Secret sharing(SS)is part of the essential techniques in cryptography but still faces many challenges in efficiency and security.Currently,SS schemes based on the Chinese Remainder Theorem(CRT)are either low in the in...Secret sharing(SS)is part of the essential techniques in cryptography but still faces many challenges in efficiency and security.Currently,SS schemes based on the Chinese Remainder Theorem(CRT)are either low in the information rate or complicated in construction.To solve the above problems,1)a simple construction of an ideal(t,n)-SS scheme is proposed based on CRT for a polynomial ring.Compared with Ning’s scheme,it is much more efficient in generating n pairwise coprime modular polynomials during the scheme construction phase.Moreover,Shamir’s scheme is also a special case of our scheme.To further improve the security,2)a common-factor-based(t,n)-SS scheme is proposed in which all shareholders share a common polynomial factor.It enables both the verification of received shares and the establishment of a secure channel among shareholders during the reconstruction phase.As a result,the scheme is resistant to eavesdropping and modification attacks by outside adversaries.展开更多
BACKGROUND Previous studies have revealed that patients with asymptomatic common bile duct(CBD)stones are at a high risk of developing post-endoscopic retrograde cholangiopancreatography(ERCP)pancreatitis(PEP).However...BACKGROUND Previous studies have revealed that patients with asymptomatic common bile duct(CBD)stones are at a high risk of developing post-endoscopic retrograde cholangiopancreatography(ERCP)pancreatitis(PEP).However,no studies to date have addressed the risk factors for PEP in patients with asymptomatic CBD stones.AIM To examine the risk factors for PEP in patients with asymptomatic CBD stones.METHODS Using medical records of three institutions in Japan for 6 years,we identified a total of 1135 patients with choledocholithiasis including 967 symptomatic patients and 168 asymptomatic patients with native papilla who underwent therapeutic ERCP.We performed univariate and multivariate analyses to examine the risk factors for PEP in the 168 patients with asymptomatic CBD stones.RESULTS The overall incidence rate of PEP in all the patients with during study period was 4.7%(53/1135).Of the 168 patients with asymptomatic CBD stones,24(14.3%)developed PEP.In univariate analysis,precut sphincterotomy(P=0.009)and biliary balloon sphincter dilation(P=0.043)were significant risk factors for PEP.In multivariate analysis,precut sphincterotomy(P=0.002,95%CI:2.2-27.8,odds ratio=7.7),biliary balloon sphincter dilation(P=0.015,95%CI:1.4-17.3,odds ratio=4.9),and trainee endoscopists(P=0.048,95%CI:1.01-8.1,odds ratio=2.9)were significant risk factors for PEP.CONCLUSION ERCP for asymptomatic CBD stones should be performed by experienced endoscopists.When performing precut sphincterotomy or biliary balloon sphincter dilation in patients with asymptomatic CBD stones,the placement of a prophylactic pancreatic stent is strongly recommended to prevent PEP.展开更多
BACKGROUND Post-endoscopic retrograde cholangiopancreatography(ERCP) pancreatitis(PEP)is a critical and poorly managed complication of ERCP. Endoscopists need to understand the risk factors for PEP. However, the major...BACKGROUND Post-endoscopic retrograde cholangiopancreatography(ERCP) pancreatitis(PEP)is a critical and poorly managed complication of ERCP. Endoscopists need to understand the risk factors for PEP. However, the majority of studies investigating ERCP-related risk factors have included well-trained endoscopists,with the issue of endoscopist experience on PEP incidence not having been systematically evaluated.AIM To explore the risk factors for PEP in beginner endoscopists without supervision.METHODS We performed a retrospective analysis of 293 patients, with na?ve papilla and no history of pancreatitis, treated using bile duct cannulation. Patients were classified according to the endoscopist’s experience(beginner vs expert). The angle of the distal common bile duct(CBD) was measured as the angle between the lower wall of the bile duct and a vertical line extending to the lower wall of the bile duct on coronal view computed tomography.RESULTS After propensity matching, there were no differences between patients treated by the expert and beginner endoscopist with regard to age, sex, mean bile duct dilatation, and ratio of benign disease. The distal CBD angle was classified as acute(> 30o) or obtuse(≤ 30o), based on the mean angle of 29.9o for the group. An acute distal CBD angle was a significant risk factor for PEP for beginner(P =0.049), but not expert.CONCLUSION For beginner endoscopists first performing unsupervised ERCP, cases with an obtuse distal CBD angle may be more appropriate to lower the risk of PEP.展开更多
Background:Research on therapeutic processes has explored the elements that enhance psychotherapy’s effectiveness,particularly the role of common factors across various models.The therapist’s use of directiveness an...Background:Research on therapeutic processes has explored the elements that enhance psychotherapy’s effectiveness,particularly the role of common factors across various models.The therapist’s use of directiveness and support,as common variables,is crucial for effective treatment.Effective therapists adapt their level of directiveness and support according to the treatment phase,the issue being addressed,and the patient’s characteristics.This study examines the importance therapists attribute to directiveness and support,as well as its relationship with theoretical orientation,access to research publications,and stance on the similar effectiveness of different psychotherapeutic models.It aims to determine whether therapists’attributions regarding this variable are in line with the importance it is given in process research.Methods:Responses from 69 psychotherapists to the Psychotherapeutic Effectiveness Attribution Questionnaire(PEAQ-12),which assesses the importance therapists place on key psychotherapeutic process variables,including the directiveness and support provided,were analyzed.Theoretical orientations,ages,and experience levels were considered.Non-parametric tests,contingency tables,χ^(2)tests,t-tests,and ANOVAs were used to assess the variation in responses.Results:Common factors were often identified as key contributors to therapeutic healing,though these differences were not statistically significant(χ^(2)(2,N=67)=3.701,p=0.157).For the“directiveness and support from the therapist”variable,significant differences were observed:Cognitive-behavioral therapists valued directiveness and support more than psychodynamic therapists(t(20)=−3.569,p=0.002;Cohen’s d=1.18).Therapists who view cognitive-behavioral therapies as most effective also rated this variable higher(t(38)=3.816,p<0.001;Cohen’s d=1.21).Those regularly accessing specialized psychotherapy research publications valued this variable less than those who do so occasionally(t(64)=−2.693,p=0.009;Cohen’s d=0.65).Therapists who support the similar effectiveness of different models tend to favor common factors,including directiveness and support(χ^(2)(2,N=66)=12.522,p=0.002).Conclusions:Therapists express doubts about the factors influencing psychotherapy’s effectiveness,reflecting the ongoing debate.They align their views on the importance of directiveness and support with their theoretical orientation and positioning on the similar effectiveness of psychotherapies.The importance of analyzing therapists’attributions about the factors responsible for therapeutic change is emphasized,which will impact clinical practice.Advocacy for therapist flexibility and adaptation of therapy to the patient’s needs,including the level of directiveness and support provided,has been shown to be essential for effective psychotherapy.展开更多
基金This work was supported by National Key R&D Project 2018YFB2100300the National Natural Science Foundation of China(Grant No.61520106007).
文摘Secret sharing(SS)is part of the essential techniques in cryptography but still faces many challenges in efficiency and security.Currently,SS schemes based on the Chinese Remainder Theorem(CRT)are either low in the information rate or complicated in construction.To solve the above problems,1)a simple construction of an ideal(t,n)-SS scheme is proposed based on CRT for a polynomial ring.Compared with Ning’s scheme,it is much more efficient in generating n pairwise coprime modular polynomials during the scheme construction phase.Moreover,Shamir’s scheme is also a special case of our scheme.To further improve the security,2)a common-factor-based(t,n)-SS scheme is proposed in which all shareholders share a common polynomial factor.It enables both the verification of received shares and the establishment of a secure channel among shareholders during the reconstruction phase.As a result,the scheme is resistant to eavesdropping and modification attacks by outside adversaries.
文摘BACKGROUND Previous studies have revealed that patients with asymptomatic common bile duct(CBD)stones are at a high risk of developing post-endoscopic retrograde cholangiopancreatography(ERCP)pancreatitis(PEP).However,no studies to date have addressed the risk factors for PEP in patients with asymptomatic CBD stones.AIM To examine the risk factors for PEP in patients with asymptomatic CBD stones.METHODS Using medical records of three institutions in Japan for 6 years,we identified a total of 1135 patients with choledocholithiasis including 967 symptomatic patients and 168 asymptomatic patients with native papilla who underwent therapeutic ERCP.We performed univariate and multivariate analyses to examine the risk factors for PEP in the 168 patients with asymptomatic CBD stones.RESULTS The overall incidence rate of PEP in all the patients with during study period was 4.7%(53/1135).Of the 168 patients with asymptomatic CBD stones,24(14.3%)developed PEP.In univariate analysis,precut sphincterotomy(P=0.009)and biliary balloon sphincter dilation(P=0.043)were significant risk factors for PEP.In multivariate analysis,precut sphincterotomy(P=0.002,95%CI:2.2-27.8,odds ratio=7.7),biliary balloon sphincter dilation(P=0.015,95%CI:1.4-17.3,odds ratio=4.9),and trainee endoscopists(P=0.048,95%CI:1.01-8.1,odds ratio=2.9)were significant risk factors for PEP.CONCLUSION ERCP for asymptomatic CBD stones should be performed by experienced endoscopists.When performing precut sphincterotomy or biliary balloon sphincter dilation in patients with asymptomatic CBD stones,the placement of a prophylactic pancreatic stent is strongly recommended to prevent PEP.
基金Supported by Biomedical Research Institute Grant,No.2019B021,Pusan National University Hospital
文摘BACKGROUND Post-endoscopic retrograde cholangiopancreatography(ERCP) pancreatitis(PEP)is a critical and poorly managed complication of ERCP. Endoscopists need to understand the risk factors for PEP. However, the majority of studies investigating ERCP-related risk factors have included well-trained endoscopists,with the issue of endoscopist experience on PEP incidence not having been systematically evaluated.AIM To explore the risk factors for PEP in beginner endoscopists without supervision.METHODS We performed a retrospective analysis of 293 patients, with na?ve papilla and no history of pancreatitis, treated using bile duct cannulation. Patients were classified according to the endoscopist’s experience(beginner vs expert). The angle of the distal common bile duct(CBD) was measured as the angle between the lower wall of the bile duct and a vertical line extending to the lower wall of the bile duct on coronal view computed tomography.RESULTS After propensity matching, there were no differences between patients treated by the expert and beginner endoscopist with regard to age, sex, mean bile duct dilatation, and ratio of benign disease. The distal CBD angle was classified as acute(> 30o) or obtuse(≤ 30o), based on the mean angle of 29.9o for the group. An acute distal CBD angle was a significant risk factor for PEP for beginner(P =0.049), but not expert.CONCLUSION For beginner endoscopists first performing unsupervised ERCP, cases with an obtuse distal CBD angle may be more appropriate to lower the risk of PEP.
文摘Background:Research on therapeutic processes has explored the elements that enhance psychotherapy’s effectiveness,particularly the role of common factors across various models.The therapist’s use of directiveness and support,as common variables,is crucial for effective treatment.Effective therapists adapt their level of directiveness and support according to the treatment phase,the issue being addressed,and the patient’s characteristics.This study examines the importance therapists attribute to directiveness and support,as well as its relationship with theoretical orientation,access to research publications,and stance on the similar effectiveness of different psychotherapeutic models.It aims to determine whether therapists’attributions regarding this variable are in line with the importance it is given in process research.Methods:Responses from 69 psychotherapists to the Psychotherapeutic Effectiveness Attribution Questionnaire(PEAQ-12),which assesses the importance therapists place on key psychotherapeutic process variables,including the directiveness and support provided,were analyzed.Theoretical orientations,ages,and experience levels were considered.Non-parametric tests,contingency tables,χ^(2)tests,t-tests,and ANOVAs were used to assess the variation in responses.Results:Common factors were often identified as key contributors to therapeutic healing,though these differences were not statistically significant(χ^(2)(2,N=67)=3.701,p=0.157).For the“directiveness and support from the therapist”variable,significant differences were observed:Cognitive-behavioral therapists valued directiveness and support more than psychodynamic therapists(t(20)=−3.569,p=0.002;Cohen’s d=1.18).Therapists who view cognitive-behavioral therapies as most effective also rated this variable higher(t(38)=3.816,p<0.001;Cohen’s d=1.21).Those regularly accessing specialized psychotherapy research publications valued this variable less than those who do so occasionally(t(64)=−2.693,p=0.009;Cohen’s d=0.65).Therapists who support the similar effectiveness of different models tend to favor common factors,including directiveness and support(χ^(2)(2,N=66)=12.522,p=0.002).Conclusions:Therapists express doubts about the factors influencing psychotherapy’s effectiveness,reflecting the ongoing debate.They align their views on the importance of directiveness and support with their theoretical orientation and positioning on the similar effectiveness of psychotherapies.The importance of analyzing therapists’attributions about the factors responsible for therapeutic change is emphasized,which will impact clinical practice.Advocacy for therapist flexibility and adaptation of therapy to the patient’s needs,including the level of directiveness and support provided,has been shown to be essential for effective psychotherapy.
