Imperative for long-term management and surveillance in Kawasaki disease

Kawasaki disease(KD)is a significant pediatric vasculitis known for its potential to cause severe coronary artery complications.Despite the effectiveness of initial treatments,such as intravenous immunoglobulin,KD patients can experience long-term cardiovascular issues,as evidenced by a recent case report of an adult who suffered a ST-segment elevation myocardial infarction due to previous KD in the World Journal of Clinical Cases.This editorial emphasizes the critical need for long-term management and regular surveillance to prevent such complications.By drawing on recent research and case studies,we advocate for a structured approach to follow-up care that includes routine cardiac evaluations and preventive measures.

Enhancing perianal disease management with integrated physical and psychological approaches

This article provides a comprehensive analysis of the study by Hou et al,focusing on the complex interplay between psychological and physical factors in the postoperative recovery(POR)of patients with perianal diseases.The study sheds light on how illness perception,anxiety,and depression significantly influence recovery outcomes.Hou et al developed a predictive model that demonstrated high accuracy in identifying patients at risk of poor recovery.The article explores the critical role of pre-operative psychological assessment,highlighting the need for mental health support and personalized recovery plans in enhancing POR quality.A multidisciplinary approach,integrating mental health professionals with surgeons,anesthesiologists,and other specialists,is emphasized to ensure comprehensive care for patients.The study’s findings serve as a call to integrate psychological care into surgical practice to optimize outcomes for patients with perianal diseases.

Solid Waste Management:A MADM Approach Using Fuzzy Parameterized Possibility Single-Valued Neutrosophic Hypersoft Expert Settings

The dramatic rise in the number of people living in cities has made many environmental and social problems worse.The search for a productive method for disposing of solid waste is the most notable of these problems.Many scholars have referred to it as a fuzzy multi-attribute or multi-criteria decision-making problem using various fuzzy set-like approaches because of the inclusion of criteria and anticipated ambiguity.The goal of the current study is to use an innovative methodology to address the expected uncertainties in the problem of solid waste site selection.The characteristics(or sub-attributes)that decision-makers select and the degree of approximation they accept for various options can both be indicators of these uncertainties.To tackle these problems,a novel mathematical structure known as the fuzzy parameterized possibility single valued neutrosophic hypersoft expert set(ρˆ-set),which is initially described,is integrated with a modified version of Sanchez’s method.Following this,an intelligent algorithm is suggested.The steps of the suggested algorithm are explained with an example that explains itself.The compatibility of solid waste management sites and systems is discussed,and rankings are established along with detailed justifications for their viability.This study’s strengths lie in its application of fuzzy parameterization and possibility grading to effectively handle the uncertainties embodied in the parameters’nature and alternative approximations,respectively.It uses specific mathematical formulations to compute the fuzzy parameterized degrees and possibility grades that are missing from the prior literature.It is simpler for the decisionmakers to look at each option separately because the decision is uncertain.Comparing the computed results,it is discovered that they are consistent and dependable because of their preferred properties.

Addressing functional constipation in children:A call for comprehensive and collaborative management

Functional constipation(FC)is the most common gastrointestinal disorder in children,with a global prevalence of 14.4%based on Rome IV criteria.This editorial explores the multifactorial pathogenesis and diagnostic complexity of FC,emphasizing the importance of early and accurate diagnosis.Effective management of FC hinges on child-oriented toilet training and the use of osmotic laxatives,particularly polyethylene glycol.Emerging therapies,including probiotics,serotonin 5-HT4 receptor agonists,chloride channel activators,and herbal remedies,offer promising options but require further research.Lifestyle modifications,such as adequate fiber and fluid intake and physiotherapy,are crucial in supporting pharmacological treatments.For intractable cases,a multidisciplinary approach involving pediatric specialists,nutritionists,physiotherapists,and psychologists is essential.This comprehensive strategy aims to improve the quality of life for children with FC and their families through continuous research,education,and collaborative care.

Management of chylous ascites after liver cirrhosis: A case report

BACKGROUND Chylous ascites is an uncommon condition,occurring in less than 1%of ascites cases.It results from traumatic or obstructive disruption of the lymphatic system,causing the leakage of thoracic or intestinal lymph into the abdominal cavity.This leads to the accumulation of a milky,triglyceride-rich fluid.In adults,malignancy and cirrhosis are the primary causes of chylous ascites.Notably,chylous ascites accounts for only 0.5%to 1%of all cirrhosis-related ascites cases.At present,there is a limited understanding of this condition,and effective timely management in clinical practice remains challenging.CASE SUMMARY This case report presents a patient with hepatic cirrhosis complicated by chylous ascites,who had experienced multiple hospitalizations due to abdominal distension.Upon admission,comprehensive examinations and assessments were conducted.The treatment strategy focused on nutritional optimization through a low-sodium,low-fat,and high-protein diet supplemented with medium-chain triglycerides,therapeutic paracentesis,and diuretics.Following a multidiscip-linary discussion and thorough evaluation of the patient’s condition,surgical indications were confirmed.After informing the patient about the benefits and risks,and obtaining consent,a transjugular intrahepatic portosystemic shunt procedure was performed,successfully alleviating the abdominal swelling symptoms.This article details the clinical characteristics and treatment approach for this uncommon case,summarizing current management methods for hepatic cirrhosis complicated by chylous ascites.The aim is to provide valuable insights for clinicians encountering similar situations.CONCLUSION Optimizing nutrition and addressing the underlying cause are essential in the treatment of chylous ascites.When conservative approaches prove ineffective,alternative interventions such as transjugular intrahepatic portosystemic shunt may be considered.

Early identification and multidisciplinary management of immune checkpoint inhibitors associated colitis can improve patient outcomes

Currently,the use of immune checkpoint inhibitors(ICIs)has shown notable clinical efficacy in treating various malignant tumors,significantly improving patient prognosis.However,while ICIs enhance the body’s anti-tumor effects,they can also trigger immune-related adverse events(irAEs),with ICI-associated colitis being one of the more prevalent forms.This condition can disrupt treatment,necessitate drug discontinuation,and adversely affect therapeutic outcomes.In severe cases,irAEs may even become life-threatening.A recent case report by Hong et al highlights the importance of vigilance for ICI-associated colitis in patients experiencing symptoms such as diarrhea and abdominal pain,which can arise both during and even after completion of ICI treatment.Early identification,multidisciplinary management,and continuous monitoring of patients are essential steps to further improve outcomes.

Ultra-Dense LEO Satellite-Aircraft Access and Service Management in Civil Aviation

With the deployment of ultra-dense low earth orbit(LEO)satellite constellations,LEO satellite access network(LEO-SAN)is envisioned to achieve global Internet coverage.Meanwhile,the civil aviation communications have increased dramatically,especially for providing airborne Internet services.However,due to dynamic service demands and onboard LEO resources over time and space,it poses huge challenges in satellite-aircraft access and service management in ultra-dense LEO satellite networks(UDLSN).In this paper,we propose a deep reinforcement learning-based approach for ultra-dense LEO satellite-aircraft access and service management.Firstly,we develop an airborne Internet architecture based on UDLSN and design a management mechanism including medium earth orbit satellites to guarantee lightweight management.Secondly,considering latency-sensitive and latency-tolerant services,we formulate the problem of satellite-aircraft access and service management for civil aviation to ensure service continuity.Finally,we propose a proximal policy optimization-based access and service management algorithm to solve the formulated problem.Simulation results demonstrate the convergence and effectiveness of the proposed algorithm with satisfying the service continuity when applying to the UDLSN.

Design and validation of real-time dynamic spectrum management in OFDM-based HNPLC systems

Time-varying frequency selective attenuation and colored noises are unfavorable characteristics of power line communication(PLC) channels of the low voltage networks.To overcome these disadvantages,a novel real-time dynamic spectrum management(DSM) algorithm in orthogonal frequency division multiplexing(OFDM)-based high-speed narrow-band power line communication(HNPLC) systems is proposed,and the corresponding FPGA circuit is designed and realized.Performance of the proposed DSM is validated with a large amount of network experiments under practical PLC circumstance.As the noise in each narrow subcarrier is approximately Gaussian,the proposed DSM adopts the BER/SER expression formulized via the AWGN channel to provide a handy and universal strategy for power allocation.The real-time requirement is guaranteed by choosing subcarriers in group and employing the same modulation scheme within each transmission.These measures are suitable for any modulation scheme no matter the system criterion is to maximize data rate or minimize power/BER.Algorithm design and hardware implementation of the proposed DSM are given with some flexible and efficient conversions.The DSM circuit is carried out with Xilinx KC705.Simulation and practical experiments validate that the proposed real-time DSM significantly improves system performance.

Design of User Interface for Tractor Cab Real-time Information Management System

In this paper,the user interface of tractor cab real-time information management system was designed. Based on the principle of "user friendly",it reasonably arranged spatial position of information management system according to spatial distribution of tractor cab. Then,it analyzed operation habits and thinking ways of drivers,and formulated design principle meeting demands of drivers. Besides,it used LabView software to design user interface,including interface layout and interface design. User interface includes basic information interface,job information interface,camera monitoring interface,and fault diagnosis interface. Finally,it made evaluation of the user interface from color,indicator lamp,dial,and pointer. Results indicate that the designed user interface layout conforms to cognition mentality and operation habits and easy to get familiar and grasp; graphical interface is vivid and easy to stimulate pleasure of drivers in operation; interface color matching is coordinated; the layout of controls is hierarchical and logic,and operating mode is consistent with Windows system.

REAL-TIME LICENSING MANAGEMENT OF SECURE MULTIMEDIA CONTENT DELIVE RY

Media Commerce is now becoming a new trend which results fr om faster development of network bandwidth and high availability of multimedia t echnologies, how to protect media content from being used in a right-violated w ay is one of most important issues to take into account. In this paper, a novel and efficient authorization and authentication Digital Rights Management (DRM) s chema is proposed firstly for secure multimedia delivery, then based on the sche ma, a real-time digital signature algorithm built on Elliptic Curve Cryptograph y (ECC) is adopted for fast authentication and verification of licensing managem ent, thus secure multimedia delivery via TCP/RTP can efficiently work with real -time transaction response and high Quality of Service (QoS) . Performance eval uations manifest the proposed schema is secure, available for real-time media s tream authentication and authorization without much effected of QoS. The propose d schema is not only available for Client/Server media service but can be easily extended to P2P and broadcasting network for trusted rights management.

Congestion Management Strategies of Real-Time Market

The high penetration of distributed energy resources (DERs) will significantly challenge the power system operation and control due to their stochastic, intermittent, and fluctuation characteristics. This enhances the difficulty of congestion management of power systems in cross-border electricity market among different regions. For handling this, the Real-Time Market is proposed for balancing capacity trading against congestions. Several strategies for Real-Time Market dealing with congestions are proposed. The strategy of two-stage crossborder markets in Day-ahead, Intra-day and Real Time Market are introduced with the congestion constraints complied. Pre-Contingency strategy is proposed as the advance preparation for the future congestion, and In-Day redispatch is used for regulation. Accordingly, the requirements on facilities considering telemetry and remote control in a fast manner are discussed at last.

Safety-assured,real-time neural active fault management for resilient microgrids integration

Federated-learning-based active fault management(AFM)is devised to achieve real-time safety assurance for microgrids and the main grid during faults.AFM was originally formulated as a distributed optimization problem.Here,federated learning is used to train each microgrid’s network with training data achieved from distributed optimization.The main contribution of this work is to replace the optimization-based AFM control algorithm with a learning-based AFM control algorithm.The replacement transfers computation from online to offline.With this replacement,the control algorithm can meet real-time requirements for a system with dozens of microgrids.By contrast,distributed-optimization-based fault management can output reference values fast enough for a system with several microgrids.More microgrids,however,lead to more computation time with optimization-based method.Distributed-optimization-based fault management would fail real-time requirements for a system with dozens of microgrids.Controller hardware-in-the-loop real-time simulations demonstrate that learning-based AFM can output reference values within 10 ms irrespective of the number of microgrids.

基于Real-time PCR法检测乳粉中牛源性成分定量研究

基于Real-timePCR建立了乳粉中牛源性成分相对定量检测方法,并对牛的特异性引物与探针进行了特异性、灵敏度和稳定性测试。通过模拟不同浓度牛乳粉与马乳粉混合样本,根据其△Ct值的函数关系进行线性拟合进而绘制标准曲线,建立乳粉中牛源性成分的相对定量检测。结果显示,该方法的最低检测限为0.00001 mg/mL,回收率为91.11%~119.2%,组间变异系数≤0.58%、组内变异系数≤1.44%。说明该方法在特异性与稳定性上适用于乳粉中牛源性成分及含量的掺假检测。

A multifunctional shear apparatus for rocks subjected to true triaxial stress and high temperature in real-time

Deep engineering disasters,such as rockbursts and collapses,are more related to the shear slip of rock joints.A novel multifunctional device was developed to study the shear failure mechanism in rocks.Using this device,the complete shearedeformation process and long-term shear creep tests could be performed on rocks under constant normal stiffness(CNS)or constant normal loading(CNL)conditions in real-time at high temperature and true-triaxial stress.During the research and development process,five key technologies were successfully broken through:(1)the ability to perform true-triaxial compressioneshear loading tests on rock samples with high stiffness;(2)a shear box with ultra-low friction throughout the entire stress space of the rock sample during loading;(3)a control system capable of maintaining high stress for a long time and responding rapidly to the brittle fracture of a rock sample as well;(4)a refined ability to measure the volumetric deformation of rock samples subjected to true triaxial shearing;and(5)a heating system capable of maintaining uniform heating of the rock sample over a long time.By developing these technologies,loading under high true triaxial stress conditions was realized.The apparatus has a maximum normal stiffness of 1000 GPa/m and a maximum operating temperature of 300C.The differences in the surface temperature of the sample are constant to within5C.Five types of true triaxial shear tests were conducted on homogeneous sandstone to verify that the apparatus has good performance and reliability.The results show that temperature,lateral stress,normal stress and time influence the shear deformation,failure mode and strength of the sandstone.The novel apparatus can be reliably used to conduct true-triaxial shear tests on rocks subjected to high temperatures and stress.

Personal Thermal Management by Radiative Cooling and Heating

Maintaining thermal comfort within the human body is crucial for optimal health and overall well-being.By merely broadening the setpoint of indoor temperatures,we could significantly slash energy usage in building heating,ventilation,and air-conditioning systems.In recent years,there has been a surge in advancements in personal thermal management(PTM),aiming to regulate heat and moisture transfer within our immediate surroundings,clothing,and skin.The advent of PTM is driven by the rapid development in nano/micro-materials and energy science and engineering.An emerging research area in PTM is personal radiative thermal management(PRTM),which demonstrates immense potential with its high radiative heat transfer efficiency and ease of regulation.However,it is less taken into account in traditional textiles,and there currently lies a gap in our knowledge and understanding of PRTM.In this review,we aim to present a thorough analysis of advanced textile materials and technologies for PRTM.Specifically,we will introduce and discuss the underlying radiation heat transfer mechanisms,fabrication methods of textiles,and various indoor/outdoor applications in light of their different regulation functionalities,including radiative cooling,radiative heating,and dual-mode thermoregulation.Furthermore,we will shine a light on the current hurdles,propose potential strategies,and delve into future technology trends for PRTM with an emphasis on functionalities and applications.

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

Objective:To conduct a systematic literature review on urethral calculi in a contemporary cohort describing etiology,investigation,and management patterns.Methods:A systematic search of MEDLINE and Cochrane Central Register of Controlled Trials(CENTRAL)databases was performed.Articles,including case reports and case series on urethral calculi published between January 2000 and December 2019,were included.Full-text manuscripts were reviewed for clinical parameters including symptomatology,etiology,medical history,investigations,treatment,and outcomes.Data were collated and analyzed with univariate methods.Results:Seventy-four publications met inclusion criteria,reporting on 95 cases.Voiding symptoms(41.1%),pain(40.0%),and acute urinary retention(32.6%)were common presenting features.Urethral calculi were most often initially investigated using plain X-ray(63.2%),with almost all radio-opaque(98.3%).Urethral calculi were frequently associated with coexistent bladder or upper urinary tract calculi(16.8%)and underlying urethral pathology(53.7%)including diverticulum(33.7%)or stricture(13.7%).Urethral calculi were most commonly managed with external urethrolithotomy(31.6%),retrograde manipulation(22.1%),and endoscopic in situ lithotripsy(17.9%).Conclusion:This unique systematic review of urethral calculi provided a summary of clinical features and treatment trends with a suggested treatment algorithm.Management in contemporary urological practice should be according to calculus size,shape,anatomical location,and presence of urethral pathology.

Overview of the immunological mechanisms in hepatitis B virus reactivation:Implications for disease progression and management strategies

Hepatitis B virus(HBV)reactivation is a clinically significant challenge in disease management.This review explores the immunological mechanisms underlying HBV reactivation,emphasizing disease progression and management.It delves into host immune responses and reactivation’s delicate balance,spanning innate and adaptive immunity.Viral factors’disruption of this balance,as are interac-tions between viral antigens,immune cells,cytokine networks,and immune checkpoint pathways,are examined.Notably,the roles of T cells,natural killer cells,and antigen-presenting cells are discussed,highlighting their influence on disease progression.HBV reactivation’s impact on disease severity,hepatic flares,liver fibrosis progression,and hepatocellular carcinoma is detailed.Management strategies,including anti-viral and immunomodulatory approaches,are critically analyzed.The role of prophylactic anti-viral therapy during immunosuppressive treatments is explored alongside novel immunotherapeutic interventions to restore immune control and prevent reactivation.In conclusion,this compre-hensive review furnishes a holistic view of the immunological mechanisms that propel HBV reactivation.With a dedicated focus on understanding its implic-ations for disease progression and the prospects of efficient management stra-tegies,this article contributes significantly to the knowledge base.The more profound insights into the intricate interactions between viral elements and the immune system will inform evidence-based approaches,ultimately enhancing disease management and elevating patient outcomes.The dynamic landscape of management strategies is critically scrutinized,spanning anti-viral and immunomodulatory approaches.The role of prophylactic anti-viral therapy in preventing reactivation during immunosuppressive treatments and the potential of innovative immunotherapeutic interventions to restore immune control and proactively deter reactivation.

Patient satisfaction and follow-up adherence to glaucoma case management clinic in China

AIM:To assess glaucoma patient satisfaction and follow-up adherence in case management and identify associated predictors to improve healthcare quality and patient outcomes.METHODS:In this cross-sectional study,a total of 119 patients completed a Patient Satisfaction Questionnaire-18 and a sociodemographic questionnaire.Clinical data was obtained from the case management system.Follow-up adherence was defined as completing each follow-up within±30d of the scheduled time set by ophthalmologists during the study period.RESULTS:Average satisfaction scored 78.65±7,with an average of 4.39±0.58 across the seven dimensions.Age negatively correlated with satisfaction(P=0.008),whilst patients with follow-up duration of 2 or more years reported higher satisfaction(P=0.045).Multivariate logistics regression analysis revealed that longer follow-up durations were associated with lower follow-up adherence(OR=0.97,95%CI,0.95-1.00,P=0.044).Additionally,patients with suspected glaucoma(OR=2.72,95%CI,1.03-7.20,P=0.044)and those with an annual income over 100000 Chinese yuan demonstrated higher adherence(OR=5.57,95%CI,1.00-30.89,P=0.049).CONCLUSION:The case management model proves effective for glaucoma patients,with positive adherence rates.The implementation of this model can be optimized in the future based on the identified factors and extended to glaucoma patients in more hospitals.

Pore-pressure and stress-coupled creep behavior in deep coal:Insights from real-time NMR analysis

Understanding the variations in microscopic pore-fracture structures(MPFS) during coal creep under pore pressure and stress coupling is crucial for coal mining and effective gas treatment. In this manuscript, a triaxial creep test on deep coal at various pore pressures using a test system that combines in-situ mechanical loading with real-time nuclear magnetic resonance(NMR) detection was conducted.Full-scale quantitative characterization, online real-time detection, and visualization of MPFS during coal creep influenced by pore pressure and stress coupling were performed using NMR and NMR imaging(NMRI) techniques. The results revealed that seepage pores and microfractures(SPM) undergo the most significant changes during coal creep, with creep failure gradually expanding from dense primary pore fractures. Pore pressure presence promotes MPFS development primarily by inhibiting SPM compression and encouraging adsorption pores(AP) to evolve into SPM. Coal enters the accelerated creep stage earlier at lower stress levels, resulting in more pronounced creep deformation. The connection between the micro and macro values was established, demonstrating that increased porosity at different pore pressures leads to a negative exponential decay of the viscosity coefficient. The Newton dashpot in the ideal viscoplastic body and the Burgers model was improved using NMR experimental results, and a creep model that considers pore pressure and stress coupling using variable-order fractional operators was developed. The model’s reasonableness was confirmed using creep experimental data. The damagestate adjustment factors ω and β were identified through a parameter sensitivity analysis to characterize the effect of pore pressure and stress coupling on the creep damage characteristics(size and degree of difficulty) of coal.

Self‑Healing Dynamic Hydrogel Microparticles with Structural Color for Wound Management

Chronic diabetic wounds confront a significant medical challenge because of increasing prevalence and difficult-healing circumstances.It is vital to develop multifunctional hydrogel dressings,with well-designed morphology and structure to enhance flexibility and effectiveness in wound management.To achieve these,we propose a self-healing hydrogel dressing based on structural color microspheres for wound management.The microsphere comprised a photothermal-responsive inverse opal framework,which was constructed by hyaluronic acid methacryloyl,silk fibroin methacryloyl and black phosphorus quantum dots(BPQDs),and was further re-filled with a dynamic hydrogel.The dynamic hydrogel filler was formed by Knoevenagel condensation reaction between cyanoacetate and benzaldehyde-functionalized dextran(DEX-CA and DEX-BA).Notably,the composite microspheres can be applied arbitrarily,and they can adhere together upon near-infrared irradiation by leveraging the BPQDs-mediated photothermal effect and the thermoreversible stiffness change of dynamic hydrogel.Additionally,eumenitin and vascular endothelial growth factor were co-loaded in the microspheres and their release behavior can be regulated by the same mechanism.Moreover,effective monitoring of the drug release process can be achieved through visual color variations.The microsphere system has demonstrated desired capabilities of controllable drug release and efficient wound management.These characteristics suggest broad prospects for the proposed composite microspheres in clinical applications.