This paper studies consensus problems in weighted scale-free networks of asymmetrically coupled dynamical units, where the asymmetry in a given link is deter：mined by the relative degree of the involved nodes. It sho...This paper studies consensus problems in weighted scale-free networks of asymmetrically coupled dynamical units, where the asymmetry in a given link is deter：mined by the relative degree of the involved nodes. It shows that the asymmetry of interactions has a great effect on the consensus. Especially, when the interactions are dominant from higher- to lower-degree nodes, both the convergence speed and the robustness to communication delay are enhanced.展开更多
This paper is discussing several features of the impact of AI(artificial intelligence)on society and human behavior.It includes(1)the question if the AI can outperform the intelligent and creative capacity of humans,(...This paper is discussing several features of the impact of AI(artificial intelligence)on society and human behavior.It includes(1)the question if the AI can outperform the intelligent and creative capacity of humans,(2)if AI capabilities could show criticality and causal emergence,(3)the predictive capacity of AI,(4)the costs related to the learning process and operating AI,and(5)the loss of consensual reality and the rise of deepfakes in the AI era.AI involves considerable systemic risks impacting the social,economic,cultural,and environmental systems.Our will is kept in accordance with how the things around us are presented to us and that is precisely what AI is also doing.For us circumstances define a situation or a moment.For AI the circumstances are just statistical relationships.AI does not have its own values but incorporates the values on which it is trained.The imaginative gap between humans and AI is not just big;it’s of an essential nature.We want not just technology in the online world;we want a moral attitude.展开更多
Background:Insufficient physical activity and prolonged sedentary behavior have emerged as major global public health challenges.Short bouts(≤10 min)of accumulated exercise(SBAE)throughout the day may be a promising ...Background:Insufficient physical activity and prolonged sedentary behavior have emerged as major global public health challenges.Short bouts(≤10 min)of accumulated exercise(SBAE)throughout the day may be a promising strategy to mitigate the adverse effects of prolonged sitting and promote physical activity,ultimately promoting overall health.However,previous ambiguity in defining this concept has resulted in a fragmented and inconsistent evidence base,impeding practical applications,the development of guidelines,and policymaking.The purpose of this study is to establish an operational definition of SBAE by synthesizing systematic reviews and research trials alongside an expert consensus.Additionally,it seeks to evaluate acute and long-term efficacy and feasibility,providing evidence-based recommendations for practice and future research directions.Methods:A literature search was performed across PubMed and Web of Science,followed by systematic screening and summarization of eligible studies based on predefined inclusion criteria.Inclusion criteria encompassed various modes/types of SBAE(bouts lasting≤10 min,performed multiple times daily with≥30 min intervals);both aerobic and resistance exercise were considered.Relevant systematic reviews and research trials were included.Methodological quality,risk of bias,and evidence certainty were assessed.Expert consensus was obtained through a survey to evaluate recommendations and agreement levels on findings.Results:After analyzing 27 systematic reviews,135 research studies,and an expert consensus involving 48 researchers from 11 countries,SBAE is defined as any exercise mode of activity,regardless of intensity,that is accumulated in either continuous or intermittent bouts lasting≤10 min per session(including multiple intermittent sets)that are performed multiple times(≥2 sessions/day)per day,with intervals of≥30 min between bouts or otherwise sufficient time for recovery.When used to interrupt prolonged periods of sedentary time,SBAE mitigates the acute adverse effects of sedentary behavior on more than 10 clinical biomarkers of endocrine,cardiovascular,and brain health/function among adults of diverse ages and conditions.Moreover,SBAE was superior for improving acute glycemic control compared to a single continuous exercise session.As a long-term intervention(average of 11 weeks),SBAE can improve over 20 health outcomes,including peak oxygen uptake,resting blood pressure,and metabolic health.Additionally,SBAE might be more effective than continuous exercise for improving longer-term glycemic control and body composition.Long-term completion rates for SBAE interventions are generally high(95%),with low dropout rates(12%)and high adherence rates even without supervision(85%),and its safety has been preliminarily validated.Conclusion:An operational definition of SBAE is provided along with its classification and acute and long-term efficacy.Practical exercise prescription recommendations and evidence-based strategies for various populations and contexts are provided.Future research should focus on generating high-quality evidence for SBAE in 5 key areas:quantification and monitoring,population-specific responses,optimization of exercise prescriptions,intervention efficacy,and practical implementation.Additionally,addressing policy,environmental,and promotional barriers is crucial for transitioning from expert consensus to public consensus,and for facilitating the application of this strategy in real-world environments.展开更多
This paper studies cooperative robust parallel operation of multiple actuators over an undirected communication graph.The plant is modeled as an uncertain linear system,and the actuators are linear and identical.Based...This paper studies cooperative robust parallel operation of multiple actuators over an undirected communication graph.The plant is modeled as an uncertain linear system,and the actuators are linear and identical.Based on the internal model principle,a distributed dynamic output feedback control law is proposed to achieve both robust output regulation of the closed-loop system and plant input sharing among the actuators.A practical example of five motors cooperatively driving an uncertain shaft under an external load torque is presented to show the effectiveness of the proposed control law.展开更多
Practical byzantine fault tolerance(PBFT)can reduce energy consumption and achieve high throughput compared with the traditional PoW algorithm,which is more suitable for a strongly consistent consortium blockchain.How...Practical byzantine fault tolerance(PBFT)can reduce energy consumption and achieve high throughput compared with the traditional PoW algorithm,which is more suitable for a strongly consistent consortium blockchain.However,due to the frequent communication among nodes,PBFT cannot realize scalability in large-scale networks.Existing PBFTbased algorithms still ignore performance and security.Therefore,we propose a secure and efficient practical byzantine fault tolerance based on double layers and multi copies(DM-PBFT).We design a reputation evaluation and node scheduling method for DMPBFT.And then we propose an adaptive node scheduling strategy based on the derived threshold values after analyzing the system communication complexity and security.Combining the above research,a node dynamic adjustment mechanism is proposed to freeze or adjust the node operation status according to the system environment.Simulation experiments show that the proposed mechanism can improve efficiency and increase the system’s throughput.展开更多
Introduction,Breast cancer is the most common cancer type in adolescents and young adults<40 years of age,accounting for 30%of cancers in this age group1.Breast cancer in the young presents significant challenges f...Introduction,Breast cancer is the most common cancer type in adolescents and young adults<40 years of age,accounting for 30%of cancers in this age group1.Breast cancer in the young presents significant challenges for patients and society,including more aggressive tumor biology,poor prognosis,genetic susceptibility,fertility preservation,and complex psychosocial issues.Moreover,because of the markedly younger median age of breast cancer,the proportion of young breast cancer patients in China is significantly higher than Western countries2.The first Young Breast Cancer in China(YBCC)consensus meeting was held in Guangzhou,China in December 2021 to address exclusive challenges and requirements facing young patients with breast cancer.Chinese medical experts from multiple specialties had an extensive discussion and formulated a consensus over several hot topics in young patients with breast cancer.The“Expert Consensus on the Diagnosis and Treatment of Young Breast Cancer in China(2022 edition)”published in the Chinese Medical Journal has garnered significant attention3,highlighting enormous interest in the YBCC consensus in the medical community and public.展开更多
OBJECTIVE:To develop an expert consensus on kidney deficiency syndrome(KDS)in pregnant women and construct a validated self-reported KDS Patient-Reported Measures Pregnancy Scale(KDS-PRMs-Pregnancy Scale)for early ide...OBJECTIVE:To develop an expert consensus on kidney deficiency syndrome(KDS)in pregnant women and construct a validated self-reported KDS Patient-Reported Measures Pregnancy Scale(KDS-PRMs-Pregnancy Scale)for early identification and management.METHODS:The study was conducted in three phases.First,a comprehensive review of Traditional Chinese Medicine(TCM)literature and diagnostic criteria was performed,generating initial KDS symptoms for pregnancy.Second,a two-round Delphi survey,involving 21 experts from TCM,obstetrics,and gynaecology,assessed importance,relevance,and appropriateness of the items.Third,a psychometric evaluation was conducted,including exploratory factor analysis and internal consistency assessment.RESULTS:In the first Delphi round,19 items were flagged for revision or removal due to expert variability,with 12 items deemed irrelevant.In the second round,consensus was reached,resulting in a 25-item scale.After psychometric evaluation,seven items were removed due to poor factor loadings,leaving an 18-item scale.Three factors—physiological discomfort,fatigue&weakness,and excretion abnormalities—accounted for 78.4%of the variance.The final scale demonstrated excellent internal consistency(Cronbach's alpha=0.959).CONCLUSION:The validated 18-item KDS-PRMsPregnancy Scale is a reliable tool for assessing KDS in pregnant women.Future research should focus on validation in diverse populations and exploring its predictive validity for pregnancy outcomes.展开更多
The Internet of Vehicles(IoV)operates in highly dynamic and open network environments and faces serious challenges in secure and real-time authentication and consensus mechanisms.Existing methods often suffer from com...The Internet of Vehicles(IoV)operates in highly dynamic and open network environments and faces serious challenges in secure and real-time authentication and consensus mechanisms.Existing methods often suffer from complex certificate management,inefficient consensus protocols,and poor resilience in high-frequency communication,resulting in high latency,poor scalability,and unstable network performance.To address these issues,this paper proposes a secure and efficient distributed authentication scheme for IoV with reputation-driven consensus and SM9.First,this paper proposes a decentralized authentication architecture that utilizes the certificate-free feature of SM9,enabling lightweight authentication and key negotiation,thereby reducing the complexity of key management.To ensure the traceability and global consistency of authentication data,this scheme also integrates blockchain technology,applying its inherent invariance.Then,this paper introduces a reputation-driven dynamic node grouping mechanism that transparently evaluates and groups’node behavior using smart contracts to enhance network stability.Furthermore,a new RBSFT(Reputation-Based SM9 Friendly-Tolerant)consensus mechanism is proposed for the first time to enhance consensus efficiency by optimizing the PBFT algorithm.RBSFT aims to write authentication information into the blockchain ledger to achieve multi-level optimization of trust management and decision-making efficiency,thereby significantly improving the responsiveness and robustness in high-frequency IoV scenarios.Experimental results show that it excels in authentication,communication efficiency,and computational cost control,making it a feasible solution for achieving IoV security and real-time performance.展开更多
This article studies the consensus problem with directed graphs for general linear multi-agent systems.New distributed state-feedback protocols with dynamic event-triggered(DET)mechanisms are proposed for directed gra...This article studies the consensus problem with directed graphs for general linear multi-agent systems.New distributed state-feedback protocols with dynamic event-triggered(DET)mechanisms are proposed for directed graphs that are strongly connected and weight-balanced,general strongly connected,and have spanning trees,respectively.It is proven that strictly positive minimum inter-event times(MIETs)are ensured using the designed DET mechanisms.Several numerical examples are presented to illustrate the effectiveness of the theoretical results.Compared with existing results,our results have the following merits:1)DET mechanisms are designed to determine the sampling instants,which can reduce the communication frequency between agents compared with static mechanisms;2)We focus on the consensus problem on directed graphs,which is more general than existing related results on undirected graphs;3)The existence of positive MIETs is shown to be guaranteed by the designed DET sampling strategies while existing related results can only exclude Zeno behavior.展开更多
In this paper,an analysis-definition-processing(ADP)framework is proposed to search positive-incentive noise in continuous action iterated dilemma(CAID).We analyze the influence of communication noise on the cooperati...In this paper,an analysis-definition-processing(ADP)framework is proposed to search positive-incentive noise in continuous action iterated dilemma(CAID).We analyze the influence of communication noise on the cooperative behavior of players in the system and introduce the concept of positive-incentive noise in CAID.We design a global cost function to ensure convergence of the system can be achieved and strive to improve the final level of cooperation.An optimal CAID control method is proposed to derive the deterministic optimal learning rate in analytical form,avoiding the variability and uncertainty brought about by neural network fitting or parameter adjustment.On this basis,the convergence of the dynamic model is further analyzed by using the Lyapunov function instead of the Jacobian matrix.Additionally,an adaptive filtering mechanism is designed to dynamically ensure that only positive-incentive noise affects the system,effectively reducing the impact of negative noise and enhancing system stability.The framework is validated through simulations involving triple classical game models,including the hawk-dove game,the stag hunt game,the chicken game on networks,and a straightforward illustrative example.展开更多
Artificial intelligence(AI)is increasingly recognized as a transformative force in the field of solid organ transplantation.From enhancing donor-recipient matching to predicting clinical risks and tailoring immunosupp...Artificial intelligence(AI)is increasingly recognized as a transformative force in the field of solid organ transplantation.From enhancing donor-recipient matching to predicting clinical risks and tailoring immunosuppressive therapy,AI has the potential to improve both operational efficiency and patient outcomes.Despite these advancements,the perspectives of transplant professionals-those at the forefront of critical decision-making-remain insufficiently explored.To address this gap,this study utilizes a multi-round electronic Delphi approach to gather and analyses insights from global experts involved in organ transplantation.Participants are invited to complete structured surveys capturing demographic data,professional roles,institutional practices,and prior exposure to AI technologies.The survey also explores perceptions of AI’s potential benefits.Quantitative responses are analyzed using descriptive statistics,while open-ended qualitative responses undergo thematic analysis.Preliminary findings indicate a generally positive outlook on AI’s role in enhancing transplantation processes,particularly in areas such as donor matching and post-operative care.These mixed views reflect both optimism and caution among professionals tasked with integrating new technologies into high-stakes clinical workflows.By capturing a wide range of expert opinions,the findings will inform future policy development,regulatory considerations,and institutional readiness frameworks for the integration of AI into organ transplantation.展开更多
Aiming at the challenges of low throughput,excessive consensus latency and high communication complexity in the Practical Byzantine Fault Tolerance(PBFT)algorithm in blockchain networks,its application in identity ver...Aiming at the challenges of low throughput,excessive consensus latency and high communication complexity in the Practical Byzantine Fault Tolerance(PBFT)algorithm in blockchain networks,its application in identity verification for distributed networking of a drone cluster is limited.Therefore,a lightweight blockchainbased identity authentication model for UAV swarms is designed,and a Credit-score and Grouping-mechanism Practical Byzantine Fault Tolerance(CG-PBFT)algorithm is proposed.CG-PBFT introduces a reputation score evaluation mechanism,classifies the reputation levels of nodes in the network,and optimizes the consensus process based on grouping consensus and BLS aggregate signature technology.Experimental results demonstrate that under identical experimental conditions,compared with the PBFT algorithm,CG-PBFT achieves a 250%increase in average throughput,a 70%reduction in average latency,and simultaneous enhancement in security,thus making it more suitable for UAV swarm networks.展开更多
Colorectal cancer(CRC)is one of the most molecularly heterogeneous malignancies,with complexity that extends far beyond traditional histopathological classifications.The consensus molecular subtypes(CMS)established in...Colorectal cancer(CRC)is one of the most molecularly heterogeneous malignancies,with complexity that extends far beyond traditional histopathological classifications.The consensus molecular subtypes(CMS)established in 2015 brought a marked advancement in the taxonomy of CRC,consolidating six classification systems into four novel subtypes,which focus on vital gene expression patterns and clinical and prognostic outcomes.However,nearly a decade of clinical experience with CMS classification has revealed fundamental limitations that underscore the inadequacy of any single classification system for capturing the full spectrum of CRC biology.The inherent challenges of the current paradigm are multifaceted.In the CMS classification,mixed phenotypes that remain unclassifiable constitute 13%of CRC cases.This reflects the remarkable heterogeneity that CRC shows.The tumor budding regions reflect the molecular shift due to CMS 2 to CMS 4 switching,causing further heterogeneity.Moreover,the reliance on bulk RNA sequencing fails to capture the spatial organization of molecular signatures within tumors and the critical contributions of the tumor microenvironment.Recent technological advances in spatial transcriptomics,singlecell RNA sequencing,and multi-omic integration have revealed the limitations of transcriptome-only classifications.The emergence of CRC intrinsic subtypes that attempt to remove microenvironmental contributions,pathway-derived subtypes,and stem cell-based classifications demonstrates the field’s recognition that multiple complementary classification systems are necessary.These newer molecular subtypes are not discrete categories but biological continua,thus highlighting that the vast molecular landscape is a tapestry of interlinked features,not rigid subtypes.Multiple technical hurdles cause difficulty in implementing the clinical translation of these newer molecular subtypes,including gene signature complexity,platform-dependent variations,and the difficulty of getting and preserving fresh frozen tissue.CMS 4 shows a poor prognostic outcome among the CMS subtypes,while CMS 1 is associated with poor survival in metastatic cases.However,the predictive value for definitive therapy remains subdued.Looking forward,the integration of artificial intelligence,liquid biopsy approaches,and real-time molecular monitoring promises to enable dynamic,multi-dimensional tumor characterization.The temporal and spatial complexity can only be captured by complementary molecular taxonomies rather than a single,unified system of CRC classification.Such an approach recognizes that different clinical questions–prognosis,treatment selection,resistance prediction–may require different molecular lenses,each optimized for specific clinical applications.This editorial advocates for a revolutionary change from pursuing a single“best”classification system toward a diverse approach that welcomes the molecular mosaic of CRC.Only through such comprehensive molecular characterization can we hope to achieve the promise of precision oncology for the diverse spectrum of patients with CRC.展开更多
With the advancement of surgical techniques and enhanced management of early gastric cancer(EGC),minimally invasive function-preserving surgical approaches have emerged as a common goal for patients and clinicians.Lap...With the advancement of surgical techniques and enhanced management of early gastric cancer(EGC),minimally invasive function-preserving surgical approaches have emerged as a common goal for patients and clinicians.Laparoscopic-endoscopic cooperative surgery combined with sentinel lymph node navigation surgery(LECSSNNS)has drawn increasing interest because of its dual benefits of minimal invasiveness and organ function preservation.However,robust evidence-based support for guiding clinical implementation remains limited.To address this gap,we systematically evaluated available studies on the clinical application of LECS-SNNS in EGC and integrated expert insights to formulate 20 recommendations.These included preoperative assessment,surgical techniques,intraoperative endoscopic procedures,pathological evaluation,postoperative care,and follow-up.This consensus aimed to provide comprehensive guidance for the standardized application of LECS-SNNS,thereby advancing precise,minimally invasive,and function-preserving treatment for EGC.展开更多
Objective:To characterize placental morphologic features in Moroccan women with adverse outcomes,across different clinical contexts,based on the Amsterdam consensus classification.Methods:A prospective analysis was co...Objective:To characterize placental morphologic features in Moroccan women with adverse outcomes,across different clinical contexts,based on the Amsterdam consensus classification.Methods:A prospective analysis was conducted on placentas with umbilical cords collected fresh between March 1,2024 and July 15,2024 from women with adverse pregnancy outcomes.Clinical data(age,parity,gravidity,complications)were retrieved.Macroscopic parameters(weight,dimensions,cord insertion,membranes,lesions)were assessed,followed by systematic sampling.Tissue was processed by standard histology(formalin fixation,paraffin embedding,hematoxylin and eosin staining),and lesions were classified per Amsterdam criteria.Results:16 placentas from patients with adverse pregnancy outcomes were included.The median maternal age was 30 years.Adverse conditions included placental abruption(50%),intrauterine growth restriction(IUGR,38%),intrauterine fetal death(IUFD,31%),pre-eclampsia/eclampsia(19%),premature rupture of membranes(13%),and oligohydramnios(13%).Several placentas were associated with more than one adverse condition.Histopathology revealed maternal vascular malperfusion lesions in 94%,particularly in pre-eclampsia,IUGR,and IUFD.Fetal vascular malperfusion was found in 88%,mainly in IUGR and IUFD.Inflammatory lesions,dominated by acute maternal and fetal responses stage 3(necrotizing chorioamnionitis and funisitis),were primarily linked to IUFD.Conclusions:Placental examination enhances understanding of the pathophysiology underlying adverse pregnancy outcomes,supports diagnostic confirmation,and guides preventive strategies for recurrence.This study highlights the prevalence of maternal vascular malperfusion in Moroccan women and emphasizes the importance of systematic placental histopathology in obstetric care.展开更多
This paper focuses on the leader-following positive consensus problems of heterogeneous switched multi-agent systems.First,a state-feedback controller with dynamic compensation is introduced to achieve positive consen...This paper focuses on the leader-following positive consensus problems of heterogeneous switched multi-agent systems.First,a state-feedback controller with dynamic compensation is introduced to achieve positive consensus under average dwell time switching.Then sufficient conditions are derived to guarantee the positive consensus.The gain matrices of the control protocol are described using a matrix decomposition approach and the corresponding computational complexity is reduced by resorting to linear programming and co-positive Lyapunov functions.Finally,two numerical examples are provided to illustrate the results obtained.展开更多
Standards are the common language that consolidates global consensus and builds the most solid foundation for international partnerships.They are the cornerstone for global sustainable and high-quality development.You...Standards are the common language that consolidates global consensus and builds the most solid foundation for international partnerships.They are the cornerstone for global sustainable and high-quality development.Young students,with their active and vibrant minds,represent the future and hope of standardization.展开更多
This paper is concerned with adaptive consensus tracking control of nonlinear multi-agent systems with actuator faults and unknown nonidentical control directions under double semi-Markovian switching topologies.Consi...This paper is concerned with adaptive consensus tracking control of nonlinear multi-agent systems with actuator faults and unknown nonidentical control directions under double semi-Markovian switching topologies.Considering the complex working environment and the stability differences in communication links between leaders and followers,a double semi-Markov process is first introduced to describe the random switching of communication topologies in the leader-follower structure.In order to address challenges from the unknown nonidentical control directions and partial loss of effectiveness actuator faults,a completely independent parameter is introduced into the Nussbaum function to overcome the inherent obstacle of mutual cancellation and avoid the rapid growth rate.Considering only the state information of agents is transmitted among the agents,an adaptive distributed fault-tolerant consensus tracking control is proposed based on the double semi-Markovian switching topologies using the designed Nussbaum function.Furthermore,the stability of the closed-loop nonlinear multi-agent systems is analyzed using contradiction argument and Lyapunov theorem,from which the asymptotic consensus tracking in mean square sense can be obtained.A numerical simulation example is provided to verify the effectiveness of the proposed algorithm.展开更多
Kidney transplantation(KT)accounts for nearly three-fourths of organ transplants in India,with living donors contributing to 82%of cases.Induction immunosuppression is essential to optimize initial immunosuppression,r...Kidney transplantation(KT)accounts for nearly three-fourths of organ transplants in India,with living donors contributing to 82%of cases.Induction immunosuppression is essential to optimize initial immunosuppression,reduce acute rejections,and enable tailored use of maintenance agents.Rabbit anti-thymocyte globulin(rATG)and interleukin-2 receptor anatagonists(IL-2RA/IL-2RBs)are the most widely used induction therapies.However,data on induction practices across India are limited.To evaluate induction immunosuppression practices across KT centers in India and establish a consensus for different subsets of KT recipients.A nationwide online survey was conducted by the Indian Society of Organ Transplantation(ISOT)among its members(400 KT centers).Responses were analyzed to assess induction practices across diverse donor types,age groups,and immunological risk profiles.Heterogeneity in practices prompted consensus building using a modified Delphi process.Literature review and expert panel discussions(April 2024)were followed by structured voting,and 16 consensus statements were finalized.Of 400 centers approached,254 participated.rATG was the most commonly used induction therapy,followed by IL-2RBs;alemtuzumab was least used.Significant heterogeneity was observed in type,dose,and duration of induction therapy.Consensus recommendations were framed:rATG for high immunological risk recipients and deceased donor KTs;IL-2RB or low-dose rATG for low immunological risk;rituximab in ABOincompatible KTs;and tailoring based on age,diabetes,donor type,infection risk,and affordability.This first ISOT consensus provides 16 India-specific statements on induction therapy in KT.It emphasizes risk-stratified,evidenceinformed,and context-appropriate induction strategies,supporting standardization of care across the country.展开更多
基金Project supported by the National Natural Science Foundation of China (Grant Nos 10775060 and 10805033)the Doctoral Education Foundation of National Education Committeethe Natural Science Foundation of Gansu Province
文摘This paper studies consensus problems in weighted scale-free networks of asymmetrically coupled dynamical units, where the asymmetry in a given link is deter：mined by the relative degree of the involved nodes. It shows that the asymmetry of interactions has a great effect on the consensus. Especially, when the interactions are dominant from higher- to lower-degree nodes, both the convergence speed and the robustness to communication delay are enhanced.
文摘This paper is discussing several features of the impact of AI(artificial intelligence)on society and human behavior.It includes(1)the question if the AI can outperform the intelligent and creative capacity of humans,(2)if AI capabilities could show criticality and causal emergence,(3)the predictive capacity of AI,(4)the costs related to the learning process and operating AI,and(5)the loss of consensual reality and the rise of deepfakes in the AI era.AI involves considerable systemic risks impacting the social,economic,cultural,and environmental systems.Our will is kept in accordance with how the things around us are presented to us and that is precisely what AI is also doing.For us circumstances define a situation or a moment.For AI the circumstances are just statistical relationships.AI does not have its own values but incorporates the values on which it is trained.The imaginative gap between humans and AI is not just big;it’s of an essential nature.We want not just technology in the online world;we want a moral attitude.
文摘Background:Insufficient physical activity and prolonged sedentary behavior have emerged as major global public health challenges.Short bouts(≤10 min)of accumulated exercise(SBAE)throughout the day may be a promising strategy to mitigate the adverse effects of prolonged sitting and promote physical activity,ultimately promoting overall health.However,previous ambiguity in defining this concept has resulted in a fragmented and inconsistent evidence base,impeding practical applications,the development of guidelines,and policymaking.The purpose of this study is to establish an operational definition of SBAE by synthesizing systematic reviews and research trials alongside an expert consensus.Additionally,it seeks to evaluate acute and long-term efficacy and feasibility,providing evidence-based recommendations for practice and future research directions.Methods:A literature search was performed across PubMed and Web of Science,followed by systematic screening and summarization of eligible studies based on predefined inclusion criteria.Inclusion criteria encompassed various modes/types of SBAE(bouts lasting≤10 min,performed multiple times daily with≥30 min intervals);both aerobic and resistance exercise were considered.Relevant systematic reviews and research trials were included.Methodological quality,risk of bias,and evidence certainty were assessed.Expert consensus was obtained through a survey to evaluate recommendations and agreement levels on findings.Results:After analyzing 27 systematic reviews,135 research studies,and an expert consensus involving 48 researchers from 11 countries,SBAE is defined as any exercise mode of activity,regardless of intensity,that is accumulated in either continuous or intermittent bouts lasting≤10 min per session(including multiple intermittent sets)that are performed multiple times(≥2 sessions/day)per day,with intervals of≥30 min between bouts or otherwise sufficient time for recovery.When used to interrupt prolonged periods of sedentary time,SBAE mitigates the acute adverse effects of sedentary behavior on more than 10 clinical biomarkers of endocrine,cardiovascular,and brain health/function among adults of diverse ages and conditions.Moreover,SBAE was superior for improving acute glycemic control compared to a single continuous exercise session.As a long-term intervention(average of 11 weeks),SBAE can improve over 20 health outcomes,including peak oxygen uptake,resting blood pressure,and metabolic health.Additionally,SBAE might be more effective than continuous exercise for improving longer-term glycemic control and body composition.Long-term completion rates for SBAE interventions are generally high(95%),with low dropout rates(12%)and high adherence rates even without supervision(85%),and its safety has been preliminarily validated.Conclusion:An operational definition of SBAE is provided along with its classification and acute and long-term efficacy.Practical exercise prescription recommendations and evidence-based strategies for various populations and contexts are provided.Future research should focus on generating high-quality evidence for SBAE in 5 key areas:quantification and monitoring,population-specific responses,optimization of exercise prescriptions,intervention efficacy,and practical implementation.Additionally,addressing policy,environmental,and promotional barriers is crucial for transitioning from expert consensus to public consensus,and for facilitating the application of this strategy in real-world environments.
基金Supported by the Shenzhen Key Laboratory of Control Theory and Intelligent Systems (ZDSYS20220330161800001)the National Natural Science Foundation of China (62303207)the Guangdong Basic and Applied Basic Research Foundation (2024A1515010725)。
文摘This paper studies cooperative robust parallel operation of multiple actuators over an undirected communication graph.The plant is modeled as an uncertain linear system,and the actuators are linear and identical.Based on the internal model principle,a distributed dynamic output feedback control law is proposed to achieve both robust output regulation of the closed-loop system and plant input sharing among the actuators.A practical example of five motors cooperatively driving an uncertain shaft under an external load torque is presented to show the effectiveness of the proposed control law.
基金supported in part by Beijing Natural Science Foundation(L244010,251038)National Natural Science Foundation of China(92467203,62372050,62502041)+2 种基金CCF-Huawei Populus Grove Fund(TC202418)Fellowship of China National Postdoctoral Program for Innovative Talents(BX20240045)China Postdoctoral Science Foundation General Program(2025M773481).
文摘Practical byzantine fault tolerance(PBFT)can reduce energy consumption and achieve high throughput compared with the traditional PoW algorithm,which is more suitable for a strongly consistent consortium blockchain.However,due to the frequent communication among nodes,PBFT cannot realize scalability in large-scale networks.Existing PBFTbased algorithms still ignore performance and security.Therefore,we propose a secure and efficient practical byzantine fault tolerance based on double layers and multi copies(DM-PBFT).We design a reputation evaluation and node scheduling method for DMPBFT.And then we propose an adaptive node scheduling strategy based on the derived threshold values after analyzing the system communication complexity and security.Combining the above research,a node dynamic adjustment mechanism is proposed to freeze or adjust the node operation status according to the system environment.Simulation experiments show that the proposed mechanism can improve efficiency and increase the system’s throughput.
基金supported by the National Natural Science Foundation of China(Grant Nos.82230057 and 82272859)the National Key R&D Program of China(Grant No.2022YFC2505101).
文摘Introduction,Breast cancer is the most common cancer type in adolescents and young adults<40 years of age,accounting for 30%of cancers in this age group1.Breast cancer in the young presents significant challenges for patients and society,including more aggressive tumor biology,poor prognosis,genetic susceptibility,fertility preservation,and complex psychosocial issues.Moreover,because of the markedly younger median age of breast cancer,the proportion of young breast cancer patients in China is significantly higher than Western countries2.The first Young Breast Cancer in China(YBCC)consensus meeting was held in Guangzhou,China in December 2021 to address exclusive challenges and requirements facing young patients with breast cancer.Chinese medical experts from multiple specialties had an extensive discussion and formulated a consensus over several hot topics in young patients with breast cancer.The“Expert Consensus on the Diagnosis and Treatment of Young Breast Cancer in China(2022 edition)”published in the Chinese Medical Journal has garnered significant attention3,highlighting enormous interest in the YBCC consensus in the medical community and public.
基金Supported by the National Natural Science Foundation of China:to Explore the Intergenerational Effects of Bu-Shen-Tian-Jing Therapeutic Principle on the Offspring of Hyper-Androgenic Polycystic Ovary Syndrome Based on Regulating Rhythmic Iron Death in the Ovarian Granulosa Cells Mediated by Fos Proto-OncogeneRetinoic Acid Receptor-Related Orphan Receptor A-Solute Carrier Family 7 Member 11(No.82274564)the National Natural Science Foundation of China:the Underlying Mechanism of Bu-Shen-Jian-Pi Therapeutic Principle in Regulating Ovarian Granulosa Cells Autophagy Mediated by Short-chain Fatty Acids-forkhead Box O1 Pathway and its Effects on the Development of Offspring of Polycystic Ovary Syndrome(No.82074476)the Open Fund Project of Zhejiang Key Laboratory of Maternal and Infant Health,Women’s Hospital,School of Medicine,Zhejiang University:Mediating Role of Kidney Deficiency in the Relationship between Fear of Childbirth and Delivery Modes:an Exploratory Investigation Grounded in the Classic Traditional Chinese Medicine Theories of“Fear Injuring Kidney”and“Kidney Storing Essence”(No.ZDFY2024-MI-2)。
文摘OBJECTIVE:To develop an expert consensus on kidney deficiency syndrome(KDS)in pregnant women and construct a validated self-reported KDS Patient-Reported Measures Pregnancy Scale(KDS-PRMs-Pregnancy Scale)for early identification and management.METHODS:The study was conducted in three phases.First,a comprehensive review of Traditional Chinese Medicine(TCM)literature and diagnostic criteria was performed,generating initial KDS symptoms for pregnancy.Second,a two-round Delphi survey,involving 21 experts from TCM,obstetrics,and gynaecology,assessed importance,relevance,and appropriateness of the items.Third,a psychometric evaluation was conducted,including exploratory factor analysis and internal consistency assessment.RESULTS:In the first Delphi round,19 items were flagged for revision or removal due to expert variability,with 12 items deemed irrelevant.In the second round,consensus was reached,resulting in a 25-item scale.After psychometric evaluation,seven items were removed due to poor factor loadings,leaving an 18-item scale.Three factors—physiological discomfort,fatigue&weakness,and excretion abnormalities—accounted for 78.4%of the variance.The final scale demonstrated excellent internal consistency(Cronbach's alpha=0.959).CONCLUSION:The validated 18-item KDS-PRMsPregnancy Scale is a reliable tool for assessing KDS in pregnant women.Future research should focus on validation in diverse populations and exploring its predictive validity for pregnancy outcomes.
基金supported by the National Natural Science Foundation of China(Grant No.61762071,Grant No.61163025).
文摘The Internet of Vehicles(IoV)operates in highly dynamic and open network environments and faces serious challenges in secure and real-time authentication and consensus mechanisms.Existing methods often suffer from complex certificate management,inefficient consensus protocols,and poor resilience in high-frequency communication,resulting in high latency,poor scalability,and unstable network performance.To address these issues,this paper proposes a secure and efficient distributed authentication scheme for IoV with reputation-driven consensus and SM9.First,this paper proposes a decentralized authentication architecture that utilizes the certificate-free feature of SM9,enabling lightweight authentication and key negotiation,thereby reducing the complexity of key management.To ensure the traceability and global consistency of authentication data,this scheme also integrates blockchain technology,applying its inherent invariance.Then,this paper introduces a reputation-driven dynamic node grouping mechanism that transparently evaluates and groups’node behavior using smart contracts to enhance network stability.Furthermore,a new RBSFT(Reputation-Based SM9 Friendly-Tolerant)consensus mechanism is proposed for the first time to enhance consensus efficiency by optimizing the PBFT algorithm.RBSFT aims to write authentication information into the blockchain ledger to achieve multi-level optimization of trust management and decision-making efficiency,thereby significantly improving the responsiveness and robustness in high-frequency IoV scenarios.Experimental results show that it excels in authentication,communication efficiency,and computational cost control,making it a feasible solution for achieving IoV security and real-time performance.
基金supported in part by the Natural Science Foundation of China(62273227,92367203)the Open Research Project of the State Key Laboratory of Industrial Control Technology,China(ICT2024B68)。
文摘This article studies the consensus problem with directed graphs for general linear multi-agent systems.New distributed state-feedback protocols with dynamic event-triggered(DET)mechanisms are proposed for directed graphs that are strongly connected and weight-balanced,general strongly connected,and have spanning trees,respectively.It is proven that strictly positive minimum inter-event times(MIETs)are ensured using the designed DET mechanisms.Several numerical examples are presented to illustrate the effectiveness of the theoretical results.Compared with existing results,our results have the following merits:1)DET mechanisms are designed to determine the sampling instants,which can reduce the communication frequency between agents compared with static mechanisms;2)We focus on the consensus problem on directed graphs,which is more general than existing related results on undirected graphs;3)The existence of positive MIETs is shown to be guaranteed by the designed DET sampling strategies while existing related results can only exclude Zeno behavior.
基金supported by the National Science Fund for Distinguished Young Scholars(62025602)the National Natural Science Foundation of China(62373302,U22B2036)+2 种基金the National Key Research and Development Program of China(2024YFF0509600)the Fundamental Research Funds for the Central Universities(G2024WD0151,D5000240309)the Tencent Foundation and XPLORER PRIZE。
文摘In this paper,an analysis-definition-processing(ADP)framework is proposed to search positive-incentive noise in continuous action iterated dilemma(CAID).We analyze the influence of communication noise on the cooperative behavior of players in the system and introduce the concept of positive-incentive noise in CAID.We design a global cost function to ensure convergence of the system can be achieved and strive to improve the final level of cooperation.An optimal CAID control method is proposed to derive the deterministic optimal learning rate in analytical form,avoiding the variability and uncertainty brought about by neural network fitting or parameter adjustment.On this basis,the convergence of the dynamic model is further analyzed by using the Lyapunov function instead of the Jacobian matrix.Additionally,an adaptive filtering mechanism is designed to dynamically ensure that only positive-incentive noise affects the system,effectively reducing the impact of negative noise and enhancing system stability.The framework is validated through simulations involving triple classical game models,including the hawk-dove game,the stag hunt game,the chicken game on networks,and a straightforward illustrative example.
文摘Artificial intelligence(AI)is increasingly recognized as a transformative force in the field of solid organ transplantation.From enhancing donor-recipient matching to predicting clinical risks and tailoring immunosuppressive therapy,AI has the potential to improve both operational efficiency and patient outcomes.Despite these advancements,the perspectives of transplant professionals-those at the forefront of critical decision-making-remain insufficiently explored.To address this gap,this study utilizes a multi-round electronic Delphi approach to gather and analyses insights from global experts involved in organ transplantation.Participants are invited to complete structured surveys capturing demographic data,professional roles,institutional practices,and prior exposure to AI technologies.The survey also explores perceptions of AI’s potential benefits.Quantitative responses are analyzed using descriptive statistics,while open-ended qualitative responses undergo thematic analysis.Preliminary findings indicate a generally positive outlook on AI’s role in enhancing transplantation processes,particularly in areas such as donor matching and post-operative care.These mixed views reflect both optimism and caution among professionals tasked with integrating new technologies into high-stakes clinical workflows.By capturing a wide range of expert opinions,the findings will inform future policy development,regulatory considerations,and institutional readiness frameworks for the integration of AI into organ transplantation.
基金supported by the following projects:Fund for technical areas of infrastructure strengthening plan projects under Grant 2023-JCJQ-JJ-0772.
文摘Aiming at the challenges of low throughput,excessive consensus latency and high communication complexity in the Practical Byzantine Fault Tolerance(PBFT)algorithm in blockchain networks,its application in identity verification for distributed networking of a drone cluster is limited.Therefore,a lightweight blockchainbased identity authentication model for UAV swarms is designed,and a Credit-score and Grouping-mechanism Practical Byzantine Fault Tolerance(CG-PBFT)algorithm is proposed.CG-PBFT introduces a reputation score evaluation mechanism,classifies the reputation levels of nodes in the network,and optimizes the consensus process based on grouping consensus and BLS aggregate signature technology.Experimental results demonstrate that under identical experimental conditions,compared with the PBFT algorithm,CG-PBFT achieves a 250%increase in average throughput,a 70%reduction in average latency,and simultaneous enhancement in security,thus making it more suitable for UAV swarm networks.
文摘Colorectal cancer(CRC)is one of the most molecularly heterogeneous malignancies,with complexity that extends far beyond traditional histopathological classifications.The consensus molecular subtypes(CMS)established in 2015 brought a marked advancement in the taxonomy of CRC,consolidating six classification systems into four novel subtypes,which focus on vital gene expression patterns and clinical and prognostic outcomes.However,nearly a decade of clinical experience with CMS classification has revealed fundamental limitations that underscore the inadequacy of any single classification system for capturing the full spectrum of CRC biology.The inherent challenges of the current paradigm are multifaceted.In the CMS classification,mixed phenotypes that remain unclassifiable constitute 13%of CRC cases.This reflects the remarkable heterogeneity that CRC shows.The tumor budding regions reflect the molecular shift due to CMS 2 to CMS 4 switching,causing further heterogeneity.Moreover,the reliance on bulk RNA sequencing fails to capture the spatial organization of molecular signatures within tumors and the critical contributions of the tumor microenvironment.Recent technological advances in spatial transcriptomics,singlecell RNA sequencing,and multi-omic integration have revealed the limitations of transcriptome-only classifications.The emergence of CRC intrinsic subtypes that attempt to remove microenvironmental contributions,pathway-derived subtypes,and stem cell-based classifications demonstrates the field’s recognition that multiple complementary classification systems are necessary.These newer molecular subtypes are not discrete categories but biological continua,thus highlighting that the vast molecular landscape is a tapestry of interlinked features,not rigid subtypes.Multiple technical hurdles cause difficulty in implementing the clinical translation of these newer molecular subtypes,including gene signature complexity,platform-dependent variations,and the difficulty of getting and preserving fresh frozen tissue.CMS 4 shows a poor prognostic outcome among the CMS subtypes,while CMS 1 is associated with poor survival in metastatic cases.However,the predictive value for definitive therapy remains subdued.Looking forward,the integration of artificial intelligence,liquid biopsy approaches,and real-time molecular monitoring promises to enable dynamic,multi-dimensional tumor characterization.The temporal and spatial complexity can only be captured by complementary molecular taxonomies rather than a single,unified system of CRC classification.Such an approach recognizes that different clinical questions–prognosis,treatment selection,resistance prediction–may require different molecular lenses,each optimized for specific clinical applications.This editorial advocates for a revolutionary change from pursuing a single“best”classification system toward a diverse approach that welcomes the molecular mosaic of CRC.Only through such comprehensive molecular characterization can we hope to achieve the promise of precision oncology for the diverse spectrum of patients with CRC.
基金supported by National Key Research and Development Program of China(No.2023YFC2507406)National Natural Science Foundation of China(No.82300646)+6 种基金Beijing Natural Science Foundation(No.7232334)Beijing Municipal Administration of Hospitals Incubating Program(No.PX2024002,PX2020001)Capital Fund for Health Development Scientific Research(No.2024-2-2028)Beijing Municipal Science&Technology Commission AI+Health Collaborative Innovation Cultivation Project(No.Z241100007724004)Research Ward Excellence Program of Beijing Municipal Health Commission(No.BRWEP2024W162020100,BRWEP2024W162020112,BRWEP2024W162020114)Excellent Plan for Capital Medicine Scientific and Technological Innovation Achievement Transformation Promotion Plan(No.YC202401QX0824)Clinical Scientific Research Fund of Beijing Integrated Medical Association[No.ZHKY-2025-1869(B012)]。
文摘With the advancement of surgical techniques and enhanced management of early gastric cancer(EGC),minimally invasive function-preserving surgical approaches have emerged as a common goal for patients and clinicians.Laparoscopic-endoscopic cooperative surgery combined with sentinel lymph node navigation surgery(LECSSNNS)has drawn increasing interest because of its dual benefits of minimal invasiveness and organ function preservation.However,robust evidence-based support for guiding clinical implementation remains limited.To address this gap,we systematically evaluated available studies on the clinical application of LECS-SNNS in EGC and integrated expert insights to formulate 20 recommendations.These included preoperative assessment,surgical techniques,intraoperative endoscopic procedures,pathological evaluation,postoperative care,and follow-up.This consensus aimed to provide comprehensive guidance for the standardized application of LECS-SNNS,thereby advancing precise,minimally invasive,and function-preserving treatment for EGC.
文摘Objective:To characterize placental morphologic features in Moroccan women with adverse outcomes,across different clinical contexts,based on the Amsterdam consensus classification.Methods:A prospective analysis was conducted on placentas with umbilical cords collected fresh between March 1,2024 and July 15,2024 from women with adverse pregnancy outcomes.Clinical data(age,parity,gravidity,complications)were retrieved.Macroscopic parameters(weight,dimensions,cord insertion,membranes,lesions)were assessed,followed by systematic sampling.Tissue was processed by standard histology(formalin fixation,paraffin embedding,hematoxylin and eosin staining),and lesions were classified per Amsterdam criteria.Results:16 placentas from patients with adverse pregnancy outcomes were included.The median maternal age was 30 years.Adverse conditions included placental abruption(50%),intrauterine growth restriction(IUGR,38%),intrauterine fetal death(IUFD,31%),pre-eclampsia/eclampsia(19%),premature rupture of membranes(13%),and oligohydramnios(13%).Several placentas were associated with more than one adverse condition.Histopathology revealed maternal vascular malperfusion lesions in 94%,particularly in pre-eclampsia,IUGR,and IUFD.Fetal vascular malperfusion was found in 88%,mainly in IUGR and IUFD.Inflammatory lesions,dominated by acute maternal and fetal responses stage 3(necrotizing chorioamnionitis and funisitis),were primarily linked to IUFD.Conclusions:Placental examination enhances understanding of the pathophysiology underlying adverse pregnancy outcomes,supports diagnostic confirmation,and guides preventive strategies for recurrence.This study highlights the prevalence of maternal vascular malperfusion in Moroccan women and emphasizes the importance of systematic placental histopathology in obstetric care.
基金supported by the National Natural Science Foundation of China(62463007,62463005)the Natural Science Foundation of Hainan Province(625RC710,625MS047)+1 种基金the System Control and Information Processing Education Ministry Key Laboratory Open Funding,China(Scip20240119)the Science Research Funding of Hainan University,China(KYQD(ZR)22180,KYQD(ZR)23180).
文摘This paper focuses on the leader-following positive consensus problems of heterogeneous switched multi-agent systems.First,a state-feedback controller with dynamic compensation is introduced to achieve positive consensus under average dwell time switching.Then sufficient conditions are derived to guarantee the positive consensus.The gain matrices of the control protocol are described using a matrix decomposition approach and the corresponding computational complexity is reduced by resorting to linear programming and co-positive Lyapunov functions.Finally,two numerical examples are provided to illustrate the results obtained.
文摘Standards are the common language that consolidates global consensus and builds the most solid foundation for international partnerships.They are the cornerstone for global sustainable and high-quality development.Young students,with their active and vibrant minds,represent the future and hope of standardization.
基金supported by the National Natural Science Foundation of China(62333011,62020106003)the Natural Science Foundation of Jiangsu Province of China(BK20222012)+1 种基金the Fundamental Research Funds for the Central Universities(NE2024005)the Postgraduate Research&Practice Innovation Program of Jiangsu Province(KYCX24_0594)。
文摘This paper is concerned with adaptive consensus tracking control of nonlinear multi-agent systems with actuator faults and unknown nonidentical control directions under double semi-Markovian switching topologies.Considering the complex working environment and the stability differences in communication links between leaders and followers,a double semi-Markov process is first introduced to describe the random switching of communication topologies in the leader-follower structure.In order to address challenges from the unknown nonidentical control directions and partial loss of effectiveness actuator faults,a completely independent parameter is introduced into the Nussbaum function to overcome the inherent obstacle of mutual cancellation and avoid the rapid growth rate.Considering only the state information of agents is transmitted among the agents,an adaptive distributed fault-tolerant consensus tracking control is proposed based on the double semi-Markovian switching topologies using the designed Nussbaum function.Furthermore,the stability of the closed-loop nonlinear multi-agent systems is analyzed using contradiction argument and Lyapunov theorem,from which the asymptotic consensus tracking in mean square sense can be obtained.A numerical simulation example is provided to verify the effectiveness of the proposed algorithm.
文摘Kidney transplantation(KT)accounts for nearly three-fourths of organ transplants in India,with living donors contributing to 82%of cases.Induction immunosuppression is essential to optimize initial immunosuppression,reduce acute rejections,and enable tailored use of maintenance agents.Rabbit anti-thymocyte globulin(rATG)and interleukin-2 receptor anatagonists(IL-2RA/IL-2RBs)are the most widely used induction therapies.However,data on induction practices across India are limited.To evaluate induction immunosuppression practices across KT centers in India and establish a consensus for different subsets of KT recipients.A nationwide online survey was conducted by the Indian Society of Organ Transplantation(ISOT)among its members(400 KT centers).Responses were analyzed to assess induction practices across diverse donor types,age groups,and immunological risk profiles.Heterogeneity in practices prompted consensus building using a modified Delphi process.Literature review and expert panel discussions(April 2024)were followed by structured voting,and 16 consensus statements were finalized.Of 400 centers approached,254 participated.rATG was the most commonly used induction therapy,followed by IL-2RBs;alemtuzumab was least used.Significant heterogeneity was observed in type,dose,and duration of induction therapy.Consensus recommendations were framed:rATG for high immunological risk recipients and deceased donor KTs;IL-2RB or low-dose rATG for low immunological risk;rituximab in ABOincompatible KTs;and tailoring based on age,diabetes,donor type,infection risk,and affordability.This first ISOT consensus provides 16 India-specific statements on induction therapy in KT.It emphasizes risk-stratified,evidenceinformed,and context-appropriate induction strategies,supporting standardization of care across the country.
