. Wave magnetosonic speed is similar to 5 AU, but it is only about 60% of the 1 AU value. From analysis of high resolution plasma and magnetic field data, only a small number of shocks (13) were identified, because of scarce data availability. On the other hand, a larger number of possible shocks (60) were identified. Most of the confirmed shocks (∼75%) were fast forward shocks, while ∼25% were reverse shocks. Mach numbers ranged from 1.2 to 3.5 (average 2.2). Shock normal angle was on average 68° with oblique to perpendicular propagation to the magnetic field. From solar wind and interplanetary shock parameters analyzed in this work, and comparison with results from other works at different radial distances, it is concluded that conditions for shock occurrence and shock strength seem to increase from 1 to 5 AU and then level off or decrease near ∼10 AU, with shock strength at 10 AU comparable to shock strength at 1 AU. These results are of interest for interplanetary dynamics and for solar wind-planetary magnetosphere coupling.

Syndrome de fuite capillaire secondaire à un accident de décompression : à propos d’un cas

BackgroundCapillary leak syndrome is a rare type of decompression sickness (DCS) that may be responsible for hypovolemic shock with edema. Clinical caseA 21-year-old amateur diver suffered from an inner ear DCS following air diving to 96msw. He presented subsequent deterioration with hypovolemia and facial edema secondary to capillary leak syndrome. DiscussionIn DCS, bubbles formation alters the wall of blood vessels and activates complex biochemical mechanisms inducing extravascular protein leakage. The clinical expression of this syndrome is variable, ranging from simple hemoconcentration to hypovolemic shock. Close clinical-biological monitoring of patients with elevated hematocrit with or without hypoalbuminemia is advisable. Early vascular filling with albumin infusion may prevent the occurrence of hypovolemic shock and improve the prognosis.

The financial accelerator and marketable debt: the prolongation channel

Abstract This paper investigates the effects of mark-to-market accounting for risky liabilities on the business cycle. While marking assets to market results in an amplification of the business cycle, as is well-known from the financial accelerator model à la Bernanke, Gertler, and Gilchrist [Bernanke, B. S., M. Gertler, and S. Gilchrist. 1999. “The Financial Accelerator in a Quantitative Business Cycle Framework.” In Handbook of Macroeconomics, edited by J. Taylor and M. Woodford, Elsevier.], allowing for debt with a specific maturity priced at market value generates ambiguous effects. Changes in the market price of debt affects firms’ net worth since the accounting principle takes the perspective of repurchasing debt. This is called the prolongation channel of debt. Real economic activity is attenuated as long as asset and debt prices move in the same direction, whereas the response of debt prices is stronger. This happens for a monetary policy shock or a shock to total factor productivity. Amplification occurs if both prices move in opposite directions, as is the case for a demand shock. The implications for the business cycle eventually depend on the occurrence of shocks. Implementing mark-to-market accounting for liabilities in a model for the US yields a higher volatility of the business cycle.

A Forward Looking Small Semi-Structural Macroeconomic Model For Bangladesh

Small semi-structural models are suitable to explicate the monetary transmission mechanism by recognizing the interrelationships among major macroeconomic variables. This study presents a small semi-structural dynamic general equilibrium (DGE) New Keynesian model for Bangladesh to explore the dynamic interrelationships among major macroeconomic variables related to the transmission mechanism of monetary policy. Our DGE model comprises of four key behavioral equations – the aggregate demand (output), aggregate supply (inflation), interest rate and, the exchange rate. Using quarterly data over the sample period from 2006:Q3 to 2016:Q2, we have used Generalized Method of Moments estimation technique, which is useful for estimating forward-looking reaction functions on the basis of expected values for macroeconomic variables. The findings demonstrate that the model is inclusive enough to capture how the selected variables are interrelated. In most of the cases, the study finds significant and similar nature of interrelationships among the major macroeconomic variables as found by previous studies on Canada, Thailand, and South Africa. The model is also flexible enough in understanding shock propagation and conducting policy analyses. For Bangladesh, the policy transmission mechanism is found less efficient to control the monetary system (over 10 years to revert to steady state after the occurrence of shocks), while Canada, South Africa, and Thailand need 5 years, 10 years, and 10 years, respectively. This happens mainly due to the weak monetary policy which has two consequences. First, a small reaction parameter in the interest rate equation which means that the interest rate is only marginally adjusted to high inflation. Second, a small effect of monetary policy on the economy through the output and exchange rate equations. Most notably, in the exchange rate equation, the uncovered interest parity indicates a low coefficient. This might happen due to the absence of inflation targeting monetary policy in Bangladesh. A strong and quick policy response is required which could be achieved by implementing two major policy tasks: adoption of an inflation-targeting monetary policy, and full autonomy of Bangladesh Bank in both administrative and functional areas.

Realization of novel constant rate of kinetic energy change (CRKEC) supersonic ejector

Ejectors invariably convert momentum and kinetic energy of incoming fluids into enthalpy and hence pressure. Since ejectors are primarily viewed as energy exchange devices, it would be appropriate to design an ejector with its geometry being a function of the rate of energy change. This would shift ejector design approach from conventional geometry based one to that of flow physics-based approach. Hence, the paper presents a unique approach to evolving ejector design considering it primarily to be a function energy change within the system, specifically being constant rate of kinetic energy change (CRKEC). This approach has benefits in terms of mitigating the occurrence of thermodynamic shock, which is a major irreversibility that besets conventional ejector systems. A 1-D gas dynamic model including frictional effects for a more realistic design has been developed for estimating supersonic ejector geometry based on CRKEC approach. The model has been used to predict the geometry of a supersonic air ejector for typical input parameters viz., entrainment ratio (ω) ∼0.53, recovery ratio(ζ) ∼1.4, primary stagnation pressure(Pop) ∼5.7 bar, secondary stagnation pressure(Pos) ∼0.7 bar. The results have been verified through detailed numerical analysis using Navier-Stokes system of equations with turbulence in a 2-D axi-symmetric formulation. Also, the experimental results on the developed prototype, which have also been discussed, are observed to be in close agreement with predictions of 1-D gas dynamic model and the numerical studies.

Dynamics of off-farm employment in Sub-Saharan Africa: A gender perspective

Off-farm income constitutes a significant share of the household livelihood portfolios across Sub-Saharan Africa. Yet, the determinants and dynamics of individuals' participation in off-farm employment activities have not received adequate attention due to the weaknesses in individual-level data collection and the lack of longitudinal studies. This paper uses national panel household survey data from Ethiopia, Malawi, Nigeria, Tanzania, and Uganda; provides empirical evidence on individual-level off-farm (wage and self) employment participation rates; analyzes the extent and drivers of entry into off-farm employment and continued employment; and conducts the analysis by gender and rural/urban location. A significant share of the rural and urban working-age individual population is found to participate in off-farm employment, ranging at the national level from 34 percent in Ethiopia to 58 percent in Malawi. Men participate in wage and self-employment to a significantly greater extent compared with women across time as well as within and across countries, apart from women's participation in non-farm enterprises being more common in Nigeria and Tanzania. The population weighted cross-country gender difference in off-farm employment stands at 9 percentage points, but this has declined over time in most countries. A substantial share of the population, amounting to about 39 million individuals across the five countries, is estimated to have entered and exited employment between 2010 and 2016, pointing to the dynamic nature of off-farm employment. Drivers of entry into off-farm employment and continued employment are country- and gender-specific, with demographic factors, occurrence of shocks, and job characteristics emerging as the most important determinants.

On optimal replacement of systems with failure rates described by a random jump process

AbstractPreventive maintenance (age replacement) of items operating in a random environment modeled by a Poisson shock process, resulting in random jump process in the system failure rate, is considered. The corresponding univariate and bivariate models are described. In the univariate model, an item is replaced either on failure or on the predetermined replacement time, whichever comes first. In the bivariate model, the preventive maintenance is performed also on the occurrence of the mth shock. Each shock in our stochastic model has a triple effect. On one hand, it acts directly on the failure rate of an item, increasing it by a random amount or resulting in a failure. On the other hand, each shock causes additional ‘damage’, which can be attributed, eg, to a short drop in the output of an item. The corresponding optimization problem is formulated and illustrated by detailed numerical examples.

Reliability modeling for dependent competing failure processes with mutually dependent degradation process and shock process

Many systems experience dependent competing failure processes resulting from simultaneous exposure to degradation processes and random shocks. Moreover, the degradation process and shock process may be mutually dependent. On the one hand, shocks can cause sudden degradation increments, which accelerate degradation process. On the other hand, the occurrence intensity of shock process will increase with the accumulation of degradation. Due to the mutual dependence between degradation and random shocks, the arrival shocks can cause abrupt degradation and then facilitate the occurrence of random shocks recursively. Therefore, the intensity is dependent on the number of arrival shocks, and the shock process cannot be described by the Poisson process used in previous studies. In this paper, a Facilitation model, which is a special type of Markov point process, is introduced to model the shock process. Furthermore, based on the Facilitation model, a novel analytical reliability model with the mutual dependence is developed. A case of a jet pipe servo valve is presented to demonstrate the developed model. The result showed that the reliability declines significantly when considering the mutual dependence.

Vitamin D deficiency and clinical outcomes related to septic shock in children with critical illness: a systematic review.

Low vitamin D blood levels are related to many clinical outcomes in children with critically illness. However, the relationship of it and septic shock has not been systematically analyzed. The objective of this review was to evaluate the effect of vitamin D on septic shock and predict if vitamin D administration can improve prognosis of it. Online databases were searched up to June 1st, 2017 for studies on the relation of vitamin D deficiency (VDD) and clinical outcomes on septic shock in children with critical illness. The primary end point was the effect of VDD on occurrence of septic shock. The secondary endpoints were the association of VDD and clinical outcomes related to septic shock. We summarized the strength of association between VDD and each factor on septic shock. Individual factors were defined as strong, moderate, weak, or inconclusive according to the numbers of the article supporting the relation between them. Eight studies published between 2012 and 2017, for a total of 1367 patients, were included in the final analysis. We extracted eight patient-level factors and among them one showed strong association of VDD and septic shock. Four factors demonstrated moderate or weak strength of evidence for it: nonresolution of shock, catecholamine refractory shock, fluid boluses, vasopressor use. But evidence for the association between VDD and severity of illness, stay of pediatric intensive care unit (PICU), are weak. Most of the articles showed no significant association between VDD and mortality. Among critically ill children, VDD might be associated with the occurrence and resolution of septic shock. A larger multicenter trial could conclusively confirm these findings. Further research is also needed to identify vitamin D administration for better outcomes in pediatric patients.

Joint Use of Seismological and Topological Statistical Methods for the Analysis of 2010–2016 Azerbaijan Seismicity

The time variation of several statistical parameters describing the complex time dynamics of the seismicity of Azerbaijan from 2010 to 2016 is investigated. Besides the well-known Gutenberg–Richter b value and the coefficients of variation, two quantities, derived by the recent method of horizontal visibility graph are analysed, namely the mean connectivity degree, which depicts an innovative way to link seismic events, and the Kullback–Leibler divergence (KLD) that informs about the irreversibility of the seismic process. Our findings indicate the emergence of pre- and co-seismic patterns in the time variation of all the analysed parameters in relationship with the strongest events of the Azerbaijan seismic catalog. In particular, the typical increase–decrease behavior has been found in b before the occurrence of large shocks. Similarly, the coefficients of variation signals are statistically significant high value in the period when the largest events occur and in most cases even before they struck the area. The mean connectivity degree and the KLD show several anomalous values in association with the occurrence of large events, in agreement with the view of earthquakes as irreversible ruptures of the crust.

Time Series Analysis of Acoustic Emissions in the Asinelli Tower during Local Seismic Activity

The existence of ongoing damage processes in a masonry wall of the Asinelli Tower in Bologna have been investigated by the acoustic emission (AE) technique. A time correlation between the AE activity in the monitored structural element and the nearby earthquakes has been observed. In particular, the largest cluster of AE signals has been recorded within a few hours after the main shock (4.1 magnitude) occurrence. The presented findings suggest that aging and deterioration of the monitored structural element significantly depend on the action of light earthquakes, even at considerable distance. Trends of two evolutionary parameters, the b-value and the natural time variance κ1, have been derived from the AE time series in order to identify the approach of the monitored structural element to a “critical state” in relation to the earthquake occurrence.

Influenza-associated neurological complications during 2014–2017 in Taiwan

IntroductionSeasonal influenza-associated neurological complications had high mortality and morbidity rates in recent studies. We reported influenza-associated encephalitis/encephalopathy in children during 2014–2017 in Taiwan, focusing on neurological presentations, neuroimaging correlations, and critical care managements. Materials/SubjectsDuring January 1st 2014 to June 30th 2017, pediatric patients reported to the Taiwan Centers for Disease Control surveillance system for severe complicated influenza infections in the hospital were retrospectively reviewed. Children with influenza-associated encephalitis/encephalopathy were inspected for clinical presentations, laboratory data, neuroimaging studies, treatment modalities, and neurological outcomes. ResultsTen children with median age 5.9 years were enrolled for analysis. Influenza-associated encephalitis/encephalopathy appeared in the spring and summer, with a delayed peak comparing with the occurrence of pneumonia and septic shock. The neurological symptoms developed rapidly within median 1 day after the first fever episode. All patients had consciousness disturbance. Seven patients (70%) had seizures at initial presentation, and six of them had status epilepticus. Anti-viral treatments were applied in all patients, with median door-to-drug time 0.9 h for oseltamivir and 6.0 h for peramivir. Multi-modality treatments also included steroid pulse therapy, immunoglobulin treatment, and target temperature management, with 85.2% of the major treatments administered within 12 h after admission. Nine of the ten patients recovered without neurological sequelae. Only one patient had epilepsy requiring long-term anticonvulsants and concomitant cognitive decline. ConclusionsIn highly prevalent area, influenza-associated encephalitis/encephalopathy should be considered irrespective of seasons. Our study suggested the effects of timely surveillance and multi-modality treatments in influenza-associated encephalitis/encephalopathy.

Measuring the economic resilience of natural disasters: An analysis of major earthquakes in Japan

In recent years, the study of resilience of regional and local systems has become a popular topic in relation to the increasing of economic, social and environmental shocks. Despite the theoretical framework has been enriched through definitions and empirical investigations, accordance in measurement is still missing. This paper aims to enlarge the discussion of regional economic resilience in the face of natural disasters through the construction of the indices of resistance and recovery for Japanese prefectures stricken by major earthquakes. These measures may help to identify changes in employment due to the occurrence of a natural shock.

Maintenance Overtime Policy with Cumulative Damage

We propose an extended maintenance overtime policy for the cumulative damage model where an operating unit suffers some damage due to shocks. It is assumed that the total damage is additive, and the unit fails when the total damage has exceeded a prespecified damage level. It is supposed that we start to observe occurrence of shocks after time T, and the unit is replaced at Nth (N=1,2,…) shock over time T or at failure, whichever occurs first. That is, we propose a new policy by extending maintenance overtime policy. One example is a rental of system such as industrial equipment with some reservations. For such systems, they should be maintained or replaced at a prespecified number of uses over a scheduled time. For such a model, we obtain the mean time to replacement and the expected costs rate. Further, we discuss about optimal number N^* and time T^* which minimizes the expected cost rate when shocks occur in a Poisson process. Finally, numerical examples are given, and suitable discussions are made.

Non-ideal oblique shock waves

From the analysis of the isentropic limit of weak compression shock waves, oblique shock waves in which the post-shock Mach number is larger than the pre-shock Mach number, named non-ideal oblique shocks, are admissible in substances characterized by moderate molecular complexity and in the close proximity to the liquid–vapour saturation curve. Non-ideal oblique shocks of finite amplitude are systematically analysed, clarifying the roles of the pre-shock thermodynamic state and Mach number. The necessary conditions for the occurrence of non-ideal oblique shocks of finite amplitude are singled out. In the parameter space of pre-shock thermodynamic states and Mach number, a new domain is defined which embeds the pre-shock states for which the Mach number increase can possibly take place. The present findings are confirmed by state-of-the-art thermodynamic models applied to selected commercially available fluids, including siloxanes and hydrocarbons currently used as working fluids in renewable energy systems.

Blood urea nitrogen (BUN) independently predicts mortality in critically ill patients admitted to ICU: A multicenter study.

The Microcirculatory Shock Occurrence in Acutely Ill Patients (micro-SOAP) study investigated associations of microcirculation and mortality. Risk stratification in critically ill patients is of utmost interest. Established score such as APACHE2 (Acute Physiology And Chronic Health Evaluation 2) are relatively complex and might therefore be of limited use. Blood urea nitrogen (BUN) was described to be associated with mortality in various diseases. We therefore aimed (i) to evaluate BUN for prediction of mortality in a cohort of critically ill patients and (ii) to investigate associations of BUN with microcirculation. 412 patients were included in our post-hoc analysis of the prospective multicenter microSOAP study. Assesment of the sublingual microcirculation (Sidestream Dark Field (SDF) imaging) and collection of laboratory values were performed on the same day in this point prevalence study. Evaluation of associations with mortality was done by logistic regression analysis. An optimal BUN cut-off was calculated by means of the Youden Index. Median BUN was 9.0 mmol/L. BUN was associated with in-hospital-mortality in a logistic regression analysis (HR 1.03; 95% CI 1.01-1.05; p < 0.001). Per quartile (BUN 0-5.4 mmol/L, 5.4-9.0 mmol/L, 9.0-15.9 mmol/L and above 15.9 mmol/L) in-hospital mortality increased by as much as 51% (HR 1.51; 95% CI 1.23-1.85; p < 0.001). ROC analysis was done (AUC 0.63 95% CI 0.58-0.67) and the statistically optimal cut-off calculated by means of the Youden Index: 9.7 mmol/L. This cut-off was associated with a significant 3-fold increase in mortality (HR 2.97 95% CI 1.88-4.70; p < 0.001) and remained robustly associated with adverse outcome after correction for APACHE2 (HR 2.71 95% CI 1.61-4.59; p < 0.001), renal function as expressed by creatinine (HR 2.63 95% CI 1.59-4.33; p = 0.001), as well in an integrative model (MAP<60 mmHg, tachycardia (heart rate >90/min), lactate above 1.5 mmol/L, age above 80 years; HR 2.43 95% CI 1.50-3.92; p < 0.001). Parameters of microvascular perfusion were associated neither with BUN nor mortality. BUN is associated with hospital mortality and a combination of BUN and clinical signs might constitute a powerful but easy-to-use tool for risk stratification in critically ill patients and help improve their outcome. BUN was not associated with parameters of microcirculation which were not associated with mortality.

Frontier Analysis and Agricultural Typologies

PARI’s main goal is to contribute to sustainable agricultural growth and food security in Africa and India by supporting the scaling of proven innovations in the agri-food sector in collaboration with all relevant actors. PARI accompanies specified innovations with ex-ante impact research and identifies further innovation opportunities, including those expressed by end users of research in collaboration with the multi-stakeholder innovation platforms. Within PARI’s work, AGRODEP and IFPRI have the task of assisting in the development of a methodology and concept for strategic analysis and visioning by providing economic modelling tools to help understand where the best opportunities for innovation investments in value chains are. For this purpose, IFPRI has constructed agricultural typologies of micro-regions for 8 of the 12 African countries in PARI to identify micro-regional level opportunities, bottlenecks and investment gaps based on the concept of the production possibilities frontier applied to farm activities, drawing on highly detailed household-level survey and geospatial data on agroecological conditions, accessibility and poverty. The stochastic frontier approach allows the econometric exploration of the notion that, given the fixed local agroecological and economic conditions in a micro-region and the occurrence of random shocks that affect agricultural production (weather, prices, etc.), the investment, production decisions and technological innovations a farmer makes translate into higher or lower production and income. In such a context, inefficiency is defined as the loss incurred in by operating away from the frontier given the current prices and fixed factors faced by the household. By estimating where the frontier lies, and how far each producer is from it, the stochastic frontier approach helps to identify local potential and efficiency levels to construct the typology. With this estimation approach estimates are obtained that allow for the prediction and extrapolation of agricultural income potential and efficiency measures at the regional level, which can then be grouped and classified into types to construct the typology. The typology then allows the identification of types of regions with extremely different needs, bottlenecks and opportunities, which in turn will result in a different set of investment recommendations for development in each type of region, including decisions regarding investments in agricultural innovation.

Hypopituitarism in Men with History of Hypovolemic Shock

Hypopituitarism is the partial or complete insufficiency of pituitary hormone secretion. It has a diverse etiology, and some causes are of vascular origin. Vascular causes of hypopituitarism are classified as hemorrhagic/ischemic or obstructive/compressive. We report the case of a patient with chronic hypopituitarism found 15 years after the occurrence of hypovolemic shock during surgery performed to remove nasal polyps. We believe that hypopituitarism in this case is very similar to that described by Sheehan, resulting from blood loss and coagulation disorders. Observation of pituitary function in patients with a history of hypovolemic shock may be necessary, as it is mandatory in patients with a history of postpartum bleeding.

Influence of three-level collaboration network of pediatric burns treatment in Anhui province on treatment effects of burn children

Objective: To explore the influence of three-level collaboration network of pediatric burns in Anhui province on treatment effects of burn children. Methods: The data of medical records of pediatric burn children transferred from Lu'an People's Hospital and Fuyang People's Hospital to the First Affiliated Hospital of Anhui Medical University from January 2014 to December 2015 and January 2016 to September 2017 (before and after establishing three-level collaboration network of pediatric burns treatment) were analyzed: percentage of transferred burn children to hospitalized burn children in corresponding period, gender, age, burn degree, treatment method, treatment result, occurrence and treatment result of shock, and operative and non-operative treatment time and cost. Rehabilitation result of burn children transferred back to local hospitals in 2016 and 2017. Data were processed with t test, chi-square test, Mann-Whitney U test, and Fisher's exact test. Results: (1) Percentage of burn children transferred from January 2014 to December 2015 was 34.3% (291/848) of the total number of hospitalized burn children in the same period of time, which was close to 30.4% (210/691) of burn children transferred from January 2016 to September 2017 (χ(2)=2.672, P>0.05). (2) Gender, age, burn degree, and treatment method of burn children transferred from the two periods of time were close (χ(2)=3.382, Z=-1.917, -1.911, χ(2)=3.133, P>0.05). (3) Cure rates of children with mild, moderate, and severe burns transferred from January 2016 to September 2017 were significantly higher than those of burn children transferred from January 2014 to December 2015 (χ(2)=11.777, 6.948, 4.310, P 0.05). (4) Children with mild and moderate burns transferred from the two periods of time were with no shock. The incidence of shock of children with severe burns transferred from January 2014 to December 2015 was 6.0% (4/67), and 3 children among them were cured. The incidence of shock of children with severe burns transferred from January 2016 to September 2017 was 3.9% (2/51), and both children were cured. The incidences and cures of shock of children with severe burns transferred from the two periods of time were close (χ(2)=0.006, P>0.05). Incidence of shock of children with extremely severe burns transferred from January 2014 to December 2015 was 57.1% (32/56), significantly higher than that of burn children transferred from January 2016 to September 2017 [34.5% (10/29), χ(2)=3.925, P 0.05). (5) Time of operative treatment of children with moderate, severe, and extremely severe burns transferred from January 2014 to December 2015 was obviously longer than that of burn children transferred from January 2016 to September 2017 (t=2.335, 2.065, 2.310, P 0.05). Costs of operative treatment of children with moderate and severe burns transferred from January 2014 to December 2015 were significantly more than those of burn children transferred from January 2016 to September 2017 (Z=-3.324, t=2.167, P 0.05). (6)Time of non-operative treatment of children with mild, moderate, and severe burns transferred from January 2014 to December 2015 was obviously longer than that of burn children transferred from January 2016 to September 2017 (t=2.335, Z=-2.095, t=2.152, P 0.05). Costs of non-operative treatment of children with moderate and severe burns transferred from January 2014 to December 2015 were obviously higher than those of burn children transferred from January 2016 to September 2017 (Z=-2.164, t=2.040, P 0.05). (7) Sixty-seven burn children transferred from January 2016 to September 2017 were transferred back to local hospitals for rehabilitation under the guidance of experts of the First Affiliated Hospital of Anhui Medical University, with 25 patients in 2016 and 42 patients in 2017. Effective rehabilitation rates of burn children transferred back to local hospitals for rehabilitation in 2016 and 2017 were both 100%. Conclusions: The three-level collaboration network of pediatric burns treatment in Anhui province can effectively increase cure rate of children with mild, moderate, and severe burns, reduce incidence of shock of children with extremely severe burns, shorten time of operative treatment of burn children with moderate, severe, and extremely severe burns, and time of non-operative treatment of children with mild, moderate, and severe burns, reduce treatment costs of children with moderate and severe burns, and improve rehabilitation effectiveness of children transferred from Lu'an People's Hospital and Fuyang People's Hospital to the the First Affiliated Hospital of Anhui Medical University.