BACKGROUND Intrathecal bupivacaine is the traditional anesthetic drug used in spinal anesthesia for caesarean sections(CSs),but ropivacaine has emerged as a potential alter-native.This meta-analysis compares the effic...BACKGROUND Intrathecal bupivacaine is the traditional anesthetic drug used in spinal anesthesia for caesarean sections(CSs),but ropivacaine has emerged as a potential alter-native.This meta-analysis compares the efficacy and safety of intrathecal hyper-baric bupivacaine vs hyperbaric ropivacaine for cesarean sections.AIM To systematically evaluate and compare the efficacy and safety of intrathecal hyperbaric bupivacaine and hyperbaric ropivacaine for spinal anesthesia in CSs.METHODS A thorough search of electronic databases was carried out to find pertinent randomized controlled trials(RCTs)comparing intrathecal hyperbaric ropi-vacaine and hyperbaric bupivacaine during CSs.PubMed,Cochrane database,Google Scholar,and Scopus were searched,and papers from January 2000 to January 2024 were deemed eligible and filtered using predetermined inclusion and exclusion criteria.Studies were assessed for methodological quality,and data were extracted for time to adequate anesthesia(sensory and motor blockade),duration of sensory and motor block,hemodynamic changes and side effect profile.The standardized mean difference with 95%CI was used for continuous data.Dichotomous variables were assessed using the Mantel-Haenszel test and the random effect model to compute the odds ratio.RESULTS Total 8 RCTs were selected from a pool of 119 search results for meta-analysis.The meta-analysis evaluated pooled effect sizes and assessed heterogeneity among the studies.The primary objective was to compare key outcomes to identify any significant variances in efficacy and safety profiles between two local anesthetics.The analysis revealed that the difference in the onset of sensory blockade between the two local anesthetics was statistically insignificant(P=0.1586).However,the onset of motor blockade appeared to be faster with bupivacaine(P=0.03589).Additionally,the regression of sensory and motor blockade occurred earlier in the ropivacaine group.Furthermore,the duration of the first analgesic effect was shorter with a significance level of P<0.05.Regarding side effects profile,including hypotension,nausea,and shivering,the study did not observe any significant differences between the two groups.CONCLUSION This meta-analysis offers insights into the effectiveness and safety of hyperbaric bupivacaine vs ropivacaine for cesarean sections.Hyperbaric ropivacaine had a comparable safety profile and faster regression of sensory and motor blockade than hyperbaric bupivacaine,perhaps aiding early mobilization of parturient and facilitating mother-child bonding.Choosing ropivacaine may offer benefits beyond efficacy for cesarean section patients and short surgical procedures.展开更多
Background: Cesarean sections have become increasingly prevalent in both developed and developing nations. Nevertheless, postoperative complications, including surgical site infections (SSIs), remain a substantial con...Background: Cesarean sections have become increasingly prevalent in both developed and developing nations. Nevertheless, postoperative complications, including surgical site infections (SSIs), remain a substantial concern that contributes to heightened morbidity and mortality. This study is designed to evaluate the frequency and key determining factors associated with surgical site infections following cesarean section procedures in a tertiary care hospital in Bangladesh. Materials and Methods: This observational cross-sectional study, conducted at the Gynecology Department of Dhaka Medical College Hospital, involved 100 patients aged 15 - 45 who had cesarean deliveries. Data was collected during hospitalization and post-discharge and analyzed to determine the prevalence and relationship between socio-demographic characteristics and surgical site infection. Results: Among the study participants, 14% developed surgical site infections following cesarean operations. More than half of these patients were under the age of 25, with a mean age of 24.45 ± 4.44 years. Surgical site infections were more prevalent in individuals over 30 years old (P-value Conclusion: Post-cesarean surgical site infections are notably prevalent among the participants in this study. Several risk factors have been identified, including age, body mass index (BMI), socioeconomic status, anemia, preterm delivery, personal hygiene practices, regular menstrual cycles, and adherence to antenatal check-ups. The implementation of an effective awareness program, coupled with updated antibiotic protocols, is crucial for significantly reducing the incidence of these infections.展开更多
AIM:To evaluate the prevalence and the causes of blindness,severe visual impairment(SVI),and visual impairment(VI)and to investigate the frequency of cataract surgery in people aged≥50y in Yueqing,Zhejiang Province,C...AIM:To evaluate the prevalence and the causes of blindness,severe visual impairment(SVI),and visual impairment(VI)and to investigate the frequency of cataract surgery in people aged≥50y in Yueqing,Zhejiang Province,China.METHODS:A population-based,cross-sectional study was performed using the Rapid Assessment of Avoidable Blindness technique.Eight-seven clusters,each consisting of 50 people aged≥50y,were selected by probabilityproportionate-to-size sampling.Three outreach teams conducted door-to-door visits.Visual acuity(VA)was measured using a tumbling E chart.Lens status and causes of VI were assessed by ophthalmologists for individuals with a VA of<6/12 in either eye.A standardized questionnaire was used to collect information about cataract surgeries.RESULTS:Of 4350 eligible individuals,4120 were examined with a 94.7%response rate.Age-and genderadjusted prevalence of blindness,SVI,and VI were 0.5%(95%CI,0.3%–0.7%),0.7%(95%CI,0.4%–1.0%),and 4.8%(95%CI,4.2%–5.5%),respectively.Age was associated with an increased prevalence of VI,and the most common cause of VI was untreated cataracts,with the main barriers to cataract surgery being a lack of knowledge or awareness about cataracts.Of the 415 eyes operated on for cataracts,68(16.4%)eyes had a poor outcomes(VA<6/60)and 303(73.0%)had a good outcomes(VA>6/18).CONCLUSION:Prevalence rates of blindness,SVI,and VI in Yueqing are lower than other reported Chinese population-based studies.Cataracts remain the most common cause of blindness and VI.展开更多
Blockchain-enabled Internet of Medical Things (BIoMT) has attracted significant attention from academia and healthcare organizations. However, the large amount of medical data involved in BIoMT has also raised concern...Blockchain-enabled Internet of Medical Things (BIoMT) has attracted significant attention from academia and healthcare organizations. However, the large amount of medical data involved in BIoMT has also raised concerns about data security and personal privacy protection. To alleviate these concerns, blind signature technology has emerged as an effective method to solve blindness and unforgeability. Unfortunately, most existing blind signature schemes suffer from the security risk of key leakage. In addition, traditional blind signature schemes are also vulnerable to quantum computing attacks. Therefore, it remains a crucial and ongoing challenge to explore the construction of key-secure, quantum-resistant blind signatures. In this paper, we introduce lattice-based forward-secure blind signature (LFSBS), a lattice-based forward-secure blind signature scheme for medical privacy preservation in BIoMT. LFSBS achieves forward security by constructing a key evolution mechanism using a binary tree structure. This mechanism ensures that even if future encryption keys are leaked, past data can still remain secure. Meanwhile, LFSBS realizes post-quantum security based on the hardness assumption of small integer solution (SIS), making it resistant to potential quantum computing attacks. In addition, we formally define and prove the security of LFSBS in a random oracle model, including blindness and forward-secure unforgeability. Comprehensive performance evaluation shows that LFSBS performs well in terms of computational overhead, with a reduction of 22%–73% compared to previous schemes.展开更多
Tissue clearing combined with high-resolution confocal imaging is a cutting-edge approach for dissecting the three-dimensional(3D)architecture of tissues and deciphering cellular spatial interactions under physiologic...Tissue clearing combined with high-resolution confocal imaging is a cutting-edge approach for dissecting the three-dimensional(3D)architecture of tissues and deciphering cellular spatial interactions under physiological and pathological conditions.Deciphering the spatial interaction of leptin receptor-expressing(LepR^(+))stromal cells with other compartments in the bone marrow is crucial for a deeper understanding of the stem cell niche and the skeletal tissue.In this study,we introduce an optimized protocol for the 3D analysis of skeletal tissues,enabling the visualization of hematopoietic and stromal cells,especially LepR+stromal cells,within optically cleared bone hemisections.Our method preserves the 3D tissue architecture and is extendable to other hematopoietic sites such as calvaria and vertebrae.The protocol entails tissue fixation,decalcification,and cryosectioning to reveal the marrow cavity.Completed within approximately 12 days,this process yields highly transparent tissues that maintain genetically encoded or antibody-stained fluorescent signals.The bone hemisections are compatible with diverse antibody labeling strategies.Confocal microscopy of these transparent samples allows for qualitative and quantitative image analysis using Aivia or Bitplane Imaris software,assessing a spectrum of parameters.With proper storage,the fluorescent signal in the stained and cleared bone hemisections remains intact for at least 2–3 months.This protocol is robust,straightforward to implement,and highly reproducible,offering a valuable tool for tissue architecture and cellular interaction studies.展开更多
The El Pintado 1 Silurian section in Seville Province,Spain,described by Loydell et al.(2015),has been ratified by the IUGS as the replacement GSSP for the base of the Telychian Stage,to replace the Cefn Cerig quarry ...The El Pintado 1 Silurian section in Seville Province,Spain,described by Loydell et al.(2015),has been ratified by the IUGS as the replacement GSSP for the base of the Telychian Stage,to replace the Cefn Cerig quarry section in the Llandovery area of Wales,which was found to be within a sedimentary mélange and therefore not a continuous section.No section other than El Pintado 1 has been found to be continuously fossiliferous across the Aeronian/Telychian boundary.展开更多
Most blind image quality assessment(BIQA)methods require a large amount of time to collect human opinion scores as training labels,which limits their usability in practice.Thus,we present an opinion-unaware BIQA metho...Most blind image quality assessment(BIQA)methods require a large amount of time to collect human opinion scores as training labels,which limits their usability in practice.Thus,we present an opinion-unaware BIQA method based on deep reinforcement learning which is trained without subjective scores,named DRL-IQA.Inspired by the human visual perception process,our model is formulated as a quality reinforced agent,which consists of the dynamic distortion generation part and the quality perception part.By considering the image distortion degradation process as a sequential decision-making process,the dynamic distortion generation part can develop a strategy to add as many different distortions as possible to an image,which enriches the distortion space to alleviate overfitting.A reward function calculated from quality degradation after adding distortion is utilized to continuously optimize the strategy.Furthermore,the quality perception part can extract rich quality features from the quality degradation process without using subjective scores,and accurately predict the state values that represent the image quality.Experimental results reveal that our method achieves competitive quality prediction performance compared to other state-of-the-art BIQA methods.展开更多
Acute pulmonary edema is a leading cause of death in patients with preeclampsia.The authors reported a case of a pregnant woman at 25 weeks of gestation with severe preeclampsia complicated by pulmonary edema,who requ...Acute pulmonary edema is a leading cause of death in patients with preeclampsia.The authors reported a case of a pregnant woman at 25 weeks of gestation with severe preeclampsia complicated by pulmonary edema,who required an emergency cesarean section,posing a significant challenge to the anesthesiologist.The patient had developed Type 1 respiratory failure and needed supplemental oxygen with high-flow nasal oxygen.Due to contraindications for neuraxial anesthesia,the cesarean section was performed under general anesthesia.After induction of anesthesia,the patient’s hypoxemia worsened.Eventually,after treatment with fluid restriction,diuretics,and albumin,oxygenation improved gradually,and the procedure was performed successfully.Both the patient and the newborn had a good prognosis.展开更多
This study begins with the fabrication and simulation of high-performance back-illuminated AlGaN-based solar-blind ultraviolet(UV)photodetectors.Based on the photodetectors,a low-noise,high-gain UV detection system ci...This study begins with the fabrication and simulation of high-performance back-illuminated AlGaN-based solar-blind ultraviolet(UV)photodetectors.Based on the photodetectors,a low-noise,high-gain UV detection system circuit is designed and fabricated,enabling the detection,acquisition,and calibration of weak solar-blind UV signals.Experimental results demonstrate that under zero bias conditions,with a UV light power density of 3.45μW/cm^(2) at 260 nm,the sample achieves a peak responsivity(R)of 0.085 A·W^(−1),an external quantum efficiency(EQE)of 40.7%,and a detectivity(D^(*))of 7.46×10^(12) cm·Hz^(1/2)·W^(−1).The system exhibits a bandpass characteristic within the 240–280 nm wavelength range,coupled with a high signal-to-noise ratio(SNR)of 39.74 dB.展开更多
The identification and characterization of rock types is a core activity in geology and related fields,including mining,petroleum,environmental science,industry,and construction.Traditionally,this task is performed by...The identification and characterization of rock types is a core activity in geology and related fields,including mining,petroleum,environmental science,industry,and construction.Traditionally,this task is performed by human specialists who analyze and describe the type,composition,texture,shape,and other properties of rock samples,whether collected in-situ or prepared in a laboratory.However,the process is subjective,dependent on the specialist’s experience,and time-consuming.This study proposes an artificial intelligence-based approach that combines computer vision and natural language processing to generate both textual and verbal descriptions from images of rock thin sections.A dataset of images and corresponding textual descriptions is used to train a hybrid deep learning model.Features extracted from the images using EfficientNetB7 are processed by a Transformer network to generate textual descriptions,which are then converted into verbal responses using a speech synthesis service.The experimental results show an accuracy of 0.892 and a BLEU score of 0.71.This model offers potential utility for research,professional,and academic applications and has been deployed as a web application for public use.展开更多
Jamming suppression is traditionally achieved through the use of spatial filters based on array signal processing theory.In order to achieve better jamming suppression performance,many studies have applied blind sourc...Jamming suppression is traditionally achieved through the use of spatial filters based on array signal processing theory.In order to achieve better jamming suppression performance,many studies have applied blind source separation(BSS)to jamming suppression.BSS can achieve the separation and extraction of the individual source signals from the mixed signal received by the array.This paper proposes a perspective to recognize BSS as spatial band-pass filters(SBPFs)for jamming suppression applications.The theoretical derivation indicates that the processing of mixed signals by BSS can be perceived as the application of a set of SBPFs that gate the source signals at various angles.Simulations are performed using radar jamming suppression as an example.The simulation results suggest that BSS and SBPFs produce approximately the same effects.Simulation results are consistent with theoretical derivation results.展开更多
Objective:The objective of this study is to determine the effect of nurse-led instructional video(NLIV)on anxiety,satisfaction,and recovery among mothers admitted for cesarean section(CS).Materials and Methods:A quasi...Objective:The objective of this study is to determine the effect of nurse-led instructional video(NLIV)on anxiety,satisfaction,and recovery among mothers admitted for cesarean section(CS).Materials and Methods:A quasi-experimental design was carried out on the mothers scheduled for CS.Eighty participants were selected by a purposive sampling technique,which were divided(40 participants in each group)into an experimental group and a control group.Nurse-led informational video(NLIV)was shown to the experimental group,and routine care was provided for the control group.Modified hospital anxiety scale(HADS),scale for measuring maternal satisfaction in cesarean birth,and obstetric quality of recovery following cesarean delivery were used to assess anxiety,satisfaction,and recovery.Results:Both the experimental and control groups showed significant reductions in anxiety by the first postintervention day(P<0.001),with the experimental group experiencing a greater mean reduction(mean difference[MD]=4.37)than the control group(MD=3.35)but the intergroup difference was not statistically significant(P>0.05).The experimental group reported significantly higher satisfaction scores(175.55±9.42)on the 3rd postoperative day compared to the control group(151.93±14.89;P<0.001).Similarly,the experimental group’s recovery scores(79.90±6.24)were considerably higher than those of the control group(62.45±15.18;P<0.001).On the 3rd postintervention day,satisfaction was significantly associated with age(P<0.001),and recovery with gravidity(P<0.05).Conclusions:NLIV can be used in the preoperative period to reduce anxiety related to CS and to improve satisfaction and recovery after the CS.展开更多
Background:Blindness and vision impairment(BVI)continue to pose significant global public health challenges,disproportionately impacting vulnerable populations and further widening socioeconomic disparities.This study...Background:Blindness and vision impairment(BVI)continue to pose significant global public health challenges,disproportionately impacting vulnerable populations and further widening socioeconomic disparities.This study conducts a comprehensive evaluation of the global burden of BVI and the socioeconomic inequalities in its distribution from 1990 to 2021,aiming to provide insights for targeted intervention strategies.Methods:Using data from Global Burden of Disease 2021,this study performed a multiscale analysis of BVI burden,examining patterns at the global,regional and national levels.We quantified the disease burden using disability-adjusted life years DALY and prevalence rates.Temporal trends were analyzed by calculating estimated annual percentage changes(EAPC).Stratified assessments were carried out by sex and age group across 21 regions and 204 countries.The study also included comparative analyses of six major eye conditions and evaluated their associations with socio-demographic index(SDI).Results:Globally,the age-standardized prevalence of BVI increased from 12,453.52 per million(95%UI:10,287.58-15,226.09)in 1990 to 15,784.33 per million(12,761.44-19,502.32)in 2021,with an EAPC of 1.09%(95%UI:0.97-1.20).During this period,global DALYs attributable to BVI increased by 37.7%.Disease trends exhibited significant divergence,with near vision loss showing the steepest increase(EAPC:1.47%),while the prevalence of glaucoma declined(EAPC:-0.73%).Geographic disparities were pronounced,with substantial improvements observed in Equatorial Guinea(EAPC:-1.75)and worsening burdens in Benin(+0.54).Disease distribution demonstrated strong regional clustering,with near vision loss being predominant in Sub-Saharan Africa(64.47%)and East Asia(50.97%),while cataract was the most common condition in Oceania(33.86%).Females consistently bore a higher burden,particularly in South Asia(646.3 vs 563.2 DALYs).Moreover,we identified a strong inverse correlation between SDI and BVI burden(Ρ=-0.772 for DALYs).Conclusions:This study highlights the severe global burden of BVI and the significant cross-country inequality,particularly in low-and middle-income countries.It emphasizes the urgent need for targeted interventions and the integration of eye care into universal health policies to promote global health equity in the post-pandemic era.展开更多
Recent deep neural network(DNN)based blind image quality assessment(BIQA)approaches take mean opinion score(MOS)as ground-truth labels,which would lead to cross-datasets biases and limited generalization ability of th...Recent deep neural network(DNN)based blind image quality assessment(BIQA)approaches take mean opinion score(MOS)as ground-truth labels,which would lead to cross-datasets biases and limited generalization ability of the DNN-based BIQA model.This work validates the natural instability of MOS through investigating the neuropsychological characteristics inside the human visual system during quality perception.By combining persistent homology analysis with electroencephalogram(EEG),the physiologically meaningful features of the brain responses to different distortion levels are extracted.The physiological features indicate that although volunteers view exactly the same image content,their EEG features are quite varied.Based on the physiological results,we advocate treating MOS as noisy labels and optimizing the DNN based BIQA model with earlystop strategies.Experimental results on both innerdataset and cross-dataset demonstrate the superiority of our optimization approach in terms of generalization ability.展开更多
In 5G new radio(NR), polar codes are adopted for e MBB downlink control channels where the blind detection is employed in user equipment(UE) to identify the correct downlink control information(DCI). However, differen...In 5G new radio(NR), polar codes are adopted for e MBB downlink control channels where the blind detection is employed in user equipment(UE) to identify the correct downlink control information(DCI). However, different from that in the 4G LTE system, the cyclic redundancy check(CRC) in polar decoding plays both error correction and error detection roles. Consequently, the false alarm rates(FAR) may not meet the system requirements(FAR<1.52 × 10^(−5)). In this paper, to mitigate the FAR in polar code blind detection, we attach a binary classifier after the polar decoder to further remove the false alarm results and meanwhile retain the correct DCI. This classifier works by tracking the squared Euclidean distance ratio(SEDR) between the received signal and hypothesis. We derive an analytical method to fast compute proper classification threshold that is implementation-friendly in practical use. Combining the well-designed classifier, we show that some very short CRC sequences can even be used to meet the FAR requirements. This consequently reduces the CRC overhead and contributes to the system error performance improvements.展开更多
AIM:To identify risk factors for postoperative blindness in patients with primary rhegmatogenous retinal detachment(RRD)at their first presentation to a tertiary center,using a large clinical database to improve under...AIM:To identify risk factors for postoperative blindness in patients with primary rhegmatogenous retinal detachment(RRD)at their first presentation to a tertiary center,using a large clinical database to improve understanding of this adverse outcome.METHODS:Electronic health records of patients with primary RRD from the Eye Hospital of Wenzhou Medical University were retrospectively analyzed.Postoperative blindness was defined according to the World Health Organization(WHO)criteria for legal blindness.Potential risk factors included demographic characteristics,preoperative clinical features,and surgical variables.Univariable and multivariable logistic regression analyses were performed to calculate odds ratios(ORs)and 95%confidence intervals(CIs)for each risk factor.RESULTS:A total of 532 patients were included in the cohort,of whom 62(12.0%;28 males,34 females)developed postoperative blindness at the final follow-up.Among these 62 patients,30 had high myopia and 32 did not.The mean age of participants was 49.0±16.4y,with 275 subjects(52%)being male and 133 patients(25%)having the condition in the right eye.In the multivariable model for all patients,the following factors were associated with an increased risk of postoperative blindness:higher preoperative logarithm of the minimum angle of resolution visual acuity(logMAR VA;OR=1.09 per 0.1 logMAR unit increase,95%CI 1.03-1.15);inferior or superior retinal breaks(OR=2.42,95%CI 1.12-5.24);and macular holes or superior retinal breaks(OR=8.46,95%CI 3.45-20.75).In the subgroup of patients with high myopia,risk factors for postoperative blindness included:pseudophakia/aphakia versus phakia(OR=6.33,95%CI 1.41-28.31);macular holes or superior retinal breaks(OR=15.15,95%CI 3.07-74.85);and proliferative vitreoretinopathy(PVR;OR=21.41,95%CI 2.14-214.57).In the subgroup of patients without high myopia,increased risk of postoperative blindness was associated with:higher preoperative logMAR VA(OR=1.11 per 0.1 logMAR unit increase,95%CI 1.04-1.18);and inferior or superior retinal breaks(OR=2.90,95%CI 1.19-7.06).CONCLUSION:Using a large real-world clinical database,we identified distinct risk factors for postoperative blindness in patients with primary RRD-including differences between those with and without high myopia.These findings emphasize the need to target specific risk factors in clinical practice to mitigate and reduce the incidence of postoperative blindness in this patient population.展开更多
OBJECTIVE:To evaluate the clinical outcome of Traditional Chinese Medicine(TCM)syndrome differentiation combined with hysteroscopic treatment for uterine incision defect after cesarean section[previous cesarean scar d...OBJECTIVE:To evaluate the clinical outcome of Traditional Chinese Medicine(TCM)syndrome differentiation combined with hysteroscopic treatment for uterine incision defect after cesarean section[previous cesarean scar defect(PCSD)]after cesarean section.METHODS:This is a single-center retrospective study.A total of 120 PCSD patients were enrolled from February 2022 to February 2023 and divided into two groups according to different treatment methods,the TCM group(n=60)and the control group(n=60).The control group was treated with hysteroscopy,and the TCM group combined TCM syndrome differentiation with hysteroscopy.Clinical outcome included menstrual scores,menstrual days,TCM symptom scores and intrauterine pregnancy recurrence rate was analyzed in two groups.RESULTS:The total response rate of the TCM group was significantly higher than that of the control group(P<0.05);after treatment,the menstrual scores,menstrual days and TCM symptoms of the two groups were decreased,and the menstrual scores,menstrual days and TCM symptoms of the TCM group were all lower than that of the control group(P<0.05);the recurrence rate of the TCM group was significantly lower than that of the control group(P<0.05).Follow-up results showed higher healing of incisional scar diverticulum in the TCM group than in the control group(P<0.05).The duration of menstruation before and after treatment,and the TCM group was better than the control group(P<0.05).CONCLUSION:TCM syndrome differentiation combined with hysteroscopy presented favorable outcome on the prolonged menstrual period of PCSD,which could significantly improve the recovery of menstruation,relief the symptoms of TCM,reduce the recurrence rate and accelerate wound healing.展开更多
The purpose of this article is to explore the design of compound interchange interweaving sections on expressways.During the research phase,based on the support of the literature research method,the classification and...The purpose of this article is to explore the design of compound interchange interweaving sections on expressways.During the research phase,based on the support of the literature research method,the classification and development of the interchange system,as well as the design forms of the compound interchange interweaving section,were analyzed.Subsequently,based on the case method,the design of the compound interchange interweaving section of the ShiWu and ShiBai expressways in Shiyan,Hubei Province,was discussed,and a design scheme and scheme comparison were proposed.It is hoped that this article can provide technical reference and ideas for China’s road and bridge engineering teams,ensuring that the design results can not only guarantee the normal passage of traffic on the North Intersection Expressway but also ensure the straight-line traffic capacity of the main highway under the background of dislocation intersection,achieving smooth and safe transitions between different expressways.展开更多
文摘BACKGROUND Intrathecal bupivacaine is the traditional anesthetic drug used in spinal anesthesia for caesarean sections(CSs),but ropivacaine has emerged as a potential alter-native.This meta-analysis compares the efficacy and safety of intrathecal hyper-baric bupivacaine vs hyperbaric ropivacaine for cesarean sections.AIM To systematically evaluate and compare the efficacy and safety of intrathecal hyperbaric bupivacaine and hyperbaric ropivacaine for spinal anesthesia in CSs.METHODS A thorough search of electronic databases was carried out to find pertinent randomized controlled trials(RCTs)comparing intrathecal hyperbaric ropi-vacaine and hyperbaric bupivacaine during CSs.PubMed,Cochrane database,Google Scholar,and Scopus were searched,and papers from January 2000 to January 2024 were deemed eligible and filtered using predetermined inclusion and exclusion criteria.Studies were assessed for methodological quality,and data were extracted for time to adequate anesthesia(sensory and motor blockade),duration of sensory and motor block,hemodynamic changes and side effect profile.The standardized mean difference with 95%CI was used for continuous data.Dichotomous variables were assessed using the Mantel-Haenszel test and the random effect model to compute the odds ratio.RESULTS Total 8 RCTs were selected from a pool of 119 search results for meta-analysis.The meta-analysis evaluated pooled effect sizes and assessed heterogeneity among the studies.The primary objective was to compare key outcomes to identify any significant variances in efficacy and safety profiles between two local anesthetics.The analysis revealed that the difference in the onset of sensory blockade between the two local anesthetics was statistically insignificant(P=0.1586).However,the onset of motor blockade appeared to be faster with bupivacaine(P=0.03589).Additionally,the regression of sensory and motor blockade occurred earlier in the ropivacaine group.Furthermore,the duration of the first analgesic effect was shorter with a significance level of P<0.05.Regarding side effects profile,including hypotension,nausea,and shivering,the study did not observe any significant differences between the two groups.CONCLUSION This meta-analysis offers insights into the effectiveness and safety of hyperbaric bupivacaine vs ropivacaine for cesarean sections.Hyperbaric ropivacaine had a comparable safety profile and faster regression of sensory and motor blockade than hyperbaric bupivacaine,perhaps aiding early mobilization of parturient and facilitating mother-child bonding.Choosing ropivacaine may offer benefits beyond efficacy for cesarean section patients and short surgical procedures.
文摘Background: Cesarean sections have become increasingly prevalent in both developed and developing nations. Nevertheless, postoperative complications, including surgical site infections (SSIs), remain a substantial concern that contributes to heightened morbidity and mortality. This study is designed to evaluate the frequency and key determining factors associated with surgical site infections following cesarean section procedures in a tertiary care hospital in Bangladesh. Materials and Methods: This observational cross-sectional study, conducted at the Gynecology Department of Dhaka Medical College Hospital, involved 100 patients aged 15 - 45 who had cesarean deliveries. Data was collected during hospitalization and post-discharge and analyzed to determine the prevalence and relationship between socio-demographic characteristics and surgical site infection. Results: Among the study participants, 14% developed surgical site infections following cesarean operations. More than half of these patients were under the age of 25, with a mean age of 24.45 ± 4.44 years. Surgical site infections were more prevalent in individuals over 30 years old (P-value Conclusion: Post-cesarean surgical site infections are notably prevalent among the participants in this study. Several risk factors have been identified, including age, body mass index (BMI), socioeconomic status, anemia, preterm delivery, personal hygiene practices, regular menstrual cycles, and adherence to antenatal check-ups. The implementation of an effective awareness program, coupled with updated antibiotic protocols, is crucial for significantly reducing the incidence of these infections.
基金Supported by Zhejiang Province Science and Technology Benefiting Project(No.2014H01007)Wenzhou Municipal Basic Research Project(No.Y20210208).
文摘AIM:To evaluate the prevalence and the causes of blindness,severe visual impairment(SVI),and visual impairment(VI)and to investigate the frequency of cataract surgery in people aged≥50y in Yueqing,Zhejiang Province,China.METHODS:A population-based,cross-sectional study was performed using the Rapid Assessment of Avoidable Blindness technique.Eight-seven clusters,each consisting of 50 people aged≥50y,were selected by probabilityproportionate-to-size sampling.Three outreach teams conducted door-to-door visits.Visual acuity(VA)was measured using a tumbling E chart.Lens status and causes of VI were assessed by ophthalmologists for individuals with a VA of<6/12 in either eye.A standardized questionnaire was used to collect information about cataract surgeries.RESULTS:Of 4350 eligible individuals,4120 were examined with a 94.7%response rate.Age-and genderadjusted prevalence of blindness,SVI,and VI were 0.5%(95%CI,0.3%–0.7%),0.7%(95%CI,0.4%–1.0%),and 4.8%(95%CI,4.2%–5.5%),respectively.Age was associated with an increased prevalence of VI,and the most common cause of VI was untreated cataracts,with the main barriers to cataract surgery being a lack of knowledge or awareness about cataracts.Of the 415 eyes operated on for cataracts,68(16.4%)eyes had a poor outcomes(VA<6/60)and 303(73.0%)had a good outcomes(VA>6/18).CONCLUSION:Prevalence rates of blindness,SVI,and VI in Yueqing are lower than other reported Chinese population-based studies.Cataracts remain the most common cause of blindness and VI.
基金funded by the Yunnan Key Laboratory of Blockchain Application Technology(202105AG070005,202305AG340008)&YNB202301,NSFC(Grant Nos.72293583,72293580,62476007,62176273,62271234)the Open Foundation of State Key Laboratory of Networking and Switching Technology(Beijing University of Posts and Telecommunications)(SKLNST-2024-1-06)+2 种基金the Project of Science and Technology Major Project of Yunnan Province(202302AF080006)Open Foundation of State Key Laboratory of Public Big Data(Guizhou University)under Grant No.PBD2022-16Double First-Class Project for Collaborative Innovation Achievements inDisciplines Construction in Heilongjiang Province under Grant No.GXCG2022-054.
文摘Blockchain-enabled Internet of Medical Things (BIoMT) has attracted significant attention from academia and healthcare organizations. However, the large amount of medical data involved in BIoMT has also raised concerns about data security and personal privacy protection. To alleviate these concerns, blind signature technology has emerged as an effective method to solve blindness and unforgeability. Unfortunately, most existing blind signature schemes suffer from the security risk of key leakage. In addition, traditional blind signature schemes are also vulnerable to quantum computing attacks. Therefore, it remains a crucial and ongoing challenge to explore the construction of key-secure, quantum-resistant blind signatures. In this paper, we introduce lattice-based forward-secure blind signature (LFSBS), a lattice-based forward-secure blind signature scheme for medical privacy preservation in BIoMT. LFSBS achieves forward security by constructing a key evolution mechanism using a binary tree structure. This mechanism ensures that even if future encryption keys are leaked, past data can still remain secure. Meanwhile, LFSBS realizes post-quantum security based on the hardness assumption of small integer solution (SIS), making it resistant to potential quantum computing attacks. In addition, we formally define and prove the security of LFSBS in a random oracle model, including blindness and forward-secure unforgeability. Comprehensive performance evaluation shows that LFSBS performs well in terms of computational overhead, with a reduction of 22%–73% compared to previous schemes.
基金National Natural Science Foundation of China(grant number 82272563 to B.S.)National Science and Technology Major Project of the Ministry of Science and Technology of China(grant number 2023ZD0501202 to B.S.)+4 种基金institutional grants allocated to the National Institute of Biological Sciences,Beijing(NIBS)from the Chinese Ministry of Science and Technology,Beijing Municipal Commission of Science and Technology,and Tsinghua Universitythe support from China Pharmaceutical University(grant number 3150140001 to S.F.)National Natural Science Foundation of China(grant numbers 82203653 to S.F.,82371957 to L.W.,and 82371956 to X.C.)Beijing Municipal Public Welfare Development and Reform Pilot Project for Medical Research Institutes(grant number JYY2023-8 to X.C.)Research Grants Council of University Grants Committee Hong Kong(grant numbers 14113723,14108720,14121721,14202920,N_CUHK472/22,C7030-18G,T13-402/17-N,and AoE/M-402/20)。
文摘Tissue clearing combined with high-resolution confocal imaging is a cutting-edge approach for dissecting the three-dimensional(3D)architecture of tissues and deciphering cellular spatial interactions under physiological and pathological conditions.Deciphering the spatial interaction of leptin receptor-expressing(LepR^(+))stromal cells with other compartments in the bone marrow is crucial for a deeper understanding of the stem cell niche and the skeletal tissue.In this study,we introduce an optimized protocol for the 3D analysis of skeletal tissues,enabling the visualization of hematopoietic and stromal cells,especially LepR+stromal cells,within optically cleared bone hemisections.Our method preserves the 3D tissue architecture and is extendable to other hematopoietic sites such as calvaria and vertebrae.The protocol entails tissue fixation,decalcification,and cryosectioning to reveal the marrow cavity.Completed within approximately 12 days,this process yields highly transparent tissues that maintain genetically encoded or antibody-stained fluorescent signals.The bone hemisections are compatible with diverse antibody labeling strategies.Confocal microscopy of these transparent samples allows for qualitative and quantitative image analysis using Aivia or Bitplane Imaris software,assessing a spectrum of parameters.With proper storage,the fluorescent signal in the stained and cleared bone hemisections remains intact for at least 2–3 months.This protocol is robust,straightforward to implement,and highly reproducible,offering a valuable tool for tissue architecture and cellular interaction studies.
基金funded by project PDI2021-125585NB-I00 of the Spanish Ministry of Science,Innovation and Universities‒Agencia Estatal de Investigacion.JF thanks the Grant Agency of the Czech Republic for support of his study(GA23-06198S).
文摘The El Pintado 1 Silurian section in Seville Province,Spain,described by Loydell et al.(2015),has been ratified by the IUGS as the replacement GSSP for the base of the Telychian Stage,to replace the Cefn Cerig quarry section in the Llandovery area of Wales,which was found to be within a sedimentary mélange and therefore not a continuous section.No section other than El Pintado 1 has been found to be continuously fossiliferous across the Aeronian/Telychian boundary.
基金supported by the Fundamental Research Funds for the Central Universities.
文摘Most blind image quality assessment(BIQA)methods require a large amount of time to collect human opinion scores as training labels,which limits their usability in practice.Thus,we present an opinion-unaware BIQA method based on deep reinforcement learning which is trained without subjective scores,named DRL-IQA.Inspired by the human visual perception process,our model is formulated as a quality reinforced agent,which consists of the dynamic distortion generation part and the quality perception part.By considering the image distortion degradation process as a sequential decision-making process,the dynamic distortion generation part can develop a strategy to add as many different distortions as possible to an image,which enriches the distortion space to alleviate overfitting.A reward function calculated from quality degradation after adding distortion is utilized to continuously optimize the strategy.Furthermore,the quality perception part can extract rich quality features from the quality degradation process without using subjective scores,and accurately predict the state values that represent the image quality.Experimental results reveal that our method achieves competitive quality prediction performance compared to other state-of-the-art BIQA methods.
文摘Acute pulmonary edema is a leading cause of death in patients with preeclampsia.The authors reported a case of a pregnant woman at 25 weeks of gestation with severe preeclampsia complicated by pulmonary edema,who required an emergency cesarean section,posing a significant challenge to the anesthesiologist.The patient had developed Type 1 respiratory failure and needed supplemental oxygen with high-flow nasal oxygen.Due to contraindications for neuraxial anesthesia,the cesarean section was performed under general anesthesia.After induction of anesthesia,the patient’s hypoxemia worsened.Eventually,after treatment with fluid restriction,diuretics,and albumin,oxygenation improved gradually,and the procedure was performed successfully.Both the patient and the newborn had a good prognosis.
基金supported by the Director’s Fund for the‘Climbing Plan’of the National Space Science Centre of the Chinese Academy of Sciences(No.E2PD10011S)the National Engineering Research Centre for Mobile Private Networks Project(No.BJTU20221102).
文摘This study begins with the fabrication and simulation of high-performance back-illuminated AlGaN-based solar-blind ultraviolet(UV)photodetectors.Based on the photodetectors,a low-noise,high-gain UV detection system circuit is designed and fabricated,enabling the detection,acquisition,and calibration of weak solar-blind UV signals.Experimental results demonstrate that under zero bias conditions,with a UV light power density of 3.45μW/cm^(2) at 260 nm,the sample achieves a peak responsivity(R)of 0.085 A·W^(−1),an external quantum efficiency(EQE)of 40.7%,and a detectivity(D^(*))of 7.46×10^(12) cm·Hz^(1/2)·W^(−1).The system exhibits a bandpass characteristic within the 240–280 nm wavelength range,coupled with a high signal-to-noise ratio(SNR)of 39.74 dB.
文摘The identification and characterization of rock types is a core activity in geology and related fields,including mining,petroleum,environmental science,industry,and construction.Traditionally,this task is performed by human specialists who analyze and describe the type,composition,texture,shape,and other properties of rock samples,whether collected in-situ or prepared in a laboratory.However,the process is subjective,dependent on the specialist’s experience,and time-consuming.This study proposes an artificial intelligence-based approach that combines computer vision and natural language processing to generate both textual and verbal descriptions from images of rock thin sections.A dataset of images and corresponding textual descriptions is used to train a hybrid deep learning model.Features extracted from the images using EfficientNetB7 are processed by a Transformer network to generate textual descriptions,which are then converted into verbal responses using a speech synthesis service.The experimental results show an accuracy of 0.892 and a BLEU score of 0.71.This model offers potential utility for research,professional,and academic applications and has been deployed as a web application for public use.
基金supported by the National Natural Science Foundation of China(6237104662201048)the Natural Science Foundation of Chongqing,China(cstc2020jcyj-msxmX0260).
文摘Jamming suppression is traditionally achieved through the use of spatial filters based on array signal processing theory.In order to achieve better jamming suppression performance,many studies have applied blind source separation(BSS)to jamming suppression.BSS can achieve the separation and extraction of the individual source signals from the mixed signal received by the array.This paper proposes a perspective to recognize BSS as spatial band-pass filters(SBPFs)for jamming suppression applications.The theoretical derivation indicates that the processing of mixed signals by BSS can be perceived as the application of a set of SBPFs that gate the source signals at various angles.Simulations are performed using radar jamming suppression as an example.The simulation results suggest that BSS and SBPFs produce approximately the same effects.Simulation results are consistent with theoretical derivation results.
文摘Objective:The objective of this study is to determine the effect of nurse-led instructional video(NLIV)on anxiety,satisfaction,and recovery among mothers admitted for cesarean section(CS).Materials and Methods:A quasi-experimental design was carried out on the mothers scheduled for CS.Eighty participants were selected by a purposive sampling technique,which were divided(40 participants in each group)into an experimental group and a control group.Nurse-led informational video(NLIV)was shown to the experimental group,and routine care was provided for the control group.Modified hospital anxiety scale(HADS),scale for measuring maternal satisfaction in cesarean birth,and obstetric quality of recovery following cesarean delivery were used to assess anxiety,satisfaction,and recovery.Results:Both the experimental and control groups showed significant reductions in anxiety by the first postintervention day(P<0.001),with the experimental group experiencing a greater mean reduction(mean difference[MD]=4.37)than the control group(MD=3.35)but the intergroup difference was not statistically significant(P>0.05).The experimental group reported significantly higher satisfaction scores(175.55±9.42)on the 3rd postoperative day compared to the control group(151.93±14.89;P<0.001).Similarly,the experimental group’s recovery scores(79.90±6.24)were considerably higher than those of the control group(62.45±15.18;P<0.001).On the 3rd postintervention day,satisfaction was significantly associated with age(P<0.001),and recovery with gravidity(P<0.05).Conclusions:NLIV can be used in the preoperative period to reduce anxiety related to CS and to improve satisfaction and recovery after the CS.
基金supported by grants from the National Natural Science Foundation of China(82000901,82171084).
文摘Background:Blindness and vision impairment(BVI)continue to pose significant global public health challenges,disproportionately impacting vulnerable populations and further widening socioeconomic disparities.This study conducts a comprehensive evaluation of the global burden of BVI and the socioeconomic inequalities in its distribution from 1990 to 2021,aiming to provide insights for targeted intervention strategies.Methods:Using data from Global Burden of Disease 2021,this study performed a multiscale analysis of BVI burden,examining patterns at the global,regional and national levels.We quantified the disease burden using disability-adjusted life years DALY and prevalence rates.Temporal trends were analyzed by calculating estimated annual percentage changes(EAPC).Stratified assessments were carried out by sex and age group across 21 regions and 204 countries.The study also included comparative analyses of six major eye conditions and evaluated their associations with socio-demographic index(SDI).Results:Globally,the age-standardized prevalence of BVI increased from 12,453.52 per million(95%UI:10,287.58-15,226.09)in 1990 to 15,784.33 per million(12,761.44-19,502.32)in 2021,with an EAPC of 1.09%(95%UI:0.97-1.20).During this period,global DALYs attributable to BVI increased by 37.7%.Disease trends exhibited significant divergence,with near vision loss showing the steepest increase(EAPC:1.47%),while the prevalence of glaucoma declined(EAPC:-0.73%).Geographic disparities were pronounced,with substantial improvements observed in Equatorial Guinea(EAPC:-1.75)and worsening burdens in Benin(+0.54).Disease distribution demonstrated strong regional clustering,with near vision loss being predominant in Sub-Saharan Africa(64.47%)and East Asia(50.97%),while cataract was the most common condition in Oceania(33.86%).Females consistently bore a higher burden,particularly in South Asia(646.3 vs 563.2 DALYs).Moreover,we identified a strong inverse correlation between SDI and BVI burden(Ρ=-0.772 for DALYs).Conclusions:This study highlights the severe global burden of BVI and the significant cross-country inequality,particularly in low-and middle-income countries.It emphasizes the urgent need for targeted interventions and the integration of eye care into universal health policies to promote global health equity in the post-pandemic era.
基金supported by the Medium and Long-term Science and Technology Plan for Radio,Television,and Online Audiovisuals(2023AC0200)the Public Welfare Technology Application Research Project of Zhejiang Province,China(No.LGF21F010001).
文摘Recent deep neural network(DNN)based blind image quality assessment(BIQA)approaches take mean opinion score(MOS)as ground-truth labels,which would lead to cross-datasets biases and limited generalization ability of the DNN-based BIQA model.This work validates the natural instability of MOS through investigating the neuropsychological characteristics inside the human visual system during quality perception.By combining persistent homology analysis with electroencephalogram(EEG),the physiologically meaningful features of the brain responses to different distortion levels are extracted.The physiological features indicate that although volunteers view exactly the same image content,their EEG features are quite varied.Based on the physiological results,we advocate treating MOS as noisy labels and optimizing the DNN based BIQA model with earlystop strategies.Experimental results on both innerdataset and cross-dataset demonstrate the superiority of our optimization approach in terms of generalization ability.
基金supported in part by National Natural Science Foundation of China(No.62471054)in part by National Natural Science Foundation of China(No.92467301)+3 种基金in part by the National Natural Science Foundation of China(No.62201562)in part by the National Natural Science Foundation of China(No.62371063)in part by the National Natural Science Foundation of China(No.62321001)in part by Liaoning Provincial Natural Science Foundation of China(No.2024–BSBA–51).
文摘In 5G new radio(NR), polar codes are adopted for e MBB downlink control channels where the blind detection is employed in user equipment(UE) to identify the correct downlink control information(DCI). However, different from that in the 4G LTE system, the cyclic redundancy check(CRC) in polar decoding plays both error correction and error detection roles. Consequently, the false alarm rates(FAR) may not meet the system requirements(FAR<1.52 × 10^(−5)). In this paper, to mitigate the FAR in polar code blind detection, we attach a binary classifier after the polar decoder to further remove the false alarm results and meanwhile retain the correct DCI. This classifier works by tracking the squared Euclidean distance ratio(SEDR) between the received signal and hypothesis. We derive an analytical method to fast compute proper classification threshold that is implementation-friendly in practical use. Combining the well-designed classifier, we show that some very short CRC sequences can even be used to meet the FAR requirements. This consequently reduces the CRC overhead and contributes to the system error performance improvements.
文摘AIM:To identify risk factors for postoperative blindness in patients with primary rhegmatogenous retinal detachment(RRD)at their first presentation to a tertiary center,using a large clinical database to improve understanding of this adverse outcome.METHODS:Electronic health records of patients with primary RRD from the Eye Hospital of Wenzhou Medical University were retrospectively analyzed.Postoperative blindness was defined according to the World Health Organization(WHO)criteria for legal blindness.Potential risk factors included demographic characteristics,preoperative clinical features,and surgical variables.Univariable and multivariable logistic regression analyses were performed to calculate odds ratios(ORs)and 95%confidence intervals(CIs)for each risk factor.RESULTS:A total of 532 patients were included in the cohort,of whom 62(12.0%;28 males,34 females)developed postoperative blindness at the final follow-up.Among these 62 patients,30 had high myopia and 32 did not.The mean age of participants was 49.0±16.4y,with 275 subjects(52%)being male and 133 patients(25%)having the condition in the right eye.In the multivariable model for all patients,the following factors were associated with an increased risk of postoperative blindness:higher preoperative logarithm of the minimum angle of resolution visual acuity(logMAR VA;OR=1.09 per 0.1 logMAR unit increase,95%CI 1.03-1.15);inferior or superior retinal breaks(OR=2.42,95%CI 1.12-5.24);and macular holes or superior retinal breaks(OR=8.46,95%CI 3.45-20.75).In the subgroup of patients with high myopia,risk factors for postoperative blindness included:pseudophakia/aphakia versus phakia(OR=6.33,95%CI 1.41-28.31);macular holes or superior retinal breaks(OR=15.15,95%CI 3.07-74.85);and proliferative vitreoretinopathy(PVR;OR=21.41,95%CI 2.14-214.57).In the subgroup of patients without high myopia,increased risk of postoperative blindness was associated with:higher preoperative logMAR VA(OR=1.11 per 0.1 logMAR unit increase,95%CI 1.04-1.18);and inferior or superior retinal breaks(OR=2.90,95%CI 1.19-7.06).CONCLUSION:Using a large real-world clinical database,we identified distinct risk factors for postoperative blindness in patients with primary RRD-including differences between those with and without high myopia.These findings emphasize the need to target specific risk factors in clinical practice to mitigate and reduce the incidence of postoperative blindness in this patient population.
文摘OBJECTIVE:To evaluate the clinical outcome of Traditional Chinese Medicine(TCM)syndrome differentiation combined with hysteroscopic treatment for uterine incision defect after cesarean section[previous cesarean scar defect(PCSD)]after cesarean section.METHODS:This is a single-center retrospective study.A total of 120 PCSD patients were enrolled from February 2022 to February 2023 and divided into two groups according to different treatment methods,the TCM group(n=60)and the control group(n=60).The control group was treated with hysteroscopy,and the TCM group combined TCM syndrome differentiation with hysteroscopy.Clinical outcome included menstrual scores,menstrual days,TCM symptom scores and intrauterine pregnancy recurrence rate was analyzed in two groups.RESULTS:The total response rate of the TCM group was significantly higher than that of the control group(P<0.05);after treatment,the menstrual scores,menstrual days and TCM symptoms of the two groups were decreased,and the menstrual scores,menstrual days and TCM symptoms of the TCM group were all lower than that of the control group(P<0.05);the recurrence rate of the TCM group was significantly lower than that of the control group(P<0.05).Follow-up results showed higher healing of incisional scar diverticulum in the TCM group than in the control group(P<0.05).The duration of menstruation before and after treatment,and the TCM group was better than the control group(P<0.05).CONCLUSION:TCM syndrome differentiation combined with hysteroscopy presented favorable outcome on the prolonged menstrual period of PCSD,which could significantly improve the recovery of menstruation,relief the symptoms of TCM,reduce the recurrence rate and accelerate wound healing.
文摘The purpose of this article is to explore the design of compound interchange interweaving sections on expressways.During the research phase,based on the support of the literature research method,the classification and development of the interchange system,as well as the design forms of the compound interchange interweaving section,were analyzed.Subsequently,based on the case method,the design of the compound interchange interweaving section of the ShiWu and ShiBai expressways in Shiyan,Hubei Province,was discussed,and a design scheme and scheme comparison were proposed.It is hoped that this article can provide technical reference and ideas for China’s road and bridge engineering teams,ensuring that the design results can not only guarantee the normal passage of traffic on the North Intersection Expressway but also ensure the straight-line traffic capacity of the main highway under the background of dislocation intersection,achieving smooth and safe transitions between different expressways.
