Octopuses,due to their flexible arms,marvelous adaptability,and powerful suckers,are able to effortlessly grasp and disengage various objects in the marine surrounding without causing devastation.However,manipulating ...Octopuses,due to their flexible arms,marvelous adaptability,and powerful suckers,are able to effortlessly grasp and disengage various objects in the marine surrounding without causing devastation.However,manipulating delicate objects such as soft and fragile foods underwater require gentle contact and stable adhesion,which poses a serious challenge to now available soft grippers.Inspired by the sucker infundibulum structure and flexible tentacles of octopus,herein we developed a hydraulically actuated hydrogel soft gripper with adaptive maneuverability by coupling multiple hydrogen bond-mediated supramolecular hydrogels and vat polymerization three-dimensional printing,in which hydrogel bionic sucker is composed of a tunable curvature membrane,a negative pressure cavity,and a pneumatic chamber.The design of the sucker structure with the alterable curvature membrane is conducive to realize the reliable and gentle switchable adhesion of the hydrogel soft gripper.As a proof-of-concept,the adaptive hydrogel soft gripper is capable of implement diversified underwater tasks,including gingerly grasping fragile foods like egg yolks and tofu,as well as underwater robots and vehicles that station-keeping and crawling based on switchable adhesion.This study therefore provides a transformative strategy for the design of novel soft grippers that will render promising utilities for underwater exploration soft robotics.展开更多
The algorithm based on combination learning usually is superior to a singleclassification algorithm on the task of protein secondary structure prediction. However,the assignment of the weight of the base classifier us...The algorithm based on combination learning usually is superior to a singleclassification algorithm on the task of protein secondary structure prediction. However,the assignment of the weight of the base classifier usually lacks decision-makingevidence. In this paper, we propose a protein secondary structure prediction method withdynamic self-adaptation combination strategy based on entropy, where the weights areassigned according to the entropy of posterior probabilities outputted by base classifiers.The higher entropy value means a lower weight for the base classifier. The final structureprediction is decided by the weighted combination of posterior probabilities. Extensiveexperiments on CB513 dataset demonstrates that the proposed method outperforms theexisting methods, which can effectively improve the prediction performance.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
Global warming and energy crisis are two major challenges in the new-century.Wearable materials that enable all-seasonal self-adapting thermal comfort without additional energy-input attract significant attention as a...Global warming and energy crisis are two major challenges in the new-century.Wearable materials that enable all-seasonal self-adapting thermal comfort without additional energy-input attract significant attention as a solution to the increasing severity of extreme climate-change.Inspired by autologous temperature-regulation and multidimensional-sensing origins of nature-skin composed of nature collagen fibers,this study engineered a nanoscale wearable natural fibers-derived thermochromic material(TMEH-skin)for robust all-season self-adapting thermal management by tactically integrating traditional immersion and spraying methods with layer-by-layer stacking-strategy.Because of the on-demand multi-functional layer-structure design,TMEH-skin achieves spontaneous~38.16%visible lightmodulation and~95.1%infrared-emission,demonstrating outstanding double-self-switching thermal management origins by simple color-changing without additional energy-input.Moreover,TMEH-skin has gratifying tensile strength of 13.18 MPa,water vapor permeability,electrical-conductivity,and hydrophobicity,further broadening the application potential and scenarios as wearable materials.In applications for military-missions or reconnaissance behind enemy-lines,TMEH-skin robustly integrates the multi-functionalities of wearing-comfort,physiological signal-response capability for accurate transmission of Morse-code,and thermal management performances under special circumstances,indicating its tremendous potential for smart military-applications.Simulation results show that TMEH-skin has prominent energy-saving efficiency in cities with different climate zones.This study provides a new reference to the booming innovation of natural-derived wearable materials for all-seasonal self-adapting thermal management.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
The intrinsic volume changes(about 300%)of Si anode during the lithiation/delithiation leads to the serious degradation of battery performance despite of theoretical capacity of 3579 mAh g^(-1) of Si.Herein,a three-di...The intrinsic volume changes(about 300%)of Si anode during the lithiation/delithiation leads to the serious degradation of battery performance despite of theoretical capacity of 3579 mAh g^(-1) of Si.Herein,a three-dimensional(3D)conductive polymer binder with adjustable crosslinking density has been designed by employing citric acid(CA)as a crosslinker between the carboxymethyl cellulose(CMC)and the poly(3,4-ethylenedioxythiophene)poly-(styrene-4-sulfonate)(PEDOT:PSS)to stabilize Si anode.By adjusting the crosslinking density,the binder can achieve a balance between rigidity and flexibility to adapt the volume expansion upon lithiation and reversible volume recovery after delithiation of Si.Therefore,Si/CMC-CA-PEDOT:PSS(Si/CCP)electrode demonstrates an excellent performance with high capacities of 2792.3 mAh g^(-1) at 0.5 A g^(-1) and a high area capacity above 2.6 mAh cm^(-2) under Si loading of 1.38 mg cm^(-2).The full cell Si/CCP paired with Li(Ni_(0.8)Co_(0.1)Mn_(0.1))O_(2) cathode discharges a capacity of 199.0 mAh g^(-1) with 84.3%ICE at 0.1 C and the capacity retention of 95.6%after 100 cycles.This work validates the effectiveness of 3D polymer binder and provides new insights to boost the performance of Si anode.展开更多
Typical p-n junctions have emerged as a promising strategy for contending with charge carrier recombination in solar conversion.However,the photo-corrosion and unsuitable energy band positions still hinder their pract...Typical p-n junctions have emerged as a promising strategy for contending with charge carrier recombination in solar conversion.However,the photo-corrosion and unsuitable energy band positions still hinder their practical application for hydrogen production from water in photoelectrochemical systems.Here,an in-situ photo-oxidation method is proposed for achieving self-adapting activation of BiVO_(4)-based photoanodes with surface-encapsulated CuGaS_(2)particles by the ZnO layer.The self-adapting activation demotes the energy band positions of CuGaS_(2),establishing an S-scheme structure with BiVO_(4),resulting in an efficient p-n junction photoanode.The optimal sample exhibits enhanced photocurrent and an onset potential cathodically shifted by~300 mV compared with BiVO_(4),which is attributed to significantly enhanced charge transport and transfer efficiencies.As expected,it attains the highest photocurrent value of 5.87 mA·cm^(-2),aided by a hole scavenger at 1.23 V versus a reversible hydrogen electrode,which significantly surpasses that of BiVO_(4)(4.32 mA·cm^(-2)).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 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
Objective To discuss the flexible supervision and communication mode in the post-approval change(PAC)of drugs,to explore how to ensure the quality and availability of drugs during the changes,and to provide some sugge...Objective To discuss the flexible supervision and communication mode in the post-approval change(PAC)of drugs,to explore how to ensure the quality and availability of drugs during the changes,and to provide some suggestions and reference for promoting the timely marketing of drugs.Methods Based on the comparability protocol guidelines issued by the US FDA in October 2022,the regulatory status quo of PAC between China and the US was compared to explore the feasibility of implementing comparability protocols in China.Results and Conclusion According to the specific situation of post-approval of drug change supervision,some suggestions were put forward to optimize the PAC management procedure,such as establishing the communication pathways between holders and health authorities,publishing relevant guidance and strengthening training,so as to provide reference for the implementation of comparability protocols in China.展开更多
Developing highly active and stable oxygen evolution reaction(OER)catalysts necessitates the establishment of a comprehensive OER catalyst database.However,the absence of a standardized benchmarking protocol has hinde...Developing highly active and stable oxygen evolution reaction(OER)catalysts necessitates the establishment of a comprehensive OER catalyst database.However,the absence of a standardized benchmarking protocol has hindered this progress.In this work,we present a systematic protocol for electrochemical measurements to thoroughly evaluate the activity and stability of OER electrocatalysts.We begin with a detailed introduction to constructing the electrochemical system,encompassing experimental setup and the selection criteria for electrodes and electrolytes.Potential contaminants originating from electrolytes,cells,and electrodes are identified and their impacts are discussed.We also examine the effects of external factors,such as temperature,magnetic fields,and natural light,on OER measurements.The protocol outlines operational mechanisms and recommended settings for various electrochemical techniques,including cyclic voltammetry(CV),potentiostatic electrochemical impedance spectroscopy(PEIS),Tafel slope analysis,and pulse voltammetry(PV).We summarize existing evaluation methodologies for assessing intrinsic activities and long-term stabilities of catalysts.Based on these discussions,we propose a comprehensive protocol for evaluating OER electrocatalysts’performance.Finally,we offer perspectives on advancing OER catalysts from laboratory research to industrial applications.展开更多
The current recommendation to avoid non-steroidal anti-inflammatory drugs(NSAIDs)in the management of dengue virus disease(DVD)is scientifically considered of very low to low certainty,despite being widely adopted wor...The current recommendation to avoid non-steroidal anti-inflammatory drugs(NSAIDs)in the management of dengue virus disease(DVD)is scientifically considered of very low to low certainty,despite being widely adopted worldwide.The same recommendation,initially made during the coronavirus disease 2019(COVID-19)pandemic,was subsequently proven incorrect.In this clinical report,we present evidence,for the first time globally,from a real-life practice that NSAIDs may actually be lifesaving in the early management of DVD as they have proved to be in COVID-19.Moreover,we propose that the personalized immunemodulatory Kelleni’s protocol,which includes nitazoxanide as a key component,can be safely and effectively used to manage various separate or concomitant viral infections and co-infections,including DVD.Importantly,this article contributes to the current medical knowledge in the global pursuit of a safe and effective broad-spectrum antiviral protocol that can be used to early manage multiple highly infectious viruses.However,it’s crucial that sufficiently powered controlled randomized clinical trials be conducted to thoroughly assess and evaluate the safety of NSAIDs in the early management of DVD as well as the efficacy of nitazoxanide with or without NSAIDs in its management.展开更多
Primary liver cancer(PLC) is the third major cause of cancer related death, which seriously affects the survival period and quality of life of patients. However, there is currently no evidence to prove which treatment...Primary liver cancer(PLC) is the third major cause of cancer related death, which seriously affects the survival period and quality of life of patients. However, there is currently no evidence to prove which treatment method is most effective. Traditional Chinese Medicine(TCM) has shown certain advantages in the treatment of PLC, especially in the side effects of Western Medicine. Therefore, we designed a clinical trial protocol for the treatment of PLC using TCM granules. Our purpose is to explore the efficacy and safety of Yangxiao Fukang granule(YXFKG, 养消复康颗粒) in the treatment of stage Ⅲ hepatitis B related PLC. A total of 216 patients from three hospitals in Henan Province will be enrolled and randomly divided into a trial group and a control group in a 1 ∶ 1 ratio. The trial group will be treated with conventional western medicine plus YXFKG, while the control group will receive conventional western medicine plus a placebo for YXFKG. All patients will receive a daily dose of either YXFKG or a placebo for six months, followed by a six-month follow-up period. The main observation outcome includes 1-year survival rate, while secondary outcomes include conversion rate to remission, objective response rate, progression free survival, overall survival, quality of life score, and TCM clinical symptom score. Blood routine, urine routine, stool routine, electrocardiogram, liver and kidney function, coagulation function test, and D-dimer are safety indicators. Collect data before treatment and during the 3rd, 6th, 9th, and 12th months of treatment, and conduct statistical analysis. This study will preliminarily verify the effectiveness and safety of YXFKG in the treatment of stage Ⅲ hepatitis B related PLC, which may provide a new choice for clinical treatment of PLC.展开更多
Introduction:With the incidence of chronic kidney disease(CKD)increasing year by year,it is particularly important to intervene in the early stage of CKD(stages 1–3).Unfortunately,the effective drug treatment methods...Introduction:With the incidence of chronic kidney disease(CKD)increasing year by year,it is particularly important to intervene in the early stage of CKD(stages 1–3).Unfortunately,the effective drug treatment methods for CKD(stages 1–3)are lacking.Guben Tongluo Formula(GTF)is the experience formula of Professor Liqun He,a famous traditional Chinese medicine(TCM)doctor in Shanghai.Our previous studies demonstrated that GTF might effectively alleviate CKD via multi-mechanisms.As the first angiotensin-2 receptor antagonist for treating hypertension,losartan potassium(LP)could effectively reduce blood pressure,decrease cardiovascular risk,and delay the occurrence of end-stage renal disease.Thus,we design this clinical protocol of GTF combining LP to observe the efficacy and safety of GTF and try to provide a novel drug treatment method for treating CKD(stages 1–3)patients.Methods and analysis:This is a multicenter randomized controlled clinical trial.160 participants will be enrolled in this trial and divided into LP group,GTF group,LP+GTF group,and placebo group randomly assigning 1:1:1:1 principle.LP group will receive general treatments combining LP,GTF group will receive general treatments combining GTF,and the GTF+LP group will receive general treatments combining GTF and LP.Placebo group will receive general treatments combining placebo treatment.The primary evaluation index will be the change of serum creatinine after treatment.Secondary evaluation indexes include changes in blood urea nitrogen,serum uric acid,estimated glomerular filtration rate,etc.;immune indicators and renal fibrosis indicators,as well as TCM symptoms.Besides,vital sign indicators and adverse events will be closely observed.Ethics and dissemination:The protocol has been approved by the Ethics Committee of Seventh People’s Hospital of Shanghai University of Traditional Chinese Medicine(reference number:2024-7th-HIRB-094)and other ethics committees at each center.With the implementation of this clinical trial,it would offer a TCM formula for the treatment of CKD(stages 1–3)and clarify the underlying mechanism of GTF for alleviating CKD.Trial registration:This trial is registered with ChiCTR2400090125 and registered on September 24,2024.展开更多
UAV networks often encounter jamming attacks, under which multi-radio protocols have to switch radios to accelerate communication recovery. However, the existing protocols rely on exchange of hello messages to detect ...UAV networks often encounter jamming attacks, under which multi-radio protocols have to switch radios to accelerate communication recovery. However, the existing protocols rely on exchange of hello messages to detect jamming, leading to long sensing time and thus slow routing recovery. To address the issues raised by jamming attacks, we propose a new routing protocol, Electromagnetic Spectrum situation awareness Optimized Link State Routing (ESOLSR) protocol, to improve the existing OLSRv2 protocol. ESOLSR utilizes the spectrum situation awareness capability from the physical layer, and adopts joint-updating of link status, updating of interface functions, and adaptive adjustment of parameters. Our simulation results show that the improved protocol, ESOLSR, can recover routing and resume normal communication 26.6% faster compared to the existing protocols.展开更多
基金the financial support from the Strategic Priority Research Program of the Chinese Academy of Sciences (XDB0470303)the National Key Research and Development Program of China (2022YFB4600101)+5 种基金the National Natural Science Foundation of China (52175201)the Research Program of Science and Technology Department of Gansu Province (24JRRA059, 24JRRA044, and 24YFFA014)the Science Fund of Shandong Laboratory of Advanced Materials and Green Manufacturing at Yantai (AMGM2024F12)the Major Program (ZYFZFX-2) of the Lanzhou Institute of Chemical Physics, CASthe Special Research Assistant Project of the Chinese Academy of Sciencesthe Oasis Scholar of Shihezi University
文摘Octopuses,due to their flexible arms,marvelous adaptability,and powerful suckers,are able to effortlessly grasp and disengage various objects in the marine surrounding without causing devastation.However,manipulating delicate objects such as soft and fragile foods underwater require gentle contact and stable adhesion,which poses a serious challenge to now available soft grippers.Inspired by the sucker infundibulum structure and flexible tentacles of octopus,herein we developed a hydraulically actuated hydrogel soft gripper with adaptive maneuverability by coupling multiple hydrogen bond-mediated supramolecular hydrogels and vat polymerization three-dimensional printing,in which hydrogel bionic sucker is composed of a tunable curvature membrane,a negative pressure cavity,and a pneumatic chamber.The design of the sucker structure with the alterable curvature membrane is conducive to realize the reliable and gentle switchable adhesion of the hydrogel soft gripper.As a proof-of-concept,the adaptive hydrogel soft gripper is capable of implement diversified underwater tasks,including gingerly grasping fragile foods like egg yolks and tofu,as well as underwater robots and vehicles that station-keeping and crawling based on switchable adhesion.This study therefore provides a transformative strategy for the design of novel soft grippers that will render promising utilities for underwater exploration soft robotics.
文摘The algorithm based on combination learning usually is superior to a singleclassification algorithm on the task of protein secondary structure prediction. However,the assignment of the weight of the base classifier usually lacks decision-makingevidence. In this paper, we propose a protein secondary structure prediction method withdynamic self-adaptation combination strategy based on entropy, where the weights areassigned according to the entropy of posterior probabilities outputted by base classifiers.The higher entropy value means a lower weight for the base classifier. The final structureprediction is decided by the weighted combination of posterior probabilities. Extensiveexperiments on CB513 dataset demonstrates that the proposed method outperforms theexisting methods, which can effectively improve the prediction performance.
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the Institute of Biomass&Functional Materials of Shaanxi University of Science and Technology for funding this research workfinancially supported by the National Natural Science Foundation of China(2207081675,22278257,22308209)+1 种基金the Key R&D Program of Shaanxi Province(2024SF-YBXM-586)the Project of Innovation Capability Support Program in Shaanxi Province(2024ZC-KJXX-005)。
文摘Global warming and energy crisis are two major challenges in the new-century.Wearable materials that enable all-seasonal self-adapting thermal comfort without additional energy-input attract significant attention as a solution to the increasing severity of extreme climate-change.Inspired by autologous temperature-regulation and multidimensional-sensing origins of nature-skin composed of nature collagen fibers,this study engineered a nanoscale wearable natural fibers-derived thermochromic material(TMEH-skin)for robust all-season self-adapting thermal management by tactically integrating traditional immersion and spraying methods with layer-by-layer stacking-strategy.Because of the on-demand multi-functional layer-structure design,TMEH-skin achieves spontaneous~38.16%visible lightmodulation and~95.1%infrared-emission,demonstrating outstanding double-self-switching thermal management origins by simple color-changing without additional energy-input.Moreover,TMEH-skin has gratifying tensile strength of 13.18 MPa,water vapor permeability,electrical-conductivity,and hydrophobicity,further broadening the application potential and scenarios as wearable materials.In applications for military-missions or reconnaissance behind enemy-lines,TMEH-skin robustly integrates the multi-functionalities of wearing-comfort,physiological signal-response capability for accurate transmission of Morse-code,and thermal management performances under special circumstances,indicating its tremendous potential for smart military-applications.Simulation results show that TMEH-skin has prominent energy-saving efficiency in cities with different climate zones.This study provides a new reference to the booming innovation of natural-derived wearable materials for all-seasonal self-adapting thermal management.
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Financial support by the NSFC no. 52371224, 51972156, and 51872131
文摘The intrinsic volume changes(about 300%)of Si anode during the lithiation/delithiation leads to the serious degradation of battery performance despite of theoretical capacity of 3579 mAh g^(-1) of Si.Herein,a three-dimensional(3D)conductive polymer binder with adjustable crosslinking density has been designed by employing citric acid(CA)as a crosslinker between the carboxymethyl cellulose(CMC)and the poly(3,4-ethylenedioxythiophene)poly-(styrene-4-sulfonate)(PEDOT:PSS)to stabilize Si anode.By adjusting the crosslinking density,the binder can achieve a balance between rigidity and flexibility to adapt the volume expansion upon lithiation and reversible volume recovery after delithiation of Si.Therefore,Si/CMC-CA-PEDOT:PSS(Si/CCP)electrode demonstrates an excellent performance with high capacities of 2792.3 mAh g^(-1) at 0.5 A g^(-1) and a high area capacity above 2.6 mAh cm^(-2) under Si loading of 1.38 mg cm^(-2).The full cell Si/CCP paired with Li(Ni_(0.8)Co_(0.1)Mn_(0.1))O_(2) cathode discharges a capacity of 199.0 mAh g^(-1) with 84.3%ICE at 0.1 C and the capacity retention of 95.6%after 100 cycles.This work validates the effectiveness of 3D polymer binder and provides new insights to boost the performance of Si anode.
基金supported by the open fund from Key Lab of Eco-restoration of Regional Contaminated Environment(Shenyang University),Ministry of Education(No.KF-22-08)the National Natural Science Foundation of China(Nos.22003074 and 42177406)+1 种基金the Youth Innovation Promotion Association CAS,Guangdong Basic and Applied Basic Research Foundation(No.2023A1515011410)S.Liu gratefully acknowledges the financial support by the National Natural Science Foundation of China(No.52302223).
文摘Typical p-n junctions have emerged as a promising strategy for contending with charge carrier recombination in solar conversion.However,the photo-corrosion and unsuitable energy band positions still hinder their practical application for hydrogen production from water in photoelectrochemical systems.Here,an in-situ photo-oxidation method is proposed for achieving self-adapting activation of BiVO_(4)-based photoanodes with surface-encapsulated CuGaS_(2)particles by the ZnO layer.The self-adapting activation demotes the energy band positions of CuGaS_(2),establishing an S-scheme structure with BiVO_(4),resulting in an efficient p-n junction photoanode.The optimal sample exhibits enhanced photocurrent and an onset potential cathodically shifted by~300 mV compared with BiVO_(4),which is attributed to significantly enhanced charge transport and transfer efficiencies.As expected,it attains the highest photocurrent value of 5.87 mA·cm^(-2),aided by a hole scavenger at 1.23 V versus a reversible hydrogen electrode,which significantly surpasses that of BiVO_(4)(4.32 mA·cm^(-2)).
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 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.
文摘Objective To discuss the flexible supervision and communication mode in the post-approval change(PAC)of drugs,to explore how to ensure the quality and availability of drugs during the changes,and to provide some suggestions and reference for promoting the timely marketing of drugs.Methods Based on the comparability protocol guidelines issued by the US FDA in October 2022,the regulatory status quo of PAC between China and the US was compared to explore the feasibility of implementing comparability protocols in China.Results and Conclusion According to the specific situation of post-approval of drug change supervision,some suggestions were put forward to optimize the PAC management procedure,such as establishing the communication pathways between holders and health authorities,publishing relevant guidance and strengthening training,so as to provide reference for the implementation of comparability protocols in China.
基金supported by the Fundamental Research Funds for the Central Universities(20822041H4082)。
文摘Developing highly active and stable oxygen evolution reaction(OER)catalysts necessitates the establishment of a comprehensive OER catalyst database.However,the absence of a standardized benchmarking protocol has hindered this progress.In this work,we present a systematic protocol for electrochemical measurements to thoroughly evaluate the activity and stability of OER electrocatalysts.We begin with a detailed introduction to constructing the electrochemical system,encompassing experimental setup and the selection criteria for electrodes and electrolytes.Potential contaminants originating from electrolytes,cells,and electrodes are identified and their impacts are discussed.We also examine the effects of external factors,such as temperature,magnetic fields,and natural light,on OER measurements.The protocol outlines operational mechanisms and recommended settings for various electrochemical techniques,including cyclic voltammetry(CV),potentiostatic electrochemical impedance spectroscopy(PEIS),Tafel slope analysis,and pulse voltammetry(PV).We summarize existing evaluation methodologies for assessing intrinsic activities and long-term stabilities of catalysts.Based on these discussions,we propose a comprehensive protocol for evaluating OER electrocatalysts’performance.Finally,we offer perspectives on advancing OER catalysts from laboratory research to industrial applications.
文摘The current recommendation to avoid non-steroidal anti-inflammatory drugs(NSAIDs)in the management of dengue virus disease(DVD)is scientifically considered of very low to low certainty,despite being widely adopted worldwide.The same recommendation,initially made during the coronavirus disease 2019(COVID-19)pandemic,was subsequently proven incorrect.In this clinical report,we present evidence,for the first time globally,from a real-life practice that NSAIDs may actually be lifesaving in the early management of DVD as they have proved to be in COVID-19.Moreover,we propose that the personalized immunemodulatory Kelleni’s protocol,which includes nitazoxanide as a key component,can be safely and effectively used to manage various separate or concomitant viral infections and co-infections,including DVD.Importantly,this article contributes to the current medical knowledge in the global pursuit of a safe and effective broad-spectrum antiviral protocol that can be used to early manage multiple highly infectious viruses.However,it’s crucial that sufficiently powered controlled randomized clinical trials be conducted to thoroughly assess and evaluate the safety of NSAIDs in the early management of DVD as well as the efficacy of nitazoxanide with or without NSAIDs in its management.
基金Supported by Henan Provincial Department of Science and Technology Project:Clinical Study on Yangxiao Fukang granule in the Treatment of StageⅢhepatitis B related Liver Cancer(232102310188)Henan Province Characteristic Backbone Discipline Construction Project:Guidelines for Traditional Chinese Medicine Diagnosis and Treatment of Hepatocellular Carcinoma after Hepatic Arterial Chemotherapy and Embolization(STG-ZYX03-202126)。
文摘Primary liver cancer(PLC) is the third major cause of cancer related death, which seriously affects the survival period and quality of life of patients. However, there is currently no evidence to prove which treatment method is most effective. Traditional Chinese Medicine(TCM) has shown certain advantages in the treatment of PLC, especially in the side effects of Western Medicine. Therefore, we designed a clinical trial protocol for the treatment of PLC using TCM granules. Our purpose is to explore the efficacy and safety of Yangxiao Fukang granule(YXFKG, 养消复康颗粒) in the treatment of stage Ⅲ hepatitis B related PLC. A total of 216 patients from three hospitals in Henan Province will be enrolled and randomly divided into a trial group and a control group in a 1 ∶ 1 ratio. The trial group will be treated with conventional western medicine plus YXFKG, while the control group will receive conventional western medicine plus a placebo for YXFKG. All patients will receive a daily dose of either YXFKG or a placebo for six months, followed by a six-month follow-up period. The main observation outcome includes 1-year survival rate, while secondary outcomes include conversion rate to remission, objective response rate, progression free survival, overall survival, quality of life score, and TCM clinical symptom score. Blood routine, urine routine, stool routine, electrocardiogram, liver and kidney function, coagulation function test, and D-dimer are safety indicators. Collect data before treatment and during the 3rd, 6th, 9th, and 12th months of treatment, and conduct statistical analysis. This study will preliminarily verify the effectiveness and safety of YXFKG in the treatment of stage Ⅲ hepatitis B related PLC, which may provide a new choice for clinical treatment of PLC.
基金supported by grants from Pudong New Area Traditional Chinese Medicine Brand Multiplication Plan-Chronic Nephropathy(PDZY-2021-0302)Construction of He Liqun’s famous TCM studio(PDZY-2022-0703)+2 种基金Clinical Observation on the Efficacy of Guben Tongluo Formula in Treating Chronic Kidney Disease Phase 1-3(PW2022D-12)Pilot Project of Inheritance,Innovation and Development of Traditional Chinese Medicine in Pudong New Area(YC-2023-0602)Pudong New Area’s Peak and Plateau Discipline Development in Clinical Medicine for Novel and Special Diseases(2025-PWXZ-15).
文摘Introduction:With the incidence of chronic kidney disease(CKD)increasing year by year,it is particularly important to intervene in the early stage of CKD(stages 1–3).Unfortunately,the effective drug treatment methods for CKD(stages 1–3)are lacking.Guben Tongluo Formula(GTF)is the experience formula of Professor Liqun He,a famous traditional Chinese medicine(TCM)doctor in Shanghai.Our previous studies demonstrated that GTF might effectively alleviate CKD via multi-mechanisms.As the first angiotensin-2 receptor antagonist for treating hypertension,losartan potassium(LP)could effectively reduce blood pressure,decrease cardiovascular risk,and delay the occurrence of end-stage renal disease.Thus,we design this clinical protocol of GTF combining LP to observe the efficacy and safety of GTF and try to provide a novel drug treatment method for treating CKD(stages 1–3)patients.Methods and analysis:This is a multicenter randomized controlled clinical trial.160 participants will be enrolled in this trial and divided into LP group,GTF group,LP+GTF group,and placebo group randomly assigning 1:1:1:1 principle.LP group will receive general treatments combining LP,GTF group will receive general treatments combining GTF,and the GTF+LP group will receive general treatments combining GTF and LP.Placebo group will receive general treatments combining placebo treatment.The primary evaluation index will be the change of serum creatinine after treatment.Secondary evaluation indexes include changes in blood urea nitrogen,serum uric acid,estimated glomerular filtration rate,etc.;immune indicators and renal fibrosis indicators,as well as TCM symptoms.Besides,vital sign indicators and adverse events will be closely observed.Ethics and dissemination:The protocol has been approved by the Ethics Committee of Seventh People’s Hospital of Shanghai University of Traditional Chinese Medicine(reference number:2024-7th-HIRB-094)and other ethics committees at each center.With the implementation of this clinical trial,it would offer a TCM formula for the treatment of CKD(stages 1–3)and clarify the underlying mechanism of GTF for alleviating CKD.Trial registration:This trial is registered with ChiCTR2400090125 and registered on September 24,2024.
基金supported in part by National Natural Science Foundation of China(Nos.61931011 and 62372230)the Jiangsu Provincial Key Research and Development Program,China(No.BE2021013-4).
文摘UAV networks often encounter jamming attacks, under which multi-radio protocols have to switch radios to accelerate communication recovery. However, the existing protocols rely on exchange of hello messages to detect jamming, leading to long sensing time and thus slow routing recovery. To address the issues raised by jamming attacks, we propose a new routing protocol, Electromagnetic Spectrum situation awareness Optimized Link State Routing (ESOLSR) protocol, to improve the existing OLSRv2 protocol. ESOLSR utilizes the spectrum situation awareness capability from the physical layer, and adopts joint-updating of link status, updating of interface functions, and adaptive adjustment of parameters. Our simulation results show that the improved protocol, ESOLSR, can recover routing and resume normal communication 26.6% faster compared to the existing protocols.
