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.

Designing Proportional-Integral Consensus Protocols for Second-Order Multi-Agent Systems Using Delayed and Memorized State Information

This paper is concerned with consensus of a secondorder linear time-invariant multi-agent system in the situation that there exists a communication delay among the agents in the network.A proportional-integral consensus protocol is designed by using delayed and memorized state information.Under the proportional-integral consensus protocol,the consensus problem of the multi-agent system is transformed into the problem of asymptotic stability of the corresponding linear time-invariant time-delay system.Note that the location of the eigenvalues of the corresponding characteristic function of the linear time-invariant time-delay system not only determines the stability of the system,but also plays a critical role in the dynamic performance of the system.In this paper,based on recent results on the distribution of roots of quasi-polynomials,several necessary conditions for Hurwitz stability for a class of quasi-polynomials are first derived.Then allowable regions of consensus protocol parameters are estimated.Some necessary and sufficient conditions for determining effective protocol parameters are provided.The designed protocol can achieve consensus and improve the dynamic performance of the second-order multi-agent system.Moreover,the effects of delays on consensus of systems of harmonic oscillators/double integrators under proportional-integral consensus protocols are investigated.Furthermore,some results on proportional-integral consensus are derived for a class of high-order linear time-invariant multi-agent systems.

Hyperbolic Tangent Function-Based Protocols for Global/Semi-Global Finite-Time Consensus of Multi-Agent Systems

This paper investigates the problem of global/semi-global finite-time consensus for integrator-type multi-agent sys-tems.New hyperbolic tangent function-based protocols are pro-posed to achieve global and semi-global finite-time consensus for both single-integrator and double-integrator multi-agent systems with leaderless undirected and leader-following directed commu-nication topologies.These new protocols not only provide an explicit upper-bound estimate for the settling time,but also have a user-prescribed bounded control level.In addition,compared to some existing results based on the saturation function,the pro-posed approach considerably simplifies the protocol design and the stability analysis.Illustrative examples and an application demonstrate the effectiveness of the proposed protocols.

Distributed Fault Estimation for Nonlinear Systems With Sensor Saturation and Deception Attacks Using Stochastic Communication Protocols

This paper is aimed at the distributed fault estimation issue associated with the potential loss of actuator efficiency for a type of discrete-time nonlinear systems with sensor saturation.For the distributed estimation structure under consideration,an estimation center is not necessary,and the estimator derives its information from itself and neighboring nodes,which fuses the state vector and the measurement vector.In an effort to cut down data conflicts in communication networks,the stochastic communication protocol(SCP)is employed so that the output signals from sensors can be selected.Additionally,a recursive security estimator scheme is created since attackers randomly inject malicious signals into the selected data.On this basis,sufficient conditions for a fault estimator with less conservatism are presented which ensure an upper bound of the estimation error covariance and the mean-square exponential boundedness of the estimating error.Finally,a numerical example is used to show the reliability and effectiveness of the considered distributed estimation algorithm.

Protocol for lower back pain management: Insights from the French healthcare system

In this editorial we comment on the article published in a recent issue of the World Journal of Clinical Cases.This article described a novel ultrasound-guided lateral recess block approach in treating a patient with lateral recess stenosis.The impact of spinal pain-related disability extends significantly,causing substantial human suffering and medical costs.Each county has its preferred treatment strategies for spinal pain.Here,we explore the lower back pain(LBP)treatment algorithm recommended in France.The treatment algorithm for LBP recommended by the French National Authority for Health emphasizes early patient activity and minimal medication use.It encourages the continuation of daily activities,limits excessive medication and spinal injections,and incorporates psychological assessments and non-pharmacological therapies for chronic cases.However,the algorithm may not aggressively address acute pain in the early stages,potentially delaying relief and increasing the risk of chronicity.Additionally,the recommended infiltrations primarily involve caudal epidural steroid injections,with limited consideration for other injection procedures,such as transforaminal or interlaminar epidural steroid injections.The fixed follow-up timeline may not accommodate patients who do not respond to initial treatment or experience intense pain,potentially delaying the exploration of alternative therapies.Despite these limitations,understanding the strengths and weaknesses of the French approach could inform adaptations in LBP treatment strategies globally,potentially enhancing patient outcomes and satisfaction across diverse healthcare systems.

Incorporating red blanket protocol within code crimson:Streamlining definitive trauma care amid the chaos

The care of a patient involved in major trauma with exsanguinating haemorrhage is time-critical to achieve definitive haemorrhage control,and it requires coordinated multidisciplinary care.During initial resuscitation of a patient in the emergency department(ED),Code Crimson activation facilitates rapid decisionmaking by multi-disciplinary specialists for definitive haemorrhage control in operating theatre(OT)and/or interventional radiology(IR)suite.Once this decision has been made,there may still be various factors that lead to delay in transporting the patient from ED to OT/IR.Red Blanket protocol identifies and addresses these factors and processes which cause delay,and aims to facilitate rapid and safe transport of the haemodynamically unstable patient from ED to OT,while minimizing delay in resuscitation during the transfer.The two processes,Code Crimson and Red Blanket,complement each other.It would be ideal to merge the two processes into a single protocol rather than having two separate workflows.Introducing these quality improvement strategies and coor-dinated processes within the trauma framework of the hospitals/healthcare systems will help in further improving the multi-disciplinary care for the complex trauma patients requiring rapid and definitive haemorrhage control.

Consensus tracking protocol and formation control of multi-agent systems with switching topology

Consensus tracking control problems for single-integrator dynamics of multi-agent systems with switching topology are investigated. In order to design effective consensus tracking protocols for a more general class of networks, which are aimed at ensuring that the concerned states of agents converge to a constant or time-varying reference state, new consensus tracking protocols with a constant and time-varying reference state are proposed, respectively. Particularly, by contrast with spanning tree, an improved condition of switching interaction topology is presented. And then, convergence analysis of two consensus tracking protocols is provided by Lyapunov stability theory. Moreover, consensus tracking protocol with a time-varying reference state is extended to achieve the fbrmation control. By introducing formation structure set, each agent can gain its individual desired trajectory. Finally, several simulations are worked out to illustrate the effectiveness of theoretical results. The test results show that the states of agents can converge to a desired constant or time-varying reference state. In addition, by selecting appropriate structure set, agents can maintain the expected formation under random switching interaction topologies.

Neural-Network-Based Control for Discrete-Time Nonlinear Systems with Input Saturation Under Stochastic Communication Protocol

In this paper,an adaptive dynamic programming(ADP)strategy is investigated for discrete-time nonlinear systems with unknown nonlinear dynamics subject to input saturation.To save the communication resources between the controller and the actuators,stochastic communication protocols(SCPs)are adopted to schedule the control signal,and therefore the closed-loop system is essentially a protocol-induced switching system.A neural network(NN)-based identifier with a robust term is exploited for approximating the unknown nonlinear system,and a set of switch-based updating rules with an additional tunable parameter of NN weights are developed with the help of the gradient descent.By virtue of a novel Lyapunov function,a sufficient condition is proposed to achieve the stability of both system identification errors and the update dynamics of NN weights.Then,a value iterative ADP algorithm in an offline way is proposed to solve the optimal control of protocol-induced switching systems with saturation constraints,and the convergence is profoundly discussed in light of mathematical induction.Furthermore,an actor-critic NN scheme is developed to approximate the control law and the proposed performance index function in the framework of ADP,and the stability of the closed-loop system is analyzed in view of the Lyapunov theory.Finally,the numerical simulation results are presented to demonstrate the effectiveness of the proposed control scheme.

Reliable transmission of consultative committee for space data systems file delivery protocol in deep space communication

In consultative committee for space data systems（CCSDS） file delivery protocol（CFDP） recommendation of reliable transmission,there are no detail transmission procedure and delay calculation of prompted negative acknowledge and asynchronous negative acknowledge models.CFDP is designed to provide data and storage management,story and forward,custody transfer and reliable end-to-end delivery over deep space characterized by huge latency,intermittent link,asymmetric bandwidth and big bit error rate（BER）.Four reliable transmission models are analyzed and an expected file-delivery time is calculated with different trans-mission rates,numbers and sizes of packet data units,BERs and frequencies of external events,etc.By comparison of four CFDP models,the requirement of BER for typical missions in deep space is obtained and rules of choosing CFDP models under different uplink state informations are given,which provides references for protocol models selection,utilization and modification.

MULTIPLE ELECTRONIC CONTROL UNITS CALIBRATION SYSTEM BASED ON EXPLICIT CALIBRATION PROTOCOL AND J1939 PROTOCOL

The rising number of electronic control units （ECUs） in vehicles and the decreasing time to market have led to the need for advanced methods of calibration. A multi-ECU calibration system was developed based on the explicit calibration protocol （XCP） and J1939 communication protocol to satisfy the need of calibrating multiple ECUs simultaneously. The messages in the controller area network （CAN） are defined in the J1939 protocol. Each CAN node can get its own calibration messages and information from other ECUs, and block other messages by qualifying the CAN messages with priority, source or destination address. The data field of the calibration message is designed with the XCP, with CAN acting as the transport layer. The calibration sessions are setup with the event-triggered XCP driver in the master node and the responding XCP driver in the slave nodes. Mirroring calibration variables from ROM to RAM enables the user to calibrate ECUs online. The application example shows that the multi-ECU calibration system can calibrate multiple ECUs simultaneously, and the main program can also accomplish its calculation and send commands to the actuators in time. By the multi-ECU calibration system, the calibration effort and time can be reduced and the variables in ECU can get a better match with the variables of other ECUs.

Event-Based Anomaly Detection for Non-Public Industrial Communication Protocols in SDN-Based Control Systems

As the main communication mediums in industrial control networks,industrial communication protocols are always vulnerable to extreme exploitations,and it is very difficult to take protective measures due to their serious privacy.Based on the SDN(Software Defined Network)technology,this paper proposes a novel event-based anomaly detection approach to identify misbehaviors using non-public industrial communication protocols,and this approach can be installed in SDN switches as a security software appliance in SDN-based control systems.Furthermore,aiming at the unknown protocol specification and message format,this approach first restructures the industrial communication sessions and merges the payloads from industrial communication packets.After that,the feature selection and event sequence extraction can be carried out by using the N-gram model and K-means algorithm.Based on the obtained event sequences,this approach finally trains an event-based HMM(Hidden Markov Model)to identify aberrant industrial communication behaviors.Experimental results clearly show that the proposed approach has obvious advantages of classification accuracy and detection efficiency.

Variance-Constrained Filtering Fusion for Nonlinear Cyber-Physical Systems With the Denial-of-Service Attacks and Stochastic Communication Protocol

In this paper,a new filtering fusion problem is studied for nonlinear cyber-physical systems under errorvariance constraints and denial-of-service attacks.To prevent data collision and reduce communication cost,the stochastic communication protocol is adopted in the sensor-to-filter channels to regulate the transmission order of sensors.Each sensor is allowed to enter the network according to the transmission priority decided by a set of independent and identicallydistributed random variables.From the defenders’view,the occurrence of the denial-of-service attack is governed by the randomly Bernoulli-distributed sequence.At the local filtering stage,a set of variance-constrained local filters are designed where the upper bounds(on the filtering error covariances)are first acquired and later minimized by appropriately designing filter parameters.At the fusion stage,all local estimates and error covariances are combined to develop a variance-constrained fusion estimator under the federated fusion rule.Furthermore,the performance of the fusion estimator is examined by studying the boundedness of the fused error covariance.A simulation example is finally presented to demonstrate the effectiveness of the proposed fusion estimator.

Consensus protocol for multi-agent continuous systems

Based on the algebraic graph theory, the networked multi-agent continuous systems are investigated. Firstly, the digraph （directed graph） represents the topology of a networked system, and then a consensus convergence criterion of system is proposed. Secondly, the issue of stability of multi-agent systems and the consensus convergence problem of information states are all analysed. Furthermore, the consensus equilibrium point of system is proved to be global and asymptotically reach the convex combination of initial states. Finally, two examples are taken to show the effectiveness of the results obtained in this paper.

Nonlinear consensus protocols for multi-agent systems based on centre manifold reduction

Nonlinear consensus protocols for dynamic directed networks of multi-agent systems with fixed and switching topologies are investigated separately in this paper. Based on the centre manifold reduction technique, nonlinear consensus protocols are presented. We prove that a group of agents can reach a β-consensus, the value of which is the group decision value varying from the minimum and the maximum values of the initial states of the agents. Moreover, we derive the conditions to guarantee that all the agents reach a β-consensus on a desired group decision value. Finally, a simulation study concerning the vertical alignment manoeuvere of a team of unmanned air vehicles is performed. Simulation results show that the nonlinear consensus protocols proposed are more effective than the linear protocols for the formation control of the agents and they are an improvement over existing protocols.

A hierarchical architecture of centralized monitoring and controlling system and its high-performance and interoperability protocol

This paper describes a hierarchical architecture and a high-performance and interoperability protocol for centralized monitoring and controlling systems (CMCS) . The protocol we proposed can interoperate different monitoring and controlling systems constructed by different companies, each with different functions and communication protocols. The protocol reduces the amount of traffic and has real-time and high-perfor-mance advantages. The protocol was implemented in CMCS for telecommunication power supply and air-condi-tioner used by the Telecommunication Bureau of Zhejiang Province. This paper deals with the hierarchical architecture and function of CMCS and packet format, command ID, and SDL description of its protocol. We also discuss the properties of the interoperability and performance of the protocol in this paper.

Routing Protocols for Transmitting Large Databases or Multi databases Systems

Most knowledgeable people agree that networking and routing technologies have been around about 25 years. Routing is simultaneously the most complicated function of a network and the most important. It is of the same kind that more than 70% of computer application fields are MIS applications. So the challenge in building and using a MIS in the network is developing the means to find, access, and communicate large databases or multi databases systems. Because general databases are not time continuous, in fact, they can not be streaming, so we can't obtain reliable and secure quality of service by deleting some unimportant datagrams in the databases transmission. In this article, we will discuss which kind of routing protocol is the best type for large databases or multi databases systems transmission in the networks.

Consensus protocol for heterogeneous multi-agent systems: A Markov chain approach

This paper deals with the consensus problem for heterogeneous multi-agent systems. Different from most existing consensus protocols, we consider the consensus seeking of two types of agents, namely, active agents and passive agents. The objective is to directly control the active agents such that the states of all the agents would achieve consensus. In order to obtain a computational approach, we subtly introduce an appropriate Markov chain to cast the heterogeneous systems into a unified framework. Such a framework is helpful for tackling the constraints from passive agents. Furthermore, a sufficient and necessary condition is established to guarantee the consensus in heterogeneous multi-agent systems. Finally, simulation results are provided to verify the theoretical analysis and the effectiveness of the proposed protocol.

Integration of naval distributed tactical training simulation system based on advanced message queuing protocol

Aiming at the problems of unreliable data transmission,poor steadiness,nonsupport of complex data types,direct couple between data transmission and exchange,a high-level method based on advanced message queuing protocol( AMQP) is proposed to integrate naval distributed tactical training simulation system after serious consideration with current information exchange features of military combat system. Transferring layer in traditional user datagram protocol is implemented by publishing and subscribing scheme of message middleware. By creating message model to standardize message structure,integration architecture is formulated to resolve potential information security risks from inconsistent data type and express data transmission. Meanwhile,a communication model is put forward based on AMQP,which is in the center position of the whole transmission framework and responsible for reliably transferring battlefield data among subsystems. Experiments show that the method can accurately post amounts of data to the subscriber without error and loss,and can get excellent real-time performance of data exchange.

Self-organization of Reconfigurable Protocol Stack for Networked Control Systems

In networked control systems （NCS）,the control performance depends on not only the control algorithm but also the communication protocol stack.The performance degradation introduced by the heterogeneous and dynamic communication environment has intensified the need for the reconfigurable protocol stack.In this paper,a novel architecture for the reconfigurable protocol stack is proposed,which is a unified specification of the protocol components and service interfaces supporting both static and dynamic reconfiguration for existing industrial communication standards.Within the architecture,a triple-level self-organization structure is designed to manage the dynamic reconfiguration procedure based on information exchanges inside and outside the protocol stack.Especially,the protocol stack can be self-adaptive to various environment and system requirements through the reconfiguration of working mode,routing and scheduling table.Finally,the study on the protocol of dynamic address management is conducted for the system of controller area network （CAN）.The results show the efficiency of our self-organizing architecture for the implementation of a reconfigurable protocol stack.

Implementation of Embedded Ethernet Based on Hardware Protocol Stack in Substation Automation System

Embedded Ethernet technology has been utilized increasingly widely as the communication mode in the substation automation system(SAS).This paper introduces the current applying situation about embedded Ethernet in SAS First.After analyzing the protocol levels used in SAS based on embedded Ethernet and the differences between the TCP and UDP,UDP/IP is selected as the communication protocol between the station-level and bay-level devices for its real-time characteristic.Then a new kind of implementation of the embedded Ethernet is presented based on hardware protocol stack.The designed scheme can be implemented easily,reduce cost significantly and shorten developing cycle.