AIM:Cardiovascular autonomic and peripheral sensoryneuropathy is a known complication of chronic alcoholicand non-alcoholic liver diseases.We aimed to assess theprevalence and risk factors for peripheral sensory nerve...AIM:Cardiovascular autonomic and peripheral sensoryneuropathy is a known complication of chronic alcoholicand non-alcoholic liver diseases.We aimed to assess theprevalence and risk factors for peripheral sensory nerveand autonomic dysfunction using sensitive methods inpatients with primary biliary cirrhosis (PBC).METHODS:Twenty-four AMA M2 positive female patientswith clinical,biochemical and histological evidence of PBCand 20 age matched healthy female subjects were studied.Five standard cardiovascular reflex tests and 2d-h heartrate variability(HRV)analysis were performed to defineautonomic function.Peripheral sensory nerve function onmedian and peroneal nerves was characterized by currentperception threshold(CPT),measured by a neuroselectivediagnostic stimulator(Neurotron,Baltimore,MD).RESULTS:Fourteen of 24 patients(58%)had at least oneabnormal cardiovascular reflex test and thirteen(54%)had peripheral sensory neuropathy.Lower heart rateresponse to deep breathing(P=0.001),standing(P=0.03)and Valsalva manoeuvre(P=0.01),and more profounddecrease of blood pressure after standing(P=0.03)wasfound in PBC patients than in controls.As a novel findingwe proved that both time domain and frequency domainparameters of 24-h HRV were significantly reduced in PBCpatients compared to controls.Each patient had at leastone abnormal parameter of HRV.Lower CPT values indicatedhyperaesthesia as a characteristic feature at peronealnerve testing at three frequencies(2000 Hz:P=0.005;250 Hz:P=0.002;5 Hz:P=0.004)in PBC compared tocontrols.Correlation of autonomic dysfunction with theseverity and duration of the disease was observed.Lowertotal power of HRV correlated with lower CPT values atmedian nerve testing at 250 Hz(P=0.0001)and at 5 Hz(P=0.002),as well as with those at peroneal nerve testingat 2000 Hz(P=0.01).CONCLUSION:Autonomic and sensory nerve dysfunctionsare frequent in PBC.Twenty-four-hour HRV analysis is moresensitive than standard cardiovascular tests for detectingof both parasympathetic and sympathetic impairments.Ournovel data suggest that hyperaesthesia is a characteristicfeature of peripheral sensory neuropathy and mightcontribute to itching in PBC.Autonomic dysfunction is relatedto the duration and severity of PBC.展开更多
The rapid integration of artificial intelligence (AI) into critical sectors has revealed a complex landscape of cybersecurity challenges that are unique to these advanced technologies. AI systems, with their extensive...The rapid integration of artificial intelligence (AI) into critical sectors has revealed a complex landscape of cybersecurity challenges that are unique to these advanced technologies. AI systems, with their extensive data dependencies and algorithmic complexities, are susceptible to a broad spectrum of cyber threats that can undermine their functionality and compromise their integrity. This paper provides a detailed analysis of these threats, which include data poisoning, adversarial attacks, and systemic vulnerabilities that arise from the AI’s operational and infrastructural frameworks. This paper critically examines the effectiveness of existing defensive mechanisms, such as adversarial training and threat modeling, that aim to fortify AI systems against such vulnerabilities. In response to the limitations of current approaches, this paper explores a comprehensive framework for the design and implementation of robust AI systems. This framework emphasizes the development of dynamic, adaptive security measures that can evolve in response to new and emerging cyber threats, thereby enhancing the resilience of AI systems. Furthermore, the paper addresses the ethical dimensions of AI cybersecurity, highlighting the need for strategies that not only protect systems but also preserve user privacy and ensure fairness across all operations. In addition to current strategies and ethical concerns, this paper explores future directions in AI cybersecurity.展开更多
文摘AIM:Cardiovascular autonomic and peripheral sensoryneuropathy is a known complication of chronic alcoholicand non-alcoholic liver diseases.We aimed to assess theprevalence and risk factors for peripheral sensory nerveand autonomic dysfunction using sensitive methods inpatients with primary biliary cirrhosis (PBC).METHODS:Twenty-four AMA M2 positive female patientswith clinical,biochemical and histological evidence of PBCand 20 age matched healthy female subjects were studied.Five standard cardiovascular reflex tests and 2d-h heartrate variability(HRV)analysis were performed to defineautonomic function.Peripheral sensory nerve function onmedian and peroneal nerves was characterized by currentperception threshold(CPT),measured by a neuroselectivediagnostic stimulator(Neurotron,Baltimore,MD).RESULTS:Fourteen of 24 patients(58%)had at least oneabnormal cardiovascular reflex test and thirteen(54%)had peripheral sensory neuropathy.Lower heart rateresponse to deep breathing(P=0.001),standing(P=0.03)and Valsalva manoeuvre(P=0.01),and more profounddecrease of blood pressure after standing(P=0.03)wasfound in PBC patients than in controls.As a novel findingwe proved that both time domain and frequency domainparameters of 24-h HRV were significantly reduced in PBCpatients compared to controls.Each patient had at leastone abnormal parameter of HRV.Lower CPT values indicatedhyperaesthesia as a characteristic feature at peronealnerve testing at three frequencies(2000 Hz:P=0.005;250 Hz:P=0.002;5 Hz:P=0.004)in PBC compared tocontrols.Correlation of autonomic dysfunction with theseverity and duration of the disease was observed.Lowertotal power of HRV correlated with lower CPT values atmedian nerve testing at 250 Hz(P=0.0001)and at 5 Hz(P=0.002),as well as with those at peroneal nerve testingat 2000 Hz(P=0.01).CONCLUSION:Autonomic and sensory nerve dysfunctionsare frequent in PBC.Twenty-four-hour HRV analysis is moresensitive than standard cardiovascular tests for detectingof both parasympathetic and sympathetic impairments.Ournovel data suggest that hyperaesthesia is a characteristicfeature of peripheral sensory neuropathy and mightcontribute to itching in PBC.Autonomic dysfunction is relatedto the duration and severity of PBC.
文摘The rapid integration of artificial intelligence (AI) into critical sectors has revealed a complex landscape of cybersecurity challenges that are unique to these advanced technologies. AI systems, with their extensive data dependencies and algorithmic complexities, are susceptible to a broad spectrum of cyber threats that can undermine their functionality and compromise their integrity. This paper provides a detailed analysis of these threats, which include data poisoning, adversarial attacks, and systemic vulnerabilities that arise from the AI’s operational and infrastructural frameworks. This paper critically examines the effectiveness of existing defensive mechanisms, such as adversarial training and threat modeling, that aim to fortify AI systems against such vulnerabilities. In response to the limitations of current approaches, this paper explores a comprehensive framework for the design and implementation of robust AI systems. This framework emphasizes the development of dynamic, adaptive security measures that can evolve in response to new and emerging cyber threats, thereby enhancing the resilience of AI systems. Furthermore, the paper addresses the ethical dimensions of AI cybersecurity, highlighting the need for strategies that not only protect systems but also preserve user privacy and ensure fairness across all operations. In addition to current strategies and ethical concerns, this paper explores future directions in AI cybersecurity.
