Rwanda secured access to one of the world’s most lucrative agricultural markets this month when it finalised a trade protocol allowing fresh avocado exports to China,a deal that could fundamentally alter the trajecto...Rwanda secured access to one of the world’s most lucrative agricultural markets this month when it finalised a trade protocol allowing fresh avocado exports to China,a deal that could fundamentally alter the trajectory of the country’s trade.展开更多
Protocol Reverse Engineering(PRE)is of great practical importance in Internet security-related fields such as intrusion detection,vulnerability mining,and protocol fuzzing.For unknown binary protocols having fixed-len...Protocol Reverse Engineering(PRE)is of great practical importance in Internet security-related fields such as intrusion detection,vulnerability mining,and protocol fuzzing.For unknown binary protocols having fixed-length fields,and the accurate identification of field boundaries has a great impact on the subsequent analysis and final performance.Hence,this paper proposes a new protocol segmentation method based on Information-theoretic statistical analysis for binary protocols by formulating the field segmentation of unsupervised binary protocols as a probabilistic inference problem and modeling its uncertainty.Specifically,we design four related constructions between entropy changes and protocol field segmentation,introduce random variables,and construct joint probability distributions with traffic sample observations.Probabilistic inference is then performed to identify the possible protocol segmentation points.Extensive trials on nine common public and industrial control protocols show that the proposed method yields higher-quality protocol segmentation results.展开更多
Accurate time synchronization is fundamental to the correct and efficient operation of Wireless Sensor Networks(WSNs),especially in security-critical,time-sensitive applications.However,most existing protocols degrade...Accurate time synchronization is fundamental to the correct and efficient operation of Wireless Sensor Networks(WSNs),especially in security-critical,time-sensitive applications.However,most existing protocols degrade substantially under malicious interference.We introduce iSTSP,an Intelligent and Secure Time Synchronization Protocol that implements a four-stage defense pipeline to ensure robust,precise synchronization even in hostile environments:(1)trust preprocessing that filters node participation using behavioral trust scoring;(2)anomaly isolation employing a lightweight autoencoder to detect and excise malicious nodes in real time;(3)reliability-weighted consensus that prioritizes high-trust nodes during time aggregation;and(4)convergence-optimized synchronization that dynamically adjusts parameters using theoretical stability bounds.We provide rigorous convergence analysis including a closed-form expression for convergence time,and validate the protocol through both simulations and realworld experiments on a controlled 16-node testbed.Under Sybil attacks with five malicious nodes within this testbed,iSTSP maintains synchronization error increases under 12%and achieves a rapid convergence.Compared to state-ofthe-art protocols like TPSN,SE-FTSP,and MMAR-CTS,iSTSP offers 60%faster detection,broader threat coverage,and more than 7 times lower synchronization error,with a modest 9.3%energy overhead over 8 h.We argue this is an acceptable trade-off for mission-critical deployments requiring guaranteed security.These findings demonstrate iSTSP’s potential as a reliable solution for secure WSN synchronization and motivate future work on large-scale IoT deployments and integration with energy-efficient communication protocols.展开更多
Medium access control( MAC) protocol of underwater acoustic communication network is a key technology for underwater acoustic networks( UANs). Most of the MAC protocols for wireless terrestrial communication networks ...Medium access control( MAC) protocol of underwater acoustic communication network is a key technology for underwater acoustic networks( UANs). Most of the MAC protocols for wireless terrestrial communication networks have been designed with negligible propagation delay. If it is deployed directly in an underwater environment,the UANs will perform inefficiently. In this paper,the characteristics of underwater acoustic channel are modeled and simulated by using the OPNET simulation tool,which are the speed of sound, propagation loss, and four sources for ambient noise: the turbulence,shipping,wind driven waves and thermal noise. The performance of pure Aloha( P-Aloha),carrier sense multiple access with collision avoidance( CSMA / CA) and multiple access collision avoidance for wireless local area network( MACAW) protocols in underwater acoustic channel environment are evaluated. The different performance of protocols in underwater environment is compared in the simulation.展开更多
The care of a patient involved in major trauma with exsanguinating haemorrhage is time-critical to achieve definitive haemorrhage control,and it requires coordinated multidisciplinary care.During initial resuscitation...The care of a patient involved in major trauma with exsanguinating haemorrhage is time-critical to achieve definitive haemorrhage control,and it requires coordinated multidisciplinary care.During initial resuscitation of a patient in the emergency department(ED),Code Crimson activation facilitates rapid decisionmaking by multi-disciplinary specialists for definitive haemorrhage control in operating theatre(OT)and/or interventional radiology(IR)suite.Once this decision has been made,there may still be various factors that lead to delay in transporting the patient from ED to OT/IR.Red Blanket protocol identifies and addresses these factors and processes which cause delay,and aims to facilitate rapid and safe transport of the haemodynamically unstable patient from ED to OT,while minimizing delay in resuscitation during the transfer.The two processes,Code Crimson and Red Blanket,complement each other.It would be ideal to merge the two processes into a single protocol rather than having two separate workflows.Introducing these quality improvement strategies and coor-dinated processes within the trauma framework of the hospitals/healthcare systems will help in further improving the multi-disciplinary care for the complex trauma patients requiring rapid and definitive haemorrhage control.展开更多
Objective:To evaluate the efficacy and safety of acupoint application for post-stroke depression(PSD)by regulating gastrointestinal function.A secondary objective is to explore the potential mechanism underlying this ...Objective:To evaluate the efficacy and safety of acupoint application for post-stroke depression(PSD)by regulating gastrointestinal function.A secondary objective is to explore the potential mechanism underlying this approach from the perspective of gut microbiota.Methods:This multicenter,randomized,double-blind(patients and assessors),placebo-controlled trial will enroll 80 patients with PSD,and include a 1-week run-in period,a 4-week treatment phase,and a 12-week follow-up.Eligible participants will randomly be assigned in a 1:1 ratio to either the acupoint application or placebo(non-acupoint)groups.Treatments will be administered thrice weekly for 4 weeks.The primary outcome is change in the Hamilton Rating Scale for Depression(HAMD)score.Secondary outcomes include the Beck Depression Inventory(BDI),36-Item Short-Form Health Survey(SF-36),Barthel Index of Activities of Daily Living,Social Adaptation Self-Evaluation Scale(SASS),and gut microbiota profiling.All outcomes will be assessed at baseline(prior to treatment),during treatment(weeks 2 and 4),and during follow-up(weeks 8,12,and 16).The Treatment Emergent Symptom Scale(TESS)will be used for evaluation throughout the 4-week treatment phase.Discussion:The results of this study will provide important evidence supporting a novel treatment strategy for PSD that targets gastrointestinal regulation,potentially informing future clinical practice.展开更多
BACKGROUND Massive rotator cuff tears(RCTs)result in impaired shoulder function and quality of life.These tears lead to structural changes in the rotator cuff muscles,which compromise recovery after repair and increas...BACKGROUND Massive rotator cuff tears(RCTs)result in impaired shoulder function and quality of life.These tears lead to structural changes in the rotator cuff muscles,which compromise recovery after repair and increase re-tear rates.AIM To investigate the potential inhibitory effects of alpha-tocopherol(vitamin E)and OTR-4131 on muscle atrophy,fatty infiltration,and fibrosis in rotator cuff muscles following a massive RCT using a Wistar rat model,and establish a standardized methodology for evaluating potential therapeutic agents.METHODS This protocol outlines a controlled animal study using 40 male Wistar rats,randomized into five groups.The experimental groups will receive either systemic administration of alpha-tocopherol or local administration of OTR-4131 via intramuscular injection into the supraspinatus and infraspinatus muscles.Two sham groups will receive systemic and local saline injections respectively,while a control group will undergo no intervention.The interventions will be administered after surgical transection of the supraspinatus and infraspinatus tendons.Outcomes will be assessed via wet muscle weight measurements,muscle fiber diameter,fatty infiltration percentage,and fibrosis evaluation using histological methods.RESULTS The study anticipates that alpha-tocopherol and OTR-4131 will reduce muscle atrophy,fatty infiltration,and fibrosis compared to control and sham groups,supporting their potential protective role in rotator cuff muscle degeneration.CONCLUSION The results are expected to improve the understanding on the role of alpha-tocopherol and OTR-4131 in rotator cuff muscle protection after massive RCT and may serve as a foundation for further preclinical and clinical research aimed at improving rotator cuff repair outcomes.展开更多
BACKGROUND Femur fractures are one of the most serious injuries that occur in the older population and are associated with severe pain and increased mortality.The primary objective of this study was to find if there w...BACKGROUND Femur fractures are one of the most serious injuries that occur in the older population and are associated with severe pain and increased mortality.The primary objective of this study was to find if there was a significant difference in pain scores in patients treated with femoral nerve blocks(FNB)compared with patients treated with the standard analgesia protocol.The secondary objective was to find if there was a significant difference in morbidity between the two groups.AIM To evaluate the effectiveness of ultrasound(US)-guided FNB in managing preoperative pain and reducing morbidity in patients with neck femur fractures compared to the standard analgesia protocol.The study seeks to determine whether FNB offers superior outcomes in terms of pain control,rehospitalization rates,and mortality.METHODS This retrospective cohort study included 1577 patients suffering from neck femur fractures.387 patients were treated with a FNB for pain management upon arrival at the emergency department,the rest were treated with standard analgesia.Pain was assessed from electronic medical records using the visual analogue scale(VAS)pre surgery,12-and 24-hour post-surgery.To determine morbidity and mortality during hospitalizations and 6 months after,it was collected from electronic medical records.RESULTS In a cohort of 1577 patients,those receiving US-guided FNB had significantly lower preoperative VAS pain scores(1.46±2.49 vs 1.82±2.59,P=0.001),reduced rehospitalization rates(0.99±1.96 vs 1.46±2.34,P<0.001),and lower mortality(16%vs 32%,P<0.001)compared to standard analgesia.CONCLUSION US guided FNB is more effective for pain management compared with standard analgesia.This method was also found to significantly reduce the risk of morbidity in those patients.展开更多
BACKGROUND Diabetes mellitus has become one of the major pandemics of the 21st century.In this scenario,nursing interventions are essential for improving self-care and quality of life in patients with type 2 diabetes ...BACKGROUND Diabetes mellitus has become one of the major pandemics of the 21st century.In this scenario,nursing interventions are essential for improving self-care and quality of life in patients with type 2 diabetes mellitus.Nursing interventions are crucial for managing the disease and preventing complications.AIM To analyse nursing interventions in recent years through a systematic review and meta-analysis and to propose improvements in care plans.METHODS This study conducted a systematic review and meta-analysis of the impact of nursing interventions on quantitative glycaemic variables,such as glycated haemoglobin and fasting plasma glucose.RESULTS After confirming that the combined effect of all studies from the past 5 years positively impacts quantitative variables,a descriptive analysis of the studies with the most significant changes was conducted.Based on this,an improvement in diabetic patient care protocols has been proposed through follow-up plans tailored to the patient’s technological skills.CONCLUSION The combined results obtained and the proposal for improvement developed in this manuscript could help to improve the quality of life of many people around the world.展开更多
BACKGROUND Lower respiratory tract viral infections are a major cause of mortality in children under five years old,leading to hundreds of thousands of fatalities annually.The highest risk is observed in infants under...BACKGROUND Lower respiratory tract viral infections are a major cause of mortality in children under five years old,leading to hundreds of thousands of fatalities annually.The highest risk is observed in infants under one year old,underscoring the critical need for safe and effective antiviral protocols.CASE SUMMARY A 9-month-old infant suffered from severe bronchiolitis as manifested by high fever(39°C),decreased appetite,tachypnea,wheezing,and oxygen desaturation(SpO284%on room air)and was effectively managed at home using Kelleni’s protocol,which includes age-adjusted dose of nitazoxanide(60 mg twice daily),ibuprofen and azithromycin,complemented by selective antihistaminic,antitussive and mucolytic immunomodulatory treatment.The fever resolved,wheezing became more prominent but without respiratory distress,and oxygen saturation gradually increased to 92%by day 10.Nitazoxanide exerts broad antiviral and immunomodulatory effects by enhancing host interferon responses and inhibiting viral replication,potentially attenuating airway inflammation and accelerating resolution of bronchiolitis.The nitazoxanide dose(60 mg twice daily for five days)was carefully adjusted based on the developmental expression and activity of the uridine diphosphate-glucuronosyltransferase 1A1 enzyme,responsible for its metabolism,ensuring safe age-appropriate administration.The infant’s clinical status steadily improved,and by day 14 the infant achieved full recovery with normalization of oxygen saturation(96%on room air).No adverse events occurred,and follow-up at day 28 confirmed sustained recovery.CONCLUSION To the best of my knowledge,this report presents,for the first time globally,a potential of nitazoxanide within Kelleni’s protocol to early manage infants younger than one year suffering from severe lower respiratory tract viral infection at home.Selective antitussive treatment,using agents such as low dose benproperine,was employed to mitigate troublesome cough and improve patient comfort without compromising respiratory function.Additionally,alpha amylase was used to facilitate pulmonary secretion clearance.The protocol aims to reduce morbidity and mortality from viral lower respiratory tract infections in this vulnerable population.展开更多
“Flying Ad Hoc Networks(FANETs)”,which use“Unmanned Aerial Vehicles(UAVs)”,are developing as a critical mechanism for numerous applications,such as military operations and civilian services.The dynamic nature of F...“Flying Ad Hoc Networks(FANETs)”,which use“Unmanned Aerial Vehicles(UAVs)”,are developing as a critical mechanism for numerous applications,such as military operations and civilian services.The dynamic nature of FANETs,with high mobility,quick node migration,and frequent topology changes,presents substantial hurdles for routing protocol development.Over the preceding few years,researchers have found that machine learning gives productive solutions in routing while preserving the nature of FANET,which is topology change and high mobility.This paper reviews current research on routing protocols and Machine Learning(ML)approaches applied to FANETs,emphasizing developments between 2021 and 2023.The research uses the PRISMA approach to sift through the literature,filtering results from the SCOPUS database to find 82 relevant publications.The research study uses machine learning-based routing algorithms to beat the issues of high mobility,dynamic topologies,and intermittent connection in FANETs.When compared with conventional routing,it gives an energy-efficient and fast decision-making solution in a real-time environment,with greater fault tolerance capabilities.These protocols aim to increase routing efficiency,flexibility,and network stability using ML’s predictive and adaptive capabilities.This comprehensive review seeks to integrate existing information,offer novel integration approaches,and recommend future research topics for improving routing efficiency and flexibility in FANETs.Moreover,the study highlights emerging trends in ML integration,discusses challenges faced during the review,and discusses overcoming these hurdles in future research.展开更多
The current recommendation to avoid non-steroidal anti-inflammatory drugs(NSAIDs)in the management of dengue virus disease(DVD)is scientifically considered of very low to low certainty,despite being widely adopted wor...The current recommendation to avoid non-steroidal anti-inflammatory drugs(NSAIDs)in the management of dengue virus disease(DVD)is scientifically considered of very low to low certainty,despite being widely adopted worldwide.The same recommendation,initially made during the coronavirus disease 2019(COVID-19)pandemic,was subsequently proven incorrect.In this clinical report,we present evidence,for the first time globally,from a real-life practice that NSAIDs may actually be lifesaving in the early management of DVD as they have proved to be in COVID-19.Moreover,we propose that the personalized immunemodulatory Kelleni’s protocol,which includes nitazoxanide as a key component,can be safely and effectively used to manage various separate or concomitant viral infections and co-infections,including DVD.Importantly,this article contributes to the current medical knowledge in the global pursuit of a safe and effective broad-spectrum antiviral protocol that can be used to early manage multiple highly infectious viruses.However,it’s crucial that sufficiently powered controlled randomized clinical trials be conducted to thoroughly assess and evaluate the safety of NSAIDs in the early management of DVD as well as the efficacy of nitazoxanide with or without NSAIDs in its management.展开更多
Objective To discuss the flexible supervision and communication mode in the post-approval change(PAC)of drugs,to explore how to ensure the quality and availability of drugs during the changes,and to provide some sugge...Objective To discuss the flexible supervision and communication mode in the post-approval change(PAC)of drugs,to explore how to ensure the quality and availability of drugs during the changes,and to provide some suggestions and reference for promoting the timely marketing of drugs.Methods Based on the comparability protocol guidelines issued by the US FDA in October 2022,the regulatory status quo of PAC between China and the US was compared to explore the feasibility of implementing comparability protocols in China.Results and Conclusion According to the specific situation of post-approval of drug change supervision,some suggestions were put forward to optimize the PAC management procedure,such as establishing the communication pathways between holders and health authorities,publishing relevant guidance and strengthening training,so as to provide reference for the implementation of comparability protocols in China.展开更多
Focusing on the ultralow expansion functionality of the crystalized glass containing the cordierite crystal phase with the molar composition 20.7MgO·20.7Al_(2)O_(3)·51.6SiO_(2)·7.0TiO_(2),we systematica...Focusing on the ultralow expansion functionality of the crystalized glass containing the cordierite crystal phase with the molar composition 20.7MgO·20.7Al_(2)O_(3)·51.6SiO_(2)·7.0TiO_(2),we systematically investigated impacts of thermal treatment protocols on T dependence of coefficients of thermal expansion(CTE).Except for the phase compositions,morphology is identified as another important factor to control the T dependence of CTE.By using X-ray diffraction and scanning electron microscope,various modes of T dependence of CTE for crystallized glasses are ascribed to their different phase compositions and microstructure with finely dispersed nanoparticles.These understanding contributes to the further modification of CTE of the crystalized glass by altering their thermal treatment scenarios.展开更多
Primary liver cancer(PLC) is the third major cause of cancer related death, which seriously affects the survival period and quality of life of patients. However, there is currently no evidence to prove which treatment...Primary liver cancer(PLC) is the third major cause of cancer related death, which seriously affects the survival period and quality of life of patients. However, there is currently no evidence to prove which treatment method is most effective. Traditional Chinese Medicine(TCM) has shown certain advantages in the treatment of PLC, especially in the side effects of Western Medicine. Therefore, we designed a clinical trial protocol for the treatment of PLC using TCM granules. Our purpose is to explore the efficacy and safety of Yangxiao Fukang granule(YXFKG, 养消复康颗粒) in the treatment of stage Ⅲ hepatitis B related PLC. A total of 216 patients from three hospitals in Henan Province will be enrolled and randomly divided into a trial group and a control group in a 1 ∶ 1 ratio. The trial group will be treated with conventional western medicine plus YXFKG, while the control group will receive conventional western medicine plus a placebo for YXFKG. All patients will receive a daily dose of either YXFKG or a placebo for six months, followed by a six-month follow-up period. The main observation outcome includes 1-year survival rate, while secondary outcomes include conversion rate to remission, objective response rate, progression free survival, overall survival, quality of life score, and TCM clinical symptom score. Blood routine, urine routine, stool routine, electrocardiogram, liver and kidney function, coagulation function test, and D-dimer are safety indicators. Collect data before treatment and during the 3rd, 6th, 9th, and 12th months of treatment, and conduct statistical analysis. This study will preliminarily verify the effectiveness and safety of YXFKG in the treatment of stage Ⅲ hepatitis B related PLC, which may provide a new choice for clinical treatment of PLC.展开更多
The Internet of Healthcare Things(IoHT)marks a significant breakthrough in modern medicine by enabling a new era of healthcare services.IoHT supports real-time,continuous,and personalized monitoring of patients’healt...The Internet of Healthcare Things(IoHT)marks a significant breakthrough in modern medicine by enabling a new era of healthcare services.IoHT supports real-time,continuous,and personalized monitoring of patients’health conditions.However,the security of sensitive data exchanged within IoHT remains a major concern,as the widespread connectivity and wireless nature of these systems expose them to various vulnerabilities.Potential threats include unauthorized access,device compromise,data breaches,and data alteration,all of which may compromise the confidentiality and integrity of patient information.In this paper,we provide an in-depth security analysis of LAP-IoHT,an authentication scheme designed to ensure secure communication in Internet of Healthcare Things environments.This analysis reveals several vulnerabilities in the LAP-IoHT protocol,namely its inability to resist various attacks,including user impersonation and privileged insider threats.To address these issues,we introduce LSAP-IoHT,a secure and lightweight authentication protocol for the Internet of Healthcare Things(IoHT).This protocol leverages Elliptic Curve Cryptography(ECC),Physical Unclonable Functions(PUFs),and Three-Factor Authentication(3FA).Its security is validated through both informal analysis and formal verification using the Scyther tool and the Real-Or-Random(ROR)model.The results demonstrate strong resistance against man-in-the-middle(MITM)attacks,replay attacks,identity spoofing,stolen smart device attacks,and insider threats,while maintaining low computational and communication costs.展开更多
Developing highly active and stable oxygen evolution reaction(OER)catalysts necessitates the establishment of a comprehensive OER catalyst database.However,the absence of a standardized benchmarking protocol has hinde...Developing highly active and stable oxygen evolution reaction(OER)catalysts necessitates the establishment of a comprehensive OER catalyst database.However,the absence of a standardized benchmarking protocol has hindered this progress.In this work,we present a systematic protocol for electrochemical measurements to thoroughly evaluate the activity and stability of OER electrocatalysts.We begin with a detailed introduction to constructing the electrochemical system,encompassing experimental setup and the selection criteria for electrodes and electrolytes.Potential contaminants originating from electrolytes,cells,and electrodes are identified and their impacts are discussed.We also examine the effects of external factors,such as temperature,magnetic fields,and natural light,on OER measurements.The protocol outlines operational mechanisms and recommended settings for various electrochemical techniques,including cyclic voltammetry(CV),potentiostatic electrochemical impedance spectroscopy(PEIS),Tafel slope analysis,and pulse voltammetry(PV).We summarize existing evaluation methodologies for assessing intrinsic activities and long-term stabilities of catalysts.Based on these discussions,we propose a comprehensive protocol for evaluating OER electrocatalysts’performance.Finally,we offer perspectives on advancing OER catalysts from laboratory research to industrial applications.展开更多
Objectives:People living with severe mental illness have a reduced life expectancy when compared to the general population largely due to physical health comorbidities.Exercise is a valuable,evidence-based component o...Objectives:People living with severe mental illness have a reduced life expectancy when compared to the general population largely due to physical health comorbidities.Exercise is a valuable,evidence-based component of mental healthcare,with positive effects on physical health,mental health,and quality of life.However,to date,there is limited evidence regarding the implementation of varied styles of supported exercise therapy within outpatient,transdiagnostic mental health services.This protocol paper outlines the methods for a hybrid effectiveness-implementation trial implementing two styles of supported exercise within an outpatient mental health hospital.Methods:Participants will be allocated to either in-person supervised exercise sessions,or independent,remotely supported exercise programs.Both intervention arms will have the target of 150 minutes of moderate intensity exercise per week across the 12-week intervention period,along with a 12-week maintenance period following the intervention periods.Assessments will be conducted at intake,intervention midpoint(i.e.,week 6–7),intervention conclusion(i.e.,week 13),and at follow-up(i.e.,week 25).Results:The evaluation of the exercise interventions will consist of implementation and effectiveness outcomes during the intervention and at follow-up.Conclusions:The outcomes from this trial will add to the ever-increasing evidence for the incorporation of exercise within care for severe mental illness.This trial will report on the implementation and effectiveness of varied levels of support in exercise therapy for consumers with severe mental illness,which may in turn guide the future implementation and improve provision of exercise therapy in hospital mental health services.展开更多
Introduction:With the incidence of chronic kidney disease(CKD)increasing year by year,it is particularly important to intervene in the early stage of CKD(stages 1–3).Unfortunately,the effective drug treatment methods...Introduction:With the incidence of chronic kidney disease(CKD)increasing year by year,it is particularly important to intervene in the early stage of CKD(stages 1–3).Unfortunately,the effective drug treatment methods for CKD(stages 1–3)are lacking.Guben Tongluo Formula(GTF)is the experience formula of Professor Liqun He,a famous traditional Chinese medicine(TCM)doctor in Shanghai.Our previous studies demonstrated that GTF might effectively alleviate CKD via multi-mechanisms.As the first angiotensin-2 receptor antagonist for treating hypertension,losartan potassium(LP)could effectively reduce blood pressure,decrease cardiovascular risk,and delay the occurrence of end-stage renal disease.Thus,we design this clinical protocol of GTF combining LP to observe the efficacy and safety of GTF and try to provide a novel drug treatment method for treating CKD(stages 1–3)patients.Methods and analysis:This is a multicenter randomized controlled clinical trial.160 participants will be enrolled in this trial and divided into LP group,GTF group,LP+GTF group,and placebo group randomly assigning 1:1:1:1 principle.LP group will receive general treatments combining LP,GTF group will receive general treatments combining GTF,and the GTF+LP group will receive general treatments combining GTF and LP.Placebo group will receive general treatments combining placebo treatment.The primary evaluation index will be the change of serum creatinine after treatment.Secondary evaluation indexes include changes in blood urea nitrogen,serum uric acid,estimated glomerular filtration rate,etc.;immune indicators and renal fibrosis indicators,as well as TCM symptoms.Besides,vital sign indicators and adverse events will be closely observed.Ethics and dissemination:The protocol has been approved by the Ethics Committee of Seventh People’s Hospital of Shanghai University of Traditional Chinese Medicine(reference number:2024-7th-HIRB-094)and other ethics committees at each center.With the implementation of this clinical trial,it would offer a TCM formula for the treatment of CKD(stages 1–3)and clarify the underlying mechanism of GTF for alleviating CKD.Trial registration:This trial is registered with ChiCTR2400090125 and registered on September 24,2024.展开更多
UAV networks often encounter jamming attacks, under which multi-radio protocols have to switch radios to accelerate communication recovery. However, the existing protocols rely on exchange of hello messages to detect ...UAV networks often encounter jamming attacks, under which multi-radio protocols have to switch radios to accelerate communication recovery. However, the existing protocols rely on exchange of hello messages to detect jamming, leading to long sensing time and thus slow routing recovery. To address the issues raised by jamming attacks, we propose a new routing protocol, Electromagnetic Spectrum situation awareness Optimized Link State Routing (ESOLSR) protocol, to improve the existing OLSRv2 protocol. ESOLSR utilizes the spectrum situation awareness capability from the physical layer, and adopts joint-updating of link status, updating of interface functions, and adaptive adjustment of parameters. Our simulation results show that the improved protocol, ESOLSR, can recover routing and resume normal communication 26.6% faster compared to the existing protocols.展开更多
文摘Rwanda secured access to one of the world’s most lucrative agricultural markets this month when it finalised a trade protocol allowing fresh avocado exports to China,a deal that could fundamentally alter the trajectory of the country’s trade.
文摘Protocol Reverse Engineering(PRE)is of great practical importance in Internet security-related fields such as intrusion detection,vulnerability mining,and protocol fuzzing.For unknown binary protocols having fixed-length fields,and the accurate identification of field boundaries has a great impact on the subsequent analysis and final performance.Hence,this paper proposes a new protocol segmentation method based on Information-theoretic statistical analysis for binary protocols by formulating the field segmentation of unsupervised binary protocols as a probabilistic inference problem and modeling its uncertainty.Specifically,we design four related constructions between entropy changes and protocol field segmentation,introduce random variables,and construct joint probability distributions with traffic sample observations.Probabilistic inference is then performed to identify the possible protocol segmentation points.Extensive trials on nine common public and industrial control protocols show that the proposed method yields higher-quality protocol segmentation results.
基金this project under Geran Putra Inisiatif(GPI)with reference of GP-GPI/2023/976210。
文摘Accurate time synchronization is fundamental to the correct and efficient operation of Wireless Sensor Networks(WSNs),especially in security-critical,time-sensitive applications.However,most existing protocols degrade substantially under malicious interference.We introduce iSTSP,an Intelligent and Secure Time Synchronization Protocol that implements a four-stage defense pipeline to ensure robust,precise synchronization even in hostile environments:(1)trust preprocessing that filters node participation using behavioral trust scoring;(2)anomaly isolation employing a lightweight autoencoder to detect and excise malicious nodes in real time;(3)reliability-weighted consensus that prioritizes high-trust nodes during time aggregation;and(4)convergence-optimized synchronization that dynamically adjusts parameters using theoretical stability bounds.We provide rigorous convergence analysis including a closed-form expression for convergence time,and validate the protocol through both simulations and realworld experiments on a controlled 16-node testbed.Under Sybil attacks with five malicious nodes within this testbed,iSTSP maintains synchronization error increases under 12%and achieves a rapid convergence.Compared to state-ofthe-art protocols like TPSN,SE-FTSP,and MMAR-CTS,iSTSP offers 60%faster detection,broader threat coverage,and more than 7 times lower synchronization error,with a modest 9.3%energy overhead over 8 h.We argue this is an acceptable trade-off for mission-critical deployments requiring guaranteed security.These findings demonstrate iSTSP’s potential as a reliable solution for secure WSN synchronization and motivate future work on large-scale IoT deployments and integration with energy-efficient communication protocols.
基金National Natural Science Foundations of China(Nos.60872073,6097501,and 51075068)the Doctoral Fund of Ministry of Education of China(No.20110092130004)the Research Foundation and Education Bureau of Anhui Province of China(No.KJ2009B137)
文摘Medium access control( MAC) protocol of underwater acoustic communication network is a key technology for underwater acoustic networks( UANs). Most of the MAC protocols for wireless terrestrial communication networks have been designed with negligible propagation delay. If it is deployed directly in an underwater environment,the UANs will perform inefficiently. In this paper,the characteristics of underwater acoustic channel are modeled and simulated by using the OPNET simulation tool,which are the speed of sound, propagation loss, and four sources for ambient noise: the turbulence,shipping,wind driven waves and thermal noise. The performance of pure Aloha( P-Aloha),carrier sense multiple access with collision avoidance( CSMA / CA) and multiple access collision avoidance for wireless local area network( MACAW) protocols in underwater acoustic channel environment are evaluated. The different performance of protocols in underwater environment is compared in the simulation.
文摘The care of a patient involved in major trauma with exsanguinating haemorrhage is time-critical to achieve definitive haemorrhage control,and it requires coordinated multidisciplinary care.During initial resuscitation of a patient in the emergency department(ED),Code Crimson activation facilitates rapid decisionmaking by multi-disciplinary specialists for definitive haemorrhage control in operating theatre(OT)and/or interventional radiology(IR)suite.Once this decision has been made,there may still be various factors that lead to delay in transporting the patient from ED to OT/IR.Red Blanket protocol identifies and addresses these factors and processes which cause delay,and aims to facilitate rapid and safe transport of the haemodynamically unstable patient from ED to OT,while minimizing delay in resuscitation during the transfer.The two processes,Code Crimson and Red Blanket,complement each other.It would be ideal to merge the two processes into a single protocol rather than having two separate workflows.Introducing these quality improvement strategies and coor-dinated processes within the trauma framework of the hospitals/healthcare systems will help in further improving the multi-disciplinary care for the complex trauma patients requiring rapid and definitive haemorrhage control.
基金supported by the Chinese Medicine Development Fund,Hong Kong SAR,China(23B2/027A_R1)the National Natural Science Foundation of China(81704198).
文摘Objective:To evaluate the efficacy and safety of acupoint application for post-stroke depression(PSD)by regulating gastrointestinal function.A secondary objective is to explore the potential mechanism underlying this approach from the perspective of gut microbiota.Methods:This multicenter,randomized,double-blind(patients and assessors),placebo-controlled trial will enroll 80 patients with PSD,and include a 1-week run-in period,a 4-week treatment phase,and a 12-week follow-up.Eligible participants will randomly be assigned in a 1:1 ratio to either the acupoint application or placebo(non-acupoint)groups.Treatments will be administered thrice weekly for 4 weeks.The primary outcome is change in the Hamilton Rating Scale for Depression(HAMD)score.Secondary outcomes include the Beck Depression Inventory(BDI),36-Item Short-Form Health Survey(SF-36),Barthel Index of Activities of Daily Living,Social Adaptation Self-Evaluation Scale(SASS),and gut microbiota profiling.All outcomes will be assessed at baseline(prior to treatment),during treatment(weeks 2 and 4),and during follow-up(weeks 8,12,and 16).The Treatment Emergent Symptom Scale(TESS)will be used for evaluation throughout the 4-week treatment phase.Discussion:The results of this study will provide important evidence supporting a novel treatment strategy for PSD that targets gastrointestinal regulation,potentially informing future clinical practice.
基金thank the staff of the accredited animal facility of the laboratory of anatomy,Histology and Embryology of Aristotle University of Thessaloniki’s veterinary school for their assistance in animal handling and care.
文摘BACKGROUND Massive rotator cuff tears(RCTs)result in impaired shoulder function and quality of life.These tears lead to structural changes in the rotator cuff muscles,which compromise recovery after repair and increase re-tear rates.AIM To investigate the potential inhibitory effects of alpha-tocopherol(vitamin E)and OTR-4131 on muscle atrophy,fatty infiltration,and fibrosis in rotator cuff muscles following a massive RCT using a Wistar rat model,and establish a standardized methodology for evaluating potential therapeutic agents.METHODS This protocol outlines a controlled animal study using 40 male Wistar rats,randomized into five groups.The experimental groups will receive either systemic administration of alpha-tocopherol or local administration of OTR-4131 via intramuscular injection into the supraspinatus and infraspinatus muscles.Two sham groups will receive systemic and local saline injections respectively,while a control group will undergo no intervention.The interventions will be administered after surgical transection of the supraspinatus and infraspinatus tendons.Outcomes will be assessed via wet muscle weight measurements,muscle fiber diameter,fatty infiltration percentage,and fibrosis evaluation using histological methods.RESULTS The study anticipates that alpha-tocopherol and OTR-4131 will reduce muscle atrophy,fatty infiltration,and fibrosis compared to control and sham groups,supporting their potential protective role in rotator cuff muscle degeneration.CONCLUSION The results are expected to improve the understanding on the role of alpha-tocopherol and OTR-4131 in rotator cuff muscle protection after massive RCT and may serve as a foundation for further preclinical and clinical research aimed at improving rotator cuff repair outcomes.
文摘BACKGROUND Femur fractures are one of the most serious injuries that occur in the older population and are associated with severe pain and increased mortality.The primary objective of this study was to find if there was a significant difference in pain scores in patients treated with femoral nerve blocks(FNB)compared with patients treated with the standard analgesia protocol.The secondary objective was to find if there was a significant difference in morbidity between the two groups.AIM To evaluate the effectiveness of ultrasound(US)-guided FNB in managing preoperative pain and reducing morbidity in patients with neck femur fractures compared to the standard analgesia protocol.The study seeks to determine whether FNB offers superior outcomes in terms of pain control,rehospitalization rates,and mortality.METHODS This retrospective cohort study included 1577 patients suffering from neck femur fractures.387 patients were treated with a FNB for pain management upon arrival at the emergency department,the rest were treated with standard analgesia.Pain was assessed from electronic medical records using the visual analogue scale(VAS)pre surgery,12-and 24-hour post-surgery.To determine morbidity and mortality during hospitalizations and 6 months after,it was collected from electronic medical records.RESULTS In a cohort of 1577 patients,those receiving US-guided FNB had significantly lower preoperative VAS pain scores(1.46±2.49 vs 1.82±2.59,P=0.001),reduced rehospitalization rates(0.99±1.96 vs 1.46±2.34,P<0.001),and lower mortality(16%vs 32%,P<0.001)compared to standard analgesia.CONCLUSION US guided FNB is more effective for pain management compared with standard analgesia.This method was also found to significantly reduce the risk of morbidity in those patients.
文摘BACKGROUND Diabetes mellitus has become one of the major pandemics of the 21st century.In this scenario,nursing interventions are essential for improving self-care and quality of life in patients with type 2 diabetes mellitus.Nursing interventions are crucial for managing the disease and preventing complications.AIM To analyse nursing interventions in recent years through a systematic review and meta-analysis and to propose improvements in care plans.METHODS This study conducted a systematic review and meta-analysis of the impact of nursing interventions on quantitative glycaemic variables,such as glycated haemoglobin and fasting plasma glucose.RESULTS After confirming that the combined effect of all studies from the past 5 years positively impacts quantitative variables,a descriptive analysis of the studies with the most significant changes was conducted.Based on this,an improvement in diabetic patient care protocols has been proposed through follow-up plans tailored to the patient’s technological skills.CONCLUSION The combined results obtained and the proposal for improvement developed in this manuscript could help to improve the quality of life of many people around the world.
文摘BACKGROUND Lower respiratory tract viral infections are a major cause of mortality in children under five years old,leading to hundreds of thousands of fatalities annually.The highest risk is observed in infants under one year old,underscoring the critical need for safe and effective antiviral protocols.CASE SUMMARY A 9-month-old infant suffered from severe bronchiolitis as manifested by high fever(39°C),decreased appetite,tachypnea,wheezing,and oxygen desaturation(SpO284%on room air)and was effectively managed at home using Kelleni’s protocol,which includes age-adjusted dose of nitazoxanide(60 mg twice daily),ibuprofen and azithromycin,complemented by selective antihistaminic,antitussive and mucolytic immunomodulatory treatment.The fever resolved,wheezing became more prominent but without respiratory distress,and oxygen saturation gradually increased to 92%by day 10.Nitazoxanide exerts broad antiviral and immunomodulatory effects by enhancing host interferon responses and inhibiting viral replication,potentially attenuating airway inflammation and accelerating resolution of bronchiolitis.The nitazoxanide dose(60 mg twice daily for five days)was carefully adjusted based on the developmental expression and activity of the uridine diphosphate-glucuronosyltransferase 1A1 enzyme,responsible for its metabolism,ensuring safe age-appropriate administration.The infant’s clinical status steadily improved,and by day 14 the infant achieved full recovery with normalization of oxygen saturation(96%on room air).No adverse events occurred,and follow-up at day 28 confirmed sustained recovery.CONCLUSION To the best of my knowledge,this report presents,for the first time globally,a potential of nitazoxanide within Kelleni’s protocol to early manage infants younger than one year suffering from severe lower respiratory tract viral infection at home.Selective antitussive treatment,using agents such as low dose benproperine,was employed to mitigate troublesome cough and improve patient comfort without compromising respiratory function.Additionally,alpha amylase was used to facilitate pulmonary secretion clearance.The protocol aims to reduce morbidity and mortality from viral lower respiratory tract infections in this vulnerable population.
基金support the findings of this study are openly available in(Scopus database)at www.scopus.com(accessed on 07 January 2025).
文摘“Flying Ad Hoc Networks(FANETs)”,which use“Unmanned Aerial Vehicles(UAVs)”,are developing as a critical mechanism for numerous applications,such as military operations and civilian services.The dynamic nature of FANETs,with high mobility,quick node migration,and frequent topology changes,presents substantial hurdles for routing protocol development.Over the preceding few years,researchers have found that machine learning gives productive solutions in routing while preserving the nature of FANET,which is topology change and high mobility.This paper reviews current research on routing protocols and Machine Learning(ML)approaches applied to FANETs,emphasizing developments between 2021 and 2023.The research uses the PRISMA approach to sift through the literature,filtering results from the SCOPUS database to find 82 relevant publications.The research study uses machine learning-based routing algorithms to beat the issues of high mobility,dynamic topologies,and intermittent connection in FANETs.When compared with conventional routing,it gives an energy-efficient and fast decision-making solution in a real-time environment,with greater fault tolerance capabilities.These protocols aim to increase routing efficiency,flexibility,and network stability using ML’s predictive and adaptive capabilities.This comprehensive review seeks to integrate existing information,offer novel integration approaches,and recommend future research topics for improving routing efficiency and flexibility in FANETs.Moreover,the study highlights emerging trends in ML integration,discusses challenges faced during the review,and discusses overcoming these hurdles in future research.
文摘The current recommendation to avoid non-steroidal anti-inflammatory drugs(NSAIDs)in the management of dengue virus disease(DVD)is scientifically considered of very low to low certainty,despite being widely adopted worldwide.The same recommendation,initially made during the coronavirus disease 2019(COVID-19)pandemic,was subsequently proven incorrect.In this clinical report,we present evidence,for the first time globally,from a real-life practice that NSAIDs may actually be lifesaving in the early management of DVD as they have proved to be in COVID-19.Moreover,we propose that the personalized immunemodulatory Kelleni’s protocol,which includes nitazoxanide as a key component,can be safely and effectively used to manage various separate or concomitant viral infections and co-infections,including DVD.Importantly,this article contributes to the current medical knowledge in the global pursuit of a safe and effective broad-spectrum antiviral protocol that can be used to early manage multiple highly infectious viruses.However,it’s crucial that sufficiently powered controlled randomized clinical trials be conducted to thoroughly assess and evaluate the safety of NSAIDs in the early management of DVD as well as the efficacy of nitazoxanide with or without NSAIDs in its management.
文摘Objective To discuss the flexible supervision and communication mode in the post-approval change(PAC)of drugs,to explore how to ensure the quality and availability of drugs during the changes,and to provide some suggestions and reference for promoting the timely marketing of drugs.Methods Based on the comparability protocol guidelines issued by the US FDA in October 2022,the regulatory status quo of PAC between China and the US was compared to explore the feasibility of implementing comparability protocols in China.Results and Conclusion According to the specific situation of post-approval of drug change supervision,some suggestions were put forward to optimize the PAC management procedure,such as establishing the communication pathways between holders and health authorities,publishing relevant guidance and strengthening training,so as to provide reference for the implementation of comparability protocols in China.
基金Funded by National Natural Science Foundation of China(No.52172007)Jiangsu Science and Technology Innovation Project for Carbon Peaking and Carbon Neutrality(No.BE2022035)。
文摘Focusing on the ultralow expansion functionality of the crystalized glass containing the cordierite crystal phase with the molar composition 20.7MgO·20.7Al_(2)O_(3)·51.6SiO_(2)·7.0TiO_(2),we systematically investigated impacts of thermal treatment protocols on T dependence of coefficients of thermal expansion(CTE).Except for the phase compositions,morphology is identified as another important factor to control the T dependence of CTE.By using X-ray diffraction and scanning electron microscope,various modes of T dependence of CTE for crystallized glasses are ascribed to their different phase compositions and microstructure with finely dispersed nanoparticles.These understanding contributes to the further modification of CTE of the crystalized glass by altering their thermal treatment scenarios.
基金Supported by Henan Provincial Department of Science and Technology Project:Clinical Study on Yangxiao Fukang granule in the Treatment of StageⅢhepatitis B related Liver Cancer(232102310188)Henan Province Characteristic Backbone Discipline Construction Project:Guidelines for Traditional Chinese Medicine Diagnosis and Treatment of Hepatocellular Carcinoma after Hepatic Arterial Chemotherapy and Embolization(STG-ZYX03-202126)。
文摘Primary liver cancer(PLC) is the third major cause of cancer related death, which seriously affects the survival period and quality of life of patients. However, there is currently no evidence to prove which treatment method is most effective. Traditional Chinese Medicine(TCM) has shown certain advantages in the treatment of PLC, especially in the side effects of Western Medicine. Therefore, we designed a clinical trial protocol for the treatment of PLC using TCM granules. Our purpose is to explore the efficacy and safety of Yangxiao Fukang granule(YXFKG, 养消复康颗粒) in the treatment of stage Ⅲ hepatitis B related PLC. A total of 216 patients from three hospitals in Henan Province will be enrolled and randomly divided into a trial group and a control group in a 1 ∶ 1 ratio. The trial group will be treated with conventional western medicine plus YXFKG, while the control group will receive conventional western medicine plus a placebo for YXFKG. All patients will receive a daily dose of either YXFKG or a placebo for six months, followed by a six-month follow-up period. The main observation outcome includes 1-year survival rate, while secondary outcomes include conversion rate to remission, objective response rate, progression free survival, overall survival, quality of life score, and TCM clinical symptom score. Blood routine, urine routine, stool routine, electrocardiogram, liver and kidney function, coagulation function test, and D-dimer are safety indicators. Collect data before treatment and during the 3rd, 6th, 9th, and 12th months of treatment, and conduct statistical analysis. This study will preliminarily verify the effectiveness and safety of YXFKG in the treatment of stage Ⅲ hepatitis B related PLC, which may provide a new choice for clinical treatment of PLC.
文摘The Internet of Healthcare Things(IoHT)marks a significant breakthrough in modern medicine by enabling a new era of healthcare services.IoHT supports real-time,continuous,and personalized monitoring of patients’health conditions.However,the security of sensitive data exchanged within IoHT remains a major concern,as the widespread connectivity and wireless nature of these systems expose them to various vulnerabilities.Potential threats include unauthorized access,device compromise,data breaches,and data alteration,all of which may compromise the confidentiality and integrity of patient information.In this paper,we provide an in-depth security analysis of LAP-IoHT,an authentication scheme designed to ensure secure communication in Internet of Healthcare Things environments.This analysis reveals several vulnerabilities in the LAP-IoHT protocol,namely its inability to resist various attacks,including user impersonation and privileged insider threats.To address these issues,we introduce LSAP-IoHT,a secure and lightweight authentication protocol for the Internet of Healthcare Things(IoHT).This protocol leverages Elliptic Curve Cryptography(ECC),Physical Unclonable Functions(PUFs),and Three-Factor Authentication(3FA).Its security is validated through both informal analysis and formal verification using the Scyther tool and the Real-Or-Random(ROR)model.The results demonstrate strong resistance against man-in-the-middle(MITM)attacks,replay attacks,identity spoofing,stolen smart device attacks,and insider threats,while maintaining low computational and communication costs.
基金supported by the Fundamental Research Funds for the Central Universities(20822041H4082)。
文摘Developing highly active and stable oxygen evolution reaction(OER)catalysts necessitates the establishment of a comprehensive OER catalyst database.However,the absence of a standardized benchmarking protocol has hindered this progress.In this work,we present a systematic protocol for electrochemical measurements to thoroughly evaluate the activity and stability of OER electrocatalysts.We begin with a detailed introduction to constructing the electrochemical system,encompassing experimental setup and the selection criteria for electrodes and electrolytes.Potential contaminants originating from electrolytes,cells,and electrodes are identified and their impacts are discussed.We also examine the effects of external factors,such as temperature,magnetic fields,and natural light,on OER measurements.The protocol outlines operational mechanisms and recommended settings for various electrochemical techniques,including cyclic voltammetry(CV),potentiostatic electrochemical impedance spectroscopy(PEIS),Tafel slope analysis,and pulse voltammetry(PV).We summarize existing evaluation methodologies for assessing intrinsic activities and long-term stabilities of catalysts.Based on these discussions,we propose a comprehensive protocol for evaluating OER electrocatalysts’performance.Finally,we offer perspectives on advancing OER catalysts from laboratory research to industrial applications.
基金sponsored by the University of Western Australia with first author CM completing this protocol paper and the associated research while receiving an Australian Commonwealth Government Research Training Program stipendwith research support and funding received from the University of Western Australia.
文摘Objectives:People living with severe mental illness have a reduced life expectancy when compared to the general population largely due to physical health comorbidities.Exercise is a valuable,evidence-based component of mental healthcare,with positive effects on physical health,mental health,and quality of life.However,to date,there is limited evidence regarding the implementation of varied styles of supported exercise therapy within outpatient,transdiagnostic mental health services.This protocol paper outlines the methods for a hybrid effectiveness-implementation trial implementing two styles of supported exercise within an outpatient mental health hospital.Methods:Participants will be allocated to either in-person supervised exercise sessions,or independent,remotely supported exercise programs.Both intervention arms will have the target of 150 minutes of moderate intensity exercise per week across the 12-week intervention period,along with a 12-week maintenance period following the intervention periods.Assessments will be conducted at intake,intervention midpoint(i.e.,week 6–7),intervention conclusion(i.e.,week 13),and at follow-up(i.e.,week 25).Results:The evaluation of the exercise interventions will consist of implementation and effectiveness outcomes during the intervention and at follow-up.Conclusions:The outcomes from this trial will add to the ever-increasing evidence for the incorporation of exercise within care for severe mental illness.This trial will report on the implementation and effectiveness of varied levels of support in exercise therapy for consumers with severe mental illness,which may in turn guide the future implementation and improve provision of exercise therapy in hospital mental health services.
基金supported by grants from Pudong New Area Traditional Chinese Medicine Brand Multiplication Plan-Chronic Nephropathy(PDZY-2021-0302)Construction of He Liqun’s famous TCM studio(PDZY-2022-0703)+2 种基金Clinical Observation on the Efficacy of Guben Tongluo Formula in Treating Chronic Kidney Disease Phase 1-3(PW2022D-12)Pilot Project of Inheritance,Innovation and Development of Traditional Chinese Medicine in Pudong New Area(YC-2023-0602)Pudong New Area’s Peak and Plateau Discipline Development in Clinical Medicine for Novel and Special Diseases(2025-PWXZ-15).
文摘Introduction:With the incidence of chronic kidney disease(CKD)increasing year by year,it is particularly important to intervene in the early stage of CKD(stages 1–3).Unfortunately,the effective drug treatment methods for CKD(stages 1–3)are lacking.Guben Tongluo Formula(GTF)is the experience formula of Professor Liqun He,a famous traditional Chinese medicine(TCM)doctor in Shanghai.Our previous studies demonstrated that GTF might effectively alleviate CKD via multi-mechanisms.As the first angiotensin-2 receptor antagonist for treating hypertension,losartan potassium(LP)could effectively reduce blood pressure,decrease cardiovascular risk,and delay the occurrence of end-stage renal disease.Thus,we design this clinical protocol of GTF combining LP to observe the efficacy and safety of GTF and try to provide a novel drug treatment method for treating CKD(stages 1–3)patients.Methods and analysis:This is a multicenter randomized controlled clinical trial.160 participants will be enrolled in this trial and divided into LP group,GTF group,LP+GTF group,and placebo group randomly assigning 1:1:1:1 principle.LP group will receive general treatments combining LP,GTF group will receive general treatments combining GTF,and the GTF+LP group will receive general treatments combining GTF and LP.Placebo group will receive general treatments combining placebo treatment.The primary evaluation index will be the change of serum creatinine after treatment.Secondary evaluation indexes include changes in blood urea nitrogen,serum uric acid,estimated glomerular filtration rate,etc.;immune indicators and renal fibrosis indicators,as well as TCM symptoms.Besides,vital sign indicators and adverse events will be closely observed.Ethics and dissemination:The protocol has been approved by the Ethics Committee of Seventh People’s Hospital of Shanghai University of Traditional Chinese Medicine(reference number:2024-7th-HIRB-094)and other ethics committees at each center.With the implementation of this clinical trial,it would offer a TCM formula for the treatment of CKD(stages 1–3)and clarify the underlying mechanism of GTF for alleviating CKD.Trial registration:This trial is registered with ChiCTR2400090125 and registered on September 24,2024.
基金supported in part by National Natural Science Foundation of China(Nos.61931011 and 62372230)the Jiangsu Provincial Key Research and Development Program,China(No.BE2021013-4).
文摘UAV networks often encounter jamming attacks, under which multi-radio protocols have to switch radios to accelerate communication recovery. However, the existing protocols rely on exchange of hello messages to detect jamming, leading to long sensing time and thus slow routing recovery. To address the issues raised by jamming attacks, we propose a new routing protocol, Electromagnetic Spectrum situation awareness Optimized Link State Routing (ESOLSR) protocol, to improve the existing OLSRv2 protocol. ESOLSR utilizes the spectrum situation awareness capability from the physical layer, and adopts joint-updating of link status, updating of interface functions, and adaptive adjustment of parameters. Our simulation results show that the improved protocol, ESOLSR, can recover routing and resume normal communication 26.6% faster compared to the existing protocols.
