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.

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.

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.

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.

A novel refined dynamic model of high-speed maglev train-bridge coupled system for random vibration and running safety assessment

Running safety assessment and tracking irregularity parametric sensitivity analysis of high-speed maglev train-bridge system are of great concern,especially need perfect refinement models in which all properties can be well characterized based on various stochastic excitations.A three-dimensional refined spatial random vibration analysis model of high-speed maglev train-bridge coupled system is established in this paper,in which multi-source uncertainty excitation can be considered simultaneously,and the probability density evolution method(PDEM)is adopted to reveal the system-specific uncertainty dynamic characteristic.The motion equation of the maglev vehicle model is composed of multi-rigid bodies with a total 210-degrees of freedom for each vehicle,and a refined electromagnetic force-air gap model is used to account for the interaction and coupling effect between the moving train and track beam bridges,which are directly established by using finite element method.The model is proven to be applicable by comparing with Monte Carlo simulation.By applying the proposed stochastic framework to the high maglev line,the random dynamic responses of maglev vehicles running on the bridges are studied for running safety and stability assessment.Moreover,the effects of track irregularity wavelength range under different amplitude and running speeds on the coupled system are investigated.The results show that the augmentation of train speed will move backward the sensitive wavelength interval,and track irregularity amplitude influences the response remarkably in the sensitive interval.

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.

Research Progress of Agricultural Genetically Modified Crop Safety Evaluation

The commercial cultivation of genetically modified(GM)crops has eased the global food crisis and brought considerable economic and social benefits to countries.Because of the potential safety problems,it is necessary to make clear the molecular genetic characteristics,edible safety,planting,processing,and other aspects of the safety evaluation of GM crops.The safety problems existing in the cultivation of GM crops,safety evaluation and detection of GM crops were introduced in this paper,which provided the basis for safety evaluation and effective supervision of GM crops and their products.Commercial cultivation and reasonable supervision based on safety evaluation have far-reaching significance for ensuring consumer safety,enhancing the credibility of the national political system and enhancing citizens'confidence in the safety of GM crop products for consumption.

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.

Artificial-intelligent-powered safety and efficiency improvement for controlling and scheduling in integrated railway systems

The multi-mode integrated railway system,anchored by the high-speed railway,caters to the diverse travel requirements both within and between cities,offering safe,comfortable,punctual,and eco-friendly transportation services.With the expansion of the railway networks,enhancing the efficiency and safety of the comprehensive system has become a crucial issue in the advanced development of railway transportation.In light of the prevailing application of artificial intelligence technologies within railway systems,this study leverages large model technology characterized by robust learning capabilities,efficient associative abilities,and linkage analysis to propose an Artificial-intelligent(AI)-powered railway control and dispatching system.This system is elaborately designed with four core functions,including global optimum unattended dispatching,synergetic transportation in multiple modes,high-speed automatic control,and precise maintenance decision and execution.The deployment pathway and essential tasks of the system are further delineated,alongside the challenges and obstacles encountered.The AI-powered system promises a significant enhancement in the operational efficiency and safety of the composite railway system,ensuring a more effective alignment between transportation services and passenger demands.

Accuracy and Electromagnetic Safety Evaluation of a Portable Electromagnetic Localization System for Micro Invasive Medical Devices in Vivo

Aiming at localizing the telemetric capsule for detecting gastrointestinal physiological parameters in vivo accurately,a portable alternating current(AC)electromagnetic localization system is designed.To verify the feasibility of the method,the model and construction of the localization system are detailed.And static and dynamic accuracy of the localization system are tested by experiments.Next,we compare the simulating results of the electromagnetic radiation aroused by the localization system with the electromagnetic safety standards of human(ICNIRP guidelines and IEEE standard C95.1-1991).Finally,in terms of the results of the static and dynamic experiments,conclusions are drawn that the accuracy of portable positioning system is high(less than 10 mm)enough to satisfy the localization need of the micro invasive medical devices in vivo,and there is no harm of electromagnetic radiation to human.

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.

Efficacy and safety of pharmacotherapeutic interventions used in visceral leishmaniasis clinical trials:A systematic review and network meta-analysis

Objective:To compare the efficacy and safety outcomes of different antileishmanial agents used in visceral leishmaniasis clinical trials.Methods:A systematic literature search in PubMed/MEDLINE,EMBASE,Cochrane,and Google Scholar was done using keywords“randomized controlled trials”,“antileishmanial”and“visceral leishmaniasis”.The outcomes included were cure rate,overall withdrawals,relapse rate,and treatment-emergent adverse events.Effect estimates through the frequentist network meta-analysis approach were presented as OR with 95%CI.Rankogram plots were used for identifying the“best intervention”based on p-scores obtained using the surface under the cumulative ranking.The risk of bias was evaluated by using Pedro Scale.Results:Seventeen randomized controlled trials with 5143 visceral leishmaniasis patients who received different antileishmanial agents(amphotericin B,miltefosine,paromomycin,meglumine antimoniate,sodium stibogluconate,sitamaquine,and pentavalent antimonials)and met the inclusion criteria were included.For efficacy outcomes of the treatments,the rankogram of the network meta-analysis revealed that paromomycin(p-score=0.8148)has the highest probability of being best in the pool,followed by sodium stibogluconate(OR 0.82,95%CI 0.24-2.79,p-score=0.7580),amphotericin B+miltefosine(OR 0.66,95%CI 0.02-19.04,p-score=0.7329)as compared to the remaining treatments;however,the most of the treatment-emergent adverse events were reported with sitamaquine.Conclusions:Paromomycin reported the highest cure rates,while the maximum treatment-emergent adverse events were seen with sitamaquine.

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.

Safety architecture of internet based multi-robot teleoperation system

Safety subsystem is one of the important parts in robot teleoperation system. In this paper, a safety architecture of safety subsystem in Internet based multi-operator-multi-robot (MOMR) teleoperation system is presented. The subsystem is divided into three layers in its logic architecture: interactive monitor layer, collaborative control layer and real-time control layer. The safety problems and the related strategy are clarified by detailed analysis of each layer and relationship among the layers. So we can obtain a high performance MOMR teleoperation system with multi-layer safety architecture.

Genetic Algorithm Optimization Model for Determining the Probability of Failure on Demand of the Safety Instrumented System

A more accurate determination for the Probability of Failure on Demand(PFD)of the Safety Instrumented System(SIS)contributes to more SIS realiability,thereby ensuring more safety and lower cost.IEC 61508 and ISA TR.84.02 provide the PFD detemination formulas.However,these formulas suffer from an uncertaity issue due to the inclusion of uncertainty sources,which,including high redundant systems architectures,cannot be assessed,have perfect proof test assumption,and are neglegted in partial stroke testing(PST)of impact on the system PFD.On the other hand,determining the values of PFD variables to achieve the target risk reduction involves daunting efforts and consumes time.This paper proposes a new approach for system PFD determination and PFD variables optimization that contributes to reduce the uncertainty problem.A higher redundant system can be assessed by generalizing the PFD formula into KooN architecture without neglecting the diagnostic coverage factor(DC)and common cause failures(CCF).In order to simulate the proof test effectiveness,the Proof Test Coverage(PTC)factor has been incorporated into the formula.Additionally,the system PFD value has been improved by incorporating PST for the final control element into the formula.The new developed formula is modelled using the Genetic Algorithm(GA)artificial technique.The GA model saves time and effort to examine system PFD and estimate near optimal values for PFD variables.The proposed model has been applicated on SIS design for crude oil test separator using MATLAB.The comparison between the proposed model and PFD formulas provided by IEC 61508 and ISA TR.84.02 showed that the proposed GA model can assess any system structure and simulate industrial reality.Furthermore,the cost and associated implementation testing activities are reduced.

Laws of strata energy release and corresponding safety warning system in metal mine

The strata deformation in mining area was monitored in Dabaoshan copper-iron mine,and an analytical method of strata energy release was put forward.On the basis of chaotic theory,by reconstructing the phase space for time series data of strata energy release,the saturated embedding dimension and the correlation dimension of the dynamic system were obtained to be 4 and 1.212 8,respectively,and the evolution laws of distances between phase points of strata energy release in the phase space were revealed.With grey theory,a prediction model of strata energy release was set up,the maximum error of which was less than 6.7%.The results show that there are chaotic characters in strata energy release during mining;after reconstructing phase space,the subtle changing characteristics of energy release can be magnified,and the internal rules can be fully demonstrated.According to the laws,a warning system for strata stability in mining area was established to provide a technical safeguard for safe mining.

Genetic Regression Model for Dam Safety Monitoring

Under-fitting problems usually occur in regression models for dam safety monitoring.To overcome the local convergence of the regression, a genetic algorithm (GA) was proposed using a real parameter coding, a ranking selection operator, an arithmetical crossover operator and a uniform mutation operator, and calculated the least-square error of the observed and computed values as its fitness function. The elitist strategy was used to improve the speed of the convergence. After that, the modified genetic algorithm was applied to reassess the coefficients of the regression model and a genetic regression model was set up. As an example, a slotted gravity dam in the Northeast of China was introduced. The computational results show that the genetic regression model can solve the under-fitting problems perfectly.