Diabetic peripheral neuropathy and neuromodulation techniques:a systematic review of progress and prospects

Neuromodulation for diabetic peripheral neuropathy represents a significant area of interest in the management of chronic pain associated with this condition.Diabetic peripheral neuropathy,a common complication of diabetes,is characterized by nerve damage due to high blood sugar levels that lead to symptoms,such as pain,tingling,and numbness,primarily in the hands and feet.The aim of this systematic review was to evaluate the efficacy of neuromodulatory techniques as potential therapeutic interventions for patients with diabetic peripheral neuropathy,while also examining recent developments in this domain.The investigation encompassed an array of neuromodulation methods,including frequency rhythmic electrical modulated systems,dorsal root ganglion stimulation,and spinal cord stimulation.This systematic review suggests that neuromodulatory techniques may be useful in the treatment of diabetic peripheral neuropathy.Understanding the advantages of these treatments will enable physicians and other healthcare providers to offer additional options for patients with symptoms refractory to standard pharmacologic treatments.Through these efforts,we may improve quality of life and increase functional capacity in patients suffering from complications related to diabetic neuropathy.

Summary of the current guidelines for managing iatrogenic colorectal perforations and the evolving role of endoluminal vacuum therapy

Colonoscopy represents a safe procedure that is widely used in medical practice either to diagnose or treat various gastrointestinal diseases.During the last few years,the incidence rate of perforations in colonoscopic procedures has increased,especially in therapeutic colonoscopies.The recent advancements in endoscopic techniques and gastrointestinal tumoral resection procedures such as endoscopic mucosal resection,endoscopic full-thickness resection,and endoscopic submucosal dissection(ESD)could be a risk factor for this increased risk.The incidence rate of mortality of serious colonoscopic perforations is 7.1%.The management plan for these perforations starts with conservative treatment in mild cases,endoscopic closure,and surgical management in severe cases.Recently,endoluminal vacuum therapy was found to be effective in the management of colorectal perforations and this has been reported in multiple case reports.This editorial provides an overview of the current guidelines for the management of iatrogenic colorectal perforations.These insights are from the perspectives of endoscopists and gastroenterologists.We also present a management algorithm based on the guidelines of the European Society of Gastrointestinal Endoscopy,the American Gastroenterological Association,and the World Society of Emergency Surgery.We also discussed in brief the use of endoluminal vacuum therapy in colorectal perforations.

Options for Managing Livestock Production Systems to Adapt to Climate Change

This paper discusses recent research findings together with management schemes in preventing and managing of thermal stress by handling external and internal factors in livestock production systems. Preventive measures against thermal stress are described as basic structural adjustments and the modifications that can be implemented readily, according to animal health and welfare requirements and refer to （1） environmental modification and thermal comfort in various housing systems; （2） action on animals, such as genetic selection for breeds resistant to infectious disease, parasites and climate extremes; （3） action on feed and （4） action on staff handling the animals. Moreover, measures to be taken both in situations of chronic thermal stress and heat or cold strokes are presented as they are applied to （1） limit stress, （2） monitor the temperature felt by animals, （3） adapt diet and drinking water supplies and （4） correct physiological imbalances. Examples are given for different farm species （cattle, sheep, goat, poultry and pigs） and different production systems （intensive, extensive and alternative）. The paper concludes with a practical guide for the effective handling of thermal stress at farm level, summarizing the results from recent research studies on the specific topic.

Managing the surge:A comprehensive review of the entire disposal framework for retired lithium-ion batteries from electric vehicles

Anticipating the imminent surge of retired lithium-ion batteries(R-LIBs)from electric vehicles,the need for safe,cost-effective and environmentally friendly disposal technologies has escalated.This paper seeks to offer a comprehensive overview of the entire disposal framework for R-LIBs,encompassing a broad spectrum of activities,including screening,repurposing and recycling.Firstly,we delve deeply into a thorough examination of current screening technologies,shifting the focus from a mere enumeration of screening methods to the exploration of the strategies for enhancing screening efficiency.Secondly,we outline battery repurposing with associated key factors,summarizing stationary applications and sizing methods for R-LIBs in their second life.A particular light is shed on available reconditioning solutions,demonstrating their great potential in facilitating battery safety and lifetime in repurposing scenarios and identifying their techno-economic issues.In the realm of battery recycling,we present an extensive survey of pre-treatment options and subsequent material recovery technologies.Particularly,we introduce several global leading recyclers to illustrate their industrial processes and technical intricacies.Furthermore,relevant challenges and evolving trends are investigated in pursuit of a sustainable end-of-life management and disposal framework.We hope that this study can serve as a valuable resource for researchers,industry professionals and policymakers in this field,ultimately facilitating the adoption of proper disposal practices.

Managing System Losses to Improve Energy Efficiency within the Electricity Company of Ghana (ECG) Limited

The inability to achieve the target of universal access to electricity is influenced by several factors including funding limitations, the use of obsolete equipment, power theft, and system losses confronting the electricity distribution services of the Electricity Company of Ghana Limited (ECG). The study assessed the components of system losses within the ECG by determining and computing the percentage of system losses within ECG, examining the causes of both commercial and technical losses in ECG, and determining ways to improve energy efficiency by reducing system losses in the most cost-efficient manner. The study adopted deductive reasoning and a quantitative approach to guide data collection and analysis of the research output. A sample of 345 technical and non-technical staff of ECG in the Greater Accra Metropolis was selected from a population of 2500. Purposive, simple random, and cluster sampling techniques were used in identifying and accessing respondents for the study. Descriptive statistics were applied to measure central tendency and degrees of dispersion and the Relative Importance Index (RII) to predict criterion and predictor variables. The impact of low voltage network losses can adversely contribute to technical losses (20%) and reduce energy efficiency in power or electricity distribution companies. Non-technical losses are mainly caused by illegal connections, meter problems, and billing problems. Each of the non-technical losses contributes a maximum of 10% to system losses. Contributors to system losses at ECG are ranked first for power theft and least for lack of incentives. System losses at ECG include metering inaccuracies, bad workmanship, unmetered supply, and lengthy distribution lines, each recording a mean value of above 3.5. Measures to improve monitoring of the networks and systems at ECG and discourage power theft should include an extensive quantification, patrolling, and inspection of the entire network to assess the extent of the network and conditions relevant for the placement of systematically planned maintenance programmes.

Advances in Zika virus vaccines and therapeutics:A systematic review

Zika virus(ZIKV)is the causative agent of a viral infection that causes neurological complications in newborns and adults worldwide.Its wide transmission route and alarming spread rates are of great concern to the scientific community.Numerous trials have been conducted to develop treatment options for ZIKV infection.This review highlights the latest developments in the fields of vaccinology and pharmaceuticals developments for ZIKV infection.A systematic and comprehensive approach was used to gather relevant and up-to-date data so that inferences could be made about the gaps in therapeutic development.The results indicate that several therapeutic interventions are being tested against ZIKV infection,such as DNA vaccines,subunit vaccines,live-attenuated vaccines,virus-vector-based vaccines,inactivated vaccines,virus-like particles,and mRNA-based vaccines.In addition,approved anti-ZIKV drugs that can reduce the global burden are discussed.Although many vaccine candidates for ZIKV are at different stages of development,none of them have received Food and Drug Authority approval for use up to now.The issue of side effects associated with these drugs in vulnerable newborns and pregnant women is a major obstacle in the therapeutic pathway.

Etiology and management of urethral calculi:A systematic review of contemporary series

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.

Systematic review of risk factors,prognosis,and management of colorectal signet-ring cell carcinoma

BACKGROUND Colorectal signet-ring cell carcinoma(CSRCC)is a rare clinical entity which accounts for approximately 1%of all colorectal cancers.Although multiple studies concerning this specific topic have been published in the past decades,the pathogenesis,associated risk factors,and potential implications on treatment are still poorly understood.Besides the low incidence,historically confusing histological criteria have resulted in confusing data.Nevertheless,the rising incidence of CSRCC along with relatively young age at presentation and associated dismal prognosis,highlight the actual interest to synthesize the known literature regarding CSRCC.AIM To provide an updated overview of risk factors,prognosis,and management of CSRCC.METHODS A literature search in the MEDLINE/PubMed database was conducted with the following search terms used:‘Signet ring cell carcinoma’and‘colorectal’.Studies in English language,published after January 1980,were included.Studies included in the qualitative synthesis were evaluated for content concerning epidemiology,risk factors,and clinical,diagnostic,histological,and molecular features,as well as metastatic pattern and therapeutic management.If possible,presented data was extracted in order to present a more detailed overview of the literature.RESULTS In total,67 articles were included for qualitative analysis,of which 54 were eligible for detailed data extraction.CSRCC has a reported incidence between 0.1%-2.4%and frequently presents with advanced disease stage at the time of diagnosis.CSRCC is associated with an impaired overall survival(5-year OS:0%-46%)and a worse stagecorrected outcome compared to mucinous and not otherwise specified adenocarcinoma.The systematic use of exploratory laparoscopy to determine the presence of peritoneal metastases has been advised.Surgery is the mainstay of treatment,although the rates of curative resection in CSRCC(21%-82%)are lower compared to those in other histological types.In case of peritoneal metastasis,cytoreductive surgery with hyperthermic intraperitoneal chemotherapy should only be proposed in selected patients.CONCLUSION CSRCC is a rare clinical entity most often characterized by young age and advanced disease at presentation.As such,diagnostic modalities and therapeutic approach should be tailored accordingly.

Nurse anesthetists’perceptions and experiences of managing emergence delirium:A qualitative study

BACKGROUND This study employs a descriptive phenomenological approach to investigate the challenges anesthesia nurses face in managing emergence delirium(ED),a common and complex postoperative complication in the post-anesthesia care unit.The role of nurses in managing ED is critical,yet research on their understanding and management strategies for ED is lacking.AIM To investigate anesthetic nurses’cognition and management experiences of ED in hopes of developing a standardized management protocol.METHODS This study employed a descriptive phenomenological approach from qualitative research methodologies.Purposeful sampling was utilized to select 12 anesthetic nurses from a tertiary hospital in Shanghai as research subjects.Semi-structured interviews were conducted,and the data were organized and analyzed using Colaizzi’s seven-step analysis method,from which the final themes were extracted.RESULTS After analyzing the interview content,four main themes and eight subthemes were distilled:Inefficient cognition hinders the identification of ED(conceptual ambiguity,empirical identification),managing diversity and challenges(patientcentered safe care,low level of medical-nursing collaboration),work responsibilities and pressure coexist(heavy work responsibilities,occupational risks and stress),demand for high-quality management(expecting the construction of predictive assessment tools and prevention strategies,and pursuing standardized management processes to enhance management effectiveness).CONCLUSION Nursing managers should prioritize the needs and suggestions of nurses in order to enhance their nursing capabilities and provide guidance for standardized management processes.

Fuzzy Logic Inference System for Managing Intensive Care Unit Resources Based on Knowledge Graph

With the rapid growth in the availability of digital health-related data,there is a great demand for the utilization of intelligent information systems within the healthcare sector.These systems can manage and manipulate this massive amount of health-related data and encourage different decision-making tasks.They can also provide various sustainable health services such as medical error reduction,diagnosis acceleration,and clinical services quality improvement.The intensive care unit(ICU)is one of the most important hospital units.However,there are limited rooms and resources in most hospitals.During times of seasonal diseases and pandemics,ICUs face high admission demand.In line with this increasing number of admissions,determining health risk levels has become an essential and imperative task.It creates a heightened demand for the implementation of an expert decision support system,enabling doctors to accurately and swiftly determine the risk level of patients.Therefore,this study proposes a fuzzy logic inference system built on domain-specific knowledge graphs,as a proof-of-concept,for tackling this healthcare-related issue.The system employs a combination of two sets of fuzzy input parameters to classify health risk levels of new admissions to hospitals.The proposed system implemented utilizes MATLAB Fuzzy Logic Toolbox via several experiments showing the validity of the proposed system.

Design and analysis of an advanced thermal management system for the solar close observations and proximity experiments spacecraft

In this paper,the mission and the thermal environment of the Solar Close Observations and Proximity Experiments(SCOPE)spacecraft are analyzed,and an advanced thermal management system(ATMS)is designed for it.The relationship and functions of the integrated database,the intelligent thermal control system and the efficient liquid cooling system in the ATMS are elaborated upon.For the complex thermal field regulation system and extreme space thermal environment,a modular simulation and thermal field planning method are proposed,and the feasibility of the planning algorithm is verified by numerical simulation.A solar array liquid cooling system is developed,and the system simulation results indicate that the temperatures of the solar arrays meet the requirements as the spacecraft flies by perihelion and aphelion.The advanced thermal management study supports the development of the SCOPE program and provides a reference for the thermal management in other deep-space exploration programs.

Managing Road Maintenance Using Geographic Information System Application

The development and economic growth of a nation is closely related to its available transportation system. Good and efficient road transport infrastructure facilities will promote industrial and socio-economic development. To provide safety and comfort to road users, a comprehensive road maintenance schedule must be formulated and adopted to ensure those roads are in good condition at all times. Preventive maintenance works, such as road rehabilitation will help to reduce the major road repairs and expenditure. Prior to this, a good database, gathered through GIS will be necessary in order to ensure maintenance is done effectively. Geographic Information System (GIS) is said to be one of the useful tools that can be utilized to manage database in road maintenance engineering. This system is capable of storing, managing, analyzing, computing and displaying all forms of geographical data for road maintenance works. In this study, the author has adopted GIS application software – ArcView, and has reviewed and analyzed its effectiveness in managing road database. These data are then used to assist the management to ensure effective and systematic road maintenance. A typical model of roads in Penang, Malaysia is used as a case study to further clarify the application of GIS in road maintenance.

A Framework for Identifying and Managing Information Quality Metrics of Corporate Performance Management System

Corporate Performance Management （CPM） system is an information system used to collect, analyze, and visualize key performance indicators （KPIs） to support both business operations and especially strategic decisions. CPM systems display KPIs in forms of scorecard and dashboard so the executives can keep track and evaluate corporate performance. The quality of the information as shown in the KPIs is very crucial for the executives to make the right decisions. Therefore, it is important that the executives must be able to retrieve not only the KPIs but also the quality of those KPIs before using such KPIs in their strategic decisions. The objectives of this study were to determine the role of the CPM system in the organizations, current data and information quality state, problems and perspectives regarding data quality, as well as data quality maturity stage of the organizations. Survey research was used in this study; a questionnaire was sent to collect data from 477 corporations listed in the Stock Exchange of Thailand （SET） on January, 2011. Forty-nine questionnaires were returned. The results show that about half of the organizations have implemented CPM systems. Most organizations are confident in the information in CPM system, but information quality issues are commonly found. Frequent problems regarding information quality are information not up to date, information not ready by time of use, inaccuracy and incomplete. The most concerned and frequently assessed quality dimensions were security, accuracy, completeness, and validity. When asked to prioritize, the most important quality dimensions are accuracy, timeliness, completeness, security, and validity respectively. In addition, most organizations concern about data govemance management and have deployed such measures. This study showed that most organizations are on level 4 on Gartner＇s data governance maturity stage in which data governance is concerned and managed, but still not effective.

Systems research helping to meet the needs and managing the trade-offs of a changing world

Facing the challenges of an increasing world population, a changing climate and ever depleting resources, agricultural intensification （Keating et al. 2010） is one of the few options for meeting the demand of food security. It is necessary to apply a dynamic and systematic approach to effectively man- age the complex agri-eco production and green processing systems. Indeed, farming systems approach for appropriate technology development and simulation modeling is a result of adopting the system thinking by the agricultural research community （Norman et al. 1995）.

Practice and New Direction of Promoting the Construction of Managing System of Modern Hospital

If we want to enhance the medical level of modern hospital,we not only need to make the career morality and professional capability of the medical staff,but also require the perfection of the governance institution of hospital in accordance with the development of society.That said,the medical staff will provide the patients with the best service,which is significant to the development of hospital.In addition,every hospital should conduct deepening reform of public hospital comprehensively to respond to call of the government.And the hospital should also put forward professional and comprehensive managing system based on the concrete conditions of the hospital.That is how the hospital can serve the people better.That said,this article focuses on how to promote the system of managing the modern hospital.

Strategies for improving crop comprehensive benefits via a decision-making system based on machine learning in the rice‒rape,rice‒wheat and rice‒garlic rotation systems in Southwest China

Rice‒rape,rice‒wheat and rice‒garlic rotations are common cropping systems in Southwest China,and they have played a significant role in ensuring ecological and economic benefits(EB)and addressing the challenges of China’s food security in the region.However,the crop yields in these rotation systems are 1.25‒14.73%lower in this region than the national averages.Intelligent decision-making with machine learning can analyze the key factors for obtaining better benefits,but it has rarely been used to enhance the probability of obtaining such benefits from rotations in Southwest China.Thus,we used a data-intensive approach to construct an intelligent decision‒making system with machine learning to provide strategies for improving the benefits of rice-rape,rice-wheat,and rice-garlic rotations in Southwest China.The results show that raising the yield and partial fertilizer productivity(PFP)by increasing seed input under high fertilizer application provided the optimal benefits with a 10%probability in the rice-garlic system.Obtaining high yields and greenhouse gas(GHG)emissions by increasing the N application and reducing the K application provided suboptimal benefits with an 8%probability in the rice-rape system.Reducing N and P to enhance PFP and yield provided optimal benefits with the lowest probability(8%)in the rice‒wheat system.Based on the predictive analysis of a random forest model,the optimal benefits were obtained with fertilization regimes by reducing N by 25%and increasing P and K by 8 and 74%,respectively,in the rice-garlic system,reducing N and K by 54 and by 36%,respectively,and increasing P by 38%in rice-rape system,and reducing N by 4%and increasing P and K by 65 and 23%in rice-wheat system.These strategies could be further optimized by 17‒34%for different benefits,and all of these measures can improve the effectiveness of the crop rotation systems to varying degrees.Overall,these findings provide insights into optimal agricultural inputs for higher benefits through an intelligent decision-making system with machine learning analysis in the rice-rape,rice‒wheat,and rice-garlic systems.

Ultra Reliable Load-Aware Connection Management(LACM)Algorithm in WIA-FA Systems

The increasing demand for industrial automation and intelligence has put forward higher requirements for the reliability of industrial wireless communication technology.As an international standard based on 802.11,Wireless networks for Industrial Automation-Factory Automation(WIA-FA)greatly improves the reliability in factory automation scenarios by Time Division Multiple Access(TDMA).However,in ultra-dense WIA-FA networks with mobile users,the basic connection management mechanism is inefficient.Most of the handover and resource management algorithms are all based on frequency division multiplexing,not suitable for the TDMA in the WIA-FA network.Therefore,we propose Load-aware Connection Management(LACM)algorithm to adjust the linkage and balance the load of access devices to avoid blocking and improve the reliability of the system.And then we simulate the algorithm to find the optimal settings of the parameters.After comparing with other existing algorithms,the result of the simulation proves that LACM is more efficient in reliability and maintains high reliability of more than 99.8%even in the ultra-dense moving scenario with 1500 field devices.Besides,this algorithm ensures that only a few signaling exchanges are required to ensure load bal-ancing,which is no more than 5 times,and less than half of the best state-of-the-art algorithm.

Optimization Control of Multi-Mode Coupling All-Wheel Drive System for Hybrid Vehicle

The all-wheel drive(AWD)hybrid system is a research focus on high-performance new energy vehicles that can meet the demands of dynamic performance and passing ability.Simultaneous optimization of the power and economy of hybrid vehicles becomes an issue.A unique multi-mode coupling(MMC)AWD hybrid system is presented to realize the distributed and centralized driving of the front and rear axles to achieve vectored distribution and full utilization of the system power between the axles of vehicles.Based on the parameters of the benchmarking model of a hybrid vehicle,the best model-predictive control-based energy management strategy is proposed.First,the drive system model was built after the analysis of the MMC-AWD’s drive modes.Next,three fundamental strategies were established to address power distribution adjustment and battery SOC maintenance when the SOC changed,which was followed by the design of a road driving force observer.Then,the energy consumption rate in the average time domain was processed before designing the minimum fuel consumption controller based on the equivalent fuel consumption coefficient.Finally,the advantage of the MMC-AWD was confirmed by comparison with the dynamic performance and economy of the BYD Song PLUS DMI-AWD.The findings indicate that,in comparison to the comparative hybrid system at road adhesion coefficients of 0.8 and 0.6,the MMC-AWD’s capacity to accelerate increases by 5.26%and 7.92%,respectively.When the road adhesion coefficient is 0.8,0.6,and 0.4,the maximum climbing ability increases by 14.22%,12.88%,and 4.55%,respectively.As a result,the dynamic performance is greatly enhanced,and the fuel savings rate per 100 km of mileage reaches 12.06%,which is also very economical.The proposed control strategies for the new hybrid AWD vehicle can optimize the power and economy simultaneously.

Enhancing Secure Development in Globally Distributed Software Product Lines: A Machine Learning-Powered Framework for Cyber-Resilient Ecosystems

Embracing software product lines(SPLs)is pivotal in the dynamic landscape of contemporary software devel-opment.However,the flexibility and global distribution inherent in modern systems pose significant challenges to managing SPL variability,underscoring the critical importance of robust cybersecurity measures.This paper advocates for leveraging machine learning(ML)to address variability management issues and fortify the security of SPL.In the context of the broader special issue theme on innovative cybersecurity approaches,our proposed ML-based framework offers an interdisciplinary perspective,blending insights from computing,social sciences,and business.Specifically,it employs ML for demand analysis,dynamic feature extraction,and enhanced feature selection in distributed settings,contributing to cyber-resilient ecosystems.Our experiments demonstrate the framework’s superiority,emphasizing its potential to boost productivity and security in SPLs.As digital threats evolve,this research catalyzes interdisciplinary collaborations,aligning with the special issue’s goal of breaking down academic barriers to strengthen digital ecosystems against sophisticated attacks while upholding ethics,privacy,and human values.

IoT-Enabled Plant Monitoring System with Power Optimization and Secure Authentication

Global food security is a pressing issue that affects the stability and well-being of communities worldwide.While existing Internet of Things(IoT)enabled plant monitoring systems have made significant strides in agricultural monitoring,they often face limitations such as high power consumption,restricted mobility,complex deployment requirements,and inadequate security measures for data access.This paper introduces an enhanced IoT application for agricultural monitoring systems that address these critical shortcomings.Our system strategically combines power efficiency,portability,and secure access capabilities,assisting farmers in monitoring and tracking crop environmental conditions.The proposed system includes a remote camera that captures images of surrounding plants and a sensor module that regularly monitors various environmental factors,including temperature,humidity,and soil moisture.We implement power management strategies to minimize energy consumption compared to existing solutions.Unlike conventional systems,our implementation utilizes the Amazon Web Services(AWS)cloud platform for reliable data storage and processing while incorporating comprehensive security measures,including Two-Factor Authentication(2FA)and JSON Web Tokens(JWT),features often overlooked in current agricultural IoT solutions.Users can access this secure monitoring system via a developed Android application,providing convenient mobile access to the gathered plant data.We validate our system’s advantages by implementing it with two potted garlic plants on Okayama University’s rooftop.Our evaluation demonstrates high sensor reliabil-ity,with strong correlations between sensor readings and reference data,achieving determination coefficients(R2)of 0.979 for temperature and 0.750 for humidity measurements.The implemented power management strategies extend battery life to 10 days on a single charge,significantly outperforming existing systems that typically require daily recharging.Furthermore,our dual-layer security implementation utilizing 2FA and JWT successfully protects sensitive agricultural data from unauthorized access.