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
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
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
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
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
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
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
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
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
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
Dear Editor,This letter studies output consensus problem of heterogeneous linear multiagent systems over directed graphs. A novel adaptive dynamic event-triggered controller is presented based only on the feedback com...Dear Editor,This letter studies output consensus problem of heterogeneous linear multiagent systems over directed graphs. A novel adaptive dynamic event-triggered controller is presented based only on the feedback combination of the agent's own state and neighbors' output,which can achieve exponential output consensus through intermittent communication. The controller is obtained by solving two linear matrix equations, and Zeno behavior is excluded.展开更多
Dear Editor,This letter studies the bipartite consensus tracking problem for heterogeneous multi-agent systems with actuator faults and a leader's unknown time-varying control input. To handle such a problem, the ...Dear Editor,This letter studies the bipartite consensus tracking problem for heterogeneous multi-agent systems with actuator faults and a leader's unknown time-varying control input. To handle such a problem, the continuous fault-tolerant control protocol via observer design is developed. In addition, it is strictly proved that the multi-agent system driven by the designed controllers can still achieve bipartite consensus tracking after faults occur.展开更多
Dear Editor,Aiming at the consensus tracking problem of a class of unknown heterogeneous nonlinear multiagent systems(MASs)with input constraints,a novel data-driven iterative learning consensus control(ILCC)protocol ...Dear Editor,Aiming at the consensus tracking problem of a class of unknown heterogeneous nonlinear multiagent systems(MASs)with input constraints,a novel data-driven iterative learning consensus control(ILCC)protocol based on zeroing neural networks(ZNNs)is proposed.First,a dynamic linearization data model(DLDM)is acquired via dynamic linearization technology(DLT).展开更多
Dear Editor,This letter introduces a novel algorithm for privacy preservation designed to safeguard both the initial and real-time states of agents under complete distributed average consensus.It addresses a gap in ex...Dear Editor,This letter introduces a novel algorithm for privacy preservation designed to safeguard both the initial and real-time states of agents under complete distributed average consensus.It addresses a gap in existing privacy preservation approaches that predominantly focus on protecting the initial state,with limited consideration for privacy implications throughout the entire process.The algorithm ensures the privacy of both the initial and real-time states by introducing perturbations to the consensus process,allowing agents to freely define these perturbations themselves.Additionally,the perturbations defined by agents arbitrarily do not compromise the accuracy of the consensus result.One of the main results derived is that no agent has access to the real-time state of another agent.展开更多
Early correction of childhood malocclusion is timely managing morphological,structural,and functional abnormalities at different dentomaxillofacial developmental stages.The selection of appropriate imaging examination...Early correction of childhood malocclusion is timely managing morphological,structural,and functional abnormalities at different dentomaxillofacial developmental stages.The selection of appropriate imaging examination and comprehensive radiological diagnosis and analysis play an important role in early correction of childhood malocclusion.This expert consensus is a collaborative effort by multidisciplinary experts in dentistry across the nation based on the current clinical evidence,aiming to provide general guidance on appropriate imaging examination selection,comprehensive and accurate imaging assessment for early orthodontic treatment patients.展开更多
The research and development of new traditional Chinese medicine(TCM)drugs have progressively established a novel system founded on the integration of TCM theory,human experience,and clinical trials(termed the“Three ...The research and development of new traditional Chinese medicine(TCM)drugs have progressively established a novel system founded on the integration of TCM theory,human experience,and clinical trials(termed the“Three Combinations”).However,considering TCM's distinctive features of“syndrome differentiation and treatment”and“multicomponent formulations and complex mechanisms”,current TCM drug development faces challenges such as insufficient understanding of the material basis and the overall mechanism of action and an incomplete evidence chain system.Moreover,significant obstacles persist in gathering human experience data,evaluating clinical efficacy,and controlling the quality of active ingredients,which impede the innovation process in TCM drug development.Network pharmacology,centered on the“network targets”theory,transcends the limitations of the conventional“single target”reductionist research model.It emphasizes the comprehensive effects of disease or syndrome biological networks as targets to elucidate the overall regulatory mechanism of TCM prescriptions.This approach aligns with the holistic perspective of TCM,offering a novel method consistent with TCM's holistic view for investigating the complex mechanisms of TCM and developing new TCM drugs.It is internationally recognized as a“next-generation drug research model”.To advance the research of new tools,methods,and standards for TCM evaluation and to overcome fundamental,critical,and cutting-edge technical challenges in TCM regulation,this consensus aims to explore the characteristics,progress,challenges,applicable pathways,and specific applications of network pharmacology as a new theory,method,and tool in TCM drug development.The goal is to enhance the quality of TCM drug research and development and accelerate the efficiency of developing new TCM products.展开更多
Patients with periodontal disease often require combined periodontal-orthodontic interventions to restore periodontal health,function,and aesthetics,ensuring both patient satisfaction and long-term stability.Managing ...Patients with periodontal disease often require combined periodontal-orthodontic interventions to restore periodontal health,function,and aesthetics,ensuring both patient satisfaction and long-term stability.Managing these patients involving orthodontic tooth movement can be particularly challenging due to compromised periodontal soft and hard tissues,especially in severe cases.Therefore,close collaboration between orthodontists and periodontists for comprehensive diagnosis and sequential treatment,along with diligent patient compliance throughout the entire process,is crucial for achieving favorable treatment outcomes.Moreover,long-term orthodontic retention and periodontal follow-up are essential to sustain treatment success.This expert consensus,informed by the latest clinical research and practical experience,addresses clinical considerations for orthodontic treatment of periodontal patients,delineating indications,objectives,procedures,and principles with the aim of providing clear and practical guidance for clinical practitioners.展开更多
The Internet of Things(IoT)has gained substantial attention in both academic research and real-world applications.The proliferation of interconnected devices across various domains promises to deliver intelligent and ...The Internet of Things(IoT)has gained substantial attention in both academic research and real-world applications.The proliferation of interconnected devices across various domains promises to deliver intelligent and advanced services.However,this rapid expansion also heightens the vulnerability of the IoT ecosystem to security threats.Consequently,innovative solutions capable of effectively mitigating risks while accommodating the unique constraints of IoT environments are urgently needed.Recently,the convergence of Blockchain technology and IoT has introduced a decentralized and robust framework for securing data and interactions,commonly referred to as the Internet of Blockchained Things(IoBT).Extensive research efforts have been devoted to adapting Blockchain technology to meet the specific requirements of IoT deployments.Within this context,consensus algorithms play a critical role in assessing the feasibility of integrating Blockchain into IoT ecosystems.The adoption of efficient and lightweight consensus mechanisms for block validation has become increasingly essential.This paper presents a comprehensive examination of lightweight,constraint-aware consensus algorithms tailored for IoBT.The study categorizes these consensus mechanisms based on their core operations,the security of the block validation process,the incorporation of AI techniques,and the specific applications they are designed to support.展开更多
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 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 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 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.
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.
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.
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.
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.
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.
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.
基金supported by the National Science and Technology Innovation 2030-Major Program(2022ZD 0115403)the National Natural Science Foundation of China(61991414)+1 种基金Chongqing Natural Science Foundation(CSTB2023NSCQJQX0018)Beijing Natural Science Foundation(L221005)
文摘Dear Editor,This letter studies output consensus problem of heterogeneous linear multiagent systems over directed graphs. A novel adaptive dynamic event-triggered controller is presented based only on the feedback combination of the agent's own state and neighbors' output,which can achieve exponential output consensus through intermittent communication. The controller is obtained by solving two linear matrix equations, and Zeno behavior is excluded.
基金supported by the National Natural Science Foundation of China(62325304,U22B2046,62073079,62376029)the Jiangsu Provincial Scientific Research Center of Applied Mathematics(BK20233002)the China Postdoctoral Science Foundation(2023M730255,2024T171123)
文摘Dear Editor,This letter studies the bipartite consensus tracking problem for heterogeneous multi-agent systems with actuator faults and a leader's unknown time-varying control input. To handle such a problem, the continuous fault-tolerant control protocol via observer design is developed. In addition, it is strictly proved that the multi-agent system driven by the designed controllers can still achieve bipartite consensus tracking after faults occur.
基金supported by the National Nature Science Foundation of China(U21A20166)the Science and Technology Development Foundation of Jilin Province(20230508095RC)+2 种基金the Major Science and Technology Projects of Jilin Province and Changchun City(20220301033GX)the Development and Reform Commission Foundation of Jilin Province(2023C034-3)the Interdisciplinary Integration and Innovation Project of JLU(JLUXKJC2020202).
文摘Dear Editor,Aiming at the consensus tracking problem of a class of unknown heterogeneous nonlinear multiagent systems(MASs)with input constraints,a novel data-driven iterative learning consensus control(ILCC)protocol based on zeroing neural networks(ZNNs)is proposed.First,a dynamic linearization data model(DLDM)is acquired via dynamic linearization technology(DLT).
基金supported in part by the National Natural Science Foundation of China(62276036)the Major Project of Scientific and Technological Research Program of Chongqing Municipal Education Commission(KJZD-M202100602)Innovation and Development Joint Fund Project of Chongqing Natural Science Foundation(CSTB2024NSCQ-LZX0118).
文摘Dear Editor,This letter introduces a novel algorithm for privacy preservation designed to safeguard both the initial and real-time states of agents under complete distributed average consensus.It addresses a gap in existing privacy preservation approaches that predominantly focus on protecting the initial state,with limited consideration for privacy implications throughout the entire process.The algorithm ensures the privacy of both the initial and real-time states by introducing perturbations to the consensus process,allowing agents to freely define these perturbations themselves.Additionally,the perturbations defined by agents arbitrarily do not compromise the accuracy of the consensus result.One of the main results derived is that no agent has access to the real-time state of another agent.
基金supports by the National Natural Science Foundation of China(Nos.82201135)"2015"Cultivation Program for Reserve Talents for Academic Leaders of Nanjing Stomatological School,Medical School of Nanjing University(No.0223A204).
文摘Early correction of childhood malocclusion is timely managing morphological,structural,and functional abnormalities at different dentomaxillofacial developmental stages.The selection of appropriate imaging examination and comprehensive radiological diagnosis and analysis play an important role in early correction of childhood malocclusion.This expert consensus is a collaborative effort by multidisciplinary experts in dentistry across the nation based on the current clinical evidence,aiming to provide general guidance on appropriate imaging examination selection,comprehensive and accurate imaging assessment for early orthodontic treatment patients.
基金supported by the National Medical Products Administration Commissioned Research Project (No.20211440216)the National Administration of Traditional Chinese Medicine Science and Technology Project (No.GZY-KJS-2024-03)+3 种基金the State Key Laboratory of Drug Regulatory Science Project (No.2023SKLDRS0104)the Basic Research Program Natural Science Fund-Frontier Leading Technology Basic Research Special Project of Jiangsu Province (No.BK20232014)the Programs Foundation for Leading Talents in National Administration of Traditional Chinese Medicine of China“Qihuang scholars”Projectthe Tianjin Administration for Market Regulation Science and Technology Key Projects (No.2022-W35)。
文摘The research and development of new traditional Chinese medicine(TCM)drugs have progressively established a novel system founded on the integration of TCM theory,human experience,and clinical trials(termed the“Three Combinations”).However,considering TCM's distinctive features of“syndrome differentiation and treatment”and“multicomponent formulations and complex mechanisms”,current TCM drug development faces challenges such as insufficient understanding of the material basis and the overall mechanism of action and an incomplete evidence chain system.Moreover,significant obstacles persist in gathering human experience data,evaluating clinical efficacy,and controlling the quality of active ingredients,which impede the innovation process in TCM drug development.Network pharmacology,centered on the“network targets”theory,transcends the limitations of the conventional“single target”reductionist research model.It emphasizes the comprehensive effects of disease or syndrome biological networks as targets to elucidate the overall regulatory mechanism of TCM prescriptions.This approach aligns with the holistic perspective of TCM,offering a novel method consistent with TCM's holistic view for investigating the complex mechanisms of TCM and developing new TCM drugs.It is internationally recognized as a“next-generation drug research model”.To advance the research of new tools,methods,and standards for TCM evaluation and to overcome fundamental,critical,and cutting-edge technical challenges in TCM regulation,this consensus aims to explore the characteristics,progress,challenges,applicable pathways,and specific applications of network pharmacology as a new theory,method,and tool in TCM drug development.The goal is to enhance the quality of TCM drug research and development and accelerate the efficiency of developing new TCM products.
基金supported by the National Key R&D Program of China(2022YFC2504200)Chongqing Young and Middle-aged Medical Excellence Team ProjectJiangsu Province Key Research and Development Program(BE2022670)。
文摘Patients with periodontal disease often require combined periodontal-orthodontic interventions to restore periodontal health,function,and aesthetics,ensuring both patient satisfaction and long-term stability.Managing these patients involving orthodontic tooth movement can be particularly challenging due to compromised periodontal soft and hard tissues,especially in severe cases.Therefore,close collaboration between orthodontists and periodontists for comprehensive diagnosis and sequential treatment,along with diligent patient compliance throughout the entire process,is crucial for achieving favorable treatment outcomes.Moreover,long-term orthodontic retention and periodontal follow-up are essential to sustain treatment success.This expert consensus,informed by the latest clinical research and practical experience,addresses clinical considerations for orthodontic treatment of periodontal patients,delineating indications,objectives,procedures,and principles with the aim of providing clear and practical guidance for clinical practitioners.
文摘The Internet of Things(IoT)has gained substantial attention in both academic research and real-world applications.The proliferation of interconnected devices across various domains promises to deliver intelligent and advanced services.However,this rapid expansion also heightens the vulnerability of the IoT ecosystem to security threats.Consequently,innovative solutions capable of effectively mitigating risks while accommodating the unique constraints of IoT environments are urgently needed.Recently,the convergence of Blockchain technology and IoT has introduced a decentralized and robust framework for securing data and interactions,commonly referred to as the Internet of Blockchained Things(IoBT).Extensive research efforts have been devoted to adapting Blockchain technology to meet the specific requirements of IoT deployments.Within this context,consensus algorithms play a critical role in assessing the feasibility of integrating Blockchain into IoT ecosystems.The adoption of efficient and lightweight consensus mechanisms for block validation has become increasingly essential.This paper presents a comprehensive examination of lightweight,constraint-aware consensus algorithms tailored for IoBT.The study categorizes these consensus mechanisms based on their core operations,the security of the block validation process,the incorporation of AI techniques,and the specific applications they are designed to support.
