Hospitals are crucial healthcare facilities where patients seek treatment,and effective budget management within hospitals significantly impacts their operational efficiency and financial performance.In the age of inf...Hospitals are crucial healthcare facilities where patients seek treatment,and effective budget management within hospitals significantly impacts their operational efficiency and financial performance.In the age of information technology and advanced healthcare solutions,the emergence of smart hospitals represents a new trend in the medical industry’s evolution.Leveraging modern information technology can enhance the development of hospital IT systems and drive budget management toward greater intelligence.This paper begins by analyzing the influence of smart hospitals on hospital budget control.It then examines the current state of budget management control within smart hospitals.Finally,it proposes several strategies for budget management control in smart hospitals,aiming to provide guidance for relevant stakeholders.展开更多
Developing technologies that can be applied simultaneously in battery thermal management(BTM)and thermal runaway(TR)mitigation is significant to improving the safety of lithium-ion battery systems.Inorganic phase chan...Developing technologies that can be applied simultaneously in battery thermal management(BTM)and thermal runaway(TR)mitigation is significant to improving the safety of lithium-ion battery systems.Inorganic phase change material(PCM)with nonflammability has the potential to achieve this dual function.This study proposed an encapsulated inorganic phase change material(EPCM)with a heat transfer enhancement for battery systems,where Na_(2)HPO_(4)·12H_(2)O was used as the core PCM encapsulated by silica and the additive of carbon nanotube(CNT)was applied to enhance the thermal conductivity.The microstructure and thermal properties of the EPCM/CNT were analyzed by a series of characterization tests.Two different incorporating methods of CNT were compared and the proper CNT adding amount was also studied.After preparation,the battery thermal management performance and TR propagation mitigation effects of EPCM/CNT were further investigated on the battery modules.The experimental results of thermal management tests showed that EPCM/CNT not only slowed down the temperature rising of the module but also improved the temperature uniformity during normal operation.The peak battery temperature decreased from 76℃to 61.2℃at 2 C discharge rate and the temperature difference was controlled below 3℃.Moreover,the results of TR propagation tests demonstrated that nonflammable EPCM/CNT with good heat absorption could work as a TR barrier,which exhibited effective mitigation on TR and TR propagation.The trigger time of three cells was successfully delayed by 129,474 and 551 s,respectively and the propagation intervals were greatly extended as well.展开更多
In groundwater hydrology,aquitard heterogeneity is often less considered compared to aquifers,despite its significant impact on groundwater hydraulics and groundwater resources evaluation.A semi-analytical solution is...In groundwater hydrology,aquitard heterogeneity is often less considered compared to aquifers,despite its significant impact on groundwater hydraulics and groundwater resources evaluation.A semi-analytical solution is derived for pumping-induced well hydraulics and groundwater budget with consideration of vertical heterogeneity in aquitard hydraulic conductivity(K)and specific storage(S_(s)).The proposed new solution is innovative in its partitioning of the aquitard into multiple homogeneous sub-layers to enable consideration of various forms of vertically heterogeneous K or S_(s).Two scenarios of analytical investigations are explored:one is the presence of aquitard interlayers with distinct K or S_(s) values,a common field-scale occurrence;another is an exponentially depth-decaying aquitard S_(s),a regional-scale phenomenon supported by statistical analysis.Analytical investigations reveal that a low-K interlayer can significantly increase aquifer drawdown and enhance aquifer/aquitard depletion;a high-S_(s) interlayer can noticeably reduce aquifer drawdown and increase aquitard depletion.Locations of low-K or high-S_(s) interlayers also significantly impact well hydraulics and groundwater budget.In the context of an exponentially depth-decaying aquitard S_(s),a larger decay exponent can enhance aquifer drawdown.When using current models with a vertically homogeneous aquitard,half the sum of the geometric and harmonic means of exponentially depth-decaying aquitard S_(s) should be used to calculate aquitard depletion and unconfined aquifer leakage.展开更多
Background: Venous thromboembolism (VTE) is a major public health problem due to its increasing frequency, mortality and management cost. This cost may require major financial efforts from patients, especially in deve...Background: Venous thromboembolism (VTE) is a major public health problem due to its increasing frequency, mortality and management cost. This cost may require major financial efforts from patients, especially in developing countries like ours where less than 7% of the population has health insurance. This study aimed to estimate the direct cost of managing VTE in three reference hospitals in Yaoundé. Methods: This was a cross-sectional retrospective study over a three-year period (from January 1st 2018 to December 31 2020) carried out in the Cardiology departments of the Central and General Hospitals, and the Emergency Centre of the city of Yaoundé. All patients managed during the study period for deep vein thrombosis and pulmonary embolism confirmed by venous ultrasound coupled with Doppler and computed tomography pulmonary angiography respectively were included. For each patient, we collected sociodemographic and clinical data as well as data on the cost of consultation, hospital stay, workups and medications. These data were analysed using SPSS version 23.0. Results: A total of 92 patient’s records were analysed. The median age was 60 years [48 - 68] with a sex ratio of 0.53. The median direct cost of management of venous thromboembolism was 766,375 CFAF [536,455 - 1,029,745] or $1415 USD. Management of pulmonary embolism associated with deep vein thrombosis was more costly than isolated pulmonary embolism or deep vein thrombosis. Factors influencing the direct cost of management of venous thromboembolism were: hospital structure (p = 0.015), health insurance (p 0.001), type of pulmonary embolism (p = 0.021), and length of hospital stay (p = 0.001). Conclusion: Management of VTE is a major financial burden for our patients and this burden is influenced by the hospital structure, health insurance, type of pulmonary embolism and length of hospital stay.展开更多
Crowdsourcing holds broad applications in information acquisition and dissemination,yet encounters challenges pertaining to data quality assessment and user reputation management.Reputation mechanisms stand as crucial...Crowdsourcing holds broad applications in information acquisition and dissemination,yet encounters challenges pertaining to data quality assessment and user reputation management.Reputation mechanisms stand as crucial solutions for appraising and updating participant reputation scores,thereby elevating the quality and dependability of crowdsourced data.However,these mechanisms face several challenges in traditional crowdsourcing systems:1)platform security lacks robust guarantees and may be susceptible to attacks;2)there exists a potential for large-scale privacy breaches;and 3)incentive mechanisms relying on reputation scores may encounter issues as reputation updates hinge on task demander evaluations,occasionally lacking a dedicated reputation update module.This paper introduces a reputation update scheme tailored for crowdsourcing,with a focus on proficiently overseeing participant reputations and alleviating the impact of malicious activities on the sensing system.Here,the reputation update scheme is determined by an Empirical Cumulative distribution-based Outlier Detection method(ECOD).Our scheme embraces a blockchain-based crowdsourcing framework utilizing a homomorphic encryption method to ensure data transparency and tamper-resistance.Computation of user reputation scores relies on their behavioral history,actively discouraging undesirable conduct.Additionally,we introduce a dynamic weight incentive mechanism that mirrors alterations in participant reputation,enabling the system to allocate incentives based on user behavior and reputation.Our scheme undergoes evaluation on 11 datasets,revealing substantial enhancements in data credibility for crowdsourcing systems and a reduction in the influence of malicious behavior.This research not only presents a practical solution for crowdsourcing reputation management but also offers valuable insights for future research and applications,holding promise for fostering more reliable and high-quality data collection in crowdsourcing across diverse domains.展开更多
In permissioned blockchain networks,the Proof of Authority(PoA)consensus,which uses the election of authorized nodes to validate transactions and blocks,has beenwidely advocated thanks to its high transaction throughp...In permissioned blockchain networks,the Proof of Authority(PoA)consensus,which uses the election of authorized nodes to validate transactions and blocks,has beenwidely advocated thanks to its high transaction throughput and fault tolerance.However,PoA suffers from the drawback of centralization dominated by a limited number of authorized nodes and the lack of anonymity due to the round-robin block proposal mechanism.As a result,traditional PoA is vulnerable to a single point of failure that compromises the security of the blockchain network.To address these issues,we propose a novel decentralized reputation management mechanism for permissioned blockchain networks to enhance security,promote liveness,and mitigate centralization while retaining the same throughput as traditional PoA.This paper aims to design an off-chain reputation evaluation and an on-chain reputation-aided consensus.First,we evaluate the nodes’reputation in the context of the blockchain networks and make the reputation globally verifiable through smart contracts.Second,building upon traditional PoA,we propose a reputation-aided PoA(rPoA)consensus to enhance securitywithout sacrificing throughput.In particular,rPoA can incentivize nodes to autonomously form committees based on reputation authority,which prevents block generation from being tracked through the randomness of reputation variation.Moreover,we develop a reputation-aided fork-choice rule for rPoA to promote the network’s liveness.Finally,experimental results show that the proposed rPoA achieves higher security performance while retaining transaction throughput compared to traditional PoA.展开更多
In mega-constellation Communication Systems, efficient routing algorithms and data transmission technologies are employed to ensure fast and reliable data transfer. However, the limited computational resources of sate...In mega-constellation Communication Systems, efficient routing algorithms and data transmission technologies are employed to ensure fast and reliable data transfer. However, the limited computational resources of satellites necessitate the use of edge computing to enhance secure communication.While edge computing reduces the burden on cloud computing, it introduces security and reliability challenges in open satellite communication channels. To address these challenges, we propose a blockchain architecture specifically designed for edge computing in mega-constellation communication systems. This architecture narrows down the consensus scope of the blockchain to meet the requirements of edge computing while ensuring comprehensive log storage across the network. Additionally, we introduce a reputation management mechanism for nodes within the blockchain, evaluating their trustworthiness, workload, and efficiency. Nodes with higher reputation scores are selected to participate in tasks and are appropriately incentivized. Simulation results demonstrate that our approach achieves a task result reliability of 95% while improving computational speed.展开更多
Objective:To conduct a systematic literature review on urethral calculi in a contemporary cohort describing etiology,investigation,and management patterns.Methods:A systematic search of MEDLINE and Cochrane Central Re...Objective:To conduct a systematic literature review on urethral calculi in a contemporary cohort describing etiology,investigation,and management patterns.Methods:A systematic search of MEDLINE and Cochrane Central Register of Controlled Trials(CENTRAL)databases was performed.Articles,including case reports and case series on urethral calculi published between January 2000 and December 2019,were included.Full-text manuscripts were reviewed for clinical parameters including symptomatology,etiology,medical history,investigations,treatment,and outcomes.Data were collated and analyzed with univariate methods.Results:Seventy-four publications met inclusion criteria,reporting on 95 cases.Voiding symptoms(41.1%),pain(40.0%),and acute urinary retention(32.6%)were common presenting features.Urethral calculi were most often initially investigated using plain X-ray(63.2%),with almost all radio-opaque(98.3%).Urethral calculi were frequently associated with coexistent bladder or upper urinary tract calculi(16.8%)and underlying urethral pathology(53.7%)including diverticulum(33.7%)or stricture(13.7%).Urethral calculi were most commonly managed with external urethrolithotomy(31.6%),retrograde manipulation(22.1%),and endoscopic in situ lithotripsy(17.9%).Conclusion:This unique systematic review of urethral calculi provided a summary of clinical features and treatment trends with a suggested treatment algorithm.Management in contemporary urological practice should be according to calculus size,shape,anatomical location,and presence of urethral pathology.展开更多
AIM:To assess glaucoma patient satisfaction and follow-up adherence in case management and identify associated predictors to improve healthcare quality and patient outcomes.METHODS:In this cross-sectional study,a tota...AIM:To assess glaucoma patient satisfaction and follow-up adherence in case management and identify associated predictors to improve healthcare quality and patient outcomes.METHODS:In this cross-sectional study,a total of 119 patients completed a Patient Satisfaction Questionnaire-18 and a sociodemographic questionnaire.Clinical data was obtained from the case management system.Follow-up adherence was defined as completing each follow-up within±30d of the scheduled time set by ophthalmologists during the study period.RESULTS:Average satisfaction scored 78.65±7,with an average of 4.39±0.58 across the seven dimensions.Age negatively correlated with satisfaction(P=0.008),whilst patients with follow-up duration of 2 or more years reported higher satisfaction(P=0.045).Multivariate logistics regression analysis revealed that longer follow-up durations were associated with lower follow-up adherence(OR=0.97,95%CI,0.95-1.00,P=0.044).Additionally,patients with suspected glaucoma(OR=2.72,95%CI,1.03-7.20,P=0.044)and those with an annual income over 100000 Chinese yuan demonstrated higher adherence(OR=5.57,95%CI,1.00-30.89,P=0.049).CONCLUSION:The case management model proves effective for glaucoma patients,with positive adherence rates.The implementation of this model can be optimized in the future based on the identified factors and extended to glaucoma patients in more hospitals.展开更多
Introduction: Malnutrition is a pathological state resulting from the relative deficiency or excess of one or more essential nutrients, whether manifested clinically or detected only by biochemical, anthropometric or ...Introduction: Malnutrition is a pathological state resulting from the relative deficiency or excess of one or more essential nutrients, whether manifested clinically or detected only by biochemical, anthropometric or physiological analyses. The overall objective was to assess the quality of management of acute malnutrition in children aged 0 - 24 months at the Boulbinet health center. Methodology: This was a prospective descriptive study lasting six (06) months from May 5 to October 5, 2018. The study included all children aged 0 to 24 months. Results: Acute malnutrition in children aged 0 - 24 months accounted for 2.11% of cases. The sex ratio was 1.41 in favor of males. The mean age of our patients was 5 months 7 days, with extremes of 1 month and 6 months. The majority came from Ra toma (40.24%). Exclusive breastfeeding was most common (54.02%). The main clinical signs were: pallor 49.42%, diarrhea 46.67, oral lesions37.96%. SAM represented 89.66% and MAM 10.34%. Most associated pathologies: anemia 49.42% and oral candidiasis 37.93%. In terms of outcome, we recorded 56.32% cures, 20.69% deaths, 18.39% dropouts and 4.60% cures. Conclusion: Improving the quality of care for malnourished children aged 0 - 24 months requires raising awareness among mothers and the general public of the consequences of malnutrition.展开更多
Background: Tuberculosis (TB) is one of the major killer diseases among infectious diseases. The success of TB control depends on the capability of the health care system to detect and accurately manage TB cases. Tube...Background: Tuberculosis (TB) is one of the major killer diseases among infectious diseases. The success of TB control depends on the capability of the health care system to detect and accurately manage TB cases. Tuberculosis in children remained a low public health priority with limited epidemiologic studies. Struggles for TB control in children need to be enhanced as children are providing the reservoir for future cases to develop. Objectives: The study evaluated diagnostic and treatment practices related to childhood pulmonary tuberculosis in Gilgit Baltistan (GB), Pakistan. Methods: A descriptive, cross-sectional study based on retrospective record review of childhood Pulmonary Tuberculosis patients registered in the year 2020 with self-administered questionnaire. Results: Data of 557 childhood cases were collected. Most childhood cases were in age group 1 - 4 years (54%) with male predominance. More than 90% were diagnosed and treated at public sector facilities. 99% of the cases were clinically diagnosed with passive case finding. Cough was considered as a symptom of childhood Tuberculosis (TB) by 94% of physicians. Other important features included failure to thrive (13%), contact with a family history of TB (15%), Malnutrition(24%) and respiratory signs (21%). 99% physicians advised chest X-ray, Complete blood count (CBC) (95%) and Erythrocytes sedimentation rate (ESR) (72%) for diagnosis and fewer physicians (2%) used sputum smear microscopy and induced sputum (0.1%). Combining data on dosage, frequency and duration for drugs, 99% of the cases were found receiving correct regimen. The treatment outcomes of the cases were cured 4 (0.8%), treatment completed 551 (99.3%) and died 2 (0.4%) with no lost to follow up. Conclusions: The study highlights inappropriate diagnostic and treatment practices for managing childhood pulmonary TB among physicians in public and private sectors of Gilgit Baltistan. Most of the cases are managed by general practitioners with no post graduate qualification in medicine or pediatrics. The deviations from the guidelines for TB control cannot be negated in the region.展开更多
Traditional blockchain key management schemes store private keys in the same location,which can easily lead to security issues such as a single point of failure.Therefore,decentralized threshold key management schemes...Traditional blockchain key management schemes store private keys in the same location,which can easily lead to security issues such as a single point of failure.Therefore,decentralized threshold key management schemes have become a research focus for blockchain private key protection.The security of private keys for blockchain user wallet is highly related to user identity authentication and digital asset security.The threshold blockchain private key management schemes based on verifiable secret sharing have made some progress,but these schemes do not consider participants’self-interested behavior,and require trusted nodes to keep private key fragments,resulting in a narrow application scope and low deployment efficiency,which cannot meet the needs of personal wallet private key escrow and recovery in public blockchains.We design a private key management scheme based on rational secret sharing that considers the self-interest of participants in secret sharing protocols,and constrains the behavior of rational participants through reasonable mechanism design,making it more suitable in distributed scenarios such as the public blockchain.The proposed scheme achieves the escrow and recovery of personal wallet private keys without the participation of trusted nodes,and simulate its implementation on smart contracts.Compared to other existing threshold wallet solutions and keymanagement schemes based on password-protected secret sharing(PPSS),the proposed scheme has a wide range of applications,verifiable private key recovery,low communication overhead,higher computational efficiency when users perform one-time multi-key escrow,no need for trusted nodes,and personal rational constraints and anti-collusion attack capabilities.展开更多
The satellite-terrestrial networks possess the ability to transcend geographical constraints inherent in traditional communication networks,enabling global coverage and offering users ubiquitous computing power suppor...The satellite-terrestrial networks possess the ability to transcend geographical constraints inherent in traditional communication networks,enabling global coverage and offering users ubiquitous computing power support,which is an important development direction of future communications.In this paper,we take into account a multi-scenario network model under the coverage of low earth orbit(LEO)satellite,which can provide computing resources to users in faraway areas to improve task processing efficiency.However,LEO satellites experience limitations in computing and communication resources and the channels are time-varying and complex,which makes the extraction of state information a daunting task.Therefore,we explore the dynamic resource management issue pertaining to joint computing,communication resource allocation and power control for multi-access edge computing(MEC).In order to tackle this formidable issue,we undertake the task of transforming the issue into a Markov decision process(MDP)problem and propose the self-attention based dynamic resource management(SABDRM)algorithm,which effectively extracts state information features to enhance the training process.Simulation results show that the proposed algorithm is capable of effectively reducing the long-term average delay and energy consumption of the tasks.展开更多
BACKGROUND Macrodactyly is a rare congenital malformation characterized by an increase in the size of all structures of a digit,accounting for less than 1%of all congenital upper extremity conditions.CASE SUMMARY We r...BACKGROUND Macrodactyly is a rare congenital malformation characterized by an increase in the size of all structures of a digit,accounting for less than 1%of all congenital upper extremity conditions.CASE SUMMARY We report a case involving a 49-year-old woman who presented for the first time with untreated,radial-sided hand macrodactyly.We performed soft tissue debulking,amputation,median nerve neurotomy and coaptation,and carpal tunnel release.At the 6-year follow-up,no significant growth was observed in the bone or soft tissue of the affected area.CONCLUSION Tissue overgrowth in patients with progressive macrodactyly can continue and progress excessively with age.Median nerve neurotomy and coaptation play a crucial role in preventing recurrence of the deformity.展开更多
Identifying a device and detecting a change in its position is critical for secure devices management in the Internet of Things(IoT).In this paper,a device management system is proposed to track the devices by using a...Identifying a device and detecting a change in its position is critical for secure devices management in the Internet of Things(IoT).In this paper,a device management system is proposed to track the devices by using audio-based location distinction techniques.In the proposed scheme,traditional cryptographic techniques,such as symmetric encryption algorithm,RSA-based signcryption scheme,and audio-based secure transmission,are utilized to provide authentication,non-repudiation,and confidentiality in the information interaction of the management system.Moreover,an audio-based location distinction method is designed to detect the position change of the devices.Specifically,the audio frequency response(AFR)of several frequency points is utilized as a device signature.The device signature has the features as follows.(1)Hardware Signature:different pairs of speaker and microphone have different signatures;(2)Distance Signature:in the same direction,the signatures are different at different distances;and(3)Direction Signature:at the same distance,the signatures are different in different directions.Based on the features above,amovement detection algorithmfor device identification and location distinction is designed.Moreover,a secure communication protocol is also proposed by using traditional cryptographic techniques to provide integrity,authentication,and non-repudiation in the process of information interaction between devices,Access Points(APs),and Severs.Extensive experiments are conducted to evaluate the performance of the proposed method.The experimental results show that the proposedmethod has a good performance in accuracy and energy consumption.展开更多
A retrospective study was conducted at the HGR de Panzi in eastern DR Congo to determine the profile of colorectal cancer (CRC) management based on 55 cases out of 129 digestive cancers diagnosed in the digestive surg...A retrospective study was conducted at the HGR de Panzi in eastern DR Congo to determine the profile of colorectal cancer (CRC) management based on 55 cases out of 129 digestive cancers diagnosed in the digestive surgery, endoscopy, and pathology department of the HGR de Panzi from January 2002 to December 2016. The prevalence of CRC was 42.6%. The mean age of patients was 50.8 years, with a range of 20 to 81 years. The male to female ratio was 2.2. In 69.1% of cases, the patients had a low socioeconomic status, and 52.7% had a history of hemorrhoids. Rectorrhagia revealed CCR in 49.1% of cases. The mode of discovery was predominantly emergency in 69.1% of cases, and 58.20% of CRCs were diagnosed by an initial endoscopy of the lower colon. Adenocarcinoma was found in 94.5% of cases, and 45% of cases required abdominoperineal amputation. Various postoperative complications were experienced by 54.5% of patients, and 25.5% of patients died. To decrease the occurrence of these types of cancers, it is necessary to focus on early detection in the population and enhance access to primary healthcare for everyone.展开更多
Moyamoya disease (MMD) is a condition characterized by the gradual narrowing and blockage of blood vessels in the brain, specifically those in the circle of Willis and the arteries that supply it. This results in redu...Moyamoya disease (MMD) is a condition characterized by the gradual narrowing and blockage of blood vessels in the brain, specifically those in the circle of Willis and the arteries that supply it. This results in reduced blood flow and oxygen to the brain, leading to progressive symptoms and potential complications. The underlying pathophysiological mechanism remains elucidated. However, recent studies have highlighted numerous etiologic factors: abnormal immune complex responses, susceptibility genes, branched-chain amino acids, antibodies, heritable diseases, and acquired diseases, which may be the great potential triggers for the development of moyamoya disease. Its clinical presentation has varying degrees from transient asymptomatic events to significant neurological deficits. Moyamoya disease (MMD) shows different patterns in children and adults. Children with MMD are more susceptible to ischemic events due to decreased blood flow to the brain. Conversely, adults with MMD are more prone to hemorrhagic events involving brain bleeding. Children with MMD may experience a range of symptoms including motor impairments, sensory issues, seizures, headaches, dizziness, cognitive delays, or ongoing neurological problems. Although adults may present with similar clinical symptoms as children, they are more prone to experiencing sudden onset intraventricular, subarachnoid, or intracerebral hemorrhages. One of the challenges in moyamoya disease is the potential for misdiagnosis or delayed diagnosis, particularly when physicians fail to consider MMD as a possible cause in stroke patients. This review aims to provide a comprehensive overview of recent global studies on the pathophysiology of MMD, along with advancements in its management. Additionally, the review will delve into various surgical treatment options for MMD, as well as its rare occurrence alongside atrioventricular malformations. Exciting prospects include the use of autologous bone marrow transplant and the potential role of Connexin 43 protein treatment in the development of moyamoya disease.展开更多
Enterprise risk management holds significant importance in fostering sustainable growth of businesses and in serving as a critical element for regulatory bodies to uphold market order.Amidst the challenges posed by in...Enterprise risk management holds significant importance in fostering sustainable growth of businesses and in serving as a critical element for regulatory bodies to uphold market order.Amidst the challenges posed by intricate and unpredictable risk factors,knowledge graph technology is effectively driving risk management,leveraging its ability to associate and infer knowledge from diverse sources.This review aims to comprehensively summarize the construction techniques of enterprise risk knowledge graphs and their prominent applications across various business scenarios.Firstly,employing bibliometric methods,the aim is to uncover the developmental trends and current research hotspots within the domain of enterprise risk knowledge graphs.In the succeeding section,systematically delineate the technical methods for knowledge extraction and fusion in the standardized construction process of enterprise risk knowledge graphs.Objectively comparing and summarizing the strengths and weaknesses of each method,we provide recommendations for addressing the existing challenges in the construction process.Subsequently,categorizing the applied research of enterprise risk knowledge graphs based on research hotspots and risk category standards,and furnishing a detailed exposition on the applicability of technical routes and methods.Finally,the future research directions that still need to be explored in enterprise risk knowledge graphs were discussed,and relevant improvement suggestions were proposed.Practitioners and researchers can gain insights into the construction of technical theories and practical guidance of enterprise risk knowledge graphs based on this foundation.展开更多
Energy management is an inspiring domain in developing of renewable energy sources.However,the growth of decentralized energy production is revealing an increased complexity for power grid managers,inferring more qual...Energy management is an inspiring domain in developing of renewable energy sources.However,the growth of decentralized energy production is revealing an increased complexity for power grid managers,inferring more quality and reliability to regulate electricity flows and less imbalance between electricity production and demand.The major objective of an energy management system is to achieve optimum energy procurement and utilization throughout the organization,minimize energy costs without affecting production,and minimize environmental effects.Modern energy management is an essential and complex subject because of the excessive consumption in residential buildings,which necessitates energy optimization and increased user comfort.To address the issue of energy management,many researchers have developed various frameworks;while the objective of each framework was to sustain a balance between user comfort and energy consumption,this problem hasn’t been fully solved because of how difficult it is to solve it.An inclusive and Intelligent Energy Management System(IEMS)aims to provide overall energy efficiency regarding increased power generation,increase flexibility,increase renewable generation systems,improve energy consumption,reduce carbon dioxide emissions,improve stability,and reduce energy costs.Machine Learning(ML)is an emerging approach that may be beneficial to predict energy efficiency in a better way with the assistance of the Internet of Energy(IoE)network.The IoE network is playing a vital role in the energy sector for collecting effective data and usage,resulting in smart resource management.In this research work,an IEMS is proposed for Smart Cities(SC)using the ML technique to better resolve the energy management problem.The proposed system minimized the energy consumption with its intelligent nature and provided better outcomes than the previous approaches in terms of 92.11% accuracy,and 7.89% miss-rate.展开更多
Spontaneous intracerebral haemorrhage (sICH) is characterised by bleeding within the brain parenchyma, without any accompanying vascular malformation, parenchymal abnormality or coagulation disorder. The study aimed t...Spontaneous intracerebral haemorrhage (sICH) is characterised by bleeding within the brain parenchyma, without any accompanying vascular malformation, parenchymal abnormality or coagulation disorder. The study aimed to depict the management of sICH at the University Hospital of Brazzaville (UHB). It was an observational, descriptive, and cross-sectional analysis. Data collection was conducted retrospectively, covering the period from January 1, 2020 to August 31, 2022, spanning two years and eight months. The study examined socio-demographic, diagnostic, therapeutic, and evolutionary variables. We included 274 cases. We observed 160 men (58.4%) and 114 women (41.6%), resulting in a sex ratio of 1.4. The mean age was 55.3 ± 11.4 years, with ages ranging from 31 to 93 years. The detection of sICH was typically a result of experiencing motor deficits (59.5%) or disorders of consciousness (37.2%). The weightiness of one half of the body was the most common reason for seeking medical advice. Hematoma was capsulo-lenticular in 159 cases (58%) and capsulo-thalamic in 63 cases (23%). Hematomas were <30 ml in 162 cases (59.1%) and >30 ml in 112 cases (40.9%), and associated with hydrocephalus in 11.7% of cases. Conservative medical treatment was administered in 257 cases (94.2%) while surgical treatment was performed in 16 cases (5.8%). The surgical techniques used were external ventricular drainage (EVD) in 2 cases, ventriculo-peritoneal shunt in 5 cases, and hematoma evacuation in 10 cases. Death occurred before the 7th day of hospitalisation in 73 cases (57.8%) and after in 46 cases (42.2%). The median time to death was four days (Q1 = 2 days;Q3 = 7 days), with extremes of 0 and 216 days. .展开更多
文摘Hospitals are crucial healthcare facilities where patients seek treatment,and effective budget management within hospitals significantly impacts their operational efficiency and financial performance.In the age of information technology and advanced healthcare solutions,the emergence of smart hospitals represents a new trend in the medical industry’s evolution.Leveraging modern information technology can enhance the development of hospital IT systems and drive budget management toward greater intelligence.This paper begins by analyzing the influence of smart hospitals on hospital budget control.It then examines the current state of budget management control within smart hospitals.Finally,it proposes several strategies for budget management control in smart hospitals,aiming to provide guidance for relevant stakeholders.
基金financially supported by the National Key Research and Development Program(Grant No.2022YFE0207400)the National Natural Science Foundation of China(Grant No.U22A20168 and 52174225)。
文摘Developing technologies that can be applied simultaneously in battery thermal management(BTM)and thermal runaway(TR)mitigation is significant to improving the safety of lithium-ion battery systems.Inorganic phase change material(PCM)with nonflammability has the potential to achieve this dual function.This study proposed an encapsulated inorganic phase change material(EPCM)with a heat transfer enhancement for battery systems,where Na_(2)HPO_(4)·12H_(2)O was used as the core PCM encapsulated by silica and the additive of carbon nanotube(CNT)was applied to enhance the thermal conductivity.The microstructure and thermal properties of the EPCM/CNT were analyzed by a series of characterization tests.Two different incorporating methods of CNT were compared and the proper CNT adding amount was also studied.After preparation,the battery thermal management performance and TR propagation mitigation effects of EPCM/CNT were further investigated on the battery modules.The experimental results of thermal management tests showed that EPCM/CNT not only slowed down the temperature rising of the module but also improved the temperature uniformity during normal operation.The peak battery temperature decreased from 76℃to 61.2℃at 2 C discharge rate and the temperature difference was controlled below 3℃.Moreover,the results of TR propagation tests demonstrated that nonflammable EPCM/CNT with good heat absorption could work as a TR barrier,which exhibited effective mitigation on TR and TR propagation.The trigger time of three cells was successfully delayed by 129,474 and 551 s,respectively and the propagation intervals were greatly extended as well.
基金financially supported by the National Key Research and Development Program of China(Grant No.2019YFC1804301)the National Science Fourdation of China(Grant No.42272279,41902244)partial support from a Discovery Grant awarded by the Natural Sciences and Engineering Research Council of Canada(NSERC)。
文摘In groundwater hydrology,aquitard heterogeneity is often less considered compared to aquifers,despite its significant impact on groundwater hydraulics and groundwater resources evaluation.A semi-analytical solution is derived for pumping-induced well hydraulics and groundwater budget with consideration of vertical heterogeneity in aquitard hydraulic conductivity(K)and specific storage(S_(s)).The proposed new solution is innovative in its partitioning of the aquitard into multiple homogeneous sub-layers to enable consideration of various forms of vertically heterogeneous K or S_(s).Two scenarios of analytical investigations are explored:one is the presence of aquitard interlayers with distinct K or S_(s) values,a common field-scale occurrence;another is an exponentially depth-decaying aquitard S_(s),a regional-scale phenomenon supported by statistical analysis.Analytical investigations reveal that a low-K interlayer can significantly increase aquifer drawdown and enhance aquifer/aquitard depletion;a high-S_(s) interlayer can noticeably reduce aquifer drawdown and increase aquitard depletion.Locations of low-K or high-S_(s) interlayers also significantly impact well hydraulics and groundwater budget.In the context of an exponentially depth-decaying aquitard S_(s),a larger decay exponent can enhance aquifer drawdown.When using current models with a vertically homogeneous aquitard,half the sum of the geometric and harmonic means of exponentially depth-decaying aquitard S_(s) should be used to calculate aquitard depletion and unconfined aquifer leakage.
文摘Background: Venous thromboembolism (VTE) is a major public health problem due to its increasing frequency, mortality and management cost. This cost may require major financial efforts from patients, especially in developing countries like ours where less than 7% of the population has health insurance. This study aimed to estimate the direct cost of managing VTE in three reference hospitals in Yaoundé. Methods: This was a cross-sectional retrospective study over a three-year period (from January 1st 2018 to December 31 2020) carried out in the Cardiology departments of the Central and General Hospitals, and the Emergency Centre of the city of Yaoundé. All patients managed during the study period for deep vein thrombosis and pulmonary embolism confirmed by venous ultrasound coupled with Doppler and computed tomography pulmonary angiography respectively were included. For each patient, we collected sociodemographic and clinical data as well as data on the cost of consultation, hospital stay, workups and medications. These data were analysed using SPSS version 23.0. Results: A total of 92 patient’s records were analysed. The median age was 60 years [48 - 68] with a sex ratio of 0.53. The median direct cost of management of venous thromboembolism was 766,375 CFAF [536,455 - 1,029,745] or $1415 USD. Management of pulmonary embolism associated with deep vein thrombosis was more costly than isolated pulmonary embolism or deep vein thrombosis. Factors influencing the direct cost of management of venous thromboembolism were: hospital structure (p = 0.015), health insurance (p 0.001), type of pulmonary embolism (p = 0.021), and length of hospital stay (p = 0.001). Conclusion: Management of VTE is a major financial burden for our patients and this burden is influenced by the hospital structure, health insurance, type of pulmonary embolism and length of hospital stay.
基金This work is supported by National Natural Science Foundation of China(Nos.U21A20463,62172117,61802383)Research Project of Pazhou Lab for Excellent Young Scholars(No.PZL2021KF0024)Guangzhou Basic and Applied Basic Research Foundation(Nos.202201010330,202201020162,202201020221).
文摘Crowdsourcing holds broad applications in information acquisition and dissemination,yet encounters challenges pertaining to data quality assessment and user reputation management.Reputation mechanisms stand as crucial solutions for appraising and updating participant reputation scores,thereby elevating the quality and dependability of crowdsourced data.However,these mechanisms face several challenges in traditional crowdsourcing systems:1)platform security lacks robust guarantees and may be susceptible to attacks;2)there exists a potential for large-scale privacy breaches;and 3)incentive mechanisms relying on reputation scores may encounter issues as reputation updates hinge on task demander evaluations,occasionally lacking a dedicated reputation update module.This paper introduces a reputation update scheme tailored for crowdsourcing,with a focus on proficiently overseeing participant reputations and alleviating the impact of malicious activities on the sensing system.Here,the reputation update scheme is determined by an Empirical Cumulative distribution-based Outlier Detection method(ECOD).Our scheme embraces a blockchain-based crowdsourcing framework utilizing a homomorphic encryption method to ensure data transparency and tamper-resistance.Computation of user reputation scores relies on their behavioral history,actively discouraging undesirable conduct.Additionally,we introduce a dynamic weight incentive mechanism that mirrors alterations in participant reputation,enabling the system to allocate incentives based on user behavior and reputation.Our scheme undergoes evaluation on 11 datasets,revealing substantial enhancements in data credibility for crowdsourcing systems and a reduction in the influence of malicious behavior.This research not only presents a practical solution for crowdsourcing reputation management but also offers valuable insights for future research and applications,holding promise for fostering more reliable and high-quality data collection in crowdsourcing across diverse domains.
基金supported by the Shenzhen Science and Technology Program under Grants KCXST20221021111404010,JSGG20220831103400002,JSGGKQTD20221101115655027,JCYJ 20210324094609027the National KeyR&DProgram of China under Grant 2021YFB2700900+1 种基金the National Natural Science Foundation of China under Grants 62371239,62376074,72301083the Jiangsu Specially-Appointed Professor Program 2021.
文摘In permissioned blockchain networks,the Proof of Authority(PoA)consensus,which uses the election of authorized nodes to validate transactions and blocks,has beenwidely advocated thanks to its high transaction throughput and fault tolerance.However,PoA suffers from the drawback of centralization dominated by a limited number of authorized nodes and the lack of anonymity due to the round-robin block proposal mechanism.As a result,traditional PoA is vulnerable to a single point of failure that compromises the security of the blockchain network.To address these issues,we propose a novel decentralized reputation management mechanism for permissioned blockchain networks to enhance security,promote liveness,and mitigate centralization while retaining the same throughput as traditional PoA.This paper aims to design an off-chain reputation evaluation and an on-chain reputation-aided consensus.First,we evaluate the nodes’reputation in the context of the blockchain networks and make the reputation globally verifiable through smart contracts.Second,building upon traditional PoA,we propose a reputation-aided PoA(rPoA)consensus to enhance securitywithout sacrificing throughput.In particular,rPoA can incentivize nodes to autonomously form committees based on reputation authority,which prevents block generation from being tracked through the randomness of reputation variation.Moreover,we develop a reputation-aided fork-choice rule for rPoA to promote the network’s liveness.Finally,experimental results show that the proposed rPoA achieves higher security performance while retaining transaction throughput compared to traditional PoA.
基金supported in part by the National Natural Science Foundation of China under Grant No.U2268204,62172061 and 61871422National Key R&D Program of China under Grant No.2020YFB1711800 and 2020YFB1707900+2 种基金the Science and Technology Project of Sichuan Province under Grant No.2023ZHCG0014,2023ZHCG0011,2022YFG0155,2022YFG0157,2021GFW019,2021YFG0152,2021YFG0025,2020YFG0322Central Universities of Southwest Minzu University under Grant No.ZYN2022032,2023NYXXS034the State Scholarship Fund of the China Scholarship Council under Grant No.202008510081。
文摘In mega-constellation Communication Systems, efficient routing algorithms and data transmission technologies are employed to ensure fast and reliable data transfer. However, the limited computational resources of satellites necessitate the use of edge computing to enhance secure communication.While edge computing reduces the burden on cloud computing, it introduces security and reliability challenges in open satellite communication channels. To address these challenges, we propose a blockchain architecture specifically designed for edge computing in mega-constellation communication systems. This architecture narrows down the consensus scope of the blockchain to meet the requirements of edge computing while ensuring comprehensive log storage across the network. Additionally, we introduce a reputation management mechanism for nodes within the blockchain, evaluating their trustworthiness, workload, and efficiency. Nodes with higher reputation scores are selected to participate in tasks and are appropriately incentivized. Simulation results demonstrate that our approach achieves a task result reliability of 95% while improving computational speed.
文摘Objective:To conduct a systematic literature review on urethral calculi in a contemporary cohort describing etiology,investigation,and management patterns.Methods:A systematic search of MEDLINE and Cochrane Central Register of Controlled Trials(CENTRAL)databases was performed.Articles,including case reports and case series on urethral calculi published between January 2000 and December 2019,were included.Full-text manuscripts were reviewed for clinical parameters including symptomatology,etiology,medical history,investigations,treatment,and outcomes.Data were collated and analyzed with univariate methods.Results:Seventy-four publications met inclusion criteria,reporting on 95 cases.Voiding symptoms(41.1%),pain(40.0%),and acute urinary retention(32.6%)were common presenting features.Urethral calculi were most often initially investigated using plain X-ray(63.2%),with almost all radio-opaque(98.3%).Urethral calculi were frequently associated with coexistent bladder or upper urinary tract calculi(16.8%)and underlying urethral pathology(53.7%)including diverticulum(33.7%)or stricture(13.7%).Urethral calculi were most commonly managed with external urethrolithotomy(31.6%),retrograde manipulation(22.1%),and endoscopic in situ lithotripsy(17.9%).Conclusion:This unique systematic review of urethral calculi provided a summary of clinical features and treatment trends with a suggested treatment algorithm.Management in contemporary urological practice should be according to calculus size,shape,anatomical location,and presence of urethral pathology.
基金Supported by the Key Innovation and Guidance Program of the Eye Hospital,School of Ophthalmology&Optometry,Wenzhou Medical University(No.YNZD2201903)the Scientific Research Foundation of the Eye Hospital,School of Ophthalmology&Optometry,Wenzhou Medical University(No.KYQD20180306)the Nursing Project of the Eye Hospital of Wenzhou Medical University(No.YNHL2201908).
文摘AIM:To assess glaucoma patient satisfaction and follow-up adherence in case management and identify associated predictors to improve healthcare quality and patient outcomes.METHODS:In this cross-sectional study,a total of 119 patients completed a Patient Satisfaction Questionnaire-18 and a sociodemographic questionnaire.Clinical data was obtained from the case management system.Follow-up adherence was defined as completing each follow-up within±30d of the scheduled time set by ophthalmologists during the study period.RESULTS:Average satisfaction scored 78.65±7,with an average of 4.39±0.58 across the seven dimensions.Age negatively correlated with satisfaction(P=0.008),whilst patients with follow-up duration of 2 or more years reported higher satisfaction(P=0.045).Multivariate logistics regression analysis revealed that longer follow-up durations were associated with lower follow-up adherence(OR=0.97,95%CI,0.95-1.00,P=0.044).Additionally,patients with suspected glaucoma(OR=2.72,95%CI,1.03-7.20,P=0.044)and those with an annual income over 100000 Chinese yuan demonstrated higher adherence(OR=5.57,95%CI,1.00-30.89,P=0.049).CONCLUSION:The case management model proves effective for glaucoma patients,with positive adherence rates.The implementation of this model can be optimized in the future based on the identified factors and extended to glaucoma patients in more hospitals.
文摘Introduction: Malnutrition is a pathological state resulting from the relative deficiency or excess of one or more essential nutrients, whether manifested clinically or detected only by biochemical, anthropometric or physiological analyses. The overall objective was to assess the quality of management of acute malnutrition in children aged 0 - 24 months at the Boulbinet health center. Methodology: This was a prospective descriptive study lasting six (06) months from May 5 to October 5, 2018. The study included all children aged 0 to 24 months. Results: Acute malnutrition in children aged 0 - 24 months accounted for 2.11% of cases. The sex ratio was 1.41 in favor of males. The mean age of our patients was 5 months 7 days, with extremes of 1 month and 6 months. The majority came from Ra toma (40.24%). Exclusive breastfeeding was most common (54.02%). The main clinical signs were: pallor 49.42%, diarrhea 46.67, oral lesions37.96%. SAM represented 89.66% and MAM 10.34%. Most associated pathologies: anemia 49.42% and oral candidiasis 37.93%. In terms of outcome, we recorded 56.32% cures, 20.69% deaths, 18.39% dropouts and 4.60% cures. Conclusion: Improving the quality of care for malnourished children aged 0 - 24 months requires raising awareness among mothers and the general public of the consequences of malnutrition.
文摘Background: Tuberculosis (TB) is one of the major killer diseases among infectious diseases. The success of TB control depends on the capability of the health care system to detect and accurately manage TB cases. Tuberculosis in children remained a low public health priority with limited epidemiologic studies. Struggles for TB control in children need to be enhanced as children are providing the reservoir for future cases to develop. Objectives: The study evaluated diagnostic and treatment practices related to childhood pulmonary tuberculosis in Gilgit Baltistan (GB), Pakistan. Methods: A descriptive, cross-sectional study based on retrospective record review of childhood Pulmonary Tuberculosis patients registered in the year 2020 with self-administered questionnaire. Results: Data of 557 childhood cases were collected. Most childhood cases were in age group 1 - 4 years (54%) with male predominance. More than 90% were diagnosed and treated at public sector facilities. 99% of the cases were clinically diagnosed with passive case finding. Cough was considered as a symptom of childhood Tuberculosis (TB) by 94% of physicians. Other important features included failure to thrive (13%), contact with a family history of TB (15%), Malnutrition(24%) and respiratory signs (21%). 99% physicians advised chest X-ray, Complete blood count (CBC) (95%) and Erythrocytes sedimentation rate (ESR) (72%) for diagnosis and fewer physicians (2%) used sputum smear microscopy and induced sputum (0.1%). Combining data on dosage, frequency and duration for drugs, 99% of the cases were found receiving correct regimen. The treatment outcomes of the cases were cured 4 (0.8%), treatment completed 551 (99.3%) and died 2 (0.4%) with no lost to follow up. Conclusions: The study highlights inappropriate diagnostic and treatment practices for managing childhood pulmonary TB among physicians in public and private sectors of Gilgit Baltistan. Most of the cases are managed by general practitioners with no post graduate qualification in medicine or pediatrics. The deviations from the guidelines for TB control cannot be negated in the region.
基金the State’s Key Project of Research and Development Plan under Grant 2022YFB2701400in part by the National Natural Science Foundation of China under Grants 62272124 and 62361010+4 种基金in part by the Science and Technology Planning Project of Guizhou Province under Grant[2020]5017in part by the Research Project of Guizhou University for Talent Introduction underGrant[2020]61in part by theCultivation Project of Guizhou University under Grant[2019]56in part by the Open Fund of Key Laboratory of Advanced Manufacturing Technology,Ministry of Education under Grant GZUAMT2021KF[01]the Science and Technology Program of Guizhou Province(No.[2023]371).
文摘Traditional blockchain key management schemes store private keys in the same location,which can easily lead to security issues such as a single point of failure.Therefore,decentralized threshold key management schemes have become a research focus for blockchain private key protection.The security of private keys for blockchain user wallet is highly related to user identity authentication and digital asset security.The threshold blockchain private key management schemes based on verifiable secret sharing have made some progress,but these schemes do not consider participants’self-interested behavior,and require trusted nodes to keep private key fragments,resulting in a narrow application scope and low deployment efficiency,which cannot meet the needs of personal wallet private key escrow and recovery in public blockchains.We design a private key management scheme based on rational secret sharing that considers the self-interest of participants in secret sharing protocols,and constrains the behavior of rational participants through reasonable mechanism design,making it more suitable in distributed scenarios such as the public blockchain.The proposed scheme achieves the escrow and recovery of personal wallet private keys without the participation of trusted nodes,and simulate its implementation on smart contracts.Compared to other existing threshold wallet solutions and keymanagement schemes based on password-protected secret sharing(PPSS),the proposed scheme has a wide range of applications,verifiable private key recovery,low communication overhead,higher computational efficiency when users perform one-time multi-key escrow,no need for trusted nodes,and personal rational constraints and anti-collusion attack capabilities.
基金supported by the National Key Research and Development Plan(No.2022YFB2902701)the key Natural Science Foundation of Shenzhen(No.JCYJ20220818102209020).
文摘The satellite-terrestrial networks possess the ability to transcend geographical constraints inherent in traditional communication networks,enabling global coverage and offering users ubiquitous computing power support,which is an important development direction of future communications.In this paper,we take into account a multi-scenario network model under the coverage of low earth orbit(LEO)satellite,which can provide computing resources to users in faraway areas to improve task processing efficiency.However,LEO satellites experience limitations in computing and communication resources and the channels are time-varying and complex,which makes the extraction of state information a daunting task.Therefore,we explore the dynamic resource management issue pertaining to joint computing,communication resource allocation and power control for multi-access edge computing(MEC).In order to tackle this formidable issue,we undertake the task of transforming the issue into a Markov decision process(MDP)problem and propose the self-attention based dynamic resource management(SABDRM)algorithm,which effectively extracts state information features to enhance the training process.Simulation results show that the proposed algorithm is capable of effectively reducing the long-term average delay and energy consumption of the tasks.
基金Supported by Special TCM Innovation Project of Hebei Provincial Department of Science and Technology,No.223777130DScientific Research Project of Hebei Province Administration of Traditional Chinese Medicine,No.2024215.
文摘BACKGROUND Macrodactyly is a rare congenital malformation characterized by an increase in the size of all structures of a digit,accounting for less than 1%of all congenital upper extremity conditions.CASE SUMMARY We report a case involving a 49-year-old woman who presented for the first time with untreated,radial-sided hand macrodactyly.We performed soft tissue debulking,amputation,median nerve neurotomy and coaptation,and carpal tunnel release.At the 6-year follow-up,no significant growth was observed in the bone or soft tissue of the affected area.CONCLUSION Tissue overgrowth in patients with progressive macrodactyly can continue and progress excessively with age.Median nerve neurotomy and coaptation play a crucial role in preventing recurrence of the deformity.
基金This work is supported by Demonstration of Scientific and Technology Achievements Transform in Sichuan Province under Grant 2022ZHCG0036National Natural Science Foundation of China(62002047).
文摘Identifying a device and detecting a change in its position is critical for secure devices management in the Internet of Things(IoT).In this paper,a device management system is proposed to track the devices by using audio-based location distinction techniques.In the proposed scheme,traditional cryptographic techniques,such as symmetric encryption algorithm,RSA-based signcryption scheme,and audio-based secure transmission,are utilized to provide authentication,non-repudiation,and confidentiality in the information interaction of the management system.Moreover,an audio-based location distinction method is designed to detect the position change of the devices.Specifically,the audio frequency response(AFR)of several frequency points is utilized as a device signature.The device signature has the features as follows.(1)Hardware Signature:different pairs of speaker and microphone have different signatures;(2)Distance Signature:in the same direction,the signatures are different at different distances;and(3)Direction Signature:at the same distance,the signatures are different in different directions.Based on the features above,amovement detection algorithmfor device identification and location distinction is designed.Moreover,a secure communication protocol is also proposed by using traditional cryptographic techniques to provide integrity,authentication,and non-repudiation in the process of information interaction between devices,Access Points(APs),and Severs.Extensive experiments are conducted to evaluate the performance of the proposed method.The experimental results show that the proposedmethod has a good performance in accuracy and energy consumption.
文摘A retrospective study was conducted at the HGR de Panzi in eastern DR Congo to determine the profile of colorectal cancer (CRC) management based on 55 cases out of 129 digestive cancers diagnosed in the digestive surgery, endoscopy, and pathology department of the HGR de Panzi from January 2002 to December 2016. The prevalence of CRC was 42.6%. The mean age of patients was 50.8 years, with a range of 20 to 81 years. The male to female ratio was 2.2. In 69.1% of cases, the patients had a low socioeconomic status, and 52.7% had a history of hemorrhoids. Rectorrhagia revealed CCR in 49.1% of cases. The mode of discovery was predominantly emergency in 69.1% of cases, and 58.20% of CRCs were diagnosed by an initial endoscopy of the lower colon. Adenocarcinoma was found in 94.5% of cases, and 45% of cases required abdominoperineal amputation. Various postoperative complications were experienced by 54.5% of patients, and 25.5% of patients died. To decrease the occurrence of these types of cancers, it is necessary to focus on early detection in the population and enhance access to primary healthcare for everyone.
文摘Moyamoya disease (MMD) is a condition characterized by the gradual narrowing and blockage of blood vessels in the brain, specifically those in the circle of Willis and the arteries that supply it. This results in reduced blood flow and oxygen to the brain, leading to progressive symptoms and potential complications. The underlying pathophysiological mechanism remains elucidated. However, recent studies have highlighted numerous etiologic factors: abnormal immune complex responses, susceptibility genes, branched-chain amino acids, antibodies, heritable diseases, and acquired diseases, which may be the great potential triggers for the development of moyamoya disease. Its clinical presentation has varying degrees from transient asymptomatic events to significant neurological deficits. Moyamoya disease (MMD) shows different patterns in children and adults. Children with MMD are more susceptible to ischemic events due to decreased blood flow to the brain. Conversely, adults with MMD are more prone to hemorrhagic events involving brain bleeding. Children with MMD may experience a range of symptoms including motor impairments, sensory issues, seizures, headaches, dizziness, cognitive delays, or ongoing neurological problems. Although adults may present with similar clinical symptoms as children, they are more prone to experiencing sudden onset intraventricular, subarachnoid, or intracerebral hemorrhages. One of the challenges in moyamoya disease is the potential for misdiagnosis or delayed diagnosis, particularly when physicians fail to consider MMD as a possible cause in stroke patients. This review aims to provide a comprehensive overview of recent global studies on the pathophysiology of MMD, along with advancements in its management. Additionally, the review will delve into various surgical treatment options for MMD, as well as its rare occurrence alongside atrioventricular malformations. Exciting prospects include the use of autologous bone marrow transplant and the potential role of Connexin 43 protein treatment in the development of moyamoya disease.
基金supported by the Shandong Province Science and Technology Project(2023TSGC0509,2022TSGC2234)Qingdao Science and Technology Plan Project(23-1-5-yqpy-2-qy).
文摘Enterprise risk management holds significant importance in fostering sustainable growth of businesses and in serving as a critical element for regulatory bodies to uphold market order.Amidst the challenges posed by intricate and unpredictable risk factors,knowledge graph technology is effectively driving risk management,leveraging its ability to associate and infer knowledge from diverse sources.This review aims to comprehensively summarize the construction techniques of enterprise risk knowledge graphs and their prominent applications across various business scenarios.Firstly,employing bibliometric methods,the aim is to uncover the developmental trends and current research hotspots within the domain of enterprise risk knowledge graphs.In the succeeding section,systematically delineate the technical methods for knowledge extraction and fusion in the standardized construction process of enterprise risk knowledge graphs.Objectively comparing and summarizing the strengths and weaknesses of each method,we provide recommendations for addressing the existing challenges in the construction process.Subsequently,categorizing the applied research of enterprise risk knowledge graphs based on research hotspots and risk category standards,and furnishing a detailed exposition on the applicability of technical routes and methods.Finally,the future research directions that still need to be explored in enterprise risk knowledge graphs were discussed,and relevant improvement suggestions were proposed.Practitioners and researchers can gain insights into the construction of technical theories and practical guidance of enterprise risk knowledge graphs based on this foundation.
文摘Energy management is an inspiring domain in developing of renewable energy sources.However,the growth of decentralized energy production is revealing an increased complexity for power grid managers,inferring more quality and reliability to regulate electricity flows and less imbalance between electricity production and demand.The major objective of an energy management system is to achieve optimum energy procurement and utilization throughout the organization,minimize energy costs without affecting production,and minimize environmental effects.Modern energy management is an essential and complex subject because of the excessive consumption in residential buildings,which necessitates energy optimization and increased user comfort.To address the issue of energy management,many researchers have developed various frameworks;while the objective of each framework was to sustain a balance between user comfort and energy consumption,this problem hasn’t been fully solved because of how difficult it is to solve it.An inclusive and Intelligent Energy Management System(IEMS)aims to provide overall energy efficiency regarding increased power generation,increase flexibility,increase renewable generation systems,improve energy consumption,reduce carbon dioxide emissions,improve stability,and reduce energy costs.Machine Learning(ML)is an emerging approach that may be beneficial to predict energy efficiency in a better way with the assistance of the Internet of Energy(IoE)network.The IoE network is playing a vital role in the energy sector for collecting effective data and usage,resulting in smart resource management.In this research work,an IEMS is proposed for Smart Cities(SC)using the ML technique to better resolve the energy management problem.The proposed system minimized the energy consumption with its intelligent nature and provided better outcomes than the previous approaches in terms of 92.11% accuracy,and 7.89% miss-rate.
文摘Spontaneous intracerebral haemorrhage (sICH) is characterised by bleeding within the brain parenchyma, without any accompanying vascular malformation, parenchymal abnormality or coagulation disorder. The study aimed to depict the management of sICH at the University Hospital of Brazzaville (UHB). It was an observational, descriptive, and cross-sectional analysis. Data collection was conducted retrospectively, covering the period from January 1, 2020 to August 31, 2022, spanning two years and eight months. The study examined socio-demographic, diagnostic, therapeutic, and evolutionary variables. We included 274 cases. We observed 160 men (58.4%) and 114 women (41.6%), resulting in a sex ratio of 1.4. The mean age was 55.3 ± 11.4 years, with ages ranging from 31 to 93 years. The detection of sICH was typically a result of experiencing motor deficits (59.5%) or disorders of consciousness (37.2%). The weightiness of one half of the body was the most common reason for seeking medical advice. Hematoma was capsulo-lenticular in 159 cases (58%) and capsulo-thalamic in 63 cases (23%). Hematomas were <30 ml in 162 cases (59.1%) and >30 ml in 112 cases (40.9%), and associated with hydrocephalus in 11.7% of cases. Conservative medical treatment was administered in 257 cases (94.2%) while surgical treatment was performed in 16 cases (5.8%). The surgical techniques used were external ventricular drainage (EVD) in 2 cases, ventriculo-peritoneal shunt in 5 cases, and hematoma evacuation in 10 cases. Death occurred before the 7th day of hospitalisation in 73 cases (57.8%) and after in 46 cases (42.2%). The median time to death was four days (Q1 = 2 days;Q3 = 7 days), with extremes of 0 and 216 days. .