BACKGROUND Lower respiratory tract viral infections are a major cause of mortality in children under five years old,leading to hundreds of thousands of fatalities annually.The highest risk is observed in infants under...BACKGROUND Lower respiratory tract viral infections are a major cause of mortality in children under five years old,leading to hundreds of thousands of fatalities annually.The highest risk is observed in infants under one year old,underscoring the critical need for safe and effective antiviral protocols.CASE SUMMARY A 9-month-old infant suffered from severe bronchiolitis as manifested by high fever(39°C),decreased appetite,tachypnea,wheezing,and oxygen desaturation(SpO284%on room air)and was effectively managed at home using Kelleni’s protocol,which includes age-adjusted dose of nitazoxanide(60 mg twice daily),ibuprofen and azithromycin,complemented by selective antihistaminic,antitussive and mucolytic immunomodulatory treatment.The fever resolved,wheezing became more prominent but without respiratory distress,and oxygen saturation gradually increased to 92%by day 10.Nitazoxanide exerts broad antiviral and immunomodulatory effects by enhancing host interferon responses and inhibiting viral replication,potentially attenuating airway inflammation and accelerating resolution of bronchiolitis.The nitazoxanide dose(60 mg twice daily for five days)was carefully adjusted based on the developmental expression and activity of the uridine diphosphate-glucuronosyltransferase 1A1 enzyme,responsible for its metabolism,ensuring safe age-appropriate administration.The infant’s clinical status steadily improved,and by day 14 the infant achieved full recovery with normalization of oxygen saturation(96%on room air).No adverse events occurred,and follow-up at day 28 confirmed sustained recovery.CONCLUSION To the best of my knowledge,this report presents,for the first time globally,a potential of nitazoxanide within Kelleni’s protocol to early manage infants younger than one year suffering from severe lower respiratory tract viral infection at home.Selective antitussive treatment,using agents such as low dose benproperine,was employed to mitigate troublesome cough and improve patient comfort without compromising respiratory function.Additionally,alpha amylase was used to facilitate pulmonary secretion clearance.The protocol aims to reduce morbidity and mortality from viral lower respiratory tract infections in this vulnerable population.展开更多
Rwanda secured access to one of the world’s most lucrative agricultural markets this month when it finalised a trade protocol allowing fresh avocado exports to China,a deal that could fundamentally alter the trajecto...Rwanda secured access to one of the world’s most lucrative agricultural markets this month when it finalised a trade protocol allowing fresh avocado exports to China,a deal that could fundamentally alter the trajectory of the country’s trade.展开更多
Considering that weak channel collision detection ability, long propagation delay and heavy load in LEO satellite communications, a valid adaptive APRMA MAC protocol was proposed. Different access probability function...Considering that weak channel collision detection ability, long propagation delay and heavy load in LEO satellite communications, a valid adaptive APRMA MAC protocol was proposed. Different access probability functions for different services were obtained and appropriate access probabilities for voice and data users were updated slot by slot based on the estimation of the voice traffic and the channel status. In the proposed MAC protocol limited wireless resource is allocated reasonably by multiple users and high capacity was achieved. Three performance parameters: voice packet loss probability, average delay of data packets and throughput of data packets were considered in simulation. Finally simulation results demonstrated that the performance of system was improved by the APRMA compared with the conventional PRMA, with an acceptable trade-off between QoS of voice and delay of data.展开更多
It is an effective method to broadcast the augmentation information of satellite navigation system using GEO technology.However,it becomes difficult to receive GEO signal in some special situation,for example in citie...It is an effective method to broadcast the augmentation information of satellite navigation system using GEO technology.However,it becomes difficult to receive GEO signal in some special situation,for example in cities or canyons,in which the signal will be sheltered by big buildings or mountains.In order to solve this problem,an Internet-based broadcast network has been proposed to utilize the infrastructure of the Internet to broadcast the augmentation information of satellite navigation system,which is based on application-layer multicast protocols.In this paper,a topology and position aware overlay network construction protocol is proposed to build the network for augmentation information of satellite navigation system.Simulation results show that the new algorithm is able to achieve better performance in terms of delay,depth and degree utilization.展开更多
As a result of the exponential growing rate of worldwide Internet usage, satellite systems are required to support broadband Internet applications. The transmission control protocol （TCP） which is widely used in the...As a result of the exponential growing rate of worldwide Internet usage, satellite systems are required to support broadband Internet applications. The transmission control protocol （TCP） which is widely used in the Internet, performs very well on wired networks. However, in the case of satellite channels, clue to the delay and transmission errors, TCP performance degrades significantly and bandwidth of satellite links can not be fully utilized. To improve the TCP performance, a new idea of placing a TCP spoofing proxy in the satellite is considered. A Novel Satellite Transport Protocol （NSTP） which takes advantage of the special properties of the satellite channel is also proposed. By using simulation, as compared with traditional TCPs, the on-board spoofing proxy integrated with the special transport protocol can significantly enhance throughput performance on the high BER satellite link, the time needed to transfer files and the bandwidth used in reverse path are sharply reduced.展开更多
Satellite networks are recognized as the most essential communication infrastructures in the world today,which complement land networks and provide valuable services for their users.Extensive coverage and service stab...Satellite networks are recognized as the most essential communication infrastructures in the world today,which complement land networks and provide valuable services for their users.Extensive coverage and service stability of these networks have increased their popularity.Since eavesdropping and active intrusion in satellite communications are much easier than in terrestrial networks,securing satellite communications is vital.So far,several protocols have been proposed for authentication and key exchange of satellite communications,but none of them fullymeet the security requirements.In this paper,we examine one of these protocols and identify its security vulnerabilities.Moreover,we propose a robust and secure authentication and session key agreement protocol using the elliptic curve cryptography(ECC).We show that the proposed protocol meets common security requirements and is resistant to known security attacks.Moreover,we prove that the proposed scheme satisfies the security features using the Automated Validation of Internet Security Protocols and Applications(AVISPA)formal verification tool and On-the fly Model-Checker(OFMC)and ATtack SEarcher(ATSE)model checkers.We have also proved the security of the session key exchange of our protocol using theReal orRandom(RoR)model.Finally,the comparison of our scheme with similar methods shows its superiority.展开更多
The care of a patient involved in major trauma with exsanguinating haemorrhage is time-critical to achieve definitive haemorrhage control,and it requires coordinated multidisciplinary care.During initial resuscitation...The care of a patient involved in major trauma with exsanguinating haemorrhage is time-critical to achieve definitive haemorrhage control,and it requires coordinated multidisciplinary care.During initial resuscitation of a patient in the emergency department(ED),Code Crimson activation facilitates rapid decisionmaking by multi-disciplinary specialists for definitive haemorrhage control in operating theatre(OT)and/or interventional radiology(IR)suite.Once this decision has been made,there may still be various factors that lead to delay in transporting the patient from ED to OT/IR.Red Blanket protocol identifies and addresses these factors and processes which cause delay,and aims to facilitate rapid and safe transport of the haemodynamically unstable patient from ED to OT,while minimizing delay in resuscitation during the transfer.The two processes,Code Crimson and Red Blanket,complement each other.It would be ideal to merge the two processes into a single protocol rather than having two separate workflows.Introducing these quality improvement strategies and coor-dinated processes within the trauma framework of the hospitals/healthcare systems will help in further improving the multi-disciplinary care for the complex trauma patients requiring rapid and definitive haemorrhage control.展开更多
Protocol Reverse Engineering(PRE)is of great practical importance in Internet security-related fields such as intrusion detection,vulnerability mining,and protocol fuzzing.For unknown binary protocols having fixed-len...Protocol Reverse Engineering(PRE)is of great practical importance in Internet security-related fields such as intrusion detection,vulnerability mining,and protocol fuzzing.For unknown binary protocols having fixed-length fields,and the accurate identification of field boundaries has a great impact on the subsequent analysis and final performance.Hence,this paper proposes a new protocol segmentation method based on Information-theoretic statistical analysis for binary protocols by formulating the field segmentation of unsupervised binary protocols as a probabilistic inference problem and modeling its uncertainty.Specifically,we design four related constructions between entropy changes and protocol field segmentation,introduce random variables,and construct joint probability distributions with traffic sample observations.Probabilistic inference is then performed to identify the possible protocol segmentation points.Extensive trials on nine common public and industrial control protocols show that the proposed method yields higher-quality protocol segmentation results.展开更多
“Flying Ad Hoc Networks(FANETs)”,which use“Unmanned Aerial Vehicles(UAVs)”,are developing as a critical mechanism for numerous applications,such as military operations and civilian services.The dynamic nature of F...“Flying Ad Hoc Networks(FANETs)”,which use“Unmanned Aerial Vehicles(UAVs)”,are developing as a critical mechanism for numerous applications,such as military operations and civilian services.The dynamic nature of FANETs,with high mobility,quick node migration,and frequent topology changes,presents substantial hurdles for routing protocol development.Over the preceding few years,researchers have found that machine learning gives productive solutions in routing while preserving the nature of FANET,which is topology change and high mobility.This paper reviews current research on routing protocols and Machine Learning(ML)approaches applied to FANETs,emphasizing developments between 2021 and 2023.The research uses the PRISMA approach to sift through the literature,filtering results from the SCOPUS database to find 82 relevant publications.The research study uses machine learning-based routing algorithms to beat the issues of high mobility,dynamic topologies,and intermittent connection in FANETs.When compared with conventional routing,it gives an energy-efficient and fast decision-making solution in a real-time environment,with greater fault tolerance capabilities.These protocols aim to increase routing efficiency,flexibility,and network stability using ML’s predictive and adaptive capabilities.This comprehensive review seeks to integrate existing information,offer novel integration approaches,and recommend future research topics for improving routing efficiency and flexibility in FANETs.Moreover,the study highlights emerging trends in ML integration,discusses challenges faced during the review,and discusses overcoming these hurdles in future research.展开更多
Accurate time synchronization is fundamental to the correct and efficient operation of Wireless Sensor Networks(WSNs),especially in security-critical,time-sensitive applications.However,most existing protocols degrade...Accurate time synchronization is fundamental to the correct and efficient operation of Wireless Sensor Networks(WSNs),especially in security-critical,time-sensitive applications.However,most existing protocols degrade substantially under malicious interference.We introduce iSTSP,an Intelligent and Secure Time Synchronization Protocol that implements a four-stage defense pipeline to ensure robust,precise synchronization even in hostile environments:(1)trust preprocessing that filters node participation using behavioral trust scoring;(2)anomaly isolation employing a lightweight autoencoder to detect and excise malicious nodes in real time;(3)reliability-weighted consensus that prioritizes high-trust nodes during time aggregation;and(4)convergence-optimized synchronization that dynamically adjusts parameters using theoretical stability bounds.We provide rigorous convergence analysis including a closed-form expression for convergence time,and validate the protocol through both simulations and realworld experiments on a controlled 16-node testbed.Under Sybil attacks with five malicious nodes within this testbed,iSTSP maintains synchronization error increases under 12%and achieves a rapid convergence.Compared to state-ofthe-art protocols like TPSN,SE-FTSP,and MMAR-CTS,iSTSP offers 60%faster detection,broader threat coverage,and more than 7 times lower synchronization error,with a modest 9.3%energy overhead over 8 h.We argue this is an acceptable trade-off for mission-critical deployments requiring guaranteed security.These findings demonstrate iSTSP’s potential as a reliable solution for secure WSN synchronization and motivate future work on large-scale IoT deployments and integration with energy-efficient communication protocols.展开更多
Objective:To evaluate the efficacy and safety of acupoint application for post-stroke depression(PSD)by regulating gastrointestinal function.A secondary objective is to explore the potential mechanism underlying this ...Objective:To evaluate the efficacy and safety of acupoint application for post-stroke depression(PSD)by regulating gastrointestinal function.A secondary objective is to explore the potential mechanism underlying this approach from the perspective of gut microbiota.Methods:This multicenter,randomized,double-blind(patients and assessors),placebo-controlled trial will enroll 80 patients with PSD,and include a 1-week run-in period,a 4-week treatment phase,and a 12-week follow-up.Eligible participants will randomly be assigned in a 1:1 ratio to either the acupoint application or placebo(non-acupoint)groups.Treatments will be administered thrice weekly for 4 weeks.The primary outcome is change in the Hamilton Rating Scale for Depression(HAMD)score.Secondary outcomes include the Beck Depression Inventory(BDI),36-Item Short-Form Health Survey(SF-36),Barthel Index of Activities of Daily Living,Social Adaptation Self-Evaluation Scale(SASS),and gut microbiota profiling.All outcomes will be assessed at baseline(prior to treatment),during treatment(weeks 2 and 4),and during follow-up(weeks 8,12,and 16).The Treatment Emergent Symptom Scale(TESS)will be used for evaluation throughout the 4-week treatment phase.Discussion:The results of this study will provide important evidence supporting a novel treatment strategy for PSD that targets gastrointestinal regulation,potentially informing future clinical practice.展开更多
Focusing on the ultralow expansion functionality of the crystalized glass containing the cordierite crystal phase with the molar composition 20.7MgO·20.7Al_(2)O_(3)·51.6SiO_(2)·7.0TiO_(2),we systematica...Focusing on the ultralow expansion functionality of the crystalized glass containing the cordierite crystal phase with the molar composition 20.7MgO·20.7Al_(2)O_(3)·51.6SiO_(2)·7.0TiO_(2),we systematically investigated impacts of thermal treatment protocols on T dependence of coefficients of thermal expansion(CTE).Except for the phase compositions,morphology is identified as another important factor to control the T dependence of CTE.By using X-ray diffraction and scanning electron microscope,various modes of T dependence of CTE for crystallized glasses are ascribed to their different phase compositions and microstructure with finely dispersed nanoparticles.These understanding contributes to the further modification of CTE of the crystalized glass by altering their thermal treatment scenarios.展开更多
BACKGROUND Femur fractures are one of the most serious injuries that occur in the older population and are associated with severe pain and increased mortality.The primary objective of this study was to find if there w...BACKGROUND Femur fractures are one of the most serious injuries that occur in the older population and are associated with severe pain and increased mortality.The primary objective of this study was to find if there was a significant difference in pain scores in patients treated with femoral nerve blocks(FNB)compared with patients treated with the standard analgesia protocol.The secondary objective was to find if there was a significant difference in morbidity between the two groups.AIM To evaluate the effectiveness of ultrasound(US)-guided FNB in managing preoperative pain and reducing morbidity in patients with neck femur fractures compared to the standard analgesia protocol.The study seeks to determine whether FNB offers superior outcomes in terms of pain control,rehospitalization rates,and mortality.METHODS This retrospective cohort study included 1577 patients suffering from neck femur fractures.387 patients were treated with a FNB for pain management upon arrival at the emergency department,the rest were treated with standard analgesia.Pain was assessed from electronic medical records using the visual analogue scale(VAS)pre surgery,12-and 24-hour post-surgery.To determine morbidity and mortality during hospitalizations and 6 months after,it was collected from electronic medical records.RESULTS In a cohort of 1577 patients,those receiving US-guided FNB had significantly lower preoperative VAS pain scores(1.46±2.49 vs 1.82±2.59,P=0.001),reduced rehospitalization rates(0.99±1.96 vs 1.46±2.34,P<0.001),and lower mortality(16%vs 32%,P<0.001)compared to standard analgesia.CONCLUSION US guided FNB is more effective for pain management compared with standard analgesia.This method was also found to significantly reduce the risk of morbidity in those patients.展开更多
BACKGROUND Diabetes mellitus has become one of the major pandemics of the 21st century.In this scenario,nursing interventions are essential for improving self-care and quality of life in patients with type 2 diabetes ...BACKGROUND Diabetes mellitus has become one of the major pandemics of the 21st century.In this scenario,nursing interventions are essential for improving self-care and quality of life in patients with type 2 diabetes mellitus.Nursing interventions are crucial for managing the disease and preventing complications.AIM To analyse nursing interventions in recent years through a systematic review and meta-analysis and to propose improvements in care plans.METHODS This study conducted a systematic review and meta-analysis of the impact of nursing interventions on quantitative glycaemic variables,such as glycated haemoglobin and fasting plasma glucose.RESULTS After confirming that the combined effect of all studies from the past 5 years positively impacts quantitative variables,a descriptive analysis of the studies with the most significant changes was conducted.Based on this,an improvement in diabetic patient care protocols has been proposed through follow-up plans tailored to the patient’s technological skills.CONCLUSION The combined results obtained and the proposal for improvement developed in this manuscript could help to improve the quality of life of many people around the world.展开更多
BACKGROUND Massive rotator cuff tears(RCTs)result in impaired shoulder function and quality of life.These tears lead to structural changes in the rotator cuff muscles,which compromise recovery after repair and increas...BACKGROUND Massive rotator cuff tears(RCTs)result in impaired shoulder function and quality of life.These tears lead to structural changes in the rotator cuff muscles,which compromise recovery after repair and increase re-tear rates.AIM To investigate the potential inhibitory effects of alpha-tocopherol(vitamin E)and OTR-4131 on muscle atrophy,fatty infiltration,and fibrosis in rotator cuff muscles following a massive RCT using a Wistar rat model,and establish a standardized methodology for evaluating potential therapeutic agents.METHODS This protocol outlines a controlled animal study using 40 male Wistar rats,randomized into five groups.The experimental groups will receive either systemic administration of alpha-tocopherol or local administration of OTR-4131 via intramuscular injection into the supraspinatus and infraspinatus muscles.Two sham groups will receive systemic and local saline injections respectively,while a control group will undergo no intervention.The interventions will be administered after surgical transection of the supraspinatus and infraspinatus tendons.Outcomes will be assessed via wet muscle weight measurements,muscle fiber diameter,fatty infiltration percentage,and fibrosis evaluation using histological methods.RESULTS The study anticipates that alpha-tocopherol and OTR-4131 will reduce muscle atrophy,fatty infiltration,and fibrosis compared to control and sham groups,supporting their potential protective role in rotator cuff muscle degeneration.CONCLUSION The results are expected to improve the understanding on the role of alpha-tocopherol and OTR-4131 in rotator cuff muscle protection after massive RCT and may serve as a foundation for further preclinical and clinical research aimed at improving rotator cuff repair outcomes.展开更多
The Internet of Healthcare Things(IoHT)marks a significant breakthrough in modern medicine by enabling a new era of healthcare services.IoHT supports real-time,continuous,and personalized monitoring of patients’healt...The Internet of Healthcare Things(IoHT)marks a significant breakthrough in modern medicine by enabling a new era of healthcare services.IoHT supports real-time,continuous,and personalized monitoring of patients’health conditions.However,the security of sensitive data exchanged within IoHT remains a major concern,as the widespread connectivity and wireless nature of these systems expose them to various vulnerabilities.Potential threats include unauthorized access,device compromise,data breaches,and data alteration,all of which may compromise the confidentiality and integrity of patient information.In this paper,we provide an in-depth security analysis of LAP-IoHT,an authentication scheme designed to ensure secure communication in Internet of Healthcare Things environments.This analysis reveals several vulnerabilities in the LAP-IoHT protocol,namely its inability to resist various attacks,including user impersonation and privileged insider threats.To address these issues,we introduce LSAP-IoHT,a secure and lightweight authentication protocol for the Internet of Healthcare Things(IoHT).This protocol leverages Elliptic Curve Cryptography(ECC),Physical Unclonable Functions(PUFs),and Three-Factor Authentication(3FA).Its security is validated through both informal analysis and formal verification using the Scyther tool and the Real-Or-Random(ROR)model.The results demonstrate strong resistance against man-in-the-middle(MITM)attacks,replay attacks,identity spoofing,stolen smart device attacks,and insider threats,while maintaining low computational and communication costs.展开更多
文摘BACKGROUND Lower respiratory tract viral infections are a major cause of mortality in children under five years old,leading to hundreds of thousands of fatalities annually.The highest risk is observed in infants under one year old,underscoring the critical need for safe and effective antiviral protocols.CASE SUMMARY A 9-month-old infant suffered from severe bronchiolitis as manifested by high fever(39°C),decreased appetite,tachypnea,wheezing,and oxygen desaturation(SpO284%on room air)and was effectively managed at home using Kelleni’s protocol,which includes age-adjusted dose of nitazoxanide(60 mg twice daily),ibuprofen and azithromycin,complemented by selective antihistaminic,antitussive and mucolytic immunomodulatory treatment.The fever resolved,wheezing became more prominent but without respiratory distress,and oxygen saturation gradually increased to 92%by day 10.Nitazoxanide exerts broad antiviral and immunomodulatory effects by enhancing host interferon responses and inhibiting viral replication,potentially attenuating airway inflammation and accelerating resolution of bronchiolitis.The nitazoxanide dose(60 mg twice daily for five days)was carefully adjusted based on the developmental expression and activity of the uridine diphosphate-glucuronosyltransferase 1A1 enzyme,responsible for its metabolism,ensuring safe age-appropriate administration.The infant’s clinical status steadily improved,and by day 14 the infant achieved full recovery with normalization of oxygen saturation(96%on room air).No adverse events occurred,and follow-up at day 28 confirmed sustained recovery.CONCLUSION To the best of my knowledge,this report presents,for the first time globally,a potential of nitazoxanide within Kelleni’s protocol to early manage infants younger than one year suffering from severe lower respiratory tract viral infection at home.Selective antitussive treatment,using agents such as low dose benproperine,was employed to mitigate troublesome cough and improve patient comfort without compromising respiratory function.Additionally,alpha amylase was used to facilitate pulmonary secretion clearance.The protocol aims to reduce morbidity and mortality from viral lower respiratory tract infections in this vulnerable population.
文摘Rwanda secured access to one of the world’s most lucrative agricultural markets this month when it finalised a trade protocol allowing fresh avocado exports to China,a deal that could fundamentally alter the trajectory of the country’s trade.
文摘Considering that weak channel collision detection ability, long propagation delay and heavy load in LEO satellite communications, a valid adaptive APRMA MAC protocol was proposed. Different access probability functions for different services were obtained and appropriate access probabilities for voice and data users were updated slot by slot based on the estimation of the voice traffic and the channel status. In the proposed MAC protocol limited wireless resource is allocated reasonably by multiple users and high capacity was achieved. Three performance parameters: voice packet loss probability, average delay of data packets and throughput of data packets were considered in simulation. Finally simulation results demonstrated that the performance of system was improved by the APRMA compared with the conventional PRMA, with an acceptable trade-off between QoS of voice and delay of data.
基金supported by National High Technical Research and Development Program of China (863 Program) under Grant No. 2009AA12Z322
文摘It is an effective method to broadcast the augmentation information of satellite navigation system using GEO technology.However,it becomes difficult to receive GEO signal in some special situation,for example in cities or canyons,in which the signal will be sheltered by big buildings or mountains.In order to solve this problem,an Internet-based broadcast network has been proposed to utilize the infrastructure of the Internet to broadcast the augmentation information of satellite navigation system,which is based on application-layer multicast protocols.In this paper,a topology and position aware overlay network construction protocol is proposed to build the network for augmentation information of satellite navigation system.Simulation results show that the new algorithm is able to achieve better performance in terms of delay,depth and degree utilization.
文摘As a result of the exponential growing rate of worldwide Internet usage, satellite systems are required to support broadband Internet applications. The transmission control protocol （TCP） which is widely used in the Internet, performs very well on wired networks. However, in the case of satellite channels, clue to the delay and transmission errors, TCP performance degrades significantly and bandwidth of satellite links can not be fully utilized. To improve the TCP performance, a new idea of placing a TCP spoofing proxy in the satellite is considered. A Novel Satellite Transport Protocol （NSTP） which takes advantage of the special properties of the satellite channel is also proposed. By using simulation, as compared with traditional TCPs, the on-board spoofing proxy integrated with the special transport protocol can significantly enhance throughput performance on the high BER satellite link, the time needed to transfer files and the bandwidth used in reverse path are sharply reduced.
文摘Satellite networks are recognized as the most essential communication infrastructures in the world today,which complement land networks and provide valuable services for their users.Extensive coverage and service stability of these networks have increased their popularity.Since eavesdropping and active intrusion in satellite communications are much easier than in terrestrial networks,securing satellite communications is vital.So far,several protocols have been proposed for authentication and key exchange of satellite communications,but none of them fullymeet the security requirements.In this paper,we examine one of these protocols and identify its security vulnerabilities.Moreover,we propose a robust and secure authentication and session key agreement protocol using the elliptic curve cryptography(ECC).We show that the proposed protocol meets common security requirements and is resistant to known security attacks.Moreover,we prove that the proposed scheme satisfies the security features using the Automated Validation of Internet Security Protocols and Applications(AVISPA)formal verification tool and On-the fly Model-Checker(OFMC)and ATtack SEarcher(ATSE)model checkers.We have also proved the security of the session key exchange of our protocol using theReal orRandom(RoR)model.Finally,the comparison of our scheme with similar methods shows its superiority.
文摘The care of a patient involved in major trauma with exsanguinating haemorrhage is time-critical to achieve definitive haemorrhage control,and it requires coordinated multidisciplinary care.During initial resuscitation of a patient in the emergency department(ED),Code Crimson activation facilitates rapid decisionmaking by multi-disciplinary specialists for definitive haemorrhage control in operating theatre(OT)and/or interventional radiology(IR)suite.Once this decision has been made,there may still be various factors that lead to delay in transporting the patient from ED to OT/IR.Red Blanket protocol identifies and addresses these factors and processes which cause delay,and aims to facilitate rapid and safe transport of the haemodynamically unstable patient from ED to OT,while minimizing delay in resuscitation during the transfer.The two processes,Code Crimson and Red Blanket,complement each other.It would be ideal to merge the two processes into a single protocol rather than having two separate workflows.Introducing these quality improvement strategies and coor-dinated processes within the trauma framework of the hospitals/healthcare systems will help in further improving the multi-disciplinary care for the complex trauma patients requiring rapid and definitive haemorrhage control.
文摘Protocol Reverse Engineering(PRE)is of great practical importance in Internet security-related fields such as intrusion detection,vulnerability mining,and protocol fuzzing.For unknown binary protocols having fixed-length fields,and the accurate identification of field boundaries has a great impact on the subsequent analysis and final performance.Hence,this paper proposes a new protocol segmentation method based on Information-theoretic statistical analysis for binary protocols by formulating the field segmentation of unsupervised binary protocols as a probabilistic inference problem and modeling its uncertainty.Specifically,we design four related constructions between entropy changes and protocol field segmentation,introduce random variables,and construct joint probability distributions with traffic sample observations.Probabilistic inference is then performed to identify the possible protocol segmentation points.Extensive trials on nine common public and industrial control protocols show that the proposed method yields higher-quality protocol segmentation results.
基金support the findings of this study are openly available in(Scopus database)at www.scopus.com(accessed on 07 January 2025).
文摘“Flying Ad Hoc Networks(FANETs)”,which use“Unmanned Aerial Vehicles(UAVs)”,are developing as a critical mechanism for numerous applications,such as military operations and civilian services.The dynamic nature of FANETs,with high mobility,quick node migration,and frequent topology changes,presents substantial hurdles for routing protocol development.Over the preceding few years,researchers have found that machine learning gives productive solutions in routing while preserving the nature of FANET,which is topology change and high mobility.This paper reviews current research on routing protocols and Machine Learning(ML)approaches applied to FANETs,emphasizing developments between 2021 and 2023.The research uses the PRISMA approach to sift through the literature,filtering results from the SCOPUS database to find 82 relevant publications.The research study uses machine learning-based routing algorithms to beat the issues of high mobility,dynamic topologies,and intermittent connection in FANETs.When compared with conventional routing,it gives an energy-efficient and fast decision-making solution in a real-time environment,with greater fault tolerance capabilities.These protocols aim to increase routing efficiency,flexibility,and network stability using ML’s predictive and adaptive capabilities.This comprehensive review seeks to integrate existing information,offer novel integration approaches,and recommend future research topics for improving routing efficiency and flexibility in FANETs.Moreover,the study highlights emerging trends in ML integration,discusses challenges faced during the review,and discusses overcoming these hurdles in future research.
基金this project under Geran Putra Inisiatif(GPI)with reference of GP-GPI/2023/976210。
文摘Accurate time synchronization is fundamental to the correct and efficient operation of Wireless Sensor Networks(WSNs),especially in security-critical,time-sensitive applications.However,most existing protocols degrade substantially under malicious interference.We introduce iSTSP,an Intelligent and Secure Time Synchronization Protocol that implements a four-stage defense pipeline to ensure robust,precise synchronization even in hostile environments:(1)trust preprocessing that filters node participation using behavioral trust scoring;(2)anomaly isolation employing a lightweight autoencoder to detect and excise malicious nodes in real time;(3)reliability-weighted consensus that prioritizes high-trust nodes during time aggregation;and(4)convergence-optimized synchronization that dynamically adjusts parameters using theoretical stability bounds.We provide rigorous convergence analysis including a closed-form expression for convergence time,and validate the protocol through both simulations and realworld experiments on a controlled 16-node testbed.Under Sybil attacks with five malicious nodes within this testbed,iSTSP maintains synchronization error increases under 12%and achieves a rapid convergence.Compared to state-ofthe-art protocols like TPSN,SE-FTSP,and MMAR-CTS,iSTSP offers 60%faster detection,broader threat coverage,and more than 7 times lower synchronization error,with a modest 9.3%energy overhead over 8 h.We argue this is an acceptable trade-off for mission-critical deployments requiring guaranteed security.These findings demonstrate iSTSP’s potential as a reliable solution for secure WSN synchronization and motivate future work on large-scale IoT deployments and integration with energy-efficient communication protocols.
基金supported by the Chinese Medicine Development Fund,Hong Kong SAR,China(23B2/027A_R1)the National Natural Science Foundation of China(81704198).
文摘Objective:To evaluate the efficacy and safety of acupoint application for post-stroke depression(PSD)by regulating gastrointestinal function.A secondary objective is to explore the potential mechanism underlying this approach from the perspective of gut microbiota.Methods:This multicenter,randomized,double-blind(patients and assessors),placebo-controlled trial will enroll 80 patients with PSD,and include a 1-week run-in period,a 4-week treatment phase,and a 12-week follow-up.Eligible participants will randomly be assigned in a 1:1 ratio to either the acupoint application or placebo(non-acupoint)groups.Treatments will be administered thrice weekly for 4 weeks.The primary outcome is change in the Hamilton Rating Scale for Depression(HAMD)score.Secondary outcomes include the Beck Depression Inventory(BDI),36-Item Short-Form Health Survey(SF-36),Barthel Index of Activities of Daily Living,Social Adaptation Self-Evaluation Scale(SASS),and gut microbiota profiling.All outcomes will be assessed at baseline(prior to treatment),during treatment(weeks 2 and 4),and during follow-up(weeks 8,12,and 16).The Treatment Emergent Symptom Scale(TESS)will be used for evaluation throughout the 4-week treatment phase.Discussion:The results of this study will provide important evidence supporting a novel treatment strategy for PSD that targets gastrointestinal regulation,potentially informing future clinical practice.
基金Funded by National Natural Science Foundation of China(No.52172007)Jiangsu Science and Technology Innovation Project for Carbon Peaking and Carbon Neutrality(No.BE2022035)。
文摘Focusing on the ultralow expansion functionality of the crystalized glass containing the cordierite crystal phase with the molar composition 20.7MgO·20.7Al_(2)O_(3)·51.6SiO_(2)·7.0TiO_(2),we systematically investigated impacts of thermal treatment protocols on T dependence of coefficients of thermal expansion(CTE).Except for the phase compositions,morphology is identified as another important factor to control the T dependence of CTE.By using X-ray diffraction and scanning electron microscope,various modes of T dependence of CTE for crystallized glasses are ascribed to their different phase compositions and microstructure with finely dispersed nanoparticles.These understanding contributes to the further modification of CTE of the crystalized glass by altering their thermal treatment scenarios.
文摘BACKGROUND Femur fractures are one of the most serious injuries that occur in the older population and are associated with severe pain and increased mortality.The primary objective of this study was to find if there was a significant difference in pain scores in patients treated with femoral nerve blocks(FNB)compared with patients treated with the standard analgesia protocol.The secondary objective was to find if there was a significant difference in morbidity between the two groups.AIM To evaluate the effectiveness of ultrasound(US)-guided FNB in managing preoperative pain and reducing morbidity in patients with neck femur fractures compared to the standard analgesia protocol.The study seeks to determine whether FNB offers superior outcomes in terms of pain control,rehospitalization rates,and mortality.METHODS This retrospective cohort study included 1577 patients suffering from neck femur fractures.387 patients were treated with a FNB for pain management upon arrival at the emergency department,the rest were treated with standard analgesia.Pain was assessed from electronic medical records using the visual analogue scale(VAS)pre surgery,12-and 24-hour post-surgery.To determine morbidity and mortality during hospitalizations and 6 months after,it was collected from electronic medical records.RESULTS In a cohort of 1577 patients,those receiving US-guided FNB had significantly lower preoperative VAS pain scores(1.46±2.49 vs 1.82±2.59,P=0.001),reduced rehospitalization rates(0.99±1.96 vs 1.46±2.34,P<0.001),and lower mortality(16%vs 32%,P<0.001)compared to standard analgesia.CONCLUSION US guided FNB is more effective for pain management compared with standard analgesia.This method was also found to significantly reduce the risk of morbidity in those patients.
文摘BACKGROUND Diabetes mellitus has become one of the major pandemics of the 21st century.In this scenario,nursing interventions are essential for improving self-care and quality of life in patients with type 2 diabetes mellitus.Nursing interventions are crucial for managing the disease and preventing complications.AIM To analyse nursing interventions in recent years through a systematic review and meta-analysis and to propose improvements in care plans.METHODS This study conducted a systematic review and meta-analysis of the impact of nursing interventions on quantitative glycaemic variables,such as glycated haemoglobin and fasting plasma glucose.RESULTS After confirming that the combined effect of all studies from the past 5 years positively impacts quantitative variables,a descriptive analysis of the studies with the most significant changes was conducted.Based on this,an improvement in diabetic patient care protocols has been proposed through follow-up plans tailored to the patient’s technological skills.CONCLUSION The combined results obtained and the proposal for improvement developed in this manuscript could help to improve the quality of life of many people around the world.
基金thank the staff of the accredited animal facility of the laboratory of anatomy,Histology and Embryology of Aristotle University of Thessaloniki’s veterinary school for their assistance in animal handling and care.
文摘BACKGROUND Massive rotator cuff tears(RCTs)result in impaired shoulder function and quality of life.These tears lead to structural changes in the rotator cuff muscles,which compromise recovery after repair and increase re-tear rates.AIM To investigate the potential inhibitory effects of alpha-tocopherol(vitamin E)and OTR-4131 on muscle atrophy,fatty infiltration,and fibrosis in rotator cuff muscles following a massive RCT using a Wistar rat model,and establish a standardized methodology for evaluating potential therapeutic agents.METHODS This protocol outlines a controlled animal study using 40 male Wistar rats,randomized into five groups.The experimental groups will receive either systemic administration of alpha-tocopherol or local administration of OTR-4131 via intramuscular injection into the supraspinatus and infraspinatus muscles.Two sham groups will receive systemic and local saline injections respectively,while a control group will undergo no intervention.The interventions will be administered after surgical transection of the supraspinatus and infraspinatus tendons.Outcomes will be assessed via wet muscle weight measurements,muscle fiber diameter,fatty infiltration percentage,and fibrosis evaluation using histological methods.RESULTS The study anticipates that alpha-tocopherol and OTR-4131 will reduce muscle atrophy,fatty infiltration,and fibrosis compared to control and sham groups,supporting their potential protective role in rotator cuff muscle degeneration.CONCLUSION The results are expected to improve the understanding on the role of alpha-tocopherol and OTR-4131 in rotator cuff muscle protection after massive RCT and may serve as a foundation for further preclinical and clinical research aimed at improving rotator cuff repair outcomes.
文摘The Internet of Healthcare Things(IoHT)marks a significant breakthrough in modern medicine by enabling a new era of healthcare services.IoHT supports real-time,continuous,and personalized monitoring of patients’health conditions.However,the security of sensitive data exchanged within IoHT remains a major concern,as the widespread connectivity and wireless nature of these systems expose them to various vulnerabilities.Potential threats include unauthorized access,device compromise,data breaches,and data alteration,all of which may compromise the confidentiality and integrity of patient information.In this paper,we provide an in-depth security analysis of LAP-IoHT,an authentication scheme designed to ensure secure communication in Internet of Healthcare Things environments.This analysis reveals several vulnerabilities in the LAP-IoHT protocol,namely its inability to resist various attacks,including user impersonation and privileged insider threats.To address these issues,we introduce LSAP-IoHT,a secure and lightweight authentication protocol for the Internet of Healthcare Things(IoHT).This protocol leverages Elliptic Curve Cryptography(ECC),Physical Unclonable Functions(PUFs),and Three-Factor Authentication(3FA).Its security is validated through both informal analysis and formal verification using the Scyther tool and the Real-Or-Random(ROR)model.The results demonstrate strong resistance against man-in-the-middle(MITM)attacks,replay attacks,identity spoofing,stolen smart device attacks,and insider threats,while maintaining low computational and communication costs.
