Appendicoliths are frequently encountered in acute appendicitis(AA)and historically considered a risk factor for treatment failure in nonoperative management(NOM).However,the impact of appendicoliths on recurrence rat...Appendicoliths are frequently encountered in acute appendicitis(AA)and historically considered a risk factor for treatment failure in nonoperative management(NOM).However,the impact of appendicoliths on recurrence rates in uncomplicated AA remains controversial.This editorial critically appraises the study by Kupietzky et al,which explored the relationship between appendicolith characteristics and NOM outcomes.Kupietzky et al conducted a retrospective analysis of 797 patients with uncomplicated AA,comparing recurrence rates between those with and without appendicoliths.The study focused on long-term follow-up(median 44.2 months)and subgroup analyses of stone characteristics.The study revealed no significant difference in overall recurrence rates between groups(26.5%vs 19.1%,P=0.14).However,patients with appendicoliths experienced earlier recurrence(3.9 months vs 5.9 months,P=0.04)and had larger appendix diameters(10.2 mm vs 8.5 mm,P=0.001).Subgroup analyses showed no correlation between stone size,location,or number and recurrence risk.Appendicoliths do not independently increase the overall recurrence risk after NOM for uncomplicated AA but may accelerate recurrence timelines.Clinical decisions should prioritize individualized risk assessment,considering patient age,symptom severity,and radiological features.These findings challenge traditional paradigms and advocate for shared decision-making between clinicians and patients.展开更多
There remains much ambiguity on what non-operative management(NOM)of rectal cancer truly entails in terms of the methods to be adopted and the best algorithm to follow.This is clearly shown by the discordance between ...There remains much ambiguity on what non-operative management(NOM)of rectal cancer truly entails in terms of the methods to be adopted and the best algorithm to follow.This is clearly shown by the discordance between various national and international guidelines on NOM of rectal cancer.The main aim of the NOM strategy is organ preservation and avoiding unnecessary surgical in-tervention,which carries its own risk of morbidity.A highly specific and sensitive surveillance program must be devised to avoid patients undergoing unnecessary surgical interventions.In many studies,NOM,often interchangeably called the Watch and Wait strategy,has been shown as a promising treatment option when undertaken in the appropriate patient population,where a clinical complete res-ponse is achieved.However,there are no clear guidelines on patient selection for NOM along with the optimal method of surveillance.展开更多
Liver trauma is the most common abdominal emergency with high morbidity and mortality. Now, nonoperative management（NOM） is a selective method for liver trauma. The aim of this study was to determine the success rat...Liver trauma is the most common abdominal emergency with high morbidity and mortality. Now, nonoperative management（NOM） is a selective method for liver trauma. The aim of this study was to determine the success rate, mortality and morbidity of NOM for isolated liver trauma.Medical records of 81 patients with isolated liver trauma in our unit were analyzed retrospectively. The success rate, mortality and morbidity of NOM were evaluated. In this series, 9 patients with grade IV-V liver injuries underwent emergent operation due to hemodynamic instability; 72 patients, 6 with grade V, 18 grade IV, 29 grade III, 15 grade II and 4 grade I, with hemodynamic stability received NOM. The overall success rate of NOM was 97.2%（70/72）. The success rates of NOM in the patients with grade I-III, IV and V liver trauma were100%, 94.4% and 83.3%. The complication rates were 10.0%and 45.5% in the patients who underwent NOM and surgical treatment, respectively. No patient with grade I-II liver trauma had complications. All patients who underwent NOM survived.NOM is the first option for the treatment of liver trauma if the patient is hemodynamically stable. The grade of liver injury and the volume of hemoperitoneum are not suitable criteria for selecting NOM. Hepatic angioembolization associated with the correction of hypothermia, coagulopathy and acidosis is important in the conservative treatment for liver trauma.展开更多
AIM: To perform a systematic review and meta-analysis comparing operative vs non-operative treatment of displaced proximal humerus fractures in elderly patients.METHODS: A systematic literature search was performed us...AIM: To perform a systematic review and meta-analysis comparing operative vs non-operative treatment of displaced proximal humerus fractures in elderly patients.METHODS: A systematic literature search was performed using EMBASE and MEDLINE through the OVID interface,CINAHL,the Cochrane Central Register of Controlled Trials(CENTRAL),Proquest,Web of Science,SAE digital library,and Transportation Research Board's TRID database.Searches of conference proceedings were also conducted.All available randomized controlled trials comparing operative vs non-operative management of displaced three- and four-part proximal humerus fractures in elderly patients were included.The primary outcomes measures included physical function,pain,health related quality of life,mortality,and the re-operation rate.RESULTS: Six randomized controlled trials(n = 287) were included.There was no statistically significant difference in function(MD = 1.72,95%CI:-2.90-6.34,P = 0.47),as measured by the Constant score,between the operative and the non-operative treatment groups.There was no statistically significance difference insecondary outcomes of health related quality of life(standardized MD = 0.27,95%CI:-0.05-0.59,P = 0.09),and mortality(relative risk 1.29,95%CI: 0.50-3.35,P = 0.60).Operative treatment had a statistically significant higher re-operation rate(relative risk 4.09,95%CI: 1.50-11.15,P = 0.006),and statistically significant decreased pain(MD = 1.26,95%CI: 0.02-2.49,P = 0.05).CONCLUSION: There is moderate quality evidence to suggest that there is no difference in functional outcomes between the two treatments.Further high quality randomized controlled trials are required to determine if certain subgroup populations benefit from surgical management.展开更多
Acute traumatic spinal cord injury is often a lifechanging and devastating event with considerable mortality and morbidity.Over half a million people suffer from traumatic spinal cord injury annually with the majority...Acute traumatic spinal cord injury is often a lifechanging and devastating event with considerable mortality and morbidity.Over half a million people suffer from traumatic spinal cord injury annually with the majority resulting from road traffic accidents or falls.The Individual,societal and economic costs are enormous.Initial recognition and treatment of acute traumatic spinal cord injury are crucial to limit secondary injury to the spinal cord and to provide patients with the best chance of some functional recovery.This article is an overview of the management of the acute traumatic spinal cord injury patient presenting to the emergency department.We review the initial assessment,criteria for imaging and clearing the spine,and evaluate the literature to determine the optimum timing of surgery and the role of non-surgical treatment in patients presenting with acute spinal cord injury.展开更多
BACKGROUND Majority of adhesive small bowel obstruction(SBO)cases can be managed nonoperatively.However,a proportion of patients failed non-operative management.AIM To evaluate the predictors of successful non-operati...BACKGROUND Majority of adhesive small bowel obstruction(SBO)cases can be managed nonoperatively.However,a proportion of patients failed non-operative management.AIM To evaluate the predictors of successful non-operative management in adhesive SBO.METHODS A retrospective study was performed for all consecutive cases of adhesive SBO from November 2015 to May 2018.Data collated included basic demographics,clinical presentation,biochemistry and imaging results and management outcomes.The imaging studies were independently analyzed by a radiologist who was blinded to the clinical outcomes.The patients were divided into group A operative(including those that failed initial non-operative management)and group B non-operative for analysis.RESULTS Of 252 patients were included in the final analysis;group A(n=90)(35.7%)and group B(n=162)(64.3%).There were no differences in the clinical features between both groups.Laboratory tests of inflammatory markers and lactate levels were similar in both groups.From the imaging findings,the presence of a definitive transition point[odds ratio(OR)=2.67,95%confidence interval(CI):0.98-7.32,P=0.048],presence of free fluid(OR=2.11,95%CI:1.15-3.89,P=0.015)and absence of small bowel faecal signs(OR=1.70,95%CI:1.01-2.88,P=0.047)were predictive of the need of surgical intervention.In patients that received water soluble contrast medium,the evidence of contrast in colon was 3.83 times predictive of successful non-operative management(95%CI:1.79-8.21,P=0.001).CONCLUSION The computed tomography findings can assist clinicians in deciding early surgical intervention in adhesive SBO cases that are unlikely to be successful with non-operative management to prevent associated morbidity and mortality.展开更多
Purpose:Non-operative management(NOM)has been validated for blunt liver and splenic injuries.Literature on continuous intra-abdominal pressure(IAP)monitoring as a part of NOM remains to be equivocal.The study aimed to...Purpose:Non-operative management(NOM)has been validated for blunt liver and splenic injuries.Literature on continuous intra-abdominal pressure(IAP)monitoring as a part of NOM remains to be equivocal.The study aimed to find any correlation between clinical parameters and IAP,and their effect on the NOM of patients with blunt liver and splenic injury.Method:A prospective cross-sectional study conducted at a level I trauma center from October 2018 to January 2020 including 174 patients who underwent NOM following blunt liver and splenic injuries.Hemodynamically unstable patients or those on ventilators were excluded,as well as patients who suffered significant head,spinal cord,and/or bladder injuries.The study predominantly included males(83.9%)with a mean age of 32.5 years.IAP was monitored continuously and the relation of IAP with various parameters,interventions,and outcomes were measured.Data were summarized as frequency(percentage)or mean±SD or median(Q1,Q3)as indicated.χ2 or Fisher's exact test was used for categorical variables,while for continuous variables parametric(independent t-test)or nonparametric tests(Wilcoxon rank sum test)were used as appropriate.Clinical and laboratory correlates of IAP<12 with p<0.200 in the univariable logistic regression analysis were included in the multivariable analysis.A p<0.05 was used to indicate statistical significance.Results:Intra-abdominal hypertension(IAH)was seen in 19.0%of the study population.IAH was strongly associated with a high injury severity score(p<0.001),and other physiological parameters like respiratory rate(p<0.001),change in abdominal girth(AG)(p<0.001),and serum creatinine(p<0.001).IAH along with the number of solid organs involved,respiratory rate,change in AG,and serum creatinine was associated with the intervention,either operative or non-operative(p=0.001,p=0.002,p<0.001,p<0.001,p=0.013,respectively).On multivariable analysis,IAP(p=0.006)and the mean change of AG(p=0.004)were significantly associated with the need for intervention.Conclusion:As a part of NOM,IAP should be monitored as a continuous vital.However,the decision for any intervention,either operative or non-operative cannot be guided by IAP values alone.展开更多
BACKGROUND Non-operative management(NOM)for uncomplicated acute appendicitis(AA)has been gaining popularity in recent years.One of the major concerns with NOM is the recurrence rate of AA following NOM.AIM To investig...BACKGROUND Non-operative management(NOM)for uncomplicated acute appendicitis(AA)has been gaining popularity in recent years.One of the major concerns with NOM is the recurrence rate of AA following NOM.AIM To investigate the impact of the presence of an appendicolith and its specific characteristics on the recurrence rate of AA following NOM.METHODS A retrospective analysis identified all patients treated with NOM for AA,at our institute between 2016 and 2024.Patients with an appendicolith on imaging were identified and their course and outcomes were compared with patients who were treated with NOM without an appendicolith.The primary outcome was defined as a recurrence of AA.RESULTS During the study period,797 patients were treated with NOM for AA.Their mean age was 25.4 years±14.4 years,and 45.4%were females.Only 68 patients(8.5%)had an appendicolith identified on imaging.Patients with an appendicolith had a larger appendix diameter(10.2 mm±4 mm vs 8.5 mm±2.1 mm,P=0.001).There was no difference in the recurrence rate of patients with and without an appendicolith(26.5%vs 19.1%,P=0.14),however patients with an appendicolith presented with a shorter time to recurrence of appendicitis(3.9 months±10.4 months vs 5.9 months±8.1 months,P=0.04).In a sub analysis,the number of appendicoliths,its size,and its location,did not influence the recurrence rate.CONCLUSION This study demonstrates that patients with appendicoliths have a shorter time to recurrence after NOM of AA,but do not experience higher overall recurrence rates.展开更多
Purpose: Liver is the most frequently injured organ in abdominal trauma. Today non-operative management (NOM) is considered as the standard of care in hemodynamically stable patients, with or without the adjunct of an...Purpose: Liver is the most frequently injured organ in abdominal trauma. Today non-operative management (NOM) is considered as the standard of care in hemodynamically stable patients, with or without the adjunct of angioembolisation (AE). This systematic review assesses the incidence of complications in patients who sustained liver injuries and were treated with simple clinical observation. Given the differences in indications of treatment and severity of liver trauma and acknowledging the limitations of this study, an analysis of the results has been done in reference to the complications in patients who were treated with AE. Methods: A systematic literature review searched "liver trauma" , "hepatic trauma" , "conservative management" , "non operative management" on MEDLINE (via PubMed), Cochrane Central Register of Controlled Trials databases, EMBASE, and Google Scholar, to identify studies published on the conservative management of traumatic liver injuries between January 1990 and June 2020. Patients with traumatic liver injuries (blunt and penetrating) treated by NOM, described at least one outcome of interests and provided morbidity outcomes from NOM were included in this study. Studies reported the outcome of NOM without separating liver from other solid organs;studies reported NOM complications together with those post-intervention;case reports;studies including less than 5 cases;studies not written in English;and studies including patients who had NOM with AE as primary management were excluded. Efficacy of NOM and overall morbidity and mortality were assessed, the specific causes of morbidity were investigated, and the American Association for the Surgery of Trauma classification was used in all the studies analysed. Statistical significance has been calculated using the Chi-square test. Results: A total of 19 studies qualified for inclusion criteria were in this review. The NOM success rate ranged from 85% to 99%. The most commonly reported complications were hepatic collection (3.1%), followed by bile leak (1.5%), with variability between the studies. Other complications included hepatic haematoma, bleeding, fistula, pseudoaneurysm, compartment syndrome, peritonitis, and gallbladder ischemia, all with an incidence below 1%. Conclusion: NOM with simple clinical observation showed an overall low incidence of complications, but higher for bile leak and collections. In patients with grade III and above injuries, the incidence of bile leak, collections and compartment syndrome did not show a statistically significant difference with the AE group. However, the latter result is limited by the small number of studies available and it requires further investigations.展开更多
Infected necrotizing pancreatitis(INP)remains a life-threatening complication of acute pancreatitis.Despite advancements such as endoscopic ultrasound(EUS)-guided drainage,lumen-apposing metal stents,and protocolized ...Infected necrotizing pancreatitis(INP)remains a life-threatening complication of acute pancreatitis.Despite advancements such as endoscopic ultrasound(EUS)-guided drainage,lumen-apposing metal stents,and protocolized step-up strate-gies,the clinical practice remains heterogeneous,with variability in endoscopic strategies,procedural timing,device selection,and adjunctive techniques contri-buting to inconsistent outcomes.This review synthesizes current evidence to contribute to a structured framework integrating multidisciplinary team decision-making,advanced imaging(three-dimensional reconstruction,contrast-enhanced computed tomography/magnetic resonance imaging),EUS assessment,and biomarker-driven risk stratification(C-reactive protein,procalcitonin)to optimize patient selection,intervention timing,and complication management.Key stan-dardization components include endoscopic assessment and procedural strate-gies,optimal timing of intervention,personalized approaches for complex pan-creatic collections,and techniques to reduce the number of endoscopic debride-ments and mitigate complications.This work aims to enhance clinical outcomes,minimize practice heterogeneity,and establish a foundation for future research and guideline development in endoscopic management of INP.展开更多
To meet the challenge of mismatches between power supply and demand,modern buildings must schedule flexible energy loads in order to improve the efficiency of power grids.Furthermore,it is essential to understand the ...To meet the challenge of mismatches between power supply and demand,modern buildings must schedule flexible energy loads in order to improve the efficiency of power grids.Furthermore,it is essential to understand the effectiveness of flexibility management strategies under different climate conditions and extreme weather events.Using both typical and extreme weather data from cities in five major climate zones of China,this study investigates the energy flexibility potential of an office building under three short-term HVAC management strategies in the context of different climates.The results show that the peak load flexibility and overall energy performance of the three short-term strategies were affected by the surrounding climate conditions.The peak load reduction rate of the pre-cooling and zone temperature reset strategies declined linearly as outdoor temperature increased.Under extreme climate conditions,the daily peak-load time was found to be over two hours earlier than under typical conditions,and the intensive solar radiation found in the extreme conditions can weaken the correlation between peak load reduction and outdoor temperature,risking the ability of a building’s HVAC system to maintain a comfortable indoor environment.展开更多
This study investigated the application and the application value of intelligent emergency in emergency management in the big data environment.It addresses the neglect of the application value(performance)measurement ...This study investigated the application and the application value of intelligent emergency in emergency management in the big data environment.It addresses the neglect of the application value(performance)measurement of intelligent emergency,further improving the effectiveness of intelligent emergency management.First,approximately 3,900 documents from the intelligent emergency field are analyzed to determine the future research trend in intelligent emergency management.The socio-technical theory concerning technical and social systems is introduced.The emergency management system concepts of“technology enabling”and“enabling value creation”are defined according to bibliometric analysis and socio-technical theory.Second,a research framework that includes technology enabling and enabling value creation for the decision-making paradigm in emergency management according to the big data environment is constructed.A detailed analysis approach from intelligent emergency technology enabling to enabling value creation in emergency management is proposed.Finally,earthquake disasters are taken as examples,and specific analyses of the intelligent emergency enabling and enabling value creation are explored;enabling value creation is discussed based on measurable indicators.The clear concept of emergency management system technology enabling and enabling value creation,as well as the detailed analysis approach from intelligent emergency technology enabling to enabling value creation,provide a theoretical bases for scholars and practitioners to evaluate the value(performance)of intelligent emergency for the first time.展开更多
In the contemporary medical landscape,the burgeoning interest in natural therapies,particularly for managing gastrointestinal disorders,has brought traditional Chinese medicine(TCM)to the forefront.This article explai...In the contemporary medical landscape,the burgeoning interest in natural therapies,particularly for managing gastrointestinal disorders,has brought traditional Chinese medicine(TCM)to the forefront.This article explains the core principles and clinical applications of TCM in treating these conditions,furthering the discourse through an examination of integrated TCM strategies,as demonstrated in the study by Zhou et al.While TCM has shown promising clinical outcomes,it encounters significant hurdles in standardization,mechanistic research,and clinical validation.Future investigations should aim to solidify the scientific underpinnings of TCM and expand its use in gastrointestinal disease management,striving for a seamless fusion of traditional and contemporary medical practices.展开更多
Construction engineering and management(CEM)has become increasingly complicated with the increasing size of engineering projects under different construction environments,motivating the digital transformation of CEM.T...Construction engineering and management(CEM)has become increasingly complicated with the increasing size of engineering projects under different construction environments,motivating the digital transformation of CEM.To contribute to a better understanding of the state of the art of smart techniques for engineering projects,this paper provides a comprehensive review of multi-criteria decision-making(MCDM)techniques,intelligent techniques,and their applications in CEM.First,a comprehensive framework detailing smart technologies for construction projects is developed.Next,the characteristics of CEM are summarized.A bibliometric review is then conducted to investigate the keywords,journals,and clusters related to the application of smart techniques in CEM during 2000-2022.Recent advancements in intelligent techniques are also discussed under the following six topics:①big data technology;②computer vision;③speech recognition;④natural language processing;⑤machine learning;and⑥knowledge representation,understanding,and reasoning.The applications of smart techniques are then illustrated via underground space exploitation.Finally,future research directions for the sustainable development of smart construction are highlighted.展开更多
This paper introduces a high-precision bandgap reference(BGR)designed for battery management systems(BMS),fea-turing an ultra-low temperature coefficient(TC)and line sensitivity(LS).The BGR employs a current-mode sche...This paper introduces a high-precision bandgap reference(BGR)designed for battery management systems(BMS),fea-turing an ultra-low temperature coefficient(TC)and line sensitivity(LS).The BGR employs a current-mode scheme with chopped op-amps and internal clock generators to eliminate op-amp offset.A low dropout regulator(LDO)and a pre-regula-tor enhance output driving and LS,respectively.Curvature compensation enhances the TC by addressing higher-order nonlinear-ity.These approaches,effective near room temperature,employs trimming at both 20 and 60°C.When combined with fixed cur-vature correction currents,it achieves an ultra-low TC for each chip.Implemented in a CMOS 180 nm process,the BGR occu-pies 0.548 mm²and operates at 2.5 V with 84μA current draw from a 5 V supply.An average TC of 2.69 ppm/℃ with two-point trimming and 0.81 ppm/℃ with multi-point trimming are achieved over the temperature range of-40 to 125℃.It accommo-dates a load current of 1 mA and an LS of 42 ppm/V,making it suitable for precise BMS applications.展开更多
The rapid advent in artificial intelligence and big data has revolutionized the dynamic requirement in the demands of the computing resource for executing specific tasks in the cloud environment.The process of achievi...The rapid advent in artificial intelligence and big data has revolutionized the dynamic requirement in the demands of the computing resource for executing specific tasks in the cloud environment.The process of achieving autonomic resource management is identified to be a herculean task due to its huge distributed and heterogeneous environment.Moreover,the cloud network needs to provide autonomic resource management and deliver potential services to the clients by complying with the requirements of Quality-of-Service(QoS)without impacting the Service Level Agreements(SLAs).However,the existing autonomic cloud resource managing frameworks are not capable in handling the resources of the cloud with its dynamic requirements.In this paper,Coot Bird Behavior Model-based Workload Aware Autonomic Resource Management Scheme(CBBM-WARMS)is proposed for handling the dynamic requirements of cloud resources through the estimation of workload that need to be policed by the cloud environment.This CBBM-WARMS initially adopted the algorithm of adaptive density peak clustering for workloads clustering of the cloud.Then,it utilized the fuzzy logic during the process of workload scheduling for achieving the determining the availability of cloud resources.It further used CBBM for potential Virtual Machine(VM)deployment that attributes towards the provision of optimal resources.It is proposed with the capability of achieving optimal QoS with minimized time,energy consumption,SLA cost and SLA violation.The experimental validation of the proposed CBBMWARMS confirms minimized SLA cost of 19.21%and reduced SLA violation rate of 18.74%,better than the compared autonomic cloud resource managing frameworks.展开更多
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 i...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.展开更多
Modern aircraft tend to use fuel thermal management systems to cool onboard heat sources.However,the design of heat transfer architectures for fuel thermal management systems relies on the experience of the engineers ...Modern aircraft tend to use fuel thermal management systems to cool onboard heat sources.However,the design of heat transfer architectures for fuel thermal management systems relies on the experience of the engineers and lacks theoretical guidance.This paper proposes a concise graph representation method based on graph theory for fuel thermal management systems,which can represent all possible connections between subsystems.A generalized optimization algorithm is proposed for fuel thermal management system architecture to minimize the heat sink.This algorithm can autonomously arrange subsystems with heat production differences and efficiently utilize the architecture of the fuel heat sink.At the same time,two evaluation indices are proposed from the perspective of subsystems.These indices intuitively and clearly show that the reason for the high efficiency of heat sink utilization is the balanced and moderate cooling of each subsystem and verify the rationality of the architecture optimization method.A set of simulations are also conducted,which demonstrate that the fuel tank temperature has no effect on the performance of the architecture.This paper provides a reference for the architectural design of aircraft fuel thermal management systems.The metrics used in this paper can also be utilized to evaluate the existing architecture.展开更多
Thedeployment of the Internet of Things(IoT)with smart sensors has facilitated the emergence of fog computing as an important technology for delivering services to smart environments such as campuses,smart cities,and ...Thedeployment of the Internet of Things(IoT)with smart sensors has facilitated the emergence of fog computing as an important technology for delivering services to smart environments such as campuses,smart cities,and smart transportation systems.Fog computing tackles a range of challenges,including processing,storage,bandwidth,latency,and reliability,by locally distributing secure information through end nodes.Consisting of endpoints,fog nodes,and back-end cloud infrastructure,it provides advanced capabilities beyond traditional cloud computing.In smart environments,particularly within smart city transportation systems,the abundance of devices and nodes poses significant challenges related to power consumption and system reliability.To address the challenges of latency,energy consumption,and fault tolerance in these environments,this paper proposes a latency-aware,faulttolerant framework for resource scheduling and data management,referred to as the FORD framework,for smart cities in fog environments.This framework is designed to meet the demands of time-sensitive applications,such as those in smart transportation systems.The FORD framework incorporates latency-aware resource scheduling to optimize task execution in smart city environments,leveraging resources from both fog and cloud environments.Through simulation-based executions,tasks are allocated to the nearest available nodes with minimum latency.In the event of execution failure,a fault-tolerantmechanism is employed to ensure the successful completion of tasks.Upon successful execution,data is efficiently stored in the cloud data center,ensuring data integrity and reliability within the smart city ecosystem.展开更多
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 pat...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.展开更多
文摘Appendicoliths are frequently encountered in acute appendicitis(AA)and historically considered a risk factor for treatment failure in nonoperative management(NOM).However,the impact of appendicoliths on recurrence rates in uncomplicated AA remains controversial.This editorial critically appraises the study by Kupietzky et al,which explored the relationship between appendicolith characteristics and NOM outcomes.Kupietzky et al conducted a retrospective analysis of 797 patients with uncomplicated AA,comparing recurrence rates between those with and without appendicoliths.The study focused on long-term follow-up(median 44.2 months)and subgroup analyses of stone characteristics.The study revealed no significant difference in overall recurrence rates between groups(26.5%vs 19.1%,P=0.14).However,patients with appendicoliths experienced earlier recurrence(3.9 months vs 5.9 months,P=0.04)and had larger appendix diameters(10.2 mm vs 8.5 mm,P=0.001).Subgroup analyses showed no correlation between stone size,location,or number and recurrence risk.Appendicoliths do not independently increase the overall recurrence risk after NOM for uncomplicated AA but may accelerate recurrence timelines.Clinical decisions should prioritize individualized risk assessment,considering patient age,symptom severity,and radiological features.These findings challenge traditional paradigms and advocate for shared decision-making between clinicians and patients.
文摘There remains much ambiguity on what non-operative management(NOM)of rectal cancer truly entails in terms of the methods to be adopted and the best algorithm to follow.This is clearly shown by the discordance between various national and international guidelines on NOM of rectal cancer.The main aim of the NOM strategy is organ preservation and avoiding unnecessary surgical in-tervention,which carries its own risk of morbidity.A highly specific and sensitive surveillance program must be devised to avoid patients undergoing unnecessary surgical interventions.In many studies,NOM,often interchangeably called the Watch and Wait strategy,has been shown as a promising treatment option when undertaken in the appropriate patient population,where a clinical complete res-ponse is achieved.However,there are no clear guidelines on patient selection for NOM along with the optimal method of surveillance.
文摘Liver trauma is the most common abdominal emergency with high morbidity and mortality. Now, nonoperative management（NOM） is a selective method for liver trauma. The aim of this study was to determine the success rate, mortality and morbidity of NOM for isolated liver trauma.Medical records of 81 patients with isolated liver trauma in our unit were analyzed retrospectively. The success rate, mortality and morbidity of NOM were evaluated. In this series, 9 patients with grade IV-V liver injuries underwent emergent operation due to hemodynamic instability; 72 patients, 6 with grade V, 18 grade IV, 29 grade III, 15 grade II and 4 grade I, with hemodynamic stability received NOM. The overall success rate of NOM was 97.2%（70/72）. The success rates of NOM in the patients with grade I-III, IV and V liver trauma were100%, 94.4% and 83.3%. The complication rates were 10.0%and 45.5% in the patients who underwent NOM and surgical treatment, respectively. No patient with grade I-II liver trauma had complications. All patients who underwent NOM survived.NOM is the first option for the treatment of liver trauma if the patient is hemodynamically stable. The grade of liver injury and the volume of hemoperitoneum are not suitable criteria for selecting NOM. Hepatic angioembolization associated with the correction of hypothermia, coagulopathy and acidosis is important in the conservative treatment for liver trauma.
基金Supported by In part by a Canada Research Chair to Dr.Bhandariin part by the Canadian Institutes of Health Research and Vancouver Coastal Health Research Institute to Dr.Slobogean
文摘AIM: To perform a systematic review and meta-analysis comparing operative vs non-operative treatment of displaced proximal humerus fractures in elderly patients.METHODS: A systematic literature search was performed using EMBASE and MEDLINE through the OVID interface,CINAHL,the Cochrane Central Register of Controlled Trials(CENTRAL),Proquest,Web of Science,SAE digital library,and Transportation Research Board's TRID database.Searches of conference proceedings were also conducted.All available randomized controlled trials comparing operative vs non-operative management of displaced three- and four-part proximal humerus fractures in elderly patients were included.The primary outcomes measures included physical function,pain,health related quality of life,mortality,and the re-operation rate.RESULTS: Six randomized controlled trials(n = 287) were included.There was no statistically significant difference in function(MD = 1.72,95%CI:-2.90-6.34,P = 0.47),as measured by the Constant score,between the operative and the non-operative treatment groups.There was no statistically significance difference insecondary outcomes of health related quality of life(standardized MD = 0.27,95%CI:-0.05-0.59,P = 0.09),and mortality(relative risk 1.29,95%CI: 0.50-3.35,P = 0.60).Operative treatment had a statistically significant higher re-operation rate(relative risk 4.09,95%CI: 1.50-11.15,P = 0.006),and statistically significant decreased pain(MD = 1.26,95%CI: 0.02-2.49,P = 0.05).CONCLUSION: There is moderate quality evidence to suggest that there is no difference in functional outcomes between the two treatments.Further high quality randomized controlled trials are required to determine if certain subgroup populations benefit from surgical management.
文摘Acute traumatic spinal cord injury is often a lifechanging and devastating event with considerable mortality and morbidity.Over half a million people suffer from traumatic spinal cord injury annually with the majority resulting from road traffic accidents or falls.The Individual,societal and economic costs are enormous.Initial recognition and treatment of acute traumatic spinal cord injury are crucial to limit secondary injury to the spinal cord and to provide patients with the best chance of some functional recovery.This article is an overview of the management of the acute traumatic spinal cord injury patient presenting to the emergency department.We review the initial assessment,criteria for imaging and clearing the spine,and evaluate the literature to determine the optimum timing of surgery and the role of non-surgical treatment in patients presenting with acute spinal cord injury.
文摘BACKGROUND Majority of adhesive small bowel obstruction(SBO)cases can be managed nonoperatively.However,a proportion of patients failed non-operative management.AIM To evaluate the predictors of successful non-operative management in adhesive SBO.METHODS A retrospective study was performed for all consecutive cases of adhesive SBO from November 2015 to May 2018.Data collated included basic demographics,clinical presentation,biochemistry and imaging results and management outcomes.The imaging studies were independently analyzed by a radiologist who was blinded to the clinical outcomes.The patients were divided into group A operative(including those that failed initial non-operative management)and group B non-operative for analysis.RESULTS Of 252 patients were included in the final analysis;group A(n=90)(35.7%)and group B(n=162)(64.3%).There were no differences in the clinical features between both groups.Laboratory tests of inflammatory markers and lactate levels were similar in both groups.From the imaging findings,the presence of a definitive transition point[odds ratio(OR)=2.67,95%confidence interval(CI):0.98-7.32,P=0.048],presence of free fluid(OR=2.11,95%CI:1.15-3.89,P=0.015)and absence of small bowel faecal signs(OR=1.70,95%CI:1.01-2.88,P=0.047)were predictive of the need of surgical intervention.In patients that received water soluble contrast medium,the evidence of contrast in colon was 3.83 times predictive of successful non-operative management(95%CI:1.79-8.21,P=0.001).CONCLUSION The computed tomography findings can assist clinicians in deciding early surgical intervention in adhesive SBO cases that are unlikely to be successful with non-operative management to prevent associated morbidity and mortality.
文摘Purpose:Non-operative management(NOM)has been validated for blunt liver and splenic injuries.Literature on continuous intra-abdominal pressure(IAP)monitoring as a part of NOM remains to be equivocal.The study aimed to find any correlation between clinical parameters and IAP,and their effect on the NOM of patients with blunt liver and splenic injury.Method:A prospective cross-sectional study conducted at a level I trauma center from October 2018 to January 2020 including 174 patients who underwent NOM following blunt liver and splenic injuries.Hemodynamically unstable patients or those on ventilators were excluded,as well as patients who suffered significant head,spinal cord,and/or bladder injuries.The study predominantly included males(83.9%)with a mean age of 32.5 years.IAP was monitored continuously and the relation of IAP with various parameters,interventions,and outcomes were measured.Data were summarized as frequency(percentage)or mean±SD or median(Q1,Q3)as indicated.χ2 or Fisher's exact test was used for categorical variables,while for continuous variables parametric(independent t-test)or nonparametric tests(Wilcoxon rank sum test)were used as appropriate.Clinical and laboratory correlates of IAP<12 with p<0.200 in the univariable logistic regression analysis were included in the multivariable analysis.A p<0.05 was used to indicate statistical significance.Results:Intra-abdominal hypertension(IAH)was seen in 19.0%of the study population.IAH was strongly associated with a high injury severity score(p<0.001),and other physiological parameters like respiratory rate(p<0.001),change in abdominal girth(AG)(p<0.001),and serum creatinine(p<0.001).IAH along with the number of solid organs involved,respiratory rate,change in AG,and serum creatinine was associated with the intervention,either operative or non-operative(p=0.001,p=0.002,p<0.001,p<0.001,p=0.013,respectively).On multivariable analysis,IAP(p=0.006)and the mean change of AG(p=0.004)were significantly associated with the need for intervention.Conclusion:As a part of NOM,IAP should be monitored as a continuous vital.However,the decision for any intervention,either operative or non-operative cannot be guided by IAP values alone.
文摘BACKGROUND Non-operative management(NOM)for uncomplicated acute appendicitis(AA)has been gaining popularity in recent years.One of the major concerns with NOM is the recurrence rate of AA following NOM.AIM To investigate the impact of the presence of an appendicolith and its specific characteristics on the recurrence rate of AA following NOM.METHODS A retrospective analysis identified all patients treated with NOM for AA,at our institute between 2016 and 2024.Patients with an appendicolith on imaging were identified and their course and outcomes were compared with patients who were treated with NOM without an appendicolith.The primary outcome was defined as a recurrence of AA.RESULTS During the study period,797 patients were treated with NOM for AA.Their mean age was 25.4 years±14.4 years,and 45.4%were females.Only 68 patients(8.5%)had an appendicolith identified on imaging.Patients with an appendicolith had a larger appendix diameter(10.2 mm±4 mm vs 8.5 mm±2.1 mm,P=0.001).There was no difference in the recurrence rate of patients with and without an appendicolith(26.5%vs 19.1%,P=0.14),however patients with an appendicolith presented with a shorter time to recurrence of appendicitis(3.9 months±10.4 months vs 5.9 months±8.1 months,P=0.04).In a sub analysis,the number of appendicoliths,its size,and its location,did not influence the recurrence rate.CONCLUSION This study demonstrates that patients with appendicoliths have a shorter time to recurrence after NOM of AA,but do not experience higher overall recurrence rates.
文摘Purpose: Liver is the most frequently injured organ in abdominal trauma. Today non-operative management (NOM) is considered as the standard of care in hemodynamically stable patients, with or without the adjunct of angioembolisation (AE). This systematic review assesses the incidence of complications in patients who sustained liver injuries and were treated with simple clinical observation. Given the differences in indications of treatment and severity of liver trauma and acknowledging the limitations of this study, an analysis of the results has been done in reference to the complications in patients who were treated with AE. Methods: A systematic literature review searched "liver trauma" , "hepatic trauma" , "conservative management" , "non operative management" on MEDLINE (via PubMed), Cochrane Central Register of Controlled Trials databases, EMBASE, and Google Scholar, to identify studies published on the conservative management of traumatic liver injuries between January 1990 and June 2020. Patients with traumatic liver injuries (blunt and penetrating) treated by NOM, described at least one outcome of interests and provided morbidity outcomes from NOM were included in this study. Studies reported the outcome of NOM without separating liver from other solid organs;studies reported NOM complications together with those post-intervention;case reports;studies including less than 5 cases;studies not written in English;and studies including patients who had NOM with AE as primary management were excluded. Efficacy of NOM and overall morbidity and mortality were assessed, the specific causes of morbidity were investigated, and the American Association for the Surgery of Trauma classification was used in all the studies analysed. Statistical significance has been calculated using the Chi-square test. Results: A total of 19 studies qualified for inclusion criteria were in this review. The NOM success rate ranged from 85% to 99%. The most commonly reported complications were hepatic collection (3.1%), followed by bile leak (1.5%), with variability between the studies. Other complications included hepatic haematoma, bleeding, fistula, pseudoaneurysm, compartment syndrome, peritonitis, and gallbladder ischemia, all with an incidence below 1%. Conclusion: NOM with simple clinical observation showed an overall low incidence of complications, but higher for bile leak and collections. In patients with grade III and above injuries, the incidence of bile leak, collections and compartment syndrome did not show a statistically significant difference with the AE group. However, the latter result is limited by the small number of studies available and it requires further investigations.
基金Supported by the Education and Teaching Reform Project of the First Clinical College of Chongqing Medical University,No.CMER202305Natural Science Foundation of Xizang Autonomous Region,No.XZ2024ZR-ZY100(Z)Program for Youth Innovation in Future Medicine,Chongqing Medical University,China,No.W0138.
文摘Infected necrotizing pancreatitis(INP)remains a life-threatening complication of acute pancreatitis.Despite advancements such as endoscopic ultrasound(EUS)-guided drainage,lumen-apposing metal stents,and protocolized step-up strate-gies,the clinical practice remains heterogeneous,with variability in endoscopic strategies,procedural timing,device selection,and adjunctive techniques contri-buting to inconsistent outcomes.This review synthesizes current evidence to contribute to a structured framework integrating multidisciplinary team decision-making,advanced imaging(three-dimensional reconstruction,contrast-enhanced computed tomography/magnetic resonance imaging),EUS assessment,and biomarker-driven risk stratification(C-reactive protein,procalcitonin)to optimize patient selection,intervention timing,and complication management.Key stan-dardization components include endoscopic assessment and procedural strate-gies,optimal timing of intervention,personalized approaches for complex pan-creatic collections,and techniques to reduce the number of endoscopic debride-ments and mitigate complications.This work aims to enhance clinical outcomes,minimize practice heterogeneity,and establish a foundation for future research and guideline development in endoscopic management of INP.
基金National Key R&D Program of China of the 13th Five-Year Plan(No.2018YFD1100704)。
文摘To meet the challenge of mismatches between power supply and demand,modern buildings must schedule flexible energy loads in order to improve the efficiency of power grids.Furthermore,it is essential to understand the effectiveness of flexibility management strategies under different climate conditions and extreme weather events.Using both typical and extreme weather data from cities in five major climate zones of China,this study investigates the energy flexibility potential of an office building under three short-term HVAC management strategies in the context of different climates.The results show that the peak load flexibility and overall energy performance of the three short-term strategies were affected by the surrounding climate conditions.The peak load reduction rate of the pre-cooling and zone temperature reset strategies declined linearly as outdoor temperature increased.Under extreme climate conditions,the daily peak-load time was found to be over two hours earlier than under typical conditions,and the intensive solar radiation found in the extreme conditions can weaken the correlation between peak load reduction and outdoor temperature,risking the ability of a building’s HVAC system to maintain a comfortable indoor environment.
基金the National Natural Science Foundation of China(Grant No.:71771061).
文摘This study investigated the application and the application value of intelligent emergency in emergency management in the big data environment.It addresses the neglect of the application value(performance)measurement of intelligent emergency,further improving the effectiveness of intelligent emergency management.First,approximately 3,900 documents from the intelligent emergency field are analyzed to determine the future research trend in intelligent emergency management.The socio-technical theory concerning technical and social systems is introduced.The emergency management system concepts of“technology enabling”and“enabling value creation”are defined according to bibliometric analysis and socio-technical theory.Second,a research framework that includes technology enabling and enabling value creation for the decision-making paradigm in emergency management according to the big data environment is constructed.A detailed analysis approach from intelligent emergency technology enabling to enabling value creation in emergency management is proposed.Finally,earthquake disasters are taken as examples,and specific analyses of the intelligent emergency enabling and enabling value creation are explored;enabling value creation is discussed based on measurable indicators.The clear concept of emergency management system technology enabling and enabling value creation,as well as the detailed analysis approach from intelligent emergency technology enabling to enabling value creation,provide a theoretical bases for scholars and practitioners to evaluate the value(performance)of intelligent emergency for the first time.
基金Supported by the 2023 Government Funded Project of the Outstanding Talents Training Program in Clinical Medicine,No.ZF2023165Key Research and Development Projects of Hebei Province,No.18277731DNatural Science Foundation of Hebei Province,No.H202423105.
文摘In the contemporary medical landscape,the burgeoning interest in natural therapies,particularly for managing gastrointestinal disorders,has brought traditional Chinese medicine(TCM)to the forefront.This article explains the core principles and clinical applications of TCM in treating these conditions,furthering the discourse through an examination of integrated TCM strategies,as demonstrated in the study by Zhou et al.While TCM has shown promising clinical outcomes,it encounters significant hurdles in standardization,mechanistic research,and clinical validation.Future investigations should aim to solidify the scientific underpinnings of TCM and expand its use in gastrointestinal disease management,striving for a seamless fusion of traditional and contemporary medical practices.
基金funded by the project of Guangdong Provincial Basic and Applied Basic Research Fund Committee(2022A1515240073)the Pearl River Talent Recruitment Program(2019CX01G338),Guangdong Province.
文摘Construction engineering and management(CEM)has become increasingly complicated with the increasing size of engineering projects under different construction environments,motivating the digital transformation of CEM.To contribute to a better understanding of the state of the art of smart techniques for engineering projects,this paper provides a comprehensive review of multi-criteria decision-making(MCDM)techniques,intelligent techniques,and their applications in CEM.First,a comprehensive framework detailing smart technologies for construction projects is developed.Next,the characteristics of CEM are summarized.A bibliometric review is then conducted to investigate the keywords,journals,and clusters related to the application of smart techniques in CEM during 2000-2022.Recent advancements in intelligent techniques are also discussed under the following six topics:①big data technology;②computer vision;③speech recognition;④natural language processing;⑤machine learning;and⑥knowledge representation,understanding,and reasoning.The applications of smart techniques are then illustrated via underground space exploitation.Finally,future research directions for the sustainable development of smart construction are highlighted.
基金supported by the National Natural Science Foundation of China(NSFC)under grant No.62204235。
文摘This paper introduces a high-precision bandgap reference(BGR)designed for battery management systems(BMS),fea-turing an ultra-low temperature coefficient(TC)and line sensitivity(LS).The BGR employs a current-mode scheme with chopped op-amps and internal clock generators to eliminate op-amp offset.A low dropout regulator(LDO)and a pre-regula-tor enhance output driving and LS,respectively.Curvature compensation enhances the TC by addressing higher-order nonlinear-ity.These approaches,effective near room temperature,employs trimming at both 20 and 60°C.When combined with fixed cur-vature correction currents,it achieves an ultra-low TC for each chip.Implemented in a CMOS 180 nm process,the BGR occu-pies 0.548 mm²and operates at 2.5 V with 84μA current draw from a 5 V supply.An average TC of 2.69 ppm/℃ with two-point trimming and 0.81 ppm/℃ with multi-point trimming are achieved over the temperature range of-40 to 125℃.It accommo-dates a load current of 1 mA and an LS of 42 ppm/V,making it suitable for precise BMS applications.
文摘The rapid advent in artificial intelligence and big data has revolutionized the dynamic requirement in the demands of the computing resource for executing specific tasks in the cloud environment.The process of achieving autonomic resource management is identified to be a herculean task due to its huge distributed and heterogeneous environment.Moreover,the cloud network needs to provide autonomic resource management and deliver potential services to the clients by complying with the requirements of Quality-of-Service(QoS)without impacting the Service Level Agreements(SLAs).However,the existing autonomic cloud resource managing frameworks are not capable in handling the resources of the cloud with its dynamic requirements.In this paper,Coot Bird Behavior Model-based Workload Aware Autonomic Resource Management Scheme(CBBM-WARMS)is proposed for handling the dynamic requirements of cloud resources through the estimation of workload that need to be policed by the cloud environment.This CBBM-WARMS initially adopted the algorithm of adaptive density peak clustering for workloads clustering of the cloud.Then,it utilized the fuzzy logic during the process of workload scheduling for achieving the determining the availability of cloud resources.It further used CBBM for potential Virtual Machine(VM)deployment that attributes towards the provision of optimal resources.It is proposed with the capability of achieving optimal QoS with minimized time,energy consumption,SLA cost and SLA violation.The experimental validation of the proposed CBBMWARMS confirms minimized SLA cost of 19.21%and reduced SLA violation rate of 18.74%,better than the compared autonomic cloud resource managing frameworks.
基金supported in part by the National Key R&D Program of China under Grant 2020YFB1806104in part by Innovation and Entrepreneurship of Jiangsu Province High-level Talent Program+1 种基金in part by Natural Sciences and Engineering Research Council of Canada (NSERC)the support from Huawei
文摘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.
文摘Modern aircraft tend to use fuel thermal management systems to cool onboard heat sources.However,the design of heat transfer architectures for fuel thermal management systems relies on the experience of the engineers and lacks theoretical guidance.This paper proposes a concise graph representation method based on graph theory for fuel thermal management systems,which can represent all possible connections between subsystems.A generalized optimization algorithm is proposed for fuel thermal management system architecture to minimize the heat sink.This algorithm can autonomously arrange subsystems with heat production differences and efficiently utilize the architecture of the fuel heat sink.At the same time,two evaluation indices are proposed from the perspective of subsystems.These indices intuitively and clearly show that the reason for the high efficiency of heat sink utilization is the balanced and moderate cooling of each subsystem and verify the rationality of the architecture optimization method.A set of simulations are also conducted,which demonstrate that the fuel tank temperature has no effect on the performance of the architecture.This paper provides a reference for the architectural design of aircraft fuel thermal management systems.The metrics used in this paper can also be utilized to evaluate the existing architecture.
基金supported by the Deanship of Scientific Research and Graduate Studies at King Khalid University under research grant number(R.G.P.2/93/45).
文摘Thedeployment of the Internet of Things(IoT)with smart sensors has facilitated the emergence of fog computing as an important technology for delivering services to smart environments such as campuses,smart cities,and smart transportation systems.Fog computing tackles a range of challenges,including processing,storage,bandwidth,latency,and reliability,by locally distributing secure information through end nodes.Consisting of endpoints,fog nodes,and back-end cloud infrastructure,it provides advanced capabilities beyond traditional cloud computing.In smart environments,particularly within smart city transportation systems,the abundance of devices and nodes poses significant challenges related to power consumption and system reliability.To address the challenges of latency,energy consumption,and fault tolerance in these environments,this paper proposes a latency-aware,faulttolerant framework for resource scheduling and data management,referred to as the FORD framework,for smart cities in fog environments.This framework is designed to meet the demands of time-sensitive applications,such as those in smart transportation systems.The FORD framework incorporates latency-aware resource scheduling to optimize task execution in smart city environments,leveraging resources from both fog and cloud environments.Through simulation-based executions,tasks are allocated to the nearest available nodes with minimum latency.In the event of execution failure,a fault-tolerantmechanism is employed to ensure the successful completion of tasks.Upon successful execution,data is efficiently stored in the cloud data center,ensuring data integrity and reliability within the smart city ecosystem.
文摘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.
