Vonoprazan-amoxicillin dual regimen with Saccharomyces boulardii as a rescue therapy for Helicobacter pylori:Current perspectives and implications

Yu et al’s study in the World Journal of Gastroenterology(2023)introduced a novel regimen of Vonoprazan-amoxicillin dual therapy combined with Saccharomyces boulardii(S.boulardii)for the rescue therapy against Helicobacter pylori(H.pylori),a pathogen responsible for peptic ulcers and gastric cancer.Vonoprazan is a potassium-competitive acid blocker renowned for its rapid and long-lasting acid suppression,which is minimally affected by mealtime.Compared to proton pump inhibitors,which bind irreversibly to cysteine residues in the H+/K+-ATPase pump,Vonoprazan competes with the K+ions,prevents the ions from binding to the pump and blocks acid secretion.Concerns with increasing antibiotic resistance,effects on the gut microbiota,patient compliance,and side effects have led to the advent of a dual regimen for H.pylori.Previous studies suggested that S.boulardii plays a role in stabilizing the gut barrier which improves H.pylori eradication rate.With an acceptable safety profile,the dual-adjunct regimen was effective regardless of prior treatment failure and antibiotic resistance profile,thereby strengthening the applicability in clinical settings.Nonetheless,S.boulardii comes in various formulations and dosages,warranting further exploration into the optimal dosage for supplementation in rescue therapy.Additionally,larger,randomized,double-blinded controlled trials are warranted to confirm these promising results.

Real-time Rescue Target Detection Based on UAV Imagery for Flood Emergency Response

Timely acquisition of rescue target information is critical for emergency response after a flood disaster.Unmanned Aerial Vehicles(UAVs)equipped with remote sensing capabilities offer distinct advantages,including high-resolution imagery and exceptional mobility,making them well suited for monitoring flood extent and identifying rescue targets during floods.However,there are some challenges in interpreting rescue information in real time from flood images captured by UAVs,such as the complexity of the scenarios of UAV images,the lack of flood rescue target detection datasets and the limited real-time processing capabilities of the airborne on-board platform.Thus,we propose a real-time rescue target detection method for UAVs that is capable of efficiently delineating flood extent and identifying rescue targets(i.e.,pedestrians and vehicles trapped by floods).The proposed method achieves real-time rescue information extraction for UAV platforms by lightweight processing and fusion of flood extent extraction model and target detection model.The flood inundation range is extracted by the proposed method in real time and detects targets such as people and vehicles to be rescued based on this layer.Our experimental results demonstrate that the Intersection over Union(IoU)for flood water extraction reaches an impressive 80%,and the IoU for real-time flood water extraction stands at a commendable 76.4%.The information on flood stricken targets extracted by this method in real time can be used for flood emergency rescue.

Substitutions of stem-loop subdomains in internal ribosome entry site of Senecavirus A:Impacts on rescue of sequence-modifying viruses

Senecavirus A(SVA)has a positive-sense,single-stranded RNA genome.Its 5´untranslated region harbors an internal ribosome entry site(IRES),comprising 10 larger or smaller stem-loop structures(including a pseudoknot)that have been demonstrated to be well conserved.However,it is still unclear whether each stem-loop subdomain,such as a single stem or loop,is also highly conserved.To clarify this issue in the present study,a set of 29 SVA cDNA clones were constructed by site-directed mutagenesis(SDM)on the IRES.The SDM-modified scenarios included:(1)stem-formed complementary sequences exchanging with each other;(2)loop transversion;(3)loop transition;and(4)point mutations.All cDNA clones were separately transfected into cells for rescuing viable viruses,whereas only four SVAs of interest could be recovered,and were genetically stable during 20 passages.One progeny grew significantly slower than the other three did.The dual-luciferase reporter assay showed that none of the SDM-modified IRESes significantly inhibited the IRES activity.Our previous study indicated that a single motif from any of the ten stem structures,if completely mutated,would cause the failure of virus recovery.Interestingly,our present study revealed three stem structures,whose individual complementary sequences could exchange with each other to rescue sequence-modifying SVAs.Moreover,one apical loop was demonstrated to have the ability to tolerate its own full-length transition,also having no impact on the recovery of sequence-modifying SVA.The present study suggested that not every stem-loop structure was strictly conserved in its conformation,while the full-length IRES itself was well conserved.This provides a new research direction on interaction between the IRES and many factors.

Rescue from complications after pancreaticoduodenectomies at a low-volume Caribbean center:Value of tailored peri-pancreatectomy protocols

BACKGROUND Pancreaticoduodenectomy(PD)is a technically complex operation,with a re-latively high risk for complications.The ability to rescue patients from post-PD complications is as a recognized quality measure.Tailored protocols were instituted at our low volume facility in the year 2013.AIM To document the rate of rescue from post-PD complications with tailored protocols in place as a measure of quality.METHODS A retrospective audit was performed to collect data from patients who experienced major post-PD complications at a low volume pancreatic surgery unit in Trinidad and Tobago between January 1,2013 and June 30,2023.Stan-dardized definitions from the International Study Group of Pancreatic Surgery were used to define post-PD complications,and the modified Clavien-Dindo classification was used to classify post-PD complications.RESULTS Over the study period,113 patients at a mean age of 57.5 years(standard deviation[SD]±9.23;range:30-90;median:56)underwent PDs at this facility.Major complications were recorded in 33(29.2%)patients at a mean age of 53.8 years(SD:±7.9).Twenty-nine(87.9%)patients who experienced major morbidity were salvaged after aggre-ssive treatment of their complication.Four(3.5%)died from bleeding pseudoaneurysm(1),septic shock secondary to a bile leak(1),anastomotic leak(1),and myocardial infarction(1).There was a significantly greater salvage rate in patients with American Society of Anesthesiologists scores≤2(93.3%vs 25%;P=0.0024).CONCLUSION This paper adds to the growing body of evidence that volume alone should not be used as a marker of quality for patients requiring PD.Despite low volumes at our facility,we demonstrated that 87.9%of patients were rescued from major complications.We attributed this to several factors including development of rescue protocols,the competence of the pancreatic surgery teams and continuous,and adaptive learning by the entire institution,cul-minating in the development of tailored peri-pancreatectomy protocols.

Failure to Rescue as a Quality Metric in Congenital Heart Surgeries in a High-Complexity Service Provider Institution Located in a Middle-Income Country

Background:Failure to rescue has been an effective quality metric in congenital heart surgery.Conversely,mor-bidity and mortality depend greatly on non-modifiable individual factors and have a weak correlation with better-quality performance.We aim to measure the complications,mortality,and risk factors in pediatric patients undergoing congenital heart surgery in a high-complexity institution located in a middle-income country and compare it with other institutions that have conducted a similar study.Methods:A retrospective observational study was conducted in a high-complexity service provider institution,in Cali,Colombia.All pediatric patients undergoing any congenital heart surgery between 2019 and 2022 were included.The main outcomes evaluated in the study were complication,mortality,and failure to rescue rate.Univariate and multivariate logistic regression analysis was performed with mortality as the outcome variable.Results:We evaluated 308 congenital heart sur-geries.Regarding the outcomes,201(65%)complications occurred,23(7.5%)patients died,and the FTR of the entire cohort was 11.4%.The presence of a postoperative complication(OR 14.88,CI 3.06–268.37,p=0.009),age(OR 0.79,CI 0.57–0.96,p=0.068),and urgent/emergent surgery(OR 8.14,CI 2.97–28.66,p<0.001)were the most significant variables in predicting mortality.Conclusions:Failure to rescue is an effective and comparable quality measure in healthcare institutions and is the major contributor to postoperative mortality in congenital heart surgeries.Despite our higher mortality and complication rate,we obtained a comparable failure to rescue rate to high-income countries’health institutions.

An Improved Iterated Greedy Algorithm for Solving Rescue Robot Path Planning Problem with Limited Survival Time

Effective path planning is crucial for mobile robots to quickly reach rescue destination and complete rescue tasks in a post-disaster scenario.In this study,we investigated the post-disaster rescue path planning problem and modeled this problem as a variant of the travel salesman problem(TSP)with life-strength constraints.To address this problem,we proposed an improved iterated greedy(IIG)algorithm.First,a push-forward insertion heuristic(PFIH)strategy was employed to generate a high-quality initial solution.Second,a greedy-based insertion strategy was designed and used in the destruction-construction stage to increase the algorithm’s exploration ability.Furthermore,three problem-specific swap operators were developed to improve the algorithm’s exploitation ability.Additionally,an improved simulated annealing(SA)strategy was used as an acceptance criterion to effectively prevent the algorithm from falling into local optima.To verify the effectiveness of the proposed algorithm,the Solomon dataset was extended to generate 27 instances for simulation.Finally,the proposed IIG was compared with five state-of-the-art algorithms.The parameter analysiswas conducted using the design of experiments(DOE)Taguchi method,and the effectiveness analysis of each component has been verified one by one.Simulation results indicate that IIGoutperforms the compared algorithms in terms of the number of rescue survivors and convergence speed,proving the effectiveness of the proposed algorithm.

Investigation of Student Nurses’Attitudes towards End-of-Life Care and Their Influencing Factors

Background: This cross-sectional investigative study aimed to determine student nurses’ attitudes towards end-of-life care. Methods: This study used a descriptive research design with stratified sampling to survey student nurses enrolled in one of four nursing colleges in China from January 2023 to December 2023. Student nurses’ general demographic and prior related information, attitudes towards death and attitudes towards end-of-life care were determined using a general information questionnaire, the Death Attitude Profile—Revised scale and the Professional End-of-Life Attitude Scale (PEAS), respectively. Results: The total PEAS score was 122.91 ± 16.123. Significant differences were noted in the attitude towards end-of-life care scores according to sources of end-of-life care knowledge (P Conclusions: Student nurses lacked an optimistic attitude towards end-of-life care, which was influenced by differences in the sources of end-of-life care knowledge.

The Association between Fear of COVID-19,Obsession with COVID-19,and Post Traumatic Stress Disorder in Korean Emergency Rescue Firefighters:A Cross-Sectional Study

During the rapid spread of COVID-19,first responders are at risk of being exposed to COVID-19 due to their role in providing first aid and responding to an unspecified number of people.This uncertainty can have adverse mental health effects,such as increased anxiety and fear.This study aimed to investigate the degree of association between fear of COVID-19,obsession with COVID-19,and post-traumatic stress disorder(PTSD)in emergency rescue firefighters.The participants were 150 emergency rescue firefighters working in Region S,Korea.They filled out self-report questionnaires:The data obtained through the Fear of COVID-19 Scale,Obsession with COVID-19 Scale,and Impact of Event Scale-Revised Korean version were subjected to nonparametric statistical analysis using SPSS WIN 25.0.The study found a significant correlation between emergency rescue firefighters’fear of COVID-19,obsession with COVID-19,and PTSD.Fear and obsession with COVID-19 were higher among first responder firefighters who were directly involved in COVID-19-related tasks.Furthermore,a one-point increase in obsession was associated with a 2.837-point increase in PTSD.Based on the results,we found that there is a need for effective control of obsessions and fears among first responder firefighters during COVID-19,and we suggest that there is a need for mental health care for first responder firefighters during the pandemic through the development and support of programs to prevent and mitigate obsessions.

Assessment of Meteorological Threats to the Coordinated Search and Rescue of Unmanned/Manned Aircraft

The architecture and working principle of coordinated search and rescue system of unmanned/manned aircraft,which is composed of manned/unmanned aircraft and manned aircraft,were first introduced,and they can cooperate with each other to complete a search and rescue task.Secondly,a threat assessment method based on meteorological data was proposed,and potential meteorological threats,such as storms and rainfall,can be predicted by collecting and analyzing meteorological data.Finally,an experiment was carried out to evaluate the performance of the proposed method in different scenarios.The experimental results show that the coordinated search and rescue system of unmanned/manned aircraft can be used to effectively assess meteorological threats and provide accurate search and rescue guidance.

Analysis of the Emergency Rescue Nursing Intervention Effect and Rescue Success Rate for Patients with Traumatic Hemorrhagic Shock

Objective:To analyze the value of emergency rescue nursing intervention in the care of patients with traumatic hemorrhagic shock and its impact on the success rate of rescue efforts.Methods:A total of 80 patients with traumatic hemorrhagic shock were selected as samples,with the timeframe from July 2022 to July 2023.The patients were randomly divided into two groups using a random number table method.Group A received emergency rescue nursing,while Group B received routine nursing care.The success rate of rescue,rescue indicators,complication rates,and family satisfaction with nursing care were compared between the two groups.Results:The rescue success rate in Group A was higher than in Group B(P<0.05);the total blood loss in Group A was less,and the rescue time,full transportation time,and hospitalization time were shorter than in Group B(P<0.05);the complication rate of patients with traumatic hemorrhagic shock in Group A was lower than in Group B(P<0.05);the family satisfaction with emergency nursing care in Group A was higher than in Group B(P<0.05).Conclusion:Emergency rescue interventions for patients with traumatic hemorrhagic shock can reduce blood loss,shorten rescue times,and improve the success rate of shock rescue,providing a safe and effective approach.

Benchmarking YOLOv5 models for improved human detection in search and rescue missions

Drone or unmanned aerial vehicle(UAV)technology has undergone significant changes.The technology allows UAV to carry out a wide range of tasks with an increasing level of sophistication,since drones can cover a large area with cameras.Meanwhile,the increasing number of computer vision applications utilizing deep learning provides a unique insight into such applications.The primary target in UAV-based detection applications is humans,yet aerial recordings are not included in the massive datasets used to train object detectors,which makes it necessary to gather the model data from such platforms.You only look once(YOLO)version 4,RetinaNet,faster region-based convolutional neural network(R-CNN),and cascade R-CNN are several well-known detectors that have been studied in the past using a variety of datasets to replicate rescue scenes.Here,we used the search and rescue(SAR)dataset to train the you only look once version 5(YOLOv5)algorithm to validate its speed,accuracy,and low false detection rate.In comparison to YOLOv4 and R-CNN,the highest mean average accuracy of 96.9%is obtained by YOLOv5.For comparison,experimental findings utilizing the SAR and the human rescue imaging database on land(HERIDAL)datasets are presented.The results show that the YOLOv5-based approach is the most successful human detection model for SAR missions.

Structural Design Study of Air-Dropped Unmanned Maritime Mobile Search and Rescue Platforms

In order to improve the efficiency and safety of search and rescue(SAR)at sea,this paper proposes a kind of emergency rapid rescue unmanned craft(air-dropped unmanned maritime motorized search and rescue platform)that can be delivered by a large transport aircraft.This paper studies the structural design scheme of the platform,and the main scale of the platform,the choice of power system and the impact resistance performance are considered in the design process to ensure its rapid response and effective rescue capability under complex sea conditions.Simulation results show that the platform can withstand the impact of air injection into the water and the shipboard equipment can operate normally under the impact load,thus verifying the feasibility and safety of the design.This study serves to improve the maritime search and rescue system and enhance the oceanic emergency response capability.

Decision model and algorithm for traffic rescue resource dispatching on expressway

In order to solve the problems of potential incident rescue on expressway networks, the opportunity cost-based method is used to establish a resource dispatch decision model. The model aims to dispatch the rescue resources from the regional road networks and to obtain the location of the rescue depots and the numbers of service vehicles assigned for the potential incidents. Due to the computational complexity of the decision model, a scene decomposition algorithm is proposed. The algorithm decomposes the dispatch problem from various kinds of resources to a single resource, and determines the original scene of rescue resources based on the rescue requirements and the resource matrix. Finally, a convenient optimal dispatch scheme is obtained by decomposing each original scene and simplifying the objective function. To illustrate the application of the decision model and the algorithm, a case of the expressway network is studied on areas around Nanjing city in China and the results show that the model used and the algorithm proposed are appropriate.

Location of emergency rescue center based on SIR epidemiological model

In view of the pressure time of emergency rescue against the infectious diseases,a mathematical model to optimize the location of emergency rescue centers is proposed.The model takes full account of the spread function of infectious diseases,the cycle of pulse vaccination,the distance between the demand area and the emergency rescue centers,as well as the building and maintenance cost for the emergency rescue center,and so on.At the same time,the model integrates the traditional location selection models which are the biggest cover model,the p-center model and the p-median model,and it embodies the principles of fairness and efficiency for the emergency center location.Finally,a computation of an example arising from practice provides satisfactory results.

Optimal dispatching method of traffic incident rescue resource for freeway network

An optimal resource dispatching method is proposed to solve the multiple-response problem under the conditions of potential incidents on freeway networks.Travel time of the response vehicle is selected instead of route distance as the weight to reflect the impact of traffic conditions on the decisions of rescue resources.According to the characteristics of different types of rescue vehicles the dispatching decision-making time is revised to show the heterogeneity among different rescue vehicle dispatching modes. The genetic algorithm is used to obtain the solutions to the rescue resources dispatching model. A case study shows that the proposed method can accurately reveal the impact of potential incidents on the costs of rescues according to the variations in the types and quantities of rescue resources and the optimal dispatching plan with respect to potential incidents can be obtained.The proposed method is applicable in real world scenarios.

传染性法氏囊病病毒Rescue技术及其应用的研究进展

传染性法氏囊病病毒(Infectious bursal disease virus,IBDV)是一种小的、无囊膜的双股RNA病毒,基因组含A、B两个片段,大片段A(3.2～3.4kb)由两端的非编码区以及两个部分重叠的开放阅读框架(ORF)组成,其中较大的ORE编码一个分子量约为110kDa的多聚蛋白,该多聚蛋白经几步裂解加工后形成VP2、VP3和VP4蛋白,较小的ORF编码一个17kDa的非结构蛋白VP5,基因组小片段B(约2.8kb)编码90kDa的具有多功能酶活性的VP1.

Medical rescue of naval combat: challenge and future

There has been no large-scale naval combat in the last 30 years. With the rapid development of battleships, weapons manufacturing and electronic technology, naval combat will present some new characteristics. Additionally, naval combat is facing unprecedented challenges. In this paper, we discuss the topic of medical rescue at sea: what challenges we face and what we could do. The contents discussed in this paper contain battlefield self-aid buddy care, clinical skills, organized health services, medical training and future medical research programs. We also discuss the characteristics of modern naval combat, medical rescue challenges, medical treatment highlights and future developments of medical rescue at sea.

多种评价指标下RoboCupRescue救援智能体算法

为了促进RoboCupRescue项目的发展,使救援智能体的表现在多种目标向量指标下获得更好的评价,通过分析13个计分向量的变化规律,研究与救援智能体(ambulance team,AT)直接相关的6个计分向量在不同救援策略下的评价惩罚,提出兼顾相关评价指标的AT调度算法.该算法包括运用粒子离散方法对市民的降级时间进行预测、基于评价惩罚规则对市民救援优先度进行排序和根据最有效救援集合对AT进行救援目标的分配,并权衡了各个计分向量相互间的影响,从而优化救援智能体的表现.最后在综合性的灾难环境Foligno-3的测试取得了具有代表性的结果,表明该算法是有效的.

DEVELOPMENT OF A SHAPE-SHIFTING MOBILE ROBOT FOR URBAN SEARCH AND RESCUE

A portable shape-shifting mobile robot system named as Amoeba Ⅱ（A-Ⅱ） is developed for the urban search and rescue application. It is designed with three degrees of freedom and two tracked drive systems. This robot consists of two modular mobile units and a joint unit. The mobile unit is a tracked mechanism to enforce the propulsion of robot. And the joint unit can transform the robot shape to get high environment adaptation. A-Ⅱ robot can not only adapt to the environment but also change its body shape according to the locus space. It behaves two work states including the linear state （named as I state） and the parallel state （named as Ⅱ state）. With the linear state the robot can climb upstairs and go through narrow space such as the pipe, cave, etc. The parallel state enables the robot with high mobility on rough ground. Also, the joint unit can propel the robot to roll in sidewise direction. Two modular A-Ⅱ robots can be connected through jointing common interfaces on the joint unit to compose a stronger shape-shifting robot, which can transform the body into four wheels-driven vehicle. The experimental results validate the adaptation and mobility of A-Ⅱ robot.

Non-variceal upper gastrointestinal bleeding: Rescue treatment with a modified cyanoacrylate

AIM To evaluate the safety and efficacy of a modified cyanoacrylate [N-butyl-2-cyanoacrylate associated with methacryloxysulfolane(NBCA + MS)] to treat nonvariceal upper gastrointestinal bleeding(NV-UGIB).METHODS In our retrospective study we took into account 579 out of 1177 patients receiving endoscopic treatment for NV-UGIB admitted to our institution from 2008 to 2015; the remaining 598 patients were treated with other treatments. Initial hemostasis was not achieved in 45 of 579 patients; early rebleeding occurred in 12 of 579 patients. Thirty-three patients were treated with modified cyanoacrylate: 27 patients had duodenal, gastric or anastomotic ulcers, 3 had post-mucosectomy bleeding, 2 had Dieulafoy's lesions, and 1 had duodenal diverticular bleeding.RESULTS Of the 45 patients treated endoscopically without initialhemostasis or with early rebleeding, 33(76.7%) were treated with modified cyanoacrylate glue, 16(37.2%) underwent surgery, and 3(7.0%) were treated with selective transarterial embolization. The mean age of patients treated with NBCA + MS(23 males and 10 females) was 74.5 years. Modified cyanoacrylate was used in 24 patients during the first endoscopy and in 9 patients experiencing rebleeding. Overall, hemostasis was achieved in 26 of 33 patients(78.8%): 19 out of 24(79.2%) during the first endoscopy and in 7 out of 9(77.8%) among early rebleeders. Two patients(22.2%) not responding to cyanoacrylate treatment were treated with surgery or transarterial embolization. One patient had early rebleeding after treatment with cyanoacrylate. No late rebleeding during the follow-up or complications related to the glue injection were recorded.CONCLUSION Modified cyanoacrylate solved definitively NV-UGIB after failure of conventional treatment. Some reported life-threatening adverse events with other formulations, advise to use it as last option.