Keratoconus is an ectatic condition characterized by gradual corneal thinning,corneal protrusion,progressive irregular astigmatism,corneal fibrosis,and visual impairment.The therapeutic options regarding improvement o...Keratoconus is an ectatic condition characterized by gradual corneal thinning,corneal protrusion,progressive irregular astigmatism,corneal fibrosis,and visual impairment.The therapeutic options regarding improvement of visual function include glasses or soft contact lenses correction for initial stages,gas-permeable rigid contact lenses,scleral lenses,implantation of intrastromal corneal ring or corneal transplants for most advanced stages.In keratoconus cases showing disease progression corneal collagen crosslinking(CXL)has been proven to be an effective,minimally invasive and safe procedure.CXL consists of a photochemical reaction of corneal collagen by riboflavin stimulation with ultraviolet A radiation,resulting in stromal crosslinks formation.The aim of this review is to carry out an examination of CXL methods based on theoretical basis and mathematical models,from the original Dresden protocol to the most recent developments in the technique,reporting the changes proposed in the last 15y and examining the advantages and disadvantages of the various treatment protocols.Finally,the limits of non-standardized methods and the perspectives offered by a customization of the treatment are highlighted.展开更多
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 consens...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.展开更多
Fair exchange protocols play a critical role in enabling two distrustful entities to conduct electronic data exchanges in a fair and secure manner.These protocols are widely used in electronic payment systems and elec...Fair exchange protocols play a critical role in enabling two distrustful entities to conduct electronic data exchanges in a fair and secure manner.These protocols are widely used in electronic payment systems and electronic contract signing,ensuring the reliability and security of network transactions.In order to address the limitations of current research methods and enhance the analytical capabilities for fair exchange protocols,this paper proposes a formal model for analyzing such protocols.The proposed model begins with a thorough analysis of fair exchange protocols,followed by the formal definition of fairness.This definition accurately captures the inherent requirements of fair exchange protocols.Building upon event logic,the model incorporates the time factor into predicates and introduces knowledge set axioms.This enhancement empowers the improved logic to effectively describe the state and knowledge of protocol participants at different time points,facilitating reasoning about their acquired knowledge.To maximize the intruder’s capabilities,channel errors are translated into the behaviors of the intruder.The participants are further categorized into honest participants and malicious participants,enabling a comprehensive evaluation of the intruder’s potential impact.By employing a typical fair exchange protocol as an illustrative example,this paper demonstrates the detailed steps of utilizing the proposed model for protocol analysis.The entire process of protocol execution under attack scenarios is presented,shedding light on the underlying reasons for the attacks and proposing corresponding countermeasures.The developedmodel enhances the ability to reason about and evaluate the security properties of fair exchange protocols,thereby contributing to the advancement of secure network transactions.展开更多
Rapid development in Information Technology(IT)has allowed several novel application regions like large outdoor vehicular networks for Vehicle-to-Vehicle(V2V)transmission.Vehicular networks give a safe and more effect...Rapid development in Information Technology(IT)has allowed several novel application regions like large outdoor vehicular networks for Vehicle-to-Vehicle(V2V)transmission.Vehicular networks give a safe and more effective driving experience by presenting time-sensitive and location-aware data.The communication occurs directly between V2V and Base Station(BS)units such as the Road Side Unit(RSU),named as a Vehicle to Infrastructure(V2I).However,the frequent topology alterations in VANETs generate several problems with data transmission as the vehicle velocity differs with time.Therefore,the scheme of an effectual routing protocol for reliable and stable communications is significant.Current research demonstrates that clustering is an intelligent method for effectual routing in a mobile environment.Therefore,this article presents a Falcon Optimization Algorithm-based Energy Efficient Communication Protocol for Cluster-based Routing(FOA-EECPCR)technique in VANETS.The FOA-EECPCR technique intends to group the vehicles and determine the shortest route in the VANET.To accomplish this,the FOA-EECPCR technique initially clusters the vehicles using FOA with fitness functions comprising energy,distance,and trust level.For the routing process,the Sparrow Search Algorithm(SSA)is derived with a fitness function that encompasses two variables,namely,energy and distance.A series of experiments have been conducted to exhibit the enhanced performance of the FOA-EECPCR method.The experimental outcomes demonstrate the enhanced performance of the FOA-EECPCR approach over other current methods.展开更多
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 ...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.展开更多
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 ...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.展开更多
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 ...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.展开更多
The gonadotropin-releasing hormone (GnRH) antagonist protocol has emerged as an efficacious alternative to the GnRH agonist protocol for controlled ovarian hyperstimulation (COH) during in vitro fertilization (IVF) cy...The gonadotropin-releasing hormone (GnRH) antagonist protocol has emerged as an efficacious alternative to the GnRH agonist protocol for controlled ovarian hyperstimulation (COH) during in vitro fertilization (IVF) cycles, and has been demonstrated applicability in infertile female patients with diverse ovarian responses. While the clinical implementation of the antagonist COH protocol has achieved widespread consensus, opportunities for refinement persist. Therefore, this review article focuses on the advantages and disadvantages of GnRH antagonist protocol, the selection of optimal standard doses, and the strategies for adjusting antagonist doses after the premature luteinizing hormone (LH) surge, aiming to provide more reasonable and scientific recommendations for the application of this scheme.展开更多
Wireless Body Area Network(WBAN)is a cutting-edge technology that is being used in healthcare applications to monitor critical events in the human body.WBAN is a collection of in-body and on-body sensors that monitor ...Wireless Body Area Network(WBAN)is a cutting-edge technology that is being used in healthcare applications to monitor critical events in the human body.WBAN is a collection of in-body and on-body sensors that monitor human physical parameters such as temperature,blood pressure,pulse rate,oxygen level,body motion,and so on.They sense the data and communicate it to the Body Area Network(BAN)Coordinator.The main challenge for the WBAN is energy consumption.These issues can be addressed by implementing an effective Medium Access Control(MAC)protocol that reduces energy consumption and increases network lifetime.The purpose of the study is to minimize the energy consumption and minimize the delay using IEEE 802.15.4 standard.In our proposed work,if any critical events have occurred the proposed work is to classify and prioritize the data.We gave priority to the highly critical data to get the Guarantee Tine Slots(GTS)in IEEE 802.15.4 standard superframe to achieve greater energy efficiency.The proposed MAC provides higher data rates for critical data based on the history and current condition and also provides the best reliable service to high critical data and critical data by predicting node similarity.As an outcome,we proposed a MAC protocol for Variable Data Rates(MVDR).When compared to existing MAC protocols,the MVDR performed very well with low energy intake,less interruption,and an enhanced packet-sharing ratio.展开更多
Land acquisition is subject of many frauds worldwide. In Africa countries, land acquisition frauds are a real curse. Main reasons of the high land acquisition frauds in Africa are a lack of a reliable land acquisition...Land acquisition is subject of many frauds worldwide. In Africa countries, land acquisition frauds are a real curse. Main reasons of the high land acquisition frauds in Africa are a lack of a reliable land acquisition protocol implementation, no centralized information system that records land transactions and integrates all actors, lack of education about the acquisition protocol and lack of applied sanctions in case of frauds. As of sanctions, the issue is bound to the corruption plague in Africa. Authorities that are supposed to rule the laws are not well paid and are part of the corruption scheme. Most frequent frauds are multiple sales of the same land, falsified land title, false owner identification. In Africa, a land belongs generally to the first residents of the area. To claim ownership of a land, an owner should be recognized by the rural or city authorities. To achieve this recognition, he must obtain from those authorities an attribution letter. The author proposed a complete and reliable land acquisition protocol named ACLAP (Africa Countries Land Acquisition Protocol). The purpose of this paper is to explain the main components of the protocol implementation and show its efficiency when confronting fraud threats. In this paper, a Generic and Reliable Land Acquisition Protocol Implementation in Sub-Saharan Africa countries context is proposed. The platform keeps relevant land transaction information for administrators, managers, buyers, sellers, or for people consultation purpose. The application may be used in village, city, department, region, or country for land management decision making.展开更多
BACKGROUND Diabetic foot ulcers(DFUs)are a common complication of diabetes,often leading to severe infections,amputations,and reduced quality of life.The current standard treatment protocols for DFUs have limitations ...BACKGROUND Diabetic foot ulcers(DFUs)are a common complication of diabetes,often leading to severe infections,amputations,and reduced quality of life.The current standard treatment protocols for DFUs have limitations in promoting efficient wound healing and preventing complications.A comprehensive treatment approach targeting multiple aspects of wound care may offer improved outcomes for patients with DFUs.The hypothesis of this study is that a comprehensive treatment protocol for DFUs will result in faster wound healing,reduced amputation rates,and improved overall patient outcomes compared to standard treatment protocols.AIM To compare the efficacy and safety of a comprehensive treatment protocol for DFUs with those of the standard treatment protocol.METHODS This retrospective study included 62 patients with DFUs,enrolled between January 2022 and January 2024,randomly assigned to the experimental(n=32)or control(n=30)group.The experimental group received a comprehensive treatment comprising blood circulation improvement,debridement,vacuum sealing drainage,recombinant human epidermal growth factor and anti-inflammatory dressing,and skin grafting.The control group received standard treatment,which included wound cleaning and dressing,antibiotics administration,and surgical debridement or amputation,if necessary.Time taken to reduce the white blood cell count,number of dressing changes,wound healing rate and time,and amputation rate were assessed.RESULTS The experimental group exhibited significantly better outcomes than those of the control group in terms of the wound healing rate,wound healing time,and amputation rate.Additionally,the comprehensive treatment protocol was safe and well tolerated by the patients.CONCLUSION Comprehensive treatment for DFUs is more effective than standard treatment,promoting granulation tissue growth,shortening hospitalization time,reducing pain and amputation rate,improving wound healing,and enhancing quality of life.展开更多
Glaucoma,characterized by a degenerative loss of retinal ganglion cells,is the second leading cause of blindness worldwide.There is currently no cure for vision loss in glaucoma because retinal ganglion cells do not r...Glaucoma,characterized by a degenerative loss of retinal ganglion cells,is the second leading cause of blindness worldwide.There is currently no cure for vision loss in glaucoma because retinal ganglion cells do not regenerate and are not replaced after injury.Human stem cell-derived retinal ganglion cell transplant is a potential therapeutic strategy for retinal ganglion cell degenerative diseases.In this review,we first discuss a 2D protocol for retinal ganglion cell differentiation from human stem cell culture,including a rapid protocol that can generate retinal ganglion cells in less than two weeks and focus on their transplantation outcomes.Next,we discuss using 3D retinal organoids for retinal ganglion cell transplantation,comparing cell suspensions and clusters.This review provides insight into current knowledge on human stem cell-derived retinal ganglion cell differentiation and transplantation,with an impact on the field of regenerative medicine and especially retinal ganglion cell degenerative diseases such as glaucoma and other optic neuropathies.展开更多
Due to the lack of authentication mechanism in BeiDou navigation satellite system(BDS),BD-II civil navigation message(BDII-CNAV)are vulnerable to spoofing attack and replay attack.To solve this problem,we present a se...Due to the lack of authentication mechanism in BeiDou navigation satellite system(BDS),BD-II civil navigation message(BDII-CNAV)are vulnerable to spoofing attack and replay attack.To solve this problem,we present a security authentication protocol,called as BDSec,which is designed by using China’s cryptography Shangyong Mima(SM)series algorithms,such as SM2/4/9 and Zu Chongzhi(ZUC)algorithm.In BDSec protocol,both of BDII-CNAV and signature information are encrypted using the SM4 algorithm(Symmetric encryption mechanism).The encrypted result is used as the subject authentication information.BDSec protocol applies SM9 algorithm(Identity-based cryptography mechanism)to protect the integrity of the BDII-CNAV,adopts the SM2 algorithm(Public key cryptosystem)to guarantee the confidentiality of the important session information,and uses the ZUC algorithm(Encryption and integrity algorithm)to verify the integrity of the message authentication serial number and initial information and the information in authentication initialization sub-protocol respectively.The results of the SVO logic reasoning and performance analysis show that BDSec protocol meets security requirements for the dual user identity authentication in BDS and can realize the security authentication of BDII-CNAV.展开更多
目的:系统综述药品集中带量采购(以下简称“集采”)政策对我国医药产业的影响。方法:通过中国知网、万方、PubMed、Web of Science数据库检索2019年1月1日至2023年7月31日公开发表的文献。借鉴市场结构(Structure)—企业行为(Conduct)...目的:系统综述药品集中带量采购(以下简称“集采”)政策对我国医药产业的影响。方法:通过中国知网、万方、PubMed、Web of Science数据库检索2019年1月1日至2023年7月31日公开发表的文献。借鉴市场结构(Structure)—企业行为(Conduct)—行业绩效(Performance)分析框架(简称“SCP范式”)构建主题框架进行资料整理分析。结果:纳入41篇文献,报告市场结构、企业行为、行业绩效三个维度影响的文献分别有10篇(24.4%)、24篇(58.5%)、23篇(56.1%),共提取10个二级主题。文献表明:市场结构上,集采政策后中标企业市场份额大幅提升,行业集中度明显提高;企业行为上,中标与未中标企业研发投入均增加,企业针对集采产品的销售投入削减,但非集采产品的销售投入未见减少;行业绩效上,集采政策对经营绩效的影响因企业而异,政策初步起到促进中标企业创新产出作用。结论:集采政策在优化市场结构、引导企业行为、提升行业绩效方面具有积极作用,为巩固和扩大政策影响,建议进一步强化药品价格综合治理,拓展集采市场边界,加强政策监测与追踪研究。展开更多
文摘Keratoconus is an ectatic condition characterized by gradual corneal thinning,corneal protrusion,progressive irregular astigmatism,corneal fibrosis,and visual impairment.The therapeutic options regarding improvement of visual function include glasses or soft contact lenses correction for initial stages,gas-permeable rigid contact lenses,scleral lenses,implantation of intrastromal corneal ring or corneal transplants for most advanced stages.In keratoconus cases showing disease progression corneal collagen crosslinking(CXL)has been proven to be an effective,minimally invasive and safe procedure.CXL consists of a photochemical reaction of corneal collagen by riboflavin stimulation with ultraviolet A radiation,resulting in stromal crosslinks formation.The aim of this review is to carry out an examination of CXL methods based on theoretical basis and mathematical models,from the original Dresden protocol to the most recent developments in the technique,reporting the changes proposed in the last 15y and examining the advantages and disadvantages of the various treatment protocols.Finally,the limits of non-standardized methods and the perspectives offered by a customization of the treatment are highlighted.
基金supported in part by the National Natural Science Foundation of China (NSFC)(61703086, 61773106)the IAPI Fundamental Research Funds (2018ZCX27)
文摘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.
基金the National Natural Science Foundation of China(Nos.61562026,61962020)Academic and Technical Leaders of Major Disciplines in Jiangxi Province(No.20172BCB22015)+1 种基金Special Fund Project for Postgraduate Innovation in Jiangxi Province(No.YC2020-B1141)Jiangxi Provincial Natural Science Foundation(No.20224ACB202006).
文摘Fair exchange protocols play a critical role in enabling two distrustful entities to conduct electronic data exchanges in a fair and secure manner.These protocols are widely used in electronic payment systems and electronic contract signing,ensuring the reliability and security of network transactions.In order to address the limitations of current research methods and enhance the analytical capabilities for fair exchange protocols,this paper proposes a formal model for analyzing such protocols.The proposed model begins with a thorough analysis of fair exchange protocols,followed by the formal definition of fairness.This definition accurately captures the inherent requirements of fair exchange protocols.Building upon event logic,the model incorporates the time factor into predicates and introduces knowledge set axioms.This enhancement empowers the improved logic to effectively describe the state and knowledge of protocol participants at different time points,facilitating reasoning about their acquired knowledge.To maximize the intruder’s capabilities,channel errors are translated into the behaviors of the intruder.The participants are further categorized into honest participants and malicious participants,enabling a comprehensive evaluation of the intruder’s potential impact.By employing a typical fair exchange protocol as an illustrative example,this paper demonstrates the detailed steps of utilizing the proposed model for protocol analysis.The entire process of protocol execution under attack scenarios is presented,shedding light on the underlying reasons for the attacks and proposing corresponding countermeasures.The developedmodel enhances the ability to reason about and evaluate the security properties of fair exchange protocols,thereby contributing to the advancement of secure network transactions.
文摘Rapid development in Information Technology(IT)has allowed several novel application regions like large outdoor vehicular networks for Vehicle-to-Vehicle(V2V)transmission.Vehicular networks give a safe and more effective driving experience by presenting time-sensitive and location-aware data.The communication occurs directly between V2V and Base Station(BS)units such as the Road Side Unit(RSU),named as a Vehicle to Infrastructure(V2I).However,the frequent topology alterations in VANETs generate several problems with data transmission as the vehicle velocity differs with time.Therefore,the scheme of an effectual routing protocol for reliable and stable communications is significant.Current research demonstrates that clustering is an intelligent method for effectual routing in a mobile environment.Therefore,this article presents a Falcon Optimization Algorithm-based Energy Efficient Communication Protocol for Cluster-based Routing(FOA-EECPCR)technique in VANETS.The FOA-EECPCR technique intends to group the vehicles and determine the shortest route in the VANET.To accomplish this,the FOA-EECPCR technique initially clusters the vehicles using FOA with fitness functions comprising energy,distance,and trust level.For the routing process,the Sparrow Search Algorithm(SSA)is derived with a fitness function that encompasses two variables,namely,energy and distance.A series of experiments have been conducted to exhibit the enhanced performance of the FOA-EECPCR method.The experimental outcomes demonstrate the enhanced performance of the FOA-EECPCR approach over other current methods.
基金supported by the National Natural Science Foundation of China(62073019)。
文摘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.
基金Supported by The National Research Foundation of Korea Grant funded by the Korea Government,No.00219725.
文摘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.
文摘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.
基金Hainan Province Major Science and Technology Plan Projects(No.ZDKJ2021037,ZDKJ2017007)National Natural Science Foundation of China(No.81960283),and Co-funded by the Hainan Provincial Academician Innovation Platform Research Project and the Hainan Provincial Clinical Medicine Center Construction Project。
文摘The gonadotropin-releasing hormone (GnRH) antagonist protocol has emerged as an efficacious alternative to the GnRH agonist protocol for controlled ovarian hyperstimulation (COH) during in vitro fertilization (IVF) cycles, and has been demonstrated applicability in infertile female patients with diverse ovarian responses. While the clinical implementation of the antagonist COH protocol has achieved widespread consensus, opportunities for refinement persist. Therefore, this review article focuses on the advantages and disadvantages of GnRH antagonist protocol, the selection of optimal standard doses, and the strategies for adjusting antagonist doses after the premature luteinizing hormone (LH) surge, aiming to provide more reasonable and scientific recommendations for the application of this scheme.
文摘Wireless Body Area Network(WBAN)is a cutting-edge technology that is being used in healthcare applications to monitor critical events in the human body.WBAN is a collection of in-body and on-body sensors that monitor human physical parameters such as temperature,blood pressure,pulse rate,oxygen level,body motion,and so on.They sense the data and communicate it to the Body Area Network(BAN)Coordinator.The main challenge for the WBAN is energy consumption.These issues can be addressed by implementing an effective Medium Access Control(MAC)protocol that reduces energy consumption and increases network lifetime.The purpose of the study is to minimize the energy consumption and minimize the delay using IEEE 802.15.4 standard.In our proposed work,if any critical events have occurred the proposed work is to classify and prioritize the data.We gave priority to the highly critical data to get the Guarantee Tine Slots(GTS)in IEEE 802.15.4 standard superframe to achieve greater energy efficiency.The proposed MAC provides higher data rates for critical data based on the history and current condition and also provides the best reliable service to high critical data and critical data by predicting node similarity.As an outcome,we proposed a MAC protocol for Variable Data Rates(MVDR).When compared to existing MAC protocols,the MVDR performed very well with low energy intake,less interruption,and an enhanced packet-sharing ratio.
文摘Land acquisition is subject of many frauds worldwide. In Africa countries, land acquisition frauds are a real curse. Main reasons of the high land acquisition frauds in Africa are a lack of a reliable land acquisition protocol implementation, no centralized information system that records land transactions and integrates all actors, lack of education about the acquisition protocol and lack of applied sanctions in case of frauds. As of sanctions, the issue is bound to the corruption plague in Africa. Authorities that are supposed to rule the laws are not well paid and are part of the corruption scheme. Most frequent frauds are multiple sales of the same land, falsified land title, false owner identification. In Africa, a land belongs generally to the first residents of the area. To claim ownership of a land, an owner should be recognized by the rural or city authorities. To achieve this recognition, he must obtain from those authorities an attribution letter. The author proposed a complete and reliable land acquisition protocol named ACLAP (Africa Countries Land Acquisition Protocol). The purpose of this paper is to explain the main components of the protocol implementation and show its efficiency when confronting fraud threats. In this paper, a Generic and Reliable Land Acquisition Protocol Implementation in Sub-Saharan Africa countries context is proposed. The platform keeps relevant land transaction information for administrators, managers, buyers, sellers, or for people consultation purpose. The application may be used in village, city, department, region, or country for land management decision making.
基金Supported by General Medical Research Fund Project,No.TYYLKYJJ-2022-021.
文摘BACKGROUND Diabetic foot ulcers(DFUs)are a common complication of diabetes,often leading to severe infections,amputations,and reduced quality of life.The current standard treatment protocols for DFUs have limitations in promoting efficient wound healing and preventing complications.A comprehensive treatment approach targeting multiple aspects of wound care may offer improved outcomes for patients with DFUs.The hypothesis of this study is that a comprehensive treatment protocol for DFUs will result in faster wound healing,reduced amputation rates,and improved overall patient outcomes compared to standard treatment protocols.AIM To compare the efficacy and safety of a comprehensive treatment protocol for DFUs with those of the standard treatment protocol.METHODS This retrospective study included 62 patients with DFUs,enrolled between January 2022 and January 2024,randomly assigned to the experimental(n=32)or control(n=30)group.The experimental group received a comprehensive treatment comprising blood circulation improvement,debridement,vacuum sealing drainage,recombinant human epidermal growth factor and anti-inflammatory dressing,and skin grafting.The control group received standard treatment,which included wound cleaning and dressing,antibiotics administration,and surgical debridement or amputation,if necessary.Time taken to reduce the white blood cell count,number of dressing changes,wound healing rate and time,and amputation rate were assessed.RESULTS The experimental group exhibited significantly better outcomes than those of the control group in terms of the wound healing rate,wound healing time,and amputation rate.Additionally,the comprehensive treatment protocol was safe and well tolerated by the patients.CONCLUSION Comprehensive treatment for DFUs is more effective than standard treatment,promoting granulation tissue growth,shortening hospitalization time,reducing pain and amputation rate,improving wound healing,and enhancing quality of life.
基金supported by NIH Core Grants P30-EY008098the Eye and Ear Foundation of Pittsburghunrestricted grants from Research to Prevent Blindness,New York,NY,USA(to KCC)。
文摘Glaucoma,characterized by a degenerative loss of retinal ganglion cells,is the second leading cause of blindness worldwide.There is currently no cure for vision loss in glaucoma because retinal ganglion cells do not regenerate and are not replaced after injury.Human stem cell-derived retinal ganglion cell transplant is a potential therapeutic strategy for retinal ganglion cell degenerative diseases.In this review,we first discuss a 2D protocol for retinal ganglion cell differentiation from human stem cell culture,including a rapid protocol that can generate retinal ganglion cells in less than two weeks and focus on their transplantation outcomes.Next,we discuss using 3D retinal organoids for retinal ganglion cell transplantation,comparing cell suspensions and clusters.This review provides insight into current knowledge on human stem cell-derived retinal ganglion cell differentiation and transplantation,with an impact on the field of regenerative medicine and especially retinal ganglion cell degenerative diseases such as glaucoma and other optic neuropathies.
基金supported in part by the National Key R&D Program of China(No.2022YFB3904503)National Natural Science Foundation of China(No.62172418)the joint funds of National Natural Science Foundation of China and Civil Aviation Administration of China(No.U2133203).
文摘Due to the lack of authentication mechanism in BeiDou navigation satellite system(BDS),BD-II civil navigation message(BDII-CNAV)are vulnerable to spoofing attack and replay attack.To solve this problem,we present a security authentication protocol,called as BDSec,which is designed by using China’s cryptography Shangyong Mima(SM)series algorithms,such as SM2/4/9 and Zu Chongzhi(ZUC)algorithm.In BDSec protocol,both of BDII-CNAV and signature information are encrypted using the SM4 algorithm(Symmetric encryption mechanism).The encrypted result is used as the subject authentication information.BDSec protocol applies SM9 algorithm(Identity-based cryptography mechanism)to protect the integrity of the BDII-CNAV,adopts the SM2 algorithm(Public key cryptosystem)to guarantee the confidentiality of the important session information,and uses the ZUC algorithm(Encryption and integrity algorithm)to verify the integrity of the message authentication serial number and initial information and the information in authentication initialization sub-protocol respectively.The results of the SVO logic reasoning and performance analysis show that BDSec protocol meets security requirements for the dual user identity authentication in BDS and can realize the security authentication of BDII-CNAV.
文摘目的:系统综述药品集中带量采购(以下简称“集采”)政策对我国医药产业的影响。方法:通过中国知网、万方、PubMed、Web of Science数据库检索2019年1月1日至2023年7月31日公开发表的文献。借鉴市场结构(Structure)—企业行为(Conduct)—行业绩效(Performance)分析框架(简称“SCP范式”)构建主题框架进行资料整理分析。结果:纳入41篇文献,报告市场结构、企业行为、行业绩效三个维度影响的文献分别有10篇(24.4%)、24篇(58.5%)、23篇(56.1%),共提取10个二级主题。文献表明:市场结构上,集采政策后中标企业市场份额大幅提升,行业集中度明显提高;企业行为上,中标与未中标企业研发投入均增加,企业针对集采产品的销售投入削减,但非集采产品的销售投入未见减少;行业绩效上,集采政策对经营绩效的影响因企业而异,政策初步起到促进中标企业创新产出作用。结论:集采政策在优化市场结构、引导企业行为、提升行业绩效方面具有积极作用,为巩固和扩大政策影响,建议进一步强化药品价格综合治理,拓展集采市场边界,加强政策监测与追踪研究。