Safety and effectiveness of butorphanol in epidural labor analgesia:A protocol for a systematic review and meta-analysis

BACKGROUND Epidural analgesia is the most effective analgesic method during labor.Butorphanol administered epidurally has been shown to be a successful analgesic method during labor.However,no comprehensive study has examined the safety and efficacy of using butorphanol as an epidural analgesic during labor.AIM To assess butorphanol's safety and efficacy for epidural labor analgesia.METHODS The PubMed,Cochrane Library,EMBASE,Web of Science,China National Knowledge Infrastructure,and Google Scholar databases will be searched from inception.Other types of literature,such as conference abstracts and references to pertinent reviews,will also be reviewed.We will include randomized controlled trials comparing butorphanol with other opioids combined with local anesthetics for epidural analgesia during labor.There will be no language restrictions.The primary outcomes will include the visual analog scale score for the first stage of labor,fetal effects,and Apgar score.Two independent reviewers will evaluate the full texts,extract data,and assess the risk of bias.Publication bias will be evaluated using Egger's or Begg's tests as well as visual analysis of a funnel plot,and heterogeneity will be evaluated using the Cochran Q test,P values,and I2 values.Meta-analysis,subgroup analysis,and sensitivity analysis will be performed using RevMan software version 5.4.This protocol was developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)Protocols statement,and the PRISMA statement will be used for the systematic review.RESULTS This study provides reliable information regarding the safety and efficacy of using butorphanol as an epidural analgesic during labor.CONCLUSION To support clinical practice and development,this study provides evidence-based findings regarding the safety and efficacy of using butorphanol as an epidural analgesic during labor.

A holistic approach to improving safety for battery energy storage systems

The integration of battery energy storage systems(BESS)throughout our energy chain poses concerns regarding safety,especially since batteries have high energy density and numerous BESS failure events have occurred.Wider spread adoption will only increase the prevalence of these failure events unless there is a step change in the management and design of BESS.To understand the causes of failure,the main challenges of BESS safety are summarised.BESS consequences and failure events are discussed,including specific focus on the chain of events causing thermal runaway,and a case study of a BESS explosion in Surprise Arizona is analysed.Based on the technology and past events,a paradigm shift is required to improve BESS safety.In this review,a holistic approach is proposed.This combines currently adopted approaches including battery cell testing,lumped cell mathematical modelling,and calorimetry,alongside additional measures taken to ensure BESS safety including the requirement for computational fluid dynamics and kinetic modelling,assessment of installation level testing of the full BESS system and not simply a single cell battery test,hazard and layers of protection analysis,gas chromatography,and composition testing.The holistic approach proposed in this study aims to address challenges of BESS safety and form the basis of a paradigm shift in the safety management and design of these systems.

Leveraging Augmented Reality,Semantic-Segmentation,and VANETs for Enhanced Driver’s Safety Assistance

Overtaking is a crucial maneuver in road transportation that requires a clear view of the road ahead.However,limited visibility of ahead vehicles can often make it challenging for drivers to assess the safety of overtaking maneuvers,leading to accidents and fatalities.In this paper,we consider atrous convolution,a powerful tool for explicitly adjusting the field-of-view of a filter as well as controlling the resolution of feature responses generated by Deep Convolutional Neural Networks in the context of semantic image segmentation.This article explores the potential of seeing-through vehicles as a solution to enhance overtaking safety.See-through vehicles leverage advanced technologies such as cameras,sensors,and displays to provide drivers with a real-time view of the vehicle ahead,including the areas hidden from their direct line of sight.To address the problems of safe passing and occlusion by huge vehicles,we designed a see-through vehicle system in this study,we employed a windshield display in the back car together with cameras in both cars.The server within the back car was used to segment the car,and the segmented portion of the car displayed the video from the front car.Our see-through system improves the driver’s field of vision and helps him change lanes,cross a large car that is blocking their view,and safely overtake other vehicles.Our network was trained and tested on the Cityscape dataset using semantic segmentation.This transparent technique will instruct the driver on the concealed traffic situation that the front vehicle has obscured.For our findings,we have achieved 97.1% F1-score.The article also discusses the challenges and opportunities of implementing see-through vehicles in real-world scenarios,including technical,regulatory,and user acceptance factors.

Seismic safety assessment with non-Gaussian random processes for train-bridge coupled systems

Extensive high-speed railway(HSR)network resembled the intricate vascular system of the human body,crisscrossing mainlands.Seismic events,known for their unpredictability,pose a significant threat to both trains and bridges,given the HSR’s extended operational duration.Therefore,ensuring the running safety of train-bridge coupled(TBC)system,primarily composed of simply supported beam bridges,is paramount.Traditional methods like the Monte Carlo method fall short in analyzing this intricate system efficiently.Instead,efficient algorithm like the new point estimate method combined with moment expansion approximation(NPEM-MEA)is applied to study random responses of numerical simulation TBC systems.Validation of the NPEM-MEA’s feasibility is conducted using the Monte Carlo method.Comparative analysis confirms the accuracy and efficiency of the method,with a recommended truncation order of four to six for the NPEM-MEA.Additionally,the influences of seismic magnitude and epicentral distance are discussed based on the random dynamic responses in the TBC system.This methodology not only facilitates seismic safety assessments for TBC systems but also contributes to standard-setting for these systems under earthquake conditions.

Efficacy and safety of perioperative therapy for locally resectable gastric cancer:A network meta-analysis of randomized clinical trials

BACKGROUND Gastric cancer(GC)is the fifth most commonly diagnosed malignancy worldwide,with over 1 million new cases per year,and the third leading cause of cancer-related death.AIM To determine the optimal perioperative treatment regimen for patients with locally resectable GC.METHODS A comprehensive literature search was conducted,focusing on phase II/III randomized controlled trials(RCTs)assessing perioperative chemotherapy and chemoradiotherapy in treating locally resectable GC.The R0 resection rate,overall survival(OS),disease-free survival(DFS),and incidence of grade 3 or higher nonsurgical severe adverse events(SAEs)associated with various perioperative regimens were analyzed.A Bayesian network meta-analysis was performed to compare treatment regimens and rank their efficacy.RESULTS Thirty RCTs involving 8346 patients were included in this study.Neoadjuvant XELOX plus neoadjuvant radiotherapy and neoadjuvant CF were found to significantly improve the R0 resection rate compared with surgery alone,and the former had the highest probability of being the most effective option in this context.Neoadjuvant plus adjuvant FLOT was associated with the highest probability of being the best regimen for improving OS.Owing to limited data,no definitive ranking could be determined for DFS.Considering nonsurgical SAEs,FLO has emerged as the safest treatment regimen.CONCLUSION This study provides valuable insights for clinicians when selecting perioperative treatment regimens for patients with locally resectable GC.Further studies are required to validate these findings.

Safety and effectiveness of neuromuscular electrical stimulation in cardiac surgery:A systematic review

BACKGROUND Lack of mobilization and prolonged stay in the intensive care unit(ICU)are major factors resulting in the development of ICU-acquired muscle weakness(ICUAW).ICUAW is a type of skeletal muscle dysfunction and a common complication of patients after cardiac surgery,and may be a risk factor for prolonged duration of mechanical ventilation,associated with a higher risk of readmission and higher mortality.Early mobilization in the ICU after cardiac surgery has been found to be low with a significant trend to increase over ICU stay and is also associated with a reduced duration of mechanical ventilation and ICU length of stay.Neuromuscular electrical stimulation(NMES)is an alternative modality of exercise in patients with muscle weakness.A major advantage of NMES is that it can be applied even in sedated patients in the ICU,a fact that might enhance early mobilization in these patients.AIM To evaluate safety,feasibility and effectiveness of NMES on functional capacity and muscle strength in patients before and after cardiac surgery.METHODS We performed a search on Pubmed,Physiotherapy Evidence Database(PEDro),Embase and CINAHL databases,selecting papers published between December 2012 and April 2023 and identified published randomized controlled trials(RCTs)that included implementation of NMES in patients before after cardiac surgery.RCTs were assessed for methodological rigor and risk of bias via the PEDro.The primary outcomes were safety and functional capacity and the secondary outcomes were muscle strength and function.RESULTS Ten studies were included in our systematic review,resulting in 703 participants.Almost half of them performed NMES and the other half were included in the control group,treated with usual care.Nine studies investigated patients after cardiac surgery and 1 study before cardiac surgery.Functional capacity was assessed in 8 studies via 6MWT or other indices,and improved only in 1 study before and in 1 after cardiac surgery.Nine studies explored the effects of NMES on muscle strength and function and,most of them,found increase of muscle strength and improvement in muscle function after NMES.NMES was safe in all studies without any significant complication.CONCLUSION NMES is safe,feasible and has beneficial effects on muscle strength and function in patients after cardiac surgery,but has no significant effect on functional capacity.

Reflection on methodology of the correlation between electromagnetic interference and safety in high-speed railway

Purpose – In the continuous development of high-speed railways, ensuring the safety of the operation controlsystem is crucial. Electromagnetic interference (EMI) faults in signaling equipment may cause transportationinterruptions, delays and even threaten the safety of train operations. Exploring the impact of disturbances onsignaling equipment and establishing evaluation methods for the correlation between EMI and safety isurgently needed.Design/methodology/approach – This paper elaborates on the necessity and significance of studying theimpact of EMI as an unavoidable and widespread risk factor in the external environment of high-speed railwayoperations and continuous development. The current status of research methods and achievements from theperspectives of standard systems, reliability analysis and safety assessment are examined layer by layer.Additionally, it provides prospects for innovative ideas for exploring the quantitative correlation between EMIand signaling safety.Findings – Despite certain innovative achievements in both domestic and international standard systems andrelated research for ensuring and evaluating railway signaling safety, there’s a lack of quantitative and strategic research on the degradation of safety performance in signaling equipment due to EMI. A quantitativecorrelation between EMI and safety has yet to be established. On this basis, this paper proposes considerationsfor research methods pertaining to the correlation between EMI and safety.Originality/value – This paper overviews a series of methods and outcomes derived from domestic andinternational studies regarding railway signaling safety, encompassing standard systems, reliability analysisand safety assessment. Recognizing the necessity for quantitatively describing and predicting the impact ofEMI on high-speed railway signaling safety, an innovative approach using risk assessment techniques as abridge to establish the correlation between EMI and signaling safety is proposed.

Field Load Test Based SHM System Safety Standard Determination for Rigid Frame Bridge

The deteriorated continuous rigid frame bridge is strengthened by external prestressing. Static loading tests wereconducted before and after the bridge rehabilitation to verify the effectiveness of the rehabilitation process. Thestiffness of the repaired bridge is improved, and the maximum deflection of the load test is reduced from 37.9 to27.6 mm. A bridge health monitoring system is installed after the bridge is reinforced. To achieve an easy assessmentof the bridge’s safety status by directly using transferred data, a real-time safety warning system is createdbased on a five-level safety standard. The threshold for each safety level will be determined by theoretical calculationsand the outcomes of static loading tests. The highest risk threshold will be set at the ultimate limit statevalue. The remaining levels, namely middle risk, low risk, and very low risk, will be determined usingreduction coefficients of 0.95, 0.9, and 0.8, respectively.

Safety Risk Assessment Analysis of Bridge Construction Using Backpropagation Neural Network

The evaluation of construction safety risks has become a crucial task with the increasing development of bridge construction.This paper aims to provide an overview of the application of backpropagation neural networks in assessing safety risks during bridge construction.It introduces the situation,principles,methods,and advantages,as well as the current status and future development directions of backpropagation-related research.

Effectiveness and safety of seven oral Chinese patent medicines as adjuvant therapy for cancer-related anemia: A systematic review and network meta-analysis of randomized controlled trials

Objective:To evaluate the effectiveness and safety of seven oral Chinese patent medicines(CPMs)as adjuvant therapy for cancer-related anemia(CRA)by network meta-analysis(NMA).Methods:A literature search to obtain randomized controlled trials(RCTs)of seven oral CPMs in the adjuvant treatment of CRA was conducted in multiple databases from the inception to April 2022.The RevMan5.3 and R 4.1.1 software were used for NMA.Results:We ultimately included 29 RCTs with 2140 patients.Traditional meta-analysis showed that Fufang E'jiao syrup(FFEJS),Shengxuebao mixture(SXBM),Shengxuening tablets(SXNT),Jianpi Shengxue granules(JPSXG),and Yixuesheng capsule(YXSC)combined with basic Western treatment(BWT)could improve the hemoglobin(HGB)level.JPSXG combined with BWT could improve the red blood cell(RBC).FFEJS combined with BWT improved the Karnofsky performance status(KPS).NMA showed that FFEJS,JPSXG,SXBM,and SXNT plus BWT improved HGB better than Shengxue tablets(SXT)plus BWT,with top three ranking results being JPSXG plus BWT>SXNT plus BWT>FFEJS plus BWT.FFEJS plus BWT,JPSXG plus BWT,SXBM plus BWT,SXNT plus BWT,and SXT plus BWT improved RBC better than BWT,with top three ranking results being SXNT plus BWT>JPSXG plus BWT>FFEJS plus BWT.In terms of the KPS score,compared with SXT plus BWT,FFEJS,JPSXG,SXBM,SXNT,and Yizhong Shengxue capsule(YZSXC)plus BWT had higher KPS,with top three ranking results being SXBM plus BWT>JPSXG plus BWT>FFEJS plus BWT.Conclusions:Our NMA demonstrated that seven oral CPMs used as adjuvant treatment of CRA had a definite clinical effect.JPSXG not only increases the levels of HGB and RBC to enhance the clinical effect but also improves patients'quality of life.More accurate conclusions need to be verified by more high-quality RCTs.

Smart Shoes Safety System for the Blind People Based on (IoT) Technology

People’s lives have become easier and simpler as technology has proliferated.This is especially true with the Internet of Things(IoT).The biggest problem for blind people is figuring out how to get where they want to go.People with good eyesight need to help these people.Smart shoes are a technique that helps blind people find their way when they walk.So,a special shoe has been made to help blind people walk safely without worrying about running into other people or solid objects.In this research,we are making a new safety system and a smart shoe for blind people.The system is based on Internet of Things(IoT)technology and uses three ultrasonic sensors to allow users to hear and react to barriers.It has ultrasonic sensors and a microprocessor that can tell how far away something is and if there are any obstacles.Water and flame sensors were used,and a sound was used to let the person know if an obstacle was near him.The sensors use Global Positioning System(GPS)technology to detect motion from almost every side to keep an eye on them and ensure they are safe.To test our proposal,we gave a questionnaire to 100 people.The questionnaire has eleven questions,and 99.1%of the people who filled it out said that the product meets their needs.

Design and development of safety evaluation system of buildings on a seismic field based on the network platform

This paper describes a set of on-site earthquake safety evaluation systems for buildings, which were developed based on a network platform. The system embedded into the quantitative research results which were completed in accordance with the provisions from Post-earthquake Field Works, Part 2： Safety Assessment of Buildings, GB18208.2 -2001, and was further developed into an easy-to-use software platform. The system is aimed at allowing engineering professionals, civil engineeing technicists or earthquake-affected victims on site to assess damaged buildings through a network after earthquakes. The authors studied the function structure, process design of the safety evaluation module, and hierarchical analysis algorithm module of the system in depth, and developed the general architecture design, development technology and database design of the system. Technologies such as hierarchical architecture design and Java EE were used in the system development, and MySQL5 was adopted in the database development. The result is a complete evaluation process of information collection, safety evaluation, and output of damage and safety degrees, as well as query and statistical analysis of identified buildings. The system can play a positive role in sharing expert post-earthquake experience and promoting safety evaluation of buildings on a seismic field.

Passive electrochemical hydrogen recombiner for hydrogen safety systems:prospects

This paper presents the concept of a passive electrochemical hydrogen recombiner(PEHR).The reaction energy of the recombination of hydrogen and oxygen is used as a source of electrical energy according to the operating principle for hydrogen fuel cells to establish forced circulation of the hydrogen mixture as an alternative to natural circulation(as is not utilized in conventional passive autocatalytic hydrogen recombiners currently used in nuclear power plants(NPPs)).The proposed concept of applying the physical operation principles of a PEHR based on a fuel cell simultaneously increases both productivity in terms of recombined hydrogen and the concentration threshold of flameless operation(the‘ignition’limit).Thus,it is possible to reliably ensure the hydrogen explosion safety of NPPs under all conditions,including beyond-design accidents.An experimental setup was assembled to test a laboratory sample of a membrane electrode assembly(MEA)at various hydrogen concentrations near the catalytic surfaces of the electrodes,and the corresponding current–voltage characteristics were recorded.The simplest MEA based on the Advent P1100W PBI membrane demonstrated stable performance(delivery of electrical power)over a wide range of hydrogen concentrations.

Adapted Speed System in a Road Bend Situation in VANET Environment

Today,road safety remains a serious concern for governments around the world.In fact,approximately 1.35 million people die and 2–50 million are injured on public roads worldwide each year.Straight bends in road traffic are the main cause of many road accidents,and excessive and inappropriate speed in this very critical area can cause drivers to lose their vehicle stability.For these reasons,new solutions must be considered to stop this disaster and save lives.Therefore,it is necessary to study this topic very carefully and use new technologies such as Vehicle Ad Hoc Networks(VANET),Internet of Things(IoT),Multi-Agent Systems(MAS)and Embedded Systems to create a new system to serve the purpose.Therefore,the efficient and intelligent operation of the VANET network can avoid such problems as it provides drivers with the necessary real-time traffic data.Thus,drivers are able to drive their vehicles under correct and realistic conditions.In this document,we propose a speed adaptation scheme for winding road situations.Our proposed scheme is based on MAS technology,the main goal of which is to provide drivers with the information they need to calculate the speed limit they must not exceed in order to maintain balance in dangerous areas,especially in curves.The proposed scheme provides flexibility,adaptability,and maintainability for traffic information,taking into account the state of infrastructure and metering conditions of the road,as well as the characteristics and behavior of vehicles.

Research on Active Safety Methodologies for Intelligent Railway Systems

Safety is essential when building a strong transportation system.As a key development direction in the global railway system,the intelligent railway has safety at its core,making safety a top priority while pursuing the goals of efficiency,convenience,economy,and environmental friendliness.This paper describes the state of the art and proposes a system architecture for intelligent railway systems.It also focuses on the development of railway safety technology at home and abroad,and proposes the active safety method and technology system based on advanced theoretical methods such as the in-depth integration of cyber–physical systems(CPS),data-driven models,and intelligent computing.Finally,several typical applications are demonstrated to verify the advancement and feasibility of active safety technology in intelligent railway systems.

Analysis on Operational Safety and Efficiency of FAO System in Urban Rail Transit

This paper discusses two urgent problems that need to be solved in fully automatic operation(FAO)for urban rail transit.The first is the analysis of safety in FAO,while another is the analysis of efficiency in FAO.Firstly,this paper establishes an operational safety evaluation index system from the perspective of operation for the unique or typical risk sources of the FAO system,and uses the analytic hierarchy process(AHP)to evaluate the indicators,analyzes various factors that affect the safe operation of FAO,and provides safety management recommendations for FAO lines operation to maintain the FAO system specifically.Secondly,taking the Yanfang Line as an example,this paper uses OpenTrack software to analyze the efficiency of FAO operation,and conducts simulation calculations for key links such as the mainline tracking interval,train entry and exit,and return limit interval.The fault impact surface of the FAO trains is simulated and discussed to verify whether FAO can meet the long-term operation requirements of Yanfang Line.Finally,this paper compares the simulation data of FAO on the Yanfang Line with manual operation(MO)to verify the advantages of FAO and guide the engineering construction of subsequent fully automated driving lines.

Intensive Training for Stroke: Evidence of Safety from Meta-analysis and Systematic Reviews

[Objectives] To investigate the safety of intensive training for stroke recovery. [Methods] A systematic electronic search was conducted up to December 1 st , 2022, and the number of falls and fall-related injuries, as well as other adverse events, were extracted. Odds ratios (ORs) were calculated to assess the two intervention methods, and a 95% confidence interval (95% CI) was calculated for each of them to ensure the statistical accuracy of the results. The heterogeneity of the included studies was also tested. [Results] Five moderate to high quality studies comprising a total of 184 participants were included in this review. All five randomized controlled trials reported adverse events, including falls that did not result in injury, pain in the joints, back, muscle, or chest, and skin injuries such as cuts, bruises, and scrapes. The pooled analysis of these trials showed no statistically significant differences between the intensive training and control groups in terms of falls ( P =0.35) , pain ( P =0.07), or skin injuries ( P =0.90). [Conclusions] This review provides good evidence to suggest that intensive training is safe and feasible as a novel intervention during the stroke recovery.

System Variables Design of Safety Analysis for Fast Reactors

This research aims to examine the risk in the technology design of fast breeder reactors while the development depends on safety considerations. The project explored the variables, which could affect positively the expected average fuel burn-up, breeding ratio, and decay heat removal. That is accomplished using features such as guard vessels and elevated pipe routing to prevent the cracked state of both core components and fuel cladding interface conditions. So, the cracked region of fuel was detected by thermal-hydraulic analysis. We used ZrFeCr alloys to estimating of the rise in fuel cladding and coolant that can be incorporated in the design ZrFeCr alloys to uniform corrosion in temperature and 10.3 Mpa pressure. Fast creep of the reactor vessel during the coolant heat-up transient is another issue to be considered corrosion resistance of structural material can be achieved by controlling oxygen content in steel alloy. In this trend, S4337 S5140 steels are wide and can be used in future fossil power plants because of their excellent high-temperature strength.

Causal temporal graph attention network for fault diagnosis of chemical processes

Fault detection and diagnosis(FDD)plays a significant role in ensuring the safety and stability of chemical processes.With the development of artificial intelligence(AI)and big data technologies,data-driven approaches with excellent performance are widely used for FDD in chemical processes.However,improved predictive accuracy has often been achieved through increased model complexity,which turns models into black-box methods and causes uncertainty regarding their decisions.In this study,a causal temporal graph attention network(CTGAN)is proposed for fault diagnosis of chemical processes.A chemical causal graph is built by causal inference to represent the propagation path of faults.The attention mechanism and chemical causal graph were combined to help us notice the key variables relating to fault fluctuations.Experiments in the Tennessee Eastman(TE)process and the green ammonia(GA)process showed that CTGAN achieved high performance and good explainability.

A perspective on the key factors of safety for rechargeable magnesium batteries

Rechargeable Mg batteries(RMBs)have become one of the best subsitutes for lithium-ion batteries due to the high volumetric capacity,abundant resources,and uniform plating behavior of Mg metal anode.However,the safety hazard induced by the formation of high-modulue Mg dendrites under a high current density(10 mA cm^(-1))was still revealed in recent years.It has forced researchers to re-examine the safety of RMBs.In this review,the intrinsic safety factors of key components in RMBs,such as uneven plating,pitting and flammability of Mg anode,heat release and crystalline water decomposition of cathode,strong corrosion,low oxidition stability and flammability of electrolytes,and soforth,are systematacially summarized.Their origins,formation mechanisms,and possible safety hazards are deeply discussed.To develop high-performance Mg anode,current strategies including designing artificial SEI,three-dimensional substrates,and Mg alloys are summarized.For practical electrolytes,the configurations of boron-centered anions and simple Mg salts and the functionalized solvent with high boiling point and low flammability are suggested to comprehensively design.In addition,the future study should more focus on the investigation on the thermal runaway and decomposition of cathode materials and separa-tors.This review aims to provide fundamental insights into the relationship between electrochemistry and safety,further promoting the sustainable development of RMBs.