Risk factors and outcomes of peptic ulcer bleed in a Pakistani population:A single-center observational study

BACKGROUND Peptic ulcer disease(PUD)remains a significant healthcare burden,contributing to morbidity and mortality worldwide.Despite advancements in therapies,its prevalence persists,particularly in regions with widespread nonsteroidal antiinflammatory drugs(NSAIDs)use and Helicobacter pylori infection.AIM To comprehensively analyse the risk factors and outcomes of PUD-related upper gastrointestinal(GI)bleeding in Pakistani population.METHODS This retrospective cohort study included 142 patients with peptic ulcer bleeding who underwent upper GI endoscopy from January to December 2022.Data on demographics,symptoms,length of stay,mortality,re-bleed,and Forrest classification was collected.RESULTS The mean age of patients was 53 years,and the majority was men(68.3%).Hematemesis(82.4%)and epigastric pain(75.4%)were the most common presenting symptoms.Most patients(73.2%)were discharged within five days.The mortality rates at one week and one month were 10.6%and 14.8%,respectively.Re-bleed within 24 h and seven days occurred in 14.1%and 18.3%of patients,respectively.Most ulcers were Forrest class(FC)Ⅲ(72.5%).Antiplatelet use was associated with higher mortality at 7 and 30 d,while alternative medications were linked to higher 24-hour re-bleed rates.NSAID use was associated with more FCⅢulcers.Re-bleed at 24 h and 7 d was strongly associated with one-week or one-month mortality.CONCLUSION Antiplatelet use and rebleeding increase the risk of early mortality in PUD-related upper GI bleeding,while alternative medicines are associated with early rebleeding.

Privacy Data Management Mechanism Based on Blockchain and Federated Learning

Due to the extensive use of various intelligent terminals and the popularity of network social tools,a large amount of data in the field of medical emerged.How to manage these massive data safely and reliably has become an important challenge for the medical network community.This paper proposes a data management framework of medical network community based on Consortium Blockchain(CB)and Federated learning(FL),which realizes the data security sharing between medical institutions and research institutions.Under this framework,the data security sharing mechanism of medical network community based on smart contract and the data privacy protection mechanism based on FL and alliance chain are designed to ensure the security of data and the privacy of important data in medical network community,respectively.An intelligent contract system based on Keyed-Homomorphic Public Key(KH-PKE)Encryption scheme is designed,so that medical data can be saved in the CB in the form of ciphertext,and the automatic sharing of data is realized.Zero knowledge mechanism is used to ensure the correctness of shared data.Moreover,the zero-knowledge mechanism introduces the dynamic group signature mechanism of chosen ciphertext attack(CCA)anonymity,which makes the scheme more efficient in computing and communication cost.In the end of this paper,the performance of the scheme is analyzed fromboth asymptotic and practical aspects.Through experimental comparative analysis,the scheme proposed in this paper is more effective and feasible.

Distributed Timestamp Mechanism Based on Verifiable Delay Functions

In the data communication system,the real-time information interaction of communication device increases the risk of privacy sensitive data being tam-pered with.Therefore,maintaining data security is one of the most important issues in network data communication.Because the timestamp is the most impor-tant way to authenticate data in information interaction,it is very necessary to pro-vide timestamp service in the data communication system.However,the existing centralized timestamp mechanism is difficult to provide credible timestamp ser-vice,and users can conspire with timestamping servers to forge timestamps.Therefore,this paper designs a distributed timestamp mechanism based on contin-uous verifiable delay functions.It utilizes multiple independent timestamp servers to provide timestamp services in a distributed model and appends the timestamp to the data once the data is generated.Thus,it can prove that the data already exists at a certain time and ensure the accuracy of the timestamp.Moreover,a digital blind signature based on elliptic curve cryptography is utilized to solve the problem of timestamp forgery in timestamp service.Finally,the security ana-lysis of the scheme ensures the data security of data communication system and the concurrency rate of timestamp.The experimental results also show that the scheme greatly improves the efficiency of digital signatures.